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:

Do you think degradation will pause/slow down once it is refrigerated or is it your experience that, once damage starts, it continues to degrade regardless?
I can see different views on this. It would be helpful if EL provided clarification but I see many people on reddit have tried and failed to get this.

I am on tenterhooks with MedEx as Royal Mail tried to deliver yesterday (no advance time given) but I was out. They said they would try again today (no time given) but I have an appointment now. I've left a big sign on the door to try a neighbour 😬

@Fromthesidelines I am not sure but I do think it would help. Can't do any harm certainly. I keep mine in the fridge at all times except when I get it out to use. If it's heat labile, I always use the fridge.

@Forevafatty I low carb and whilst previous attempts to lose weight by low carbing have been successful, I do think MJ has given me the edge. I just can't be trusted around carbs and sugar. I know a lot of people thinks its extreme but when I'm not stuffing my face with bread, pasta, potato, cakes and chocolate (you know all the really nice delicious stuff) I make much better choices around veg and protein. My carbs per day are generally around 20g but this I will need to start increasing as I get closer to my goal weight.

Oh this has made me feel a lot better, thank you. And bizarrely, when I think that you've lost 10 pounds, it seems a reasonable amount - perhaps we're always just harder on ourselves!

@montysma1
how frustrating! I started with Boots as a trusted name didn't realise that they were so much more expensive than most of the others. I'm now considering moving to a cheaper supplier but have been put off by the problems everyone has had with deliveries. Boots you just go and collect direct from the pharmacy where they keep it in the fridge. And their cut off is BMI 23 which whilst it is a bit higher than my hypothetical GW would still be completely amazing if I got there.

That said I am probably going to give MexExpress a go - I now know they are (by far) the biggest supplier of MJ in the country, so a balance of 30% cheaper than Boots but BIG so unlikely to be hit with supply issues. And as has been discussed here this week if they're going to offer maintenance it's game changing! I do not want to do all this hard work and then pile it all back on.

The thing with boots giving you the pen from the fridge, you've had no sight of how it was transported to them or if their ice packs melted en-route or anything like that.

Same as all the suppliers really we don't see them when it's gets shipped from the manufacturer to them either.

So they could all be at lower temperatures with us being non the wiser.

Higher temps even

We have got this 😘

If anyone is interested I renewed my subscription with Hava today and got 3-months free access. It's from the Diet Doctor team. The new site is still a bit of a work in progress, but they have some good clean recipes and the approach is more about satiety than low-carbing (but still lots of low carb recipes). I think it's similar to the Zoe approach but obviously not tailored individually. They are offering 90 days free as standard I think.

I've lost 9.5 lbs in my first 4 weeks on Mounjaro but I need to sort my diet out as I'm still eating less than optimally!

Edit - the link below was automatically generated by MN, it's the Hava link I wanted to promote.

I have just started a 5mg weekly dose up from 2.5mg.

I did use Ozempic from manual and maxed out the therapeutic dose with them and was still absolutely starving every day but I am noticing my appetite waining on mounjaro.

I just want to document somewhere that my weight today is 107.70kg to see if this works for me and to hold me accountable.

God, 5mg is no joke. 24 hours after injecting and I can't finish my protein yoghurt. Just found myself stirring it around and around trying to find the will to eat it. Unheard of!

Can't believe this is something I'm having to whinge about coming up against but...
Has anybody been questioned yet on why they're 'losing weight so quickly'? I took my 12th injection Tuesday and my weight loss is standing at 2st10.5lb or 15.95% body weight loss.
I had my request held back by the doctors until I answered a few more questions and confirmed I wasn't really ill or dehydrated etc, I also went into great depth about the fact that I've taken this weight loss journey seriously and am following a healthier lifestyle with exercise and a ketogenic diet which will be contributing to the losses hugely only to be ignored and refused!
I've just had to call them up and ask them to reconsider looking at my file again because although I've done really well in a short space of time, I'm still BMI33!!!

This is the dream for me.

I'm not an emotional eater, and I don't really do binges, I just never feel full. Feeling hungry is so painful to me, I've tried the drink glasses of water before and after meals but it doesn't change the fact I'm hungry.

