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 had 2 and a half glasses of wine last night and feel like I drank 2 and a half bottles 😣

For those on the my protein watch, they are doing 70% plus 20% on some items until tomorrow morning. I've just bought a can of collagen for 18 quid.
I've tried two other collagens and this is the best by a long mile - as it is completely unflavoured and it has no smell!
Haven't bought any shakes as I have loads in the cupboard!

Yeah I had a bit. First for about 2 years but not much and stopped now. Periods had been almost non existent in run up to menopause as on Mirena so not quite sure when periods really stopped but gynaecologist said I was post menopausal last year when prescribing HRT etc

@Thebaldprimadonna

I think its my anxiety. I worry sonething bad will happen.

I've been post menopause for ten years and last year when on Ozempic I had periods of breakthrough bleeding but when I stopped Izempic, the bleeding stopped. I'm now nearing the end of month 3 on MJ and the spotting has started again!
It's really pissing me off

Just checking into the new thread got yet another upset stomach I’m. It sure what is causing it.

Don’t worry about it. Everyone should check their poo for any sign of change.

Some food is harder to digest than others and MJ works by slowing your digestion system down so it’s possible that some food gets missed by the system. That’s my theory anyway

That makes sense. Is that why the pill doesn't work?

Is it because its absorbed too slowness or nit absorbed at all?

Yeah that sounds annoying! Quite weird after 10 years. I thought maybe I wasn’t quite as post menopausal as I thought - I’m “only” 50 but my hormones were close to zero so gynaecologist said it was defo done and dusted. If it can trigger breakthrough bleeds after 10 years i wonder how it does work

Yeah I agree I think the impact on digestion could have this effect, I also wouldn’t worry. And defo everyone should check their stools, I think the bowel cancer campaigns make that clear

Wow, it's really weird that you should post that this morning. I had spotting for the first time last night. I'm probably several years post menopause (age 57) and had been thrilled that my flushes disappeared almost instantly I started on MJ, 7 weeks ago, but I really don't want to now get bleeding again instead. I couldn't use HRT because it caused almost constant bleeding and, partly due to the impact on primary health care during covid, I gave up on resolving this and just learnt to live with the symptoms in preference to bleeding. After an almost perfect response to MJ, with no notable SEs so far, I'm really worried.

Hello! I have two questions if anyone knows and has a moment.

1. when do Voy cut you off? Do they promote maintenance? If anyone knows that would be much appreciated.

2. the fifth dose... the needles recommended above to buy to extract it seem too small at 1mm. Do I inject three times?

@KrankyKumquat

I'm on HRT and have been with no problems at all but since starting GLP1 drugs I'm spotting.
It's clearly the drugs as when I stopped for 9 months I had no spotting at all.

I've read about oestrogen being in fat cells that are released when you lose weight so I'm presuming I'm producing excess oestrogen for my progesterone part of my HRT to cope with?

Although I've not lost much strangely

Oh that's interesting re. fat cells and suggests it may be temporary perhaps? Once it's all been released, that's the end? I'm going to do a bit of research myself today so will share anything useful. Damn annoying 😡

Yes!! No periods since 2011 (mirena coils - praise the lord the finest invention of all time)… and menopausal since 2020 & HRT for 3 yrs.

I’ve had 2 breakthrough bleeds - just spotting but very annoying. I know all post menopausal bleeds should be investigated but I know I’m not alone in this side effect and frankly cannot face another endometrial biopsy!

Hello!

1. no idea!
2. Can you explain what you mean…? I don’t know of any 1mm needles, do you mean 1ml syringes? No you should not need to inject 3 times. Simply withdraw 0.6ml, change to a fresh needle & inject at a 45 degree angle to keep the product sub-cut.

Oh @BellaCriesAndThatsAlright thats rubbish. I don’t have a hangover but I’m similar it feels like a drank more than I did. I did enjoy a sweet cocktail before I remembered I’m strict keto right now so I think that affected me more!

Just sharing a few low cal meals I’ve had on repeat lately, if anyone is in need of inspiration:

1. eggwhites & spinach omelette (a drizzle of sriracha on top makes it 👌🏼)
2. coconut chia pudding with berries and almond butter
3. banana nice cream (blend frozen bananas and if you like peanut butter, add a spoonful) - it tastes like a treat!
4. grilled chicken breast with green salad (lettuce, baby spinach, cucumbers, cherry tomatoes, sweetcorn or chickpeas or black beans, red onion)
5. wrap with hummus, iceberg lettuce, spicy prawns
6. grilled fish (salmon , sea bass, sea bream) with steamed tenderstem broccoli and roasted sweet potato wedges
7. bagel with cottage cheese and turkey slices
8. toasted fitness bread/pumpernickel bread with egg salad and micro greens
9. tofu stir fry but with lentil noodles and homemade sauce

My breakfast is always first a drink of electrolytes; then a banana milkshake (almond milk, banana, vanilla protein powder)
Then lunch and dinner are some variation of the above.
Sweet treats are on rotation: protein bar or protein pudding, or homemade banana noce cream, or chia pudding with cacao and peanut butter.

Hey @TurningPointe ive taken 2 x 5th doses now and I just used the pen as normal, harder than normal twist so I used pliers. I didn’t want the hassle of getting separate syringes.

@Abigailandthefoxes are you using clear whey protein powder or other manufactured high protein foods? I find that has been giving me an upset tummy recently.

The clear whey is better if really diluted. 1 serve in a litre of water rather than a glass.

So I'm a few days in from my first switch injection -ozempic to mounjaro.

Appetite suppression is good, and the nausea is far less - this may be because I'm on such a low starting dose compared to my ozempic dose though?

I'm very thirsty, much like I was when I first started ozempic, and I'd say I'm quite tired but it's nearly the end of the school year so that's to be expected. 😂

I'm craving meat - proteins and fats - as opposed to carbs so that is good.

I'm starting to break through my stall already, but I'm going to try not to weigh again until the end of the week now. I've got some gym classes booked (it's been a while!) that I'm looking forward too though.

Had a great evening and ended up having 2 glasses... My head is so thick today.
Came as a real shock that 2 glasses would affect me so much but at least I didn't get the runs or even die.

I’m drinking my electrolytes and starting to feel myself.

I read on here that Voy cut off at BMI of 25. But I’m with BMI but altho they have a tracker I’ve never used it so can’t see how they would know? I had a BMI of 30 and it says I just have to send new pics at 6 months. I’m hoping to be done by then but even if I wasn’t it crossed my mind that they wouldn’t know if the pics were current. If BMI starts lower than 30 (ie 27 + health conditions) they ask for pics at 3 months I think. If you do try it this gives you £85 off first month ( and my next month half price, hence anyone on Voy is keen to share codes) : joinvoy.com/r/U-aWOMzJ57O6

I get the odd bit of post menopausal spotting. Am on continuous HRT and have put it down to Mounjaro slowing down my HRT absorption which gives me breakthrough spotting.

Pre Mounjaro I noticed that if I missed a dose of HRT I would get light bleeding a couple of days later so have assumed any current spotting is the same. I could probably chart to see if it is related to when I seem more bunged up or in days 1-3 of the dose but I haven't.

I would be more concerned if the bleeding was heavy and fresh red blood rather than old dark blood. The more frequent it was would also concern me it might be something serious. If you think it isn't normal for you and isn't a one off \ has a viable explanation it might be worth a quick check with the GP.