Continuing Mounjaro...part 16

[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.
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 - 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.

9 - 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

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

11 - 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

12 - 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

13 - 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.

14 - Drink lots of water. Water helps with the weight loss. Try and drink at least 2ltrs a day.

15 - 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.

16 - 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
furthet reading about injection sites and the effects: https://www.medicalnewstoday.com/articles/316618

17 - 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.

18 - 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.

19 - 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.

20- 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.

21 - 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.

22 - 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

15th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5107426-continuing-mounjaropart-15?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 know this will have been asked before but I can't find it, sorry. Zava sent my new pen yesterday and it doesn't look like it will arrive until tomorrow. How long is too long out of the fridge, please?

Even at my healthiest and when I looked perfect I had a BMI of 30! (That was wearing size 10-12)

I don't look good at 30.
I think it's down to your shape and where you carry the weight though isn't it.

I am broad shouldered, broad backed with a short body, and no waist at the best of times 😁. Stick some flab on that and it's not good😂

@JusteanBiscuits @montysma1 I am not sure i really trust BMI, and I think it really depends on your build as to whether 25 or lower is the healthiest. ATM I am at 29.6 BMI. My first goal will be 27.5 BMi which is another 12.5lbs. Now that I have lost 20+ lbs I can feel my knee bones clunk when I lie down (having lost a lot of thigh fat) and while I am not bruised there, I feel close to it. I am short but with a heavy bone structure (think hobbit or Neanderthal!) and quite muscled up - just naturally not because I work out. At my very lowest in recent history I just achieved 24.9 BMI at 10st 5lbs. While that is my long-term goal, I am wondering a bit if it is too low.

When I get to my first goal, I will re-evaluate.

Does anyone else have this bone problem? My ankle bones are now prominent, and knees as above. I havent really evaluated the rest. On the bum issue, no danger of me losing that! I would have to get awfully skinny

Not neanderthal - Anglo Saxon! Short, stout and strong!

Weight loss isn't the main goal for me, but is very needed. My consultant is convinced it will make me feel so much better, so will keep my fingers crossed.

Sadly my bum now has the same spaniel ears look as my boobs. Flatter with a more rounded bit hanging down. It's not a good look for boobs. It's even worse for your bum!

Hello ladies!
I haven’t been here for a few weeks and missed all of thread 15. Life’s been a bit busy.
End of week 15 put on half a kilo 🤪, week 16 lost 200 grams 😅, week 17 lost 200 grams 🙄
No surprises there as I indulged quite a lot during week 15, week 16 was better but completely lacked protein and week 17 I started a one off job for the next 7 weeks with some high profile kids visiting London.
We eat in restaurants, some days are great in nice restaurants with healthy options and others we end up in some rubbish fast food place.

Was supposed to inject dose 18 4 days ago but couldn’t as I usually force the pen with no problems but forced it too hard and now it’s lose so can’t count the clicks properly so I’ve ordered some needles to extract instead.

I’m still on 2.5mg and this will be my 8th dose from a 5mg pen.
Can’t really say if the effect is less after using the pen for more than the recommended 30 days because when I injected the 5th dose (still was within the 30 days) I already felt little suppression so now I don’t know if the dose is not having great effect because I’ve been on 2.5mg for long or because the pen the has been opened for more than 30 days.
Will know and report when I open my next pen.

As my dose is low I’ve been eating
Note: “”Using a pen for more than 30 days can pose some risks”” I’m just sharing my experience.

Started MJ 8th March
Height: 1.56 Weight: 73.50kg / 162lbs BMI:30.2
All doses 2.5mg
Dose 1 (-4kg / -8.8lbs) = 69.50
Dose 2 (-2kg / -4.4lbs) = 67.50
Dose 3 (-1.10kg / -2.4lbs) = 66.40
Dose 4 (-500gr / -1.10lbs) = 65.90
Dose 5 (-500gr / -1.10lbs) = 65.40
Dose 6 (+850gr / +1.8lbs) = 66.25
Dose 7 (-1.10kg /- 2.4lbs) = 65.15
Dose 8 (-600gr / -1.3lbs) = 64.55
Dose 9 (-600gr / -1.3lbs) = 63.95
Dose 10 (-500gr /-1.1lbs) = 63.45
Dose 11 (stayed the same) = 63.45
Dose 12 (-900gr / -1.9lbs) = 62.55
Dose 13 (-800gr / -1.7lbs) = 61.75
Dose 14 (-650gr / -1.4lbs) = 61.10
Dose 15 (+500gr / 1.10lbs) = 61.60
Dose 16 (-200gr / 0.44lbs) = 61.40
Dose 17 (-200gr / 0.44lbs) = 61.20

Total loss so far 13.65 kgs/ 30 lbs
BMI: 25.1

@GrimDamnFanjo

Same here, 6-7yr difference depending if you take into account my upcoming birthday.

4 months, just over 20kg lost and no change at all 🙄

Thank you @ObsidianTree for your response to me re the drained feeling. Weirdly I have felt like a different person today. Hope
It stays that way

Useful and interesting post @LatinaLondon thank you.

