Continuing Mounjaro...part 18

[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)

Mumsnet does not allow promo codes. Please do not post any. If you want one, ask and someone will PM you a code or there are now threads on the promo page that have codes for Mounjaro.

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.
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 - 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.

10 - 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

11 - 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!

12 - Once you take your first dose you can choose to keep your pen in the fridge or somewhere else. It's up to you.

13 - 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

14 - 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

15 - 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.

16 - Drink lots of water. Water helps with the weight loss. Try and drink at least 2ltrs a day.

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 your 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: Now saying they support maintenance upto 2 years.

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 to 9th thread, get link from thread 10

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

17th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5122095-continuing-mounjaropart-17?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 @Slimstar13 - I will look out for the Lidl protein bars and wraps. I like the idea of using it as a pizza base.

@ObsidianTree - I don't suppose you happen to know which providers are giving out that number of pens to travellers from the US do you?? Bolt have agreed in theory to 3 months supply for me with a few hoops to jump through (which I'm happy to do). I could really have done with 4 pens though to see my through from the middle of August to the middle of December!

Still such an inspiring thread, keep going everyone. I'm not even worried now if I stall a bit, seeing everyone's ups and downs makes me feel quite sanguine about it, especially as I can feel the benefit in my eating habits being healthier, less binges and less wine.

@Slimstar13 again, thank you 😁 added your posts to my notes in my phone so I can check out your recommendations!

@ObsidianTree maybe a pm since you’re having issues, don’t know why they’re censoring this!

They deleted the name before I saw it. Apparently someone reported the pescribers that sold them. They had to put in 2 orders of 4 pens as they couldn't order 8 in one go, but was able to order two lots of 4!

Who are you with at the moment? I'm pretty sure you can order one a week from some providers. They don't question you on why you are ordering too often. Zava also do a two pen bundle with one order.

Hey, I've just pm'd you ☺️

I don't know why they sensored me either. Wondering if it's mentioning collagen g u m m I e s!

Gummies

Lol... I just tested it and it was definitely that word 🤣

I’ve just been to Sicily. All Inclusive. I reduced my dose and spaced them out 8 days too. First day back it looked as though I’d gained 4lbs, but within 2-3 days on normal eating I was back where I’d started.

I had breakfast (fresh local fruits and a cappuccino, sometimes a bit of yoghurt), sometimes I skipped lunch but asked someone to bring me back an apple/banana, and in the evening I just did the 1/4 of a plate with protein, rest salad and veg. I even had a bit of desert some nights, just a few mouthfuls usually. Also had a couple of small glasses of Prosecco most nights (actually struggled to keep this up after a week, as I kind of wasn’t enjoying it and only having a glass to keep him company - this didn’t spoil things though, as it wasn’t about the food/drink but about sitting with the family, watching the evening entertainment and the sunset over the bay, which was stunning.

So did not eat much in all, as I still wasn’t especially hungry, but I also didn’t get the thing where you get 1/3 of the way through the plate and then really cannot fit it in. I’ve been back 10 days now and have actually lost another couple of pounds since resetting at pre-holiday weight.

I think you will fine so long as you are eating something with everyone else, no one will notice, but also you absolutely CAN eat something. I reckon I was on 1500-1600 cals/day?

Disclaimer: I did have a bout of the runs, though, about 4 days in - nothing that impacted anyone else as we just hung by the pool/beach that day and it was over in a couple of hours.

For me to weigh myself omg I saw my reply “for weight “ 🤔 I blame the heat ! Honesty knocked me for six today

I also had this dilemma back in May. Was going on an AI hol with lots of family for 11 nights. I took my dose before I left as usual and went for a full dose. Was kind of suppressed for the first half a week but still able to eat a bit. I didn't take my second dose for the 2nd week and could definitely eat and drink more by the end of the week. People didn't really notice when I wasn't eating much. I think it's less obvious at an AI as people wouldn't be aware of how many times you are going to get food etc. I would go up to get food a few times but take very small amounts of food each time. If we went for an Al a carte restaurant I would tend to each about half of my main and was prepared to say I was trying not to each too much if people asked, but they never did!

I would say go with a 2.5mg dose as you don't want side effects etc. So best to play it safe. It was easy enough to restart when I returned. I did gain weight when I got back but it was water weight and it was all gone by the following week.

Have a good holiday ☺️

@Watchinghockey this is one of the most welcome side effects of mounjaro for me. I used to always feel dizzy/shaky if I hadn't eaten much, but now I never do, ever.

