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:

Fingers crossed! I’m in the same boat and still trying to titrate up but am too scared to go above 4mg!

I am thinking it's something along these lines. They probably think if they put a longer date on then people will use the 15mg pens to take smaller doses to make the pen lasts longer. I am going to message Zava to ask why the shelf life is so short. But considering I have messaged them twice recently and they haven't replied, I won't hold my breath!

I am not going to order another pen for a good few months now then. Might as well use my stock then move to bolt for maintenance. I guess by putting short dates they are trying to stop stock piling then.

Yes! Not only did I not have to do a desperate sprint to the bathroom at any point in the night but I slept like one of those mythical babies that all of my friends seemed to have who you say good night to and don't hear a murmur for several hours. And I have woken up feeling clear headed and with a sense of energy. When I first went onto MJ, I noticed what an impact it had had on my sleep - similar to that when I started HRT - but that seemed to have worn off in the past week or so.
I often think about maintenance. I only have 10lbs or so to get to BMI 25. I definitely want to still be on this in December as I usually gain 7 - 10lbs over the month and, whilst it used to be the case that a few of those were water weight and would disappear overnight and the rest would be gone by the end of January with a bit of discipline, that hasn't been the case for a couple of years now. However, I am increasingly convinced that I want to be on this permanently as it has so many other benefits for me. I would even be interested in coming off HRT and trying MJ alone and seeing how that suits me (although given the myriad of benefits of HRT and being in a low risk group, am happy to be on both). I had hoped that sticking on 2.5 or something might be an option but the change between this week and last suggests that it might need to be higher than that.
Interesting!
Has anyone fed any information back to the manufacturer? Is there a way of doing it? I do think we are quite an interesting group and have some valuable data between us.
On the subject of medical changes, I continue to be amazed by @MelissaLouRocks. How are you? Are you still incarcerated?

Still have terrible diarrhea, took second 3.75mg jab on Friday morning. Runs started Saturday night. Not sure what to do, I'm drinking plenty of water and eating ok. May drop back to 2.5mg on Friday or change from tummy to thigh. Any advice anyone?

@ObsidianTree I am thinking along the same lines. As I am not in the UK all the time I have built up a stock of 3 10mg which expire next year and now have a new 12.5 from the family chemist which expires in November. But if we did stop ordering would Bolt be willing to take us on for maintenance if we have had a gap in ordering and will be under BMI 30? It's a risk or am I missing something?

I’ve had diarrhoea every week (comes on the 2nd night after I inject and lasts 3-4 nights) since I moved up to 5ml four months ago. I find that diary makes it worse, but nothing I eat or don’t eat will make it better. When I need to not be ill, I take a lot of Imodium, but then I don’t poop for days and don’t lose any weight :(

Hello! Sorry I've not read the full thread as they seem to go so quickly these days. Just thought I'd do my end of week 20 check in.

Still a loooong way to go but the weight loss seems consistent enough.

68lbs down in total (at least another 34 to go). But now I'm thinking anywhere up to 64 pounds would be great and make me a healthy weight for the first time since I was about 12!

By the way, it's handy that I'm getting lots of positive side effects as I haven't actually lost any weight now for the best part of a month. It sometimes goes down a pound but can then go up two.
My D&V sessions weren't triggered by anything and part of the problem the last time I went up to 5 was that I had scarcely eaten anything so was really struggling. I've only had relatively small amounts of all of these things but can drink alcohol, eat cake, chocolate, sweets, fish & chips and whatever else I like with no side effects.

This is my worry that there would be too long of a gap. Not sure how much info Bolt needs to switch over to them. I am with Zava currently so guess I could order a pen once I've run out of my stock and if they say it's been too long a gap, I'll say I ordered my pens with them so they will know I ordered each of my pens quite early etc.

Or maybe I will push it to ordering every two months with Zava and message them saying I had enough medication so didn't order for a while etc. I doubt they check much tbh. When I left Asda it took them a few months to notice, and even then they kept asking me to order.

@ObsidianTree @chesterlestreet i would be wary of assuming that you can use up your stock and then move to a new supplier. Anything could happen in the interim eg a news story about someone prescribing against guidelines to make them really tighten up. If your BMI is high enough you could then start again on 2.5mg and work your way back up but that would slow your losses.

I am in the same boat as have pens in hand from early ordering and now have a BMI of 27. My plan is to use the pens in order of expiry and take whatever dose I planned to take from each pen. I will keep ordering from Bolt every 5 weeks until I get to BMI of 25 and then assess how much more I think I want to lose v how much I have in the fridge and how long it will take. At some point I will then stop ordering new pens and use up my stockpile as my maintenance doses.

If more guidance comes out about being able to stay on it forever I will reassess this plan as I would love to be on a small dose forever to keep me on track.

You might get lucky and get a later date/ different batch. Fingers crossed! Let me know when it comes today. When did you plan to use yours?

@Choux just been doing some maths and thinking I will use the 15mg for my next pen and take 10/12.5mg from it. Then do the 12.5mg pen. Won't order anymore higher dose pens. Will order still but pace it out my orders more I think.

I will message mine too. That does make sense they would want to prevent people using them for smaller doses

The ‘dangers of weight loss drugs’ was just on GMB and Dr Hilary was very negative . There was someone being interviewed who has serious side effects but took 4x the recommended 1st dose by accident. Hardly a balanced account. Typical.

This is a good idea. Thanks! Is there a chart somewhere about how many clicks for certain doses? I’m sure I’ve seen one. I’ve only ever taken full doses so far

@ObsidianTree @Choux thanks will aim to stretch orders out as much as I can without stopping altogether. Weight loss has been so unpredictable it's difficult to estimate where the tail off will be but better to err on the side of caution

The high dose pens are better value for money but if you can't use 12.5mg or 15mg doses (and i haven't taken above 10mg yet although next week should be an increase to 12.5mg) the short expiry dates mean you might end up wasting some.

@Louboo3 the first post in the thread has a click chart.

Blood pressure!
Despite my weight, age and family history I've always been lucky to have OK blood pressure, although when last checked about a year ago, it had crept up to the higher end of normal so about 130/90.
Yesterday, as I was at home all day, I decided to do hourly checks. My BP averaged 100/75 which, after 10 weeks on MJ, seems like a bit of a coincidence and too big a drop to be down to the 30lbs weight loss alone, perhaps? I'm also wondering if this is why I'm still struggling with lethargy, and dizziness when exercising or even just bending over! I know it's not dangerously low but it's interesting.

@silverheels How the hell does someone take 4x the dose 'by accident'?? Order a 10mg by mistake?? Wind the pen out and in 4x?? Honestly unbelievable!

@KrankyKumquat blimey, big change! Lowering blood pressure is a known side effect and one of the main reasons I am trying to lose weight. It's also the one side effect I am still waiting for 🤦‍♀️😁

My blood pressure is normal again too, it had been starting to get quite high so I knew I had to start loosing weight.

It is a side effect of MJ.
My BP too was on higher side of normal and gas now dropped. I am delighted.

It's quite an impact isn't it? It did creep up as the day went on but during the morning, was well below 100. I'm tempted to do my reading at the doctors and hand it in, I might get a clap!