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:

Re weight training - this is so, so, important!
I have been doing this now for about 16 months at a specialised gym, where you get one on one PT service.
It has been transformational. I go 3x a week, with regular review of my training programme. As you age, weight training is key to keeping you mobile, avoiding falls etc. I just wish more of my friends would do it.
Minor downside is it probably increases your dress size due to muscle build up, esp arms & shoulders. I doubt I would ever fit into a size 10, no matter how much weight I lost!

This is so reassuring!

Clothes wise, I started at size 16/18, but more 18 than 16. I’m 5ft7. After a stone, all of my 18’s either went in the bin or to the charity shop and I could wear 14 top and 16 bottom. Now I’m 2 stone down, I can comfortably wear a 14 top and bottom.

My trusty skinny jeans in a 16 hang off me now so they are next to be replaced. I don’t expect to fit a 12 for at least another stone yet. I do need to get bra measured again as I’ve lost 5 inches from chest and most of my bras are starting to ride up my back

My BMI was 36 when I started and is now 29.

My hip and knee pain is almost completely gone and I have realised I had been making that ‘oooffftt’ noise when I stood up due to the effort required. I have stoped and now can stand up silently without inadvertently making a noise !

On another note I am at this festival, I forgot to have my dose Wednesday so I had it Thursday morning. Probably a big mistake, as I could not eat a thing yesterday.

As soon as I got peckish my son decided he didn't want his ice cream, there were no bins nearby, so I ate the rest of it and that made me feel over bloated.

I forced myself to get some food but I am autistic and food vans at festivals tend to over hippify food.

Grapes in their coleslaw, fritters- but what was it they had frittered? It was different every single bite so only had a couple of bites, and the salad was primarily Swiss chard which tastes like soil to me, like beetroot.

I don't actually know what I'm going to do about eating today and tomorrow.

This sounds great. I see my PT once a week for weight training but am seriously struggling to get to the gym the rest of the week. I need to find a way to get there more often. Part of it is that I see her in a cross fit gym which she loves but I find a bit full on for me, but my local general gym is tricky to do weights programmes in because the machines get taken up so quickly. I need to find a body pump (or similar) class or two I can get to reliably as once a week is better than nothing but it’s not enough.

I was so optimistic that I might finally have dropped down a pound today but no!
One of the reasons for my optimism was I spent a bit of time last night working on beating the bloat. I really swell up in the heat so the last few days have been tough. Last night, I had a tepid bath during which I exfoliated my legs & feet, then I got out of the bath and lay on my bed with my feet up against the wall for 30 mins running in foot lotion and leg lotion and massaging my stomach and the lymph nodes at the top of my thighs. I also drank a lot of water and peppermint tea. It worked and I am feeling so much more comfortable today.

@PonyPatter44 Have you thought about getting a tape measure and measuring your waist and arms etc? I do this as I’m often losing inches. Might help you come to terms with your loss. I also like a before and after photo as it helps me to accept the difference.

@ObsidianTree i agree, it’s exciting to get dressed now as I’ve got so much choice and I know it all fits! Previously I had a few pieces that I lived in - all black. Who was I kidding!

Towards the end of my fat days I was living in leggings and dresses as no trousers fit me anymore! So nice to not have that scratching head moment each morning where I have to find something that still fits!

I so hear this! I’ll also add in that I’m not farting as I get up off the sofa anymore 🤣

I envy your lack of farting 😂

Good morning everyone.

10.10lbs this morning. Started In May at 12.5 and loosing slow and steady. I’m 5.1 and a bit and am now starting to see my body changing. I’d love to get to 9 stone but we will see, as I like to lift (when I’m feeling normal).

Went up to 10mg last week and it totally wiped me out! Dizziness, nausea, fatigue and the rest. I’d had a few weeks poorly with shingles so am thinking the meds for that masked the 7.5 effects so going up to 10mg just as I finished the meds was like a shock to my body!

Ive used clicks this week so taken 8.5mg instead and I have to say I feel less woozy and sick.

Im having to make sure I eat regular small snacks as I’m clearly getting low blood pressure symptoms aswell.

Off to Weymouth on Monday so panicking a bit about transporting the pen. Hubs has bought ice packs and small ice box so I’m sure it will be fine.

Lovely to hear about everyone’s successes!

If anyone has any tips on how to keep motivated/ get rid of fatigue and low level nausea, feel free to throw them this way :)! I really want to get back to the gym to lift three times a week but for the last few months I just haven’t felt well/energetic enough :(

I woke up to the generic "sorry for the delay in processing your order, we are experiencing unforseen delays" email from MedExpress. I'm not surprised, I did expect as much as I've been following the thread daily.

I wonder when it'll come, hopefully by Christmas 🙄

I just got my MedExpress delivery. Ice was melted but still cold so that's good. Given it sat in the system for 2 days and it's been hot I'm pleasantly surprised it wasn't warm.

Can I have some advice please?

I ordered from Cloud this time as the Zava time scales for delivery would have ran over days I wasn't in the house.

Order was packaged at cloud ready for despatch Thursday 1st Aug at 17:20.

Received by Royal Mail 1st Aug at 18:06.

Item has sat in the Royal Mail system over 2 depots since then and I received it today at 09:24.

Which in itself failed the 24 hour special delivery by 1pm as I should have received it yesterday by 1pm.