@Slimstar13 great food suggestions, thanks.

I did my second dose of 10mg last night, after the first one wiped me out last week I did this one in my thigh instead hoping it wouldn't be as harsh. Nope. Woke at 5am with explosive diarrhoea and had such bad nausea all day I spent the morning huffing alcohol wipes (it's a thing, honestly - smelling isopropyl alcohol is very effective for nausea!) and wondering how I'd get through the day. Couldn't leave work as I was fully booked and nowhere to move my patients to. The insane heat in my clinic nearly killed me, on top of that.
Still feel sick now. Managed to eat dinner, but felt worse afterwards.
I should have done 7.5 again. I will drop down next week as I need to get stuff done. We're moving in 4 weeks!

@RagzRebooted if nausea is a real issue for you, I've had success taking Cyclizine for it. I bought mine from MedExpress and I take it on the first days after injecting if I'm feeling sick. It really has worked.

@Slimstar13

Thanks so much for that list. I haven't seen the protein wraps at Lidl, so will keep an eye out. They have the sandwich thins as well now, which I tried last shop and I think are pretty good.

To add to your list, Lidl have a high protein granola in two flavours which is fab to make a yoghurt parfait with berries. I find the honey one better as it's a little bit sweeter so cuts through the tartness of the protein Greek yoghurt. I have about 100g yoghurt, 30-40g berries and 30g granola as a relatively high cal and very high protein snack. Can be helpful if you need to calorie load as haven't hit your targets for the day.

This is AMAZING. Thank you! I’ve been relying on aldi chocolate protein shakes but they are only 22g so the Lidl sound way better. Huge thanks.

@Jaijai38 I’m going to be the dissenting vote and say I would keep to your dosing schedule. I’m recently back from a cruise with my in laws and extended family (no escaping anyone on a ship) and what I found is that no one is actually paying attention to what anyone else eats really. We think they are, because we are, but they’re not. I keep to my schedule and packed my scales but the reason for this was 2 fold:
1 - I cannot afford to dick about with this medication, it’s too £££ & too effective. I want it to work and I’m not going to allow a backslide for any reason at this point.
2 - I realised that at some point it was going to become v obvious I was loosing weight, and it’s okay for people to realise I was eating less.

I’m about to go away for 3 weeks and as well as family I will be with a friend who has made a lot of comments about my recent eating habits. I don’t care. This is my journey and I won’t be sabotaged or self-sabotage this time.

Only you know what right for you.

Thanks, just tried but they won't sell it to me as I have an underactive thyroid.

Renpho!
From Amazon, they have an app. They measure lots of stats which can be a bit wtf?

This really helpful. Thank you for posting.

That's odd, as I'm on daily cyclizine injections with underactive thyroid. Just checked BNF and not marked as contra-indicated. 🤔

Be careful with Cyclizine, you can become dependant on it and it can have some serious side effects.
I took it throughout pregnancy due to extreme morning sickness and had heart palpitations at one point.
Have also seen patients with a dependency to it.

Long-term use of cyclizind can definitely lead to dependency - occasional use on injection day is fine. It's definitely not contraindicated in hypothyroidism.

I've another question, more of a what would you do?

I've finished my 2.5mg pen - got just over 3mg from my last dose.

Ready to start my 5mg tomorrow, but how much to take? I had diarrhea twice in the last week - once after a meal out and definitely ate more than usual. Second time - no idea why!

Suppression could be better I guess but is definitely there to a degree, it comes and goes throughout the week.

However I'm going on holiday next week! Happy to have good suppression on holiday but not so keen on the diarrhoea! Will get immodium ready just in case!

Would you do 3.75mg, or the full 5mg?

@RagzRebooted sounds like 10mg is too much still. I suggest going back down to 7.5mg until you feel ready to move up again, then try 8.75mg for a bit. Then try 10mg again. This is what I did when 10mg was too much for me.

Hope you feel better soon.

I think it's med express. They don't take anyone with an underactive thyroid for mj. So must be the same for their other medications.

@RagzRebooted maybe try to get cyclizine from other suppliers that don't reject automatically if you have any other conditions.

That’s weird, I have an underactive thyroid and get my mj from MedExpress. I noticed they only started asking about thyroid conditions from my second order though. Hope they don’t cut me off.

Just seen the BBC Breakfast (bbc 2) are doing a piece at 8.50am about ‘dodgy’ online pharmacies selling weight loss injections and the rise of A and E cases. My husband gave me a ‘look’ . I think I will keep the TV on the Triathlon!