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:

@BlackFriYay well you've had your break now come back. The internet js full of keyboard warriors and some people will judge you no matter what you do. I agree we are all adults and doing what we think is best for our own lives. I'm still not sure if they will send me the pen or not but it was worth a go!!!

Thanks! I really struggle, but I also revenge procrastinate at night, so it's probably as much my fault as mj!

We've a big week at work next week so I need to be on form. So I'll be taking their advice!

@CiderJabs thank you! Think I'll order and extra pen this week then. Start stockpiling 👀 I'm still over 30 BMI, but I might as well with the discount

Glad you're back 😊 Sorry you felt like you had to step away

@BlackFriYay No judgement from me either. I would do the same. This is expensive stuff.

I have been on Mounjaro for 2 weeks, I have had strong appetite suppression from the start, and haven't had more than 1,200 calories/day, some days lower.

I have lost 2 pounds in my first week, and another 2 in my second week. Starting weight was 14st 4.

I'm coming round to the idea of slow and steady (although have to admit to being a bit disappointed I haven't lost more than this).

However, what I'm wondering is: is there any expectation that weight loss might increase once I get to 5mg dose?

As I'm already experiencing good appetite suppression and have a pretty low daily calorie count, is there anything else that kicks in as the doses increase that might lead to swifter losses?

I don't snack any more, zero interest in sugar or alcohol now, I eat 2 meals/day (have been intermittent fasting for ages before starting MJ), walk 30 mins twice a day, drink lots of water (2-3 litres/day) - I sound like a right boring cow, I know, but it seems like my body just doesn't want to release weight any faster

Also no judgement @BlackFriYay

I work on the assumption we are all adults and can make decisions.

I shared some info from Numan re how long a pen lasts in good faith and was challenged, albeit in a friendly way it's hard not to be disheartened when we're all trying to navigate the best way for us.

@CiderJabs Any idea what Health express are for 15mg?

@BlackFriYay I’m sorry you stepped back, I do get why. I remember way back on about thread two or three there was something that made me go eff this. I think it was recipes or something inane and I thought I will have a break. Instead I just ignored posts.

We are all adults. I leave my more random meanderings for FB.

@PlinkyPlonkyDonkey my experience and my experience only is increase of doses didn’t speed weight loss. If anything it slows more and stalled a few times as I went up. But I’ve also lost nearly 4 stone in 5 months on this, so I may not be the best basis of comparison.

I've just had this exact conversation with Zava. Mine took several days to be delivered. At first they said just to use it in 30 days, and I said no, I'm not ready to use it yet. Then they said they'll replace only if I send this one back at my own expense. I'm quite disappointed with them.

I've just worked out that if I use the next one when I plan to, it'll be 41 days. I wanted to split the bonus dose into two to top up my remaining 2.5 bonus dose, but I'm not sure how safe this will be now.

@Forevafatty was it a royal mail issue?

Yes it was. I understand that's not their fault (beyond choice of courier) but still very frustrating. And the send back at your own expense feels like they don't believe me, even though they can see the tracking information too.

I think someone earlier said on thread that maybe Zava are saying it's despatched but it's actually not despatched or something. Was it cold still when you unpacked it?

I'm worried as I ordered a pen from Zava yesterday and definitely not ready to start it as soon as I get it if it's days in transit!

Yes, that poster was responding to me. Mine was definitely dispatched, unfortunately - it was in a Royal Mail hub by Tuesday afternoon but didn't arrive until this afternoon.

I know it's all a matter of personal choice about risk, but has anyone used over the 30 days? Is the risk more infection or lack of efficacy?

Hey, just checking, did you get your order today and was it cold? Thanks ☺️

Was it still cold @Forevafatty

Not really. Cool-ish, I suppose, but the ice packs were completely melted and room temperature.

I need to find a new provider now and I'm not sure where to look next!

Hmm tricky. I would say put it in fridge and hope for the best. You can only use it when you're ready to use it. If it was me I'd hope it was cold enough and stick in fridge! Maybe would aim for that to be my next pen

My Zava pen wasn't very cold, the ice pack had melted, obviously but it definitely wasn't at the optimum temperature for storage. I've emailed them but if I don't get a replacement I'm going to do a charge back on my credit card. I've paid for something that isn't fit for purpose, ie, all the doses being usable during the 30 day use by period due to the cold chain being breached.

Oh and, Bolt keep prescribing for maintenance, but have no offers. So if you wanted to stay on MJ when your BMI hits 25, then bolt seems to be the way to go for long term use

I’d be interested if anyone else has used Care as well. I was about to switch to Zava but the delivery issues are making me think twice and the prices with Care seem good

Med Express might have stopped the discount codes but their parcels are always still icy. Two ice packs and a load of wool insulation.

Yeah, I went back to them with gritted teeth after 2 pens were very delayed from Curate.
Seemingly both suppliers use Royal Mail 24 Hr tracked ..........Med express always arrives quickly whilst the Curate took forever. Then they cancelled saying Royal Mail had trouble delivering to my "remote area". Which is strange because Royal Mail have no delivery problems at all when they are delivering from Med Express🙄. Hmmmmm

Med Express pens always very cold.
Although my delayed Curate ones were cool enough, certainly lying below room temp despite everything.

@ObsidianTree @Forevafatty Nope, I didn't get my pen today and I'm fuming. Royal Mail are crap. It was due for delivery on Wednesday, then that changed to Thursday when I knew I would be in the office. So before it even reached my city from the NW superhub, I redirected it to my local post office to pick up on my way home. It wasn't there, tracking still shows it as sat in my city's mail centre. I won't be able to pick it up before that post office closes tomorrow, and I won't be at home to accept delivery there either so Zava are going to be getting a firmly worded complaint as there's no way it will still be chilled. I do have my theory about them generating labels before dispatch, but there's no way it will survive Weds - Sat in the postal system and still be cold.

My contract of sale is with Zava, not Royal Mail, so they are ultimately responsible for ensuring that the medication reaches me in a state fit to use. I will be reminding them of that when I contact them and telling them that if they want the warm pen back, it will be at their expense, not mine!

@montysma1 Yes, I said I wasn't paying to post back, and they did eventually agree that I could post a photo of the receipt and they'd reimburse me.

I think part of the problem is that I don't trust them to just receive it back and send the next one out straight away. They are really bad at answering the messages on their patient forum. I imagine I will have to chase a lot, and I will then have no product at all.

I wish I'd paid on credit card but I never thought, and so no hope of a chargeback. Did you email or post a message on the patient communication?

@Forevafatty It was Curate I had the issue with. Once I got stroppy to be fair they sent out replacement pens immediately and didn't want them sent back. It's not like they can re sell them.
How did you pay?
Even if it's through a debit card and not a credit card you can raise a case with your bank. I have done it a few times and have always had the bank reimburse me.