I’ve just thought of another unexpected benefit of MJ… I don’t fart as I get up off the sofa anymore 🤣

I was thinking that today - the farting and burping have all but disappeared!

Just some more ozempic to mounjaro musings..... definitely more suppressed. Far less nausea, nowhere near as tired either - I'm actually staying up to a grown up bed time!

Feeling really good tbh actually!

@WeKnowFrogsGoShaLaLaLaLa I can see why novo Nordisks share price has gone down! Mounjaro is far superior!

I'm getting quite annoyed that I have only lost 5lbs in the last month. I'm doing my 3rd 7.5 flab jab tomorrow and the 10 is in the fridge. I do have some NSVs and people are starting to comment on my weight loss, but it seems I'm at a real plateau!
I have eaten a few unhealthy things in the past week or 2 as I've had events where I couldn't control the food (but I doubt I went over 1300 calories) - it just seems that unless I'm strict with food and water intake, I don't lose.
Sorry, just a fed up moan!

Bonus dose done today with an insulin needle. I was squeezing the air out of it and jolted suddenly and pushed more liquid out of the needle 🤦‍♀️ I think I still got about 3.5 mg or thereabouts. I’ll go up to 5mg next week.

I haven’t been brilliant with food the last few days. I certainly haven’t drank enough. I really need to pull my finger out!

Does anyone here use oushk pharmacy? I was just watching a live that Hira Malik the pharmacist did. She's delightful and seems to really care. Even said non customers can contact her for advice. I feel like I might give them a go. They're ever so slightly more expensive than zava but I do like the personal touch.

@MrsBurtMacklin

I am now 5 or 6 weeks into 7.5mg and it's definitely been my slowest loss period, "only" 3-4kg in the past month, compared to a stone in each of the first three months.

But good news, stall seems to have passed in the last 2-3 days and I'm hopefully on my way back down again.

I have another 7.5mg pen in the fridge and will stick with it as still have suppression and I'm not overeating. If I start to feel it's not effective I will calculate a 10mg dose and inject with an insulin syringe.

Keep at it and the losses will follow. ❤️

I'm in the same boat, my second pen from Zava is due tomorrow after being sent on Monday. Except I don't think they have actually been sent until today, I reckon they are batch processing delivery labels the day before orders actually get packed and picked up. I use Royal Mail Tracked for my own business and do the same thing myself, and the tracking status is the same as what it is when I generate and print my labels. As soon as it gets picked up and scanned by Royal Mail, the status changes to "we've got it", which didn't happen until mid-afternoon today for my Zava order.

It will be interesting to see how cold it is when it arrives tomorrow to see if my theory is right. I hope they are not packing orders knowing that they won't be collected by RM until the following day, that would be very bad practice unless they are keeping packaged orders in cold storage.

I believe the pens are OK out of the fridge for up to 30 days as long as they are kept below 30°c, but I don't have my leaflet to hand to double check that.

Thank you for replying. I hope that's true for yours, but mine says that it was received at a 'super hub' at 5.30pm yesterday and has been at a delivery hub since 4am today. So if it comes tomorrow, it will have been out of the fridge for nearly 48 hours.

You're right about the 30 days, but I'd ordered it early to use in a week or so, so with the bonus dose, it'll end up later than 30 days. I don't want to have wasted all this money, so I'm not sure what to do.

@Forevafatty Oh no, I'm sorry - that is crap. It's one of the downsidws of Zava unfortunately, them using Royal Mail for delivery. I would definitely be contacting customer services to complain if it arrives warm.

I've just moved to them for 5mg from Medexpress. No issues at all with 1st delivery (dpd), very quick, packaging excellent. I chose due to approach to maintenance and flexibility re dosing, having also seen Hira on live Q&A session. Use code MJUK10 for extra £10 off each order.

@Soukmyfalafel I went so far as to get a new job!

But I firmly believe I am in 'adhd boredom' thought it was burnout, as it has similar symptoms. But, I haven't moved jobs in 18 months so thinking it's that.

I can fully see how you could be feeling similar as mj has definitely heightened these feelings for me!

I think something odd is going on.
I was with Med Express for first few pens. They use royal mail and everything arrived quickly. This despite me living in a remote area.

I switched to Curate, also using Royal Mail, and had a pen sit in a " hub" for 24 hours.
I insisted on a replacement which they sent. This pen then sat even longer at the hub.
When I complained they said royal mail were struggling to deliver to my remote area......which is nonsense. I get parcels every day of the week.

They cancelled due to my location and refunded me. Both pens did arrive eventually and surprisingly were still quite cold , so I ended up with 2 free pens!

I then bit the bullet and went back to Med Express, and as I had experienced before, the orer arrived quickly as always.

They all claim to use Royal Mail 24 hour tracked. But I do wonder if the cheaper suppliers are cutting corners on which postal tariff they are actually using.

@montysma1 That's really interesting and sounds plausible. I'm feeling a bit stressed about it. I'm worried that if I ask for a refund, they'll say it's fine for 30 days out of the fridge and that's that. But surely we should be able to buy and not have to use straight away?
I also don't find Zava very easy to get hold of, so who knows of they'll reply to my replacement request.