Continuing Mounjaro...part 17

[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! Make sure the needle is twisted on tightly. Priming will help confirm if the needle is on securely and not faulty.
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 - 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 - Taking Mounjaro can stop birth control from being effective. If you are on birth control, consider extra protection if you aren't planning on conceiving anytime soon!
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. Try and drink at least 2ltrs a day.
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
15th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5107426-continuing-mounjaropart-15?page=1
16th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5115015-continuing-mounjaropart-16?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:

Interesting to see this - I'm also on the same week (2nd of 7.5mg) and have lost almost exactly the same amount. Slow but steady averaging just under a kg/week (1-2lbs), with some higher ones near the start and some flats or gains as I go along. I've never felt so suppressed I can't eat, unlike several on here. I do welcome the relief from food noise, especially as it creeps back by day 7. MJ is enabling me to eat to a clear 3 meal plan, but not putting me right off eating. I don't find it frustrating because I want to actively shift into eating like a slim person, so that when I have to do it without MJ I can. I don't see a post-MJ world where I don't have to commit to smaller portions and fewer treats than I otherwise would have. So I hope the fact that I'm not totally suppressed means I'm building some good habits and making friends with a desire to eat without binging, with MJ providing the safety net.

It sounds like you're doing really well to manage your food and keep losing if you're less suppressed than you'd like.

@QueenOfHiraeth I'm pretty similar. Week 9 for me on my 4th dose of 5mg. Losing about 1.5lbs a week, though nothing this week and no starting whoosh. Trying to do IF but very hungry ATM and trying to resist eating anything.
The mj is really just a bit of a helping hand but isn't stopping me enjoying my food. What I'm hoping, and I think it is happening, is the cravings that usually become overwhelming when I've lost a bit of weight and derail the diet, will be more manageable.
So maybe continuing being able to eat reasonably well and losing weight more slowly will lead to more sustainable new habits. At least that's what I tell myself when I read about the amazing weight loss of some!

Ok @QueenOfHiraeth come and sit down and get your lecture from me...

At 16.47 today did you not reply to me saying 'it is normal to feel hunger and MJ should not be used to suppress all feelings of it.'? You are learning far more about healthy eating by still having an appetite, making good choices and eating a reasonable portion size. That is why, unlike previous times this diet will work.

You say you have only lost 22lbs in 12 weeks. That's an amazing loss! It's almost 1.8lbs a week. I think it's a matter of perspective - I have lost 28lbs in 20 weeks which is only 1.4lbs a week so would love to be losing 1.8lbs a week. But I am focussing on being happy with what I'm losing and learning on this miracle drug which is going to change my life.

If you compare yourself to others you will always find someone thinner, younger, prettier, smarter or richer. Don't forget that to some people you will be the thinner, younger, prettier, smarter, richer one but you won't see that. Just be YOU - keep on keeping on the right path. A new world is opening up at just the right pace for you!

I want to put weight back on so I can try it!

@MassiveSaladDodger @DesparatePragmatist @Fromthesidelines @Choux
Thank you all. I'm trying to tell myself all those things but just have a wobble here and there. I think I feel a bit trimmer but measurements are, very mysteriously, not changing despite the weight loss so maybe I'll feel better when they do.
@Choux I accept the lecture with good grace
Everything you all say is very logical and I agree, I know you are all correct but, emotionally, I still want to stamp my feet and wail!

God I hadn’t thought to titrate DOWN with the 7.5mg. I feel stupid! I’ve been doing 8 instead of 7 days as well. Only in 7.5mg - it’s so strong for me. I will try 7mg. That will be 28 clicks I think.

I got a response from Bolt re maintenance:

We will continue to provide you with weight loss injections until your BMI reaches 22.5, at this point you will trigger a treatment review with the clinical team. In this review we will discuss the benefits and risks of continuing treatment and make a joint decision about whether continuing treatment is in your best interest and for how long it should be continued. We do not have a black and white stance as every patient is different however options include tapering down to a lower strength of treatment to help you maintain weight without losing further weight.

I can't imagine I will be able to get to a BMI of 22.5 so perhaps I can stay on a low dose forever? On the one hand their response is more detailed than that of MedExpress but it seems to say they might cut me off. Maybe a blanket and vague 2 years like MedExpress claim is a better bet? But these companies want to sell it to you to make money as long as you can show you are using it responsibly so maybe I don't need to worry about it being taken away before I am ready.

Are you saying you want 7mg out of a 7.5mg per dose pen? I don't think that will be 28 clicks if so because on a 7.5mg pen 60 clicks would be the full amount so 28 clicks would be less than half.

Morning all. Just done the bonus dose from my 2.5mg pen, and managed to get 0.8ml out using an insulin syringe, so I think that's 3.75mg? I'm a bit nervous about going up to 5mg next week, so wanted whatever I could get out of the pen to try and bridge that dose doubling.

