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:

Thanks, any tips on how to use the insulin needle or where I can look, I wouldn't know where to start x

@ObsidianTree I am in the same boat. I had my thyroid removed a few years ago so have been artificially powered by levothyroxine for awhile and yes my dose does need to change as my weight changes. I have been meaning to get in touch with my thyroid nurse as my resting heart rate is also higher as I have lost so think the levo needs reducing.

Thanks @NewLifter and @SilverHeels

Have only just realised that with my weight loss my dose should be reducing. So must explain the heart rate.

I am working from home Wednesday so will try and get a Dr appointment.

It's a relief to think there is likely a simple explanation for the HR for sure!

@NewLifter yes definitely. I've never had to reduce my dose of levothyroxine before so didn't even consider it.

Did a bit of searching on the Reddit for Mounjaro US and it seems those with underactive thyroid do sometimes have to reduce their dose as they go hyper.

@ObsidianTree yes, I believe this is a thing with thyroxine. I'm planning to get mine checked soon as I have lost 20lbs. I'll keep an eye on my heart rate too.

Thank you for the kind words of congrats and encouragement 🙂

RE appetite suppression on 7.5mg - it's a bit of a weird one for me this dose! I do feel hungry, annoyingly, and there is a little bit of food noise.. but when it comes down to eating I feel full very quickly.

So it's doing something, it's just different to the general suppression I became accustomed to over my 2.5 pen and the two pens of 5mg.

I prefer the general suppression and abolishing of food noise personally 😂

I'm due on right now and have stalled over the past week. I won't weigh again until my period has been and gone as I'm hoping for a little 2lb whoosh. We shall see.

If I don't lose anything on this 7.5 by the end of the 4 weeks I'll be going straight onto the 10mg I have in the fridge to lose the last stone or so, hopefully, and then I'll use my backup 7.5 pen to titrate down.

First 3 weeks were ok but I could feel it wearing off towards end of the week.
week 4 it wore off after a few days.
3.5 is so different! I did bonus dose of 2.5 and 10 clicks of 5mg pen.
next week I’ll do 50 clicks so still not a full 5mg

Place marking. Today I've taken my second 'going down' dose - 3.75. So I've done just one week on 5 and decided to go down (mainly because I had half a bonus dose left in the pen!)
This week I've hovered between 9-13 and 10-1 so I'm happy about it. BMI 23.7 ish.
Considering doing 7/8 weeks on 2.5 and then braving the wild world of hunger! I'm actually really scared of failing even though I know I've developed good habits in the last few months but I also know the menopause monster is still alive 😢

Wow another thread already! Has anyone used a 5mg pen only for 2.5 doses? I understand a 5mg should have 8 doses of 2.5 but is it ok to use the same pen for that long beyond the recommended 30 days? I bought the 5mg pen with the intention of titrating up but l’m now a bit scared to take 5mg. I have lost 10lbs in the first 4 weeks on 2.5 which l am very pleased about but with last weeks and this weeks bonus dose injection l have bruised really badly where l injected and l am freaking myself out a bit about it. I’ve decided that if l am going to continue at all with this then l don’t want to go beyond 2.5 😬

@ObsidianTree I have just checked the clinical interactions in the BNF and, while there is nothing listed for tirzepatide, there is a potential interaction listed for semaglutide which works very similarly:
"Semaglutide slightly increases the exposure to Levothyroxine. Manufacturer advises monitor thyroid function. Severity: Moderate; Evidence: Study."
so you may be overtreated. I would suggest you don't reduce your dose before testing as you may skew the test results but contact GP, scare them with your heart rate and ask for test to be done urgently.

@UpsyDaisy77 I have seen one supplier company suggest the pen is ok for up to 6 weeks but have never seen that confirmed by the manufacturer and, personally, I would not use a pen for longer. You have to remember every time you inject you are puncturing the seal on the pen which weakens it and increases the chance of it allowing contamination in as well as using it beyond the recommended expiry. When people use a bonus dose they are still within the 30 days as the first dose is day 1 so fifth (bonus) is day 29.

Wow these threads go so quickly!!

Has anyone else experienced head rushes/sudden light headedness after standing up? I’m almost at week 3 of 7.5mg and for the past week or so im almost falling over if I stand up too quick.

I did think I may have not eaten/drank enough but over the past few days I’ve upped both and still no change, if anything it’s worse!

.

@Lastchancefatty excuse me for asking, but just wondering about the referral. Do you have any long term health conditions? Or was it just based on weight?

@summerlovingvibes I have a fatty liver, PCOS and high cholesterol. Not sure if they count towards the criteria for referral. The first gp I saw was very dismissive. Then on a call with another gp regarding my cholesterol he suggested it. Even after knowing I was already taking MJ.

h ok, the fatty liver and raised cholesterol would be reasons for referral. Glad they suggested it to you (well the one did) even if it didn't work out for you. Means the message is getting out there to GP's!

@QueenOfHiraeth thanks yes probably best not to go beyond 6 weeks max, l’m already freaking myself out about injecting myself and the bruising/reaction at the injection site so l don’t need to add anxiety about injecting out of date doses into the mix as well. I think l will try two doses of 2.5 from this pen then decide if l’ll continue.

I have seen mention on other threads about telling people about taking MJ, has anyone had to deal with whether or not to tell a new partner? I have recently started dating someone, we haven’t got to the physical stage yet but l am worried that when we do the large bruises on my stomach will be a giveaway 😬he works in the medical field so l don’t think l would get away with an excuse for it and ideally l don’t want him to know l’m taking MJ which is another reason why l’m thinking of stopping 😕

The first one told me some of us are just genetically pre disposed and will have to diet our whole lives. Well that's what I've been doing love and it wasn't working! So glad I took the plunge and paid myself.

@mcdle I'm afraid I've only used hard twist method. I'm sure somewhere else in the threads there's advice on using an insulin needle.

New thread checking in!

Hope everyone is well... Off to catch up

Checking in, still struggling to keep my water intake up - must try harder!

Yes, me. It happens almost every time I stand up from sitting. I get up too quickly and have to steady myself by holding on to something and closing my eyes for a couple of seconds.

It's a common thing for people on the drug it seems.

Mind how you go, some poor bloke on one of the FB threads actually passed out and bruised all of his face 😔

I forgot to add - it's possibly to do with blood pressure being low, atleast that's what I've read.

Checking in. Just taken dose 4 of 2.5. I never want my brain to not feel this clear of food noise! I feel like a new women.

Did anyone see the weight loss injection bit on Lorraine? It was similar to that article. In fact Dr Hilary was a bit scary as he mentioned blindness and that we didn't know the long term affects. Didn't say that about the covid vaccine.

It's on catch up if anyone wants to watch it.