Continuing Mounjaro...part 5

[ObsidianTree]

Please note: Mounjaro can only be taken if your BMI is above 30.

Pointers for newbies:

1 - For taking your first dose you need to twist the pen a lot to get to 1! The instructions say prime each time you take a dose, but actually Eli Lilly have confirmed you only need to prime for the first ever use of a pen. (The video posted says every use, but this isn't true!)

2 - When injecting, hold down the button until the number goes back to 0. Once at 0, keep holding down the button and count to 5 with the needle still in so no medication is lost!

3 - Your first dose may not have an immediate effect. For some people the effects build slowly. It could take 3 or 4 days to notice anything, it could take a few weeks. Some people don't feel the meds working until they get to 5mg. See titration chart which shows how the medication builds up in your system.

4 - 2.5mg isn't a therapeutic dose, meaning you aren’t meant to lose on 2.5mg. You need to start on 2.5mg to get your body used to the drug and gradually introduce it into your system and get used to any side effects.

5 - Not everyone loses a lot in the first few weeks. Don't feel discouraged if you don't lose a lot initially. Again, you might need a higher dose to start losing. Also, inches can be lost without anything showing on the scales. Start your journey by taking measurements and check them as you go along.

6 - If you do lose a lot in the first few weeks, please don't assume you will continue losing at this rate. The first few weeks it is usually water weight that is lost, after than a good weight loss is about 2lbs a week. Some weeks you might not lose anything, but this is ok too…again, taking measurements might show inches lost instead.

7 - Constipation, coldness, nausea, diarrhea, headaches, aches, are side effects. There may be be other side effects also. Read info here :
www.medicines.org.uk/emc/files/pil.14201.pdf

8 - Once you take your first dose you can choose to keep your pen in the fridge or somewhere else. It's up to you.

9 - Don't reuse any needles as this could risk infection. If you damage a needle or one isn't working, you can buy a pack of about 100 spares. Ask for suggestions of sites /types to buy.

10 - Protein is important as eating less protein can cause muscle wastage and hair loss. Try to have at least 100g a day. There are protein supplements you can take. Myprotein have a good range. Ask for a referral code if you want to buy some.

11 - Some natural sources of protein:
www.bbcgoodfood.com/howto/guide/best-sources-protein
www.medicalnewstoday.com/articles/321522#high-protein-foods

12 - You can use supplements, some that people use are magnesium(for sleep and constipation), protein(to reduce muscle wastage), collagen (skin elasticity), aloe vera(for constipation), electrolytes.

13 - Drink lota of water. Water helps with the weight loss. Drink at least 2ltrs a day. Preferably 3ltrs.

14 - Don't be afraid to feel hungry. It is entirely normal and healthy to feel hungry. Just eat something. Treat it as an opportunity to start good habits around hunger. Eat a nice balanced snack or a meal if it's a meal time. It's ok.

15 - Does it makes any difference where you inject? yes it does! Drugs get absorbed at different rates depending on injection site

In order of fastest absorption, it goes:
• Tummy
• Arms
• Thighs
further reading about injection sites and the effects: www.medicalnewstoday.com/articles/316618

16 - Abdominal side-effects are much easier to control with smaller meals. For example, having 4 small meals in the day vs 2 big meals can have an improvement in nausea and burps.

17 - You can track your calories / protein on apps such as My fitnessPal, Carb Manager or Nutracheck. Nutracheck is quite useful and easy to find foods /build recipes.

18 - Some of the places you can order from are:

• MedExpress - £149.99 - Sometimes there are codes that can be used for a discount. Ask for a code on here or do a Google search to try and find one.
• Voy - £114.99 for first month then £229 after. Need a referral code (ask on here for one if needed)
• The Family Chemist -£149
• Simple online pharmacy - £159 2.5mg £179 for 5mg
• Bolt pharmacy 2.5mg £125, 5mg £179. Or starter pack with 2.5mg and 5mg pen £319
• Asda £184
• Boots £219
• Chemist4U £179
• Pharmacy2u
• Superdrug

There other other sellers, we don't have them all listed

19 - If you want to switch suppliers, make sure you have pics of your Mounjaro box with your name and dose. This will come in useful when other suppliers ask for evidence.