I've never not finished a meal.

I don't have a concept of feeling "just right".

I'd love to be able to say "that's OK I've had enough now" and stop.

I had my dose yesterday and today I've not eaten yet and I'm not even a little bit peckish.

I think with the unpredictability of delivery and orders it might be best to order closer to you needing to use it instead of weeks in advance so if the pen does arrive it is still stable and able to use for the 30 days if that makes sense.

If you order the pen the day after you take the bonus dose and it takes 4 days to get to you then timings are:

New pen
Dose 1 - approx 2 days after cold chain lost
Dose 2 - 9 days after cold chain lost
Dose 3 - 16 days after cold chain lost
Dose 4 - 23 days after cold chain lost
Bonus dose - 30 days after cold chain lost

But waiting till you have no Mounjaro in the house before ordering would make me very nervous.

Agreed @Choux especially as Zava are taking 6 or more days from ordering.

Ordering my 3rd pen from Zava went as follows:

Ordered on Sunday
Approved on Tuesday
Received today

All good yes?

Except RM left it on the doorstep, in the full sun. We were both home and 2 cars were on the driveway. Luckily, I was getting something from my car and saw the parcel. Ice pack melted but still cold.

No!

You are doing well and taking it seriously and with a BMI of 33 now are obviously not yet at risk of being severely underweight. You do seem to respond well to it though. I have taken 20 weeks to lose 15% of my body weight.

Were you ordering a higher dose or the same pen as last time? Because if you were losing 3+ lbs a week on 7.5mg it would seem sensible to suggest you stay on that dose. On 10mg you might lose 4+lbs a week. I don't understand why they would refuse you completely though.

Hi all. Been following for ages. Now, I have been doing so well on MJ - 4 stone down.. but was on my next increase up to 12.5mg, wowzers, even worse than 10mg.. Since I started 10 I have only eaten 2 days a week, towards the end of the week when I am due an injection. After finally getting an answer from ME they have suggested to drop down to 7.5mg... So I ordered and now there is a delay.
I have a 12.5 in my fridge... how many clicks to get a 7.5 please?

Exactly @Choux I was ordering my second pen of 7.5mg as I've found, exactly as you say, consistent higher losses. I stupidly rushed through 5mg following prescribers recommended advice of 'increasing every 4 weeks' and now I know better have made the plan to stay at 7.5 until losses stop or I reach target whichever comes first!

They even tried recommending only prescribing me 5mg in the first round of emails. I sent them pictures of my prescription and my dispensing label proving that im on 7.5 and that is where I'd like to stay as I'm not showing any signs of side effects other than a really good suppression at the right times of day. Just seems so backwards that because I'm doing well that I should be prescribed less dosage or none at all!

36 clicks is 7.5mg from a 12.5mg pen.

If you were only eating 2 days a week on 10mg why did you go up to 12.5mg? Eating 2 days a week might get the scales to go down but it isn't healthy and you aren't putting good building blocks down for your future relationship with food. The prescriber seems to have given you good advice to drop back to 7.5mg. I hope it gives you your appetite back.

@QueenGoo well you should have no trouble moving suppliers at 33 if they won't supply you. Care to name them?

@Choux You are amazing thank you so much... and I totally agree with you.. it was not really hitting home, as I was drinking protein shakes and I take green powder, multi vitamins etc... but when I did not even want to stomach the shakes I knew something was up... it is hard to know what to do when you are advised to up it and up it... so now I know to keep on 7.5 until it is not as effective.

@Choux this was medexpress. I had used them just under 8 weeks ago for a 5mg pen but had moved to zava for my 7.5mg to take advantage of the lower prices and 15% off. However given the recent news breaking form ME that they were offering maintenance dosing plans and the referral benefits I figured I'll go back to them as that had in some way redeemed them after the whole 'removing codes' debacle. However I was completely transparent with them about that, didn't hide the fact that I had received a 7.5mg pen from elsewhere and provided proof.
If they refuse again then I guess it's back to zava with my tail between my legs but I had hoped to stick with ME based on their maintenance stance alone!