Continuing Mounjaro...part 15

[ObsidianTree]

Please note: Mounjaro will only be be prescribed initially if your BMI is above 30. If you have additional health conditions you can get the medication with a BMI 27. (Prediabetes, high blood pressure, high cholesterol or heart problems)

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. Also below you can plot the effect of your doses.
https://glp1plotter.com/

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 that 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 - Some people find that they don't need to go up a pen dose each month if the current pen dosage is working well for them. If you are unsure when to go up, speak to your prescriber.

8 - The move up from 2.5mg to 5mg can be quite a shock to the system. Some people chose to take 3.75mg dosage for a few weeks to ease the transition.

9 - If you are having bad side effects after titrating up or you are struggling to eat your calories each day, your dose may be too high so should consider lowering your dose. Speak to your prescriber if unsure.

10 - Constipation, coldness, nausea, diarrhea, vomiting, headaches, aches, are side effects. There may be other side effects also. Read info here :
www.medicines.org.uk/emc/product/15481/pil#about-medicine

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

12 - 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. https://www.chemist-4-u.com/carepoint-pen-needles-31g-4mm-pack-of-100?gclid=Cj0KCQjwiYOxBhC5ARIsAIvdH51rLZBVFQxuvS7mDJooegtK8BMiyT0PwREMRHhH_1atfQIo8TEbsmkaAkA0EALw_wcB
Also there is a 5th dose in each pen. To extract it you can either try a hard twist or use an insulin needle.
https://medbasic.co.uk/bd-micro-fine-30g-1ml-syringes-needles

13 - Protein is important as eating less protein can cause muscle wastage and hair loss.
Some natural sources of protein:
https://www.bbcgoodfood.com/howto/guide/best-sources-protein
https://www.medicalnewstoday.com/articles/321522#high-protein-foods

14 - 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), psylum husks(fibre for constipation), electrolytes.

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

16 - 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.

17 - 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: https://www.medicalnewstoday.com/articles/316618

18 - 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.

19 - 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.

20 - Some of the places you can order from are:
MedExpress:
2.5mg and 5mg. £149.99. 7.5mg £169.99, 10mg £189.99. 12.5mg £209.99. 15mg £209.99 Coupon codes no longer working!
The Family Chemist:
2.5mg and 5mg £149. 7.5mg £169, 10mg £169, 12.5mg £194, 15mg £199
Zava medical:
2.5mg £139, 5mg £139, 7.5mg £169, 10mg £189. 12.5mg £204. 15mg £204. Zava offer refer a friend discount of 15% off. Ask for a code on here.
Simple online pharmacy:
£149 2.5mg, £149 5mg, £169 7.5mg £189 10mg
Bolt pharmacy:
2.5mg £149, 5mg £149. 7.5mg £169, 10mg £179, 12.5mg £199, 15mg £199
Asda:
2.5mg and 5mg £179. 7.5mg £189, 10mg £189, 12.5mg £204 15mg £204
There are others not listed.

21- You will still be prescribed Mounjaro when your BMI falls below 30. However, it may be harder to move suppliers once you BMI is below 30 if you wanted to move.

22 - Worried about your supply being cut off when you get to a healthy BMI? Below is some info on some places maintenance plans.
The Family chemist :Would consult you as approached healthy BMI to discuss maintenance under close supervision(if you started with family chemist)
Curate: up to 2 years
Cloud: up to 2 years
Boots: Cut off at BMI 23
Asda: Cut off at a healthy BMI
Pharmacy2u: Will supply for maintenance
Bolt:Individual assessment once BMI 22 and does offer maintenance
Zava:Once healthy BMI will stop prescribing this treatment
Med Express: BMI 25 and cut off.

23 - 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-continuing-mounjaropart-4?page=1
5th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5048290-continuing-mounjaropart-5?page=1
6th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5057916-continuing-mounjaropart-6?page=1
7th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5062935-continuing-mounjaropart-7?page=1
8th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5068850-continuing-mounjaropart-8?page=1
9th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5074054-continuing-mounjaropart-9?page=1
10th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5080755-continuing-mounjaro-thread-10?page=1
11th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5085436-continuing-mounjaro-thread-11?page=1
12th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5090788-continuing-mounjaro-thread-12?page=1
13th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5096704-continuing-mounjaropart-13?page=1
14th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5102149-continuing-mounjaropart-14?page=1

Thread for newbies just starting out in July:
https://www.mumsnet.com/talk/weight-loss-injections/5101435-mounjaro-july-2024

Video on how to inject:

I ordered my on Saturday night. It was approved on Monday and arrived yesterday x

Thanks both. Hopefully it will be here soon then

Apart from not sleeping last night and feeling a bit queasy at times, I haven't really lost my appetite - I was very tempted by donuts and cakes in the office today but I really want my first week to go well so have declined...so far! I usually do really well for a month on WW and have a decent loss but then the willpower goes - which is why I'm trying Mounjaro. Second 2.5mg injection on Sunday, hopefully it'll kick in soon

I know it is about semaglutide not mounjaro which is tirzepatide which also contains a GIP receptor agonist but the drugs are very similar and so far have a similar profile of side effects. This article links the issue to all glp-1R agonists and blow is a flow chart from the study to show what they found.

https://www.reviewofoptometry.com/news/article/risk-of-naion-higher-in-patients-on-glp1-drugs-for-diabetes-or-weight-loss

I know that often these kinds of studies are just indications to do more studies to see what is actually causing this issue and that we shouldn’t all panic and stop using the medication but I think it is still concerning especially as it is a very sudden and irreversible damage to your sight, other side effects mostly seem to be reversible or have a better prognosis but sudden sight loss that is irreversible would be devastating to anyone.