1st thread:

https://www.mumsnet.com/talk/weight_loss_chat/5007744-mourjano-starting-soon?page=1

2nd thread:

https://www.mumsnet.com/talk/weight_loss_chat/5028495-continuing-murnjaropart-2?page=1

3rd thread:

https://www.mumsnet.com/talk/weight_loss_chat/5037623-continuing-mounjaropart-3?page=1

4th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5044316-continu
ing-mounjaropart-4?page=1

Good luck everyone!

Believe it or not, there are people who actively GAIN weight so that they can be put forward for bariatric surgery!

Yes i have heard of this too

watched an episode of secret eaters years ago that showed a guy who had had the surgery lost lots of weight and would eat too much be sick then eat again it was awful to watch very sad I think it’s often not taken into account lhow much comfort we do get from food

I thought about it all weekend and have decide to jump in. Ordered this morning and it’s on track to be delivered tomorrow lunchtime!
I ordered MedExpress and used Consult-bunny for 15% off. Didn’t spot the new users code till just now.

Now my biggest decision is when to start.
I want to start Tuesday evening, but I have to go to a conference Weds and Thurs and don’t want to be caught short in a big crowded place if there are side effects.

Sensible thing to do would be to wait until Thurs evening but I’m impatient to start!

Welcome all newcomers, can't believe how busy this thread is getting. Though I've got several other people at work on it now! We work in healthcare so no one is bothered by the idea of injections. I've told quite a few colleagues and they've all been supportive.

Just took my extra 5th dose of 2.5mg, extracted 0.8ml but threw away the extra 0.2ml as I may want to stay on 2.5mg for a bit longer and want to see how that goes. New pen should come tomorrow or Wednesday (I moved my day from Wednesday to Monday halfway through the course), which is cutting it a bit fine from Voy but luckily I don't need it yet.
This will be the first time I've done it before dinner (fajitas) so hopefully I don't regret that!

I've been thinking a lot about the bonus dose and doubling up. I do wonder if its a waste of time to use it to attempt a 5mg week as I recall a poster earlier in these threads who had been told by some healthcare professional that it "doesn't work that way" and it got be thinking.

People on here have worked out that 0.6ml equals 2.5mg. There must be a reason why the amount was set at 0.6ml. Perhaps its the way it releases over time and/or the solution allows the body to process x amount of active ingredient per week.

Is the 5mg dose also in 0.6ml of carrier fluid? If so, then taking a 5mg dose in 1.2ml of solution (as in taking two doses of 2.5mg Mounjaro) may not actually have the same effect as injections from a 5mg pen and may not actually deliver any more active ingredient.

Also, the act of injecting the 5ml into different injection sites may have an impact too.

2x 2.5mg in 1.2ml carrier fluid may not be equal to 1x 5mg injection.

I'm trying to think of an example of what I mean. They say that the body can only process x amount of iron and the rest is excreted out. Perhaps that could be the same for whatever the injection carrier fluid is?!

Just some musings and it would be really interesting to hear anyone's more knowledgeable insight regarding injection chemistry/biology! I just have a feeling that 2.5 + 2.5 may not = 5 in this instance!

I would wait, side effects can be unpredictable, most people’s are mild but can involve diarrhoea, especially in the day or two after a dose so might not be the best idea before conference!

Interesting thought in America their dose is 2.5mg/0.5ml and stays 0.5ml through the higher doses

I think due to the shortages it's been quite common for Americans to split doses and also use two smaller doses to make up the needed dose. Advice I've seen is use two different locations.

@MeAndMounjaro

The 5mg is also the same volume of liquid 0.60ml

Not sure on the answer to the effects of doubling up. However, I did double dose on my last 2.5mg pen dose and I felt it worked as 5mg. Mainly because my symptoms were stronger than they had been on just 2.5mg.

I don't know if many others did double up their last dose to see how it affected others.

I doubled up mine and felt absolutely awful so I'm pretty sure it worked as 5!

