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:

@3wDavid your GP is not up to date. Mounjaro is approved for weight loss in the UK. It was approved for weight loss before diabetes here (that might have changed now).

@3wDavid am afraid your GP is out of date or simply incorrect (he may assume Mounjaro is the same as Wegovy/Ozempic, worrying really). It was recently approved in draft guidance by NICE for the treatment of both diabetes and obesity. You might want to email the practice, say that you felt rather chastened in your recent appointment but would like to draw his attention to the following article.

https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/treating-your-diabetes/tablets-and-medication/glp-1/mounjaro#:~:text=Treatment%20for%20weight%20loss&text=Under%20new%20draft%20NICE%20guidelines,that%20are%20related%20to%20obesity.

I have not seen my GP but it is worth knowing [in any case] that MJ was approved for weight loss by the MHRA back in November 2023. Direct from their website. Sounds like your doc is not up to speed!

"The Medicines and Healthcare products Regulatory Agency (MHRA) has today (8 November 2023) authorised via a national application route, a new indication for the diabetes medicine, Mounjaro (tirzepatide), for weight loss and weight management in adults aged 18 and over.
Mounjaro is now authorised for adult patients with a BMI of 30kg/m² or more (obesity), as well as those with a BMI between 27-30kg/m² (overweight) who also have weight-related health problems such as prediabetes, high blood pressure, high cholesterol, or heart problems."

@DesparatePragmatist that's fab news you must be so happy.

Re GP mine has received two letters from medexpress and had no issue with it they just said I should notify medexpress about a pre existing condition.

For bloating and water retention I've been trying out willpowders electrotide its electrolytes and diuretic combined. Tastes disgusting but thought it was worth a shot.

I did however start it at the same time as moving up to 7.5 and taking collagen and mct oil, so not sure if my increased weight loss is due to the electrotide, collagen, mct oil or the Mounjaro

Started my fifth week of 5mg yesterday. injected into my thigh for the first time to see if it’s any different to injecting into the stomach. No noticeable differences so far as far as I can tell. But I’ve been lucky in that I haven’t experienced any unpleasant side effects during this Mounjaro journey.

My injection day is Sunday but I'm doing a Friday to Friday trip next week and I'm planning to switch injection day to the morning that I go away and the evening I come back to avoid the hassle of bringing the pen with me.

What's everyone's thoughts on cloud pharmacy? Looking to order for a family member and they seem to be cheapest in general for all doses

I’ve just had an email to say they approved it! Weird I was expecting it to be declined too!

I’ve heard positive things, there’s a few users on TT who use them. Though I do think some are in paid partnerships so I’m always a bit iffy about those!

Dose due this evening and I'm going to step down from 10mg back to 7.5mg as I was totally floored by the nausea for the first 4 days last week after my second shot of 10mg. Had hoped it would be better than the first week but was actually worse. I was barely able to eat until Saturday.
We're moving in 3 weeks and I need energy, so have to be able to eat!

Also considering curate as they seem to have discount codes that work each month?

I'm sticking with medexpress currently for my own order but think my relative will be better off with another supplier. Just unsure who to choose

SV: I achieved my first weight goal today. 18kg in 17 weeks. Now I’ve set up a new goal based on a much lower weight loss rate. March 2025!

NSV: I was meeting a friend on Saturday, got to the area with 30 minutes to spare. Went into a shop and saw a wonderful dress. size 40. French brand. Asked it they had 42 or 44. No, only 2 left, both size 40. Checked online. Sold out. Tried anyway as it was kind of floaty, thinking it would be tight (and unwearable) around chest and waist.
Reader, it FITS!

So HAD to buy it

Oh not Curate, heard such horror stories about them. Not sure it's all true, but just remember hearing a lot of negative stuff about them.

People tend to "like" Zava (bit hit and miss it sounds like though), Bolt, Oushk

I'm also with MedExpress but itching to change them.

@Mencia absolutely bloody brilliant!! Living for these kinds of updates! Well done you!

@Mencia

Awesome NSV! Isn't it great when that happens?

Ok so not curate but possibly cloud

Voy are brilliant and I have a code if you want to use it?

You get everything delivered quickly, a weight loss coach and lots of online support/videos.

Pm me if you want to use my code

@3wDavid you're having a horrible time! I'm so sorry. Definitely send MedExpress a rocket, they need to replace your warm pen. I sent an email of complaint after my experience last week and it hasn't been as bad as yours! And the GP conversation sounds miserable. I know how awful it feels to take your health into your own hands and make the commitment to doing the research and finding the money, only to be told you're wrong and irresponsible (and by implication should accept your lot and not aspire to better). Huge sympathy and I hope your week improves.

@imnottoofussed I’m with Voy at the moment and very happy with them but if/when I move, I reckon it will be to The Care Pharmacy. Price promise, price matching, free next day delivery and they seem very responsive. Maybe have a look at them too?

I have a pre existing diagnosis of slow transit constipation for which I'm on huge amounts of prescribed laxatives and MJ is unfortunately making it a bit worse but this isn't unexpected.

I added psyllium husks into my regime but I can't say they have helped particularly. Being so constipated causes me to hang on to weight and even gain. I'm 3kg this past week despite moving up to 5mg a fortnight ago and eating less than 800 cals most days. The gain is definitely the full bowel, no question about it.

It is not unusual for me to go 3 weeks and suffer an impacted bowel and ended up hospitalised if I don't take what I need to shift it.

Oof thanks so much @DesparatePragmatist !

RE the GP - I did take the advice of someone upthread and emailed my GP surgeries - it wasn’t a confrontational email, just a “Hey, I had this conversation and it made me feel some type of way, here’s the official guidelines, here’s my BMI at starting - FYI”. It does not impact me - it’s my money, I am doing it with or without my GP’s blessing. Just was caught so off guard about it! I literally mentioned it because I have to go on an antibiotic for a cough and wanted to be upfront and make sure the two won’t interfere with each other. Spoiler alert - they won’t and it’s fine, but to your point I felt like an irresponsible moron about the MJ. Which I know I’m not. It just felt that way momentarily.

RE MedExpress warm pen - I emailed them. Don’t know when I’ll hear back; I don’t want them to palm me off, I literally don’t know what else to say / use to make my case. Absolutely absurd. I am just filled with dread now about are they going to respond, what are they going to respond, what am I going to do… 😩

@butterfly0404 OMW! That sounds awful. I feel for you.

I tried fybogel/psyllium but am nervous it is just adding to the bulk i am already hanging onto - and am not sure it had any effect either!

I take my jab later and sometimes that triggers a little clearout, but I am doubling up on senakot today to make sure. I get IBS, battled it for decades, but I always had diarrhoea with it so never understood just how uncomfortable (word seems weak) it can be. I had a thrombosed pile that took 8 weeks to resolve and was effing painful when I first switched and it’s taken to now to realise it was connected as I’ve never had those either.

Have bought a 2L water bottle and a variety of squashes to sort out my fluid intake and just discovered that the banana a day that I thought would help has probably made it worse 🤦🏽‍♀️

@IReallyNeedThisToWork do you know if care pharmacy price match to suppliers who offer discount codes?

Cloud seem to offer 5%off each month which makes them cheaper than most others but only by a small margin

MedExpress only price match to full price items I believe. Just trying to get them to price match currently on my latest 7.5 order