I do sometimes feel that there can be a tendency for people to be dismissive about studies which show things they just don’t like and I can understand peoples skepticism but at the same time I think it is important we are able to talk about all the possible side effects good and bad and not just ignore things that don’t suit us.

Good luck @Mounjaroooooh but I don't think you are going to need it. I felt my appetite and cravings change in week 1 and only lost 4lb (I've now lost 26lb). You don't think Mounjaro hasn't kicked in yet but have lost 5lbs in 4 days. You are going to kill it as the weeks go by and the doses get stronger!

Thanks. I hear what you're saying but I always have a big loss in the first week when doing WW - biggest was 11 lbs but I was a few stone heavier back then and it was years ago. I don't feel it's kicked in from a suppression angle as I'm still wanting to eat the junk but as it's my first week, as I do without Mounjaro, I'm managing to say no. Hopefully the feelings of suppression will kick in as I'm seriously tempted to a donut right now lol but I won't, I will go home and have my planned dinner instead and hope I'm not tempted by the chocolate biscuits afterwards!

Well done on your loss so far

I feel like this, you are not alone!
I know it's going to be about changing the habits I have around eating as much as just the willpower. I can happily eat when I'm not hungry, just because something is delicious and I enjoy it.
I'm hoping that paying the money to do this will help me keep on track, but again in the past I've paid a fortune for an online coach and just not stuck with it. I know it's down to me, but the 'fuck its' happen too often. I think I actually need the nauseous feelings to make me not want to eat...
Good luck!! 🤞

There's still not enough information there to reach any conclusions.

Why did they only recruit people who already have eye issues? Why didn't they match sample size in each group?

Did they confound for ages, whether someone's diabetes was meaning managed, other health conditions, severity of obesity?

@NewLifter Yes I know but in the flow chart it’s clear people on the glp1 medication had more events of this kind for whatever reason.

Here is a link to the full study which I cannot access:

https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2820255

While it isn’t enough to say we are all at risk of this if we are using these kinds of medications it’s also worthy of mention and consideration.

@DDisnotnormal was your order a repeat or first time? Wonder why mine is taking longer🤔 possibly luck of the draw

@thehousewiththesagegreensofa
I was on 2.5 and 5 with virtually no side effects. 7.5 and 10 with the odd vomit the morning after my injection, This is a new 10mg pen and I took one 10mg dose and counted clicks the next week for a 5mg dose. Both weeks I have been really ill and up in the night with D&V, stomach pain and sulphur burps for three days. Either it’s a dodgy batch or I have changed somehow. I am going on holiday tomorrow and don’t want to risk being this ill but hoping maybe they will let me start back on 2.5 after a break even though my BMI is below 30 now (although it won’t be for long if I stop). I will see what they say tomorrow.

I reported it to Lilly and got a slapped wrist for counting clicks.

I ordered Wednesday (3 July) at 5pm. Its been approved, expecting dispatch today for delivery tomorrow (Friday 4 July).

Ah seems like I don't need to worry, thanks

Just to update a post I made a few days ago about moving from Medexpress to Oushk due to their very enlightened approach to maintenance, I started the process just yesterday afternoon, by ordering the 7.5 from them. With £10 discount (MJUK10), the price with P&P was £166.99. There were the usual requests for info (including 1 body photo and 1 photo of previous MJ box) but all very straightforward and delivery with DPD is due tomorrow (1hr slot, with PIN to give driver). All in all, it was surprisingly easy and fast to change suppliers.

They just emailed confirming dispatch!

That's good feedback. I exchanged emails with Hira the owner and heard about her video via the facebook group and I think its encouraging she recognises that maintenance needs support. I had thought I'd change but in the end have stayed with MedExpress as I'm not expecting to go under BMI 25 so less of a concern for me now.

My anxiety is back with a vengeance following my 7.5mg dose yesterday. I’m really gutted but it’s so obvious the effect this is having on me. I’ve been a nervous wreck today, hardly slept last night. Going around like a zombie today barely able to complete basic tasks. Luckily I’m off work and kids at school/ in childcare so no pressure to do anything.

I am sadly going to need to titrate down and possibly stop.

Just sharing my experience to show it’s not all rosey and effects can kick in later in your journey (18 weeks for me).

You poor love. How long does it take to dissipate?

MedExpress I ordered yesterday afternoon at 2pm and my prescription was approved at 5:30pm and sent for delivery today at 7:30am. When I'll actually get it is another matter

Yes Hira is extremely likeable and approachable. Nice to have a real person to deal with, especially in the absence of GP oversight and support. I can't even imagine what BMI under 25 would be like (currently at 28 from 32) but it does seem to be approaching quite fast and, after all this effort, I can't bear the thought of putting it all back on so a long term, reduced, maintenance dose is my ultimate aim. That might be at 23 or 25, I don't really know till I get there.

Wow I’ve been away for a week and we’re half way through a new thread! I have the end of the last one and this to catch up on but for now just marking my place to come back to later!

Definitely going to hold off weighing til Saturday as I have not been watching what I’ve been eating on hols at all. But I’ve enjoyed myself and now I can start afresh and hopefully continue my losses.

Repeat order x

received a text from MedExpress; 25% off next order ENDS TONIGHT (4th July)

SUMMER25

I'm probably being stupid as well, but I can't make sense of the numbers. On the news report it called NAION a rare condition, so even with the increased risk it should still be reasonably rare. But this data says 20 out of the 254 on semaglutide, which is about 8%, which sounds really high. Have I got that right?