Not sure what to do today. I am on my second week (inject on Thursdays) and I am starving this evening. I still have no lost on the scale so I don't know if I should eat something (had a really nice and healthy dinner) or just try and be a bit hungry until tomorrow morning.

I extracted all I was able to with my 'bonus' 2.5 this morning and I can relate to this.

I tend to get a mild 'responds to paracetamol' headache the first day I inject but I got the most god awful migraine today after the bigger dose.

When this happens to me I drink a load more water which helps with the amount of 'hungry' I am.

Don't deprive yourself though. If you are really hungry then absolutely eat.

Yes, it's equivalent to the full dose & identical if the same amount of fluid is injected. I used to work in a Pharmacokinetic lab in research years ago.
But there doesn't seem to be an identical amount of extra solution in all the pens which is worrying. I can't find anywhere that Eli Lily have listed the total mls available in the Mounjaro pens.
We all on Ozempic used to use the extra dose. But the pen worked exactly the same way & you knew there was an exact extra dose there.

I think if you twist the pen again you wouldn't end up with more than an extra dose because it still twists to the same dose point. But you might end up with less than a full dose depending on what's in there. .

Personally I feel like I can't ever see the liquid in that pen anyway when I stare at it so I'd have no idea if there was more left after I did it!

The doses are all 0.6ml because of the pens they use. So they make it more concentrated otherwise the 15mg dose would be 6ml! Taking 0.3ml would halve the dose listed and doubling the volume would double it.
There are some people saying it doesn't work like that, but it does. There are doctors in America telling people to split their pens to get different doses. The carrier fluid isn't relevant, the drug all gets absorbed within a few hours it's just the breakdown by the body that determines the half life etc
I'll be splitting my 5mg pen into half doses to continue on 2.5mg if needed.

Staying contrary, what if the side effects are from doubling the extra carrier fluid and not actually from the actives?!

I'm going to see if I find the OP, I'm sure it was her husband who said it doesn't work that way and he was a GP so hopefully he can explain that rabbit hole I've gone down!

Side effects from the carrier fluid? I don't know what the carrier fluid is (perhaps the patient info has the name of it) but I am sure that there have been tests to ensure that the carrier fluid has no effects. Given all the liquid drugs and drips being used in hospitals globally and self injected by diabetics I would think that they have mastered a carrier fluid that doesn't cause side effects.

Really really struggling today. Im on week 5 of 2.5 (got the extra dose out) and injected yesterday. I have had the worst indigestion and eggy burps known to man today. Can't eat as so bloated. This is so new as apart from a rough few days in week one, I've been absolutely fine.
I think I had food poisoning last week so I'm.wondering if injecting so soon after it eased up (2 days) has irritated my system.

I've taken an omeprazole and am lying with a hot water bottle on my belly. Feeling dead sorry for myself and really worried about starting 5mg next week.

Does that mean that you can get 10 2.5mg doses from a 5mg pen? The 4 doses split into 8 plus the bonus dose split into 2.

I won’t be doing this btw I’m not brave enough

@Cheeseismyfavourite theoretically, yes. Though you may be pushing the expiry date/how long you have to use the pen from opening it.

Yes it does mean you can get 10 doses.

However, instructions says use the meds up in 30 days once pen started. So taking 10 doses would put you way over that 30 days.

We haven't had any evidence saying them pen will last longer than 30 days, so probably not worth the risk.

I did. And my side effects have been present (thirst, cold, headache, jaw clenching).

That said - and this is directed at no one in particular, these threads are now becoming cyclical. We had all these discussions 3-4 weeks ago. I know it’s simply the nature of threads when they move on and more and more people join but I am starting to see why regulars on the Saxenda threads got more and more short tempered.

But also. I’m thirsty, cold, have a headache and am clenching my jaw 😂god help me.

You can't escape the cyclical! Unless maybe you had a month thread like in antenatal so everyone was at roughly the same point.

Yes I was thinking that as I typed it. It’s okay - you can all call for my head to roll in a month when I’m asking for a voucher code 😆