I opened the box and it was warm, inside the silver packaging it was warm, the gel pack had a 1cm tear in it and water had leaked all over inside the foil packaging. The zip bag which the mounjaro box was in with the needles loose was wet and after opening the box with the pen in, it's warm.

I've put a meat thermometer against the glass bit where the liquid is and it's showing as 23 degrees and the pen doesn't feel cold in the slightest.

Reading guidance it says it would be OK to use at that temperature 30 days from despatch but I don't need to open this pen for another 2 weeks. So I would only get 2 weeks out of a full pen.

Is this correct does anyone know?

@cappycap that sounds so annoying! Is it worth emailing Cloud and asking them? This is one of the reasons I'm sticking with Asda even though it's not cheap- I can collect from the in-store pharmacy now, and don't have to worry about being in to receive it.

@ObsidianTree I'm only 5ft, so every kilo shows, either coming or going! I've got to buy some new bras tomorrow anyway, so I might just pull myself together and see what else fits!

@PonyPatter44 hello lovely, may I assist with your head wobble?! You have lost over three and a half stone. On dumpy little bodies like mine (5’2”) that is three dress sizes, but it’s certainly dress sizes on anybody’s body! Don’t get hung up on the numbers in the garments. Tailored stuff you might be two sizes smaller, casual you might be three or even four. But here’s the thing. You have lost the weight of a toddler and should be absolutely fizzing with pride, like we are for you. Go to those shops but don’t tell yourself you’re going for clothes. Tell yourself you’re just going out to play. I remember the first time I went into a non-Evans clothes shop, many years ago, having lost three stone. I felt sick with nerves and was sure everyone was looking at me and laughing. They weren’t, of course. I went into Marks and Spencer and bought my first ever dress, then came home and cried with sheer emotion. So you get your shopping trainers on, go out there and have a fun day. And tell us what you bought when you come back❤️

@cappycap quite a few of us have taken delivery of warm pens of late and most have had no success with pharmacies who simply say to use it within 30 days. As you say, that's often not possible if you've ordered to give yourself a bit of latitude.
Someone (@Greyrockin I think but couldn't find the post) quoted EL helpline as saying it should be ok if refrigerated straight away, didn't get over 30 degrees and doesn't spend longer than 30 days in total put of the fridge. Hopefully I haven't misrepresented that.
I am starting my warm zava pen tomorrow which I received 2 weeks ago and so will find out if it's still effective after a couple of weeks use!
That said, it is still pretty poor practice from pharmacies.

I’ve lost almost 2.5st since I started dieting (I lost some of that pre Mounjaro) and I wouldn’t officially say I’ve lost a dress size yet. Before I would have said that I was a 22 but realistically I think I was a 24, as I only wore stretchy clothes and had started avoiding certain outfits that I knew wouldn’t fit - convincing myself they were “small fitting” 22’s 🥴

Now, my 22’s are starting to feel a little loose - except for the genuinely small fitting ones 😂 and my size 20 clothes seem to fit now. It’s quite hard to tell because I’ve bought stretchy clothes for so long. It’s a bit disheartening as I dream of size 18’s but because I’m tall I think I have a couple of stone to go before I can brave the 18’s!

For anyone on the FB group I wore the jumpsuit, that was a 22 and had no stretch in it whatsoever 😂

I'm 20lbs down and a few people have noticed, my knees are starting to touch more when I walk or in bed and it's super weird. I don't want to lose too much just enough to feel healthier and happier in myself. My clothes fit much better.

I've got an event coming up at the end of August and I can't wait.

Morning all!

First time poster - I have my first MJ pen arriving this afternoon. Excited to get started, using this to help me lose 28lbs and reset my relationship with diet and exercise.

Anyone else here using Juniper?

• Betty

@PonyPatter44

It's a shame as approval was really quick and they did get it despatched in good time it's just been delayed at the Royal Mail side of things. However, the packaging I'm sure would have been more efficient should the frozen gel pack they used hadn't had a tear in it caused leakage, which as far as I am concerned is a Cloud pharmacy cock up.

Zava were great for delivery and pen arrived chilled, however, since my last order with them, the delivery timescales are not good and give too much scope which means I can't guarantee I would be in for delivery and Zava need it signing or else I'd of ordered again with them.

@Fromthesidelines

I looked on the Numan website as I can't see anything on the Cloud website which has the following text. To me, this means 30 days from date of despatch if it doesn't arrive chilled but below 30 degrees.

"My injection pens have been at the parcel shop for a few days, can I still use them?
Your medication is delivered in cold chain packaging which can maintain a fridge temperature (2 - 8 C) for up to 72 hours. If your pen arrives warmer than fridge temperature:
Ozempic/Wegovy will still be suitable to use for up to 6 weeks after the date of dispatch.

Mounjaro will still be suitable to use for up to 30 days after the date of dispatch."

I don't want to take any chance with warm medication if it will mean it would be after the stated timescale.
Not only from a health perspective of injecting a medication that clearly states it shouldn't be used 30 days after despatch when not arriving chilled but also the worry of does it mean the medication is less effective?

We spend a lot of money on buying Mounjaro, it's not cheap and it should be fit for purpose.

I will email Cloud, I have photos of the broken ice pack, the thermometer temperature and also the pool of water in the bottom so let's see what they say.

Not sure I would want a replacement though as their packaging is disappointing. The sandwich bag that the pen and needles came in wasn't actually pressed sealed, so the water leaked into there too and has wetted the paper seal of the needles.

@cappycap hope Cloud are more helpful than Zava! Good luck.