Depends on the type aircraft and the capabilities I have to "adjust" my flight controls.

If for some reason I found myself in this situation in a KC-135, I can cut out the inboard spoilers, deploy the outboards and it's like gaining about 2 units of nose up trim.

Not much, but it may be enough to overcome the nose heavy issue and get it in the air.

Beyond that, you get into the wonderful question of do you want to go off the end at 150 kts or 30 kts, and I HATE that discussion.