Anyway, getting it out and injecting with an insulin syringe was absolutely fine. In fact, I found it a bit easier to inject than using the pen, I've got small hands 😂

Omg I had a terrible dream last night, I was eating cake! So much cake!

@ThirdStorm how did you go about getting your MedExpress discount? Did you just order as normal and then email them asking for a price match?

Just realised it's been 5wks since my last order so I ought to order asap. BMI is under 30 now so I'm limited to who I can move to, so might as well stick with MedExpress.

Weigh day a day early for me, lost 3lb this week (it was four yesterday but gained 1lb overnight!)

SW- 20stone 2lb
CW- 16 stone 0
GW- 14 stone

four down, two to go! Good luck today everyone!

I replied to one of your earlier posts yesterday about experiencing full appetite suppression and want to apologise as it may have come across as bragging. I worded it clumsily… what I meant was that I’m not deliberately using MJ to fully suppress my appetite and therefore eat as little as possible, that is just the effect it’s having on me. I’d far rather be able to use the opportunity to create better eating habits while losing weight steadily, instead of having to force myself to eat and feeling uncomfortable. That’s partly the reason I’ve stepped back down to 2.5mg for a while, as it was nice on holiday to feel hungry and enjoy food again after my missed dose! I guess what I’m saying is that full appetite suppression isn’t the holy grail, dropping weight slowly and steadily while learning new habits is much better!

Originally I emailed saying I loved their service but it was expensive so I was thinking of moving to Oushk because they are cheaper. They responded saying they would price match to Oushk and added a credit to my account for my next order. I screenshotted Oushk's website with prices. This time I placed my order and emailed them straight after to ask if they would consider price matching along with another screen shot - lets see what happens. I should have chosen a cheaper comparator but I had been thinking of moving to Oushk so it felt okay! They told me previously they do price match and they will accept requests up to 7 days from last order.

2 stone in 3 months is still an insane loss! Well done

Does anybody know of a supplier who do not use Royal Mail? My parcel from Bolt went missing, Royal Mail say they don't deliver to the doorstep in blocks of flats, only to the building, therefore neither Bolt or Royal Mail will take responsibility and I'm down £180! Would prefer a supplier who also supports maintenance.

You’re right, I just had 30 clicks in my head for some reason!! God know what I was thinking. Just not thinking clearly that’s for sure!

I’ve just had my last appointment with my NHS tier 3 weight mgt dietician. She is so lovely. I had the option of asking to go on to the bariatric surgery pathway and I’ve opted not to. I also no longer medically qualify, which is mind blowing to me.

I will make a GP appt for a couple of weeks time to review everything and will let you all know if there is a patient choice option in the pipeline.

Oushk gives you the option of RM or DPD and you can choose delivery day. They do support maintenance.

Asda Online Doctor have so far used DPD which has been quick and reliable. The packs have always been cold, with the ice packs still frozen. I don't know what their policy is on maintenance though, sorry.

I switched from Asda as they cut you off at BMI 25. Unless their policy has since changed. @KrankyKumquat Thank you. I will look into Oushk. I know it's not Bolt's fault but I'm still not sure I want to return to them. Their only advice is to call the police. The police didn't do anything when my catalytic converter was stolen, they aren't going to investigate a missing parcel ffs.

Weighed this morning and my total loss so far is 38lbs so I'm really pleased. Been on MJ 16 weeks now. Have stayed on 2.5mg then tried 5mg but it did not agree with me so dropped down to 3.75mg and it seems to be ok for now although I'm still getting really hungry the two days leading up to my next jab. I still have a huge amount of weight to loose as my BMI was nearly 50 when I started this journey, currently it's 41. NSV. I can breathe and cut my toenails at the same time. 😁

Weigh in day today, and 2.2lb off.

SW: 12.6.6
CW: 10.3
IGW: 10.0.0

I am 2lbs off being within a healthy weight range - ok, at the very top of the range, but still there!

Once I get to my interim goal weight of 10 stone, I will look at where I want to be within my healthy range.
According to the NHS BMI calculator, my healthy weight is between 7 stone 7 and 10 stone 1. Halfway is 8 stone 11. Is that too much to hope for? I think I might go for half stone interim goals for now. But I will wait until I get there before I decide.

Congrats on everyone's losses, commiserations for the stalls. We are all heading in the right direction, whatever speed we are going.

Bloody Zava are so useless! They replied to my message. I thought, amazing! Less than 24 hrs! However, the message was a generic message about maintenance! So they must have bots picking out words and sending generic response instead of actually reading the messages.

I did ask about maintenance in the message I sent yesterday but said that as other places are now offering for 2 years will they change their stance. Got a generic reply saying no maintenance. They didn't answer the question about expiry date at all. Even though the title of the question was about expiry dates and my email was mainly about expiry dates! I will email again and take out the maintenance question. Looks like they aren't actually monitoring their emails anyway as they never reply properly.

So hopefully Eli lilly will reply to my question as Zava are completely useless!