Any advice please, stop MJ because of unrelated unconfirmed health issues /upcoming surgery

[ShakerMakerGirl]

I would really appreciate peoples thoughts on this please.
So I've been on MJ since March, I've lost 4 stone 9 and 4lbs away from goal/BMI 25.

However I've found a breast lump, I had a needle biopsy and the results have been indeterminate with abnormal cells, so they'd like to remove in under general anesthetic and then do further pathology tests.

I was going to remain on MJ to maintain but with all this going on I am wondering if I should come off it, but I'm terrified of gaining all the weight! I've got 1 more 10mg pen in the fridge. I was due to take it on Sunday and I still haven't taken this weeks dose as I don't know what to do.
If my results say its cancer obviously I would stop taking it but if it's not and I stop my provider might cut me off as my BMI is now 26.

Anyone have any thoughts. Sorry for the rambling. I am not getting much sleep.

You need to discuss this with a medical professional.

How distressing.

i would be entirely guided by medical professionals on this.

Agree with the PPs that you need to speak to the surgical team and ask them. Sorry that you're in this situation and hope that you get the best possible outcome.

Thank you. Sorry I should have added that. Consultant said he didn't really know anything about it, but he wasn't concerned as it was approved drug and it was up to me. He did say try get my energy levels up though as I said I was tired all the time and that's definately the MJ.

Also ladies. Please all check your breasts. If I hadn't lost all this weight, I don't think I would have noticed this lump, I was just adjusting myself because of a very ill fitting bra that was far too big! X

I'd then speak to the prescriber - the pharmacist that prescribed Mounjaro to you. You can contact them about anything especially this so they can give you proper advice regarding MJ and other issues.

Edit: I'd say to speak to the GP too but they also may not know much about MJ, so I'd speak to the person who prescribed it and is knowledgeable about MJ as their advice will be Mounjaro-specific, which is what you're asking here. Of course speak to GP too if you need to.

Speak to your GP. Ask for an appt to discuss.

So sorry. You must be so worried. I would stop taking mounjaro for now.

When I was starting off I delayed because everything I read said that surgeons were advising patients to stop injectables for 4 weeks before a GA.

That's a bit rubbish of the surgeon to say that. There will be plenty of approved drugs that have a possible negative interaction with a GA and it would be reasonable to expect the surgeon to check.

I would hold off the injections for now, and ask for advice from your prescriber.

Thank you all.

That's really useful to know about holding off for 4 weeks,luckily as I have already delayed taking it this week, it will work out 4 weeks and 1 day.

Yes he wasn't the best, he was quite dismissive of my questions. I also get very sick on General Anesthetic, vomited for 48 hours after my last one, and he brushed that off too and said I could just WFH day after but the specialist nurse pulled me to one side when i left and said have at least one week to two weeks off work to recover! Especially given I have two very little children. Anyway, if he is a good surgeon that's all the matters.

Thank you. Sounds like the best thing is to come off it and face the scary hunger pangs and binge eating returning. Typically I am a stress eater too. I know it sounds pathetic but I've tried for 8 years to lose this weight and it feels so good to finally have done it.

I don’t really think any of us are well placed to give you advice as this is such a serious and scary predicament for you. Talk to all the medical professionals including the pharmacy that gives you MJ and ask the hospital again for a clearer answer. Ultimately if you felt the hospital consultant gave you a clear answer, you wouldn’t have started this thread, so it’s in their best interests to give you reassurance and clear this up for you. The consultant saying he doesn’t know much about the drug, but also saying it’s up to you is odd. He could have done some research or deferred to his colleagues, leaving it up to you seems a bit weird. It would be different if he outright said the drug won’t impact your treatment and therefore it’s up to you.

Just rang my GP and I can't have an appointment until 27th November. 9 days after my surgery! I have contacted pharmacy2U and they have asked me to write an email and they will get the doctor to look into it ASAP.

Based on the general anesthetic advice online to stay off it for a least 1 week in America and 3 weeks in Canada. I'll stay off it for the for 4 weeks as above.

You are right. Perhaps I misunderstood him. It's a been a bit of a blur but there was a language barrier as he had to write a couple of things down for me when I didn't understand his pronunciation.

Thanks everyone. I will post if the pharmacy gives anything specific in case someone else ends up having general anesthetic.

Just a reassuring hug from me at this scary time.

I stopped MJ two weeks ago and have lost another KG.

I’ve been on it since April and there is no denying the hunger is back with a vengeance - however since I haven’t felt that feeling since April, it’s not surprising I’m noticing it now.

Ive had three meals a day and haven’t gone back to the binge eating I used to do, it’s like anything, do what you’ve always done and you’ll get what you’ve always got.

If your medical professional says stop then you’ll be fine - all it takes is some thought as to if you need to eat this or that, if you’d have done weight watchers and then at the end went back to anything you fancied you’d obviously put the weight back on too, so MJ is no different than other diets in that respect.

You can do it! Best of luck with your op

I just had another thought, you can contact the manufacturer Eli Lilly directly too. They might be able to give you some information

If you feel sick after a GA ask the anaesthetist to ensure they give you meds for it.
My dm experienced vomiting after a GA once and now always asks for the anti sickness drug to be given.

I was on the two week cancer pathway back in the summer for breast and gynaecological cancer, they were happy for me to continue taking it. Also had a lot of dental surgery recently and it was the same. I. Waiting on a hysterectomy at the minute and they have said carry on. Go with your surgeons advice.

There was a research paper published in the last week that said a minimum of 10 days off GLP1s before GA, which is increased from the previous advice of 7 days.

Thanks all.

The pharmacist has replied with the below info.

With regards to preoperative use of Mounjaro, whilst there are no established UK guidelines, we recommend that you stop using Mounjaro 2 weeks before you are due for surgery under general anaesthesia. This ensures the drug is completely cleared from your body to reduce the risk of any possible complications such as low blood sugar.

Additionally, if the results are benign and you wish to continue treatment after your procedure, the dose that you use will depend on the number of doses that you have omitted. Therefore, please get in touch with us and our clinical team will review your case and provide you with the most appropriate recommendation.

Additionally, if the results are benign and you wish to continue treatment

So presumably if not benign then they wouldn’t recommend re-starting?

Fingers crossed it is benign 💐

That's probably phrased that way because I said I wouldn't continue if I had cancer and asked if I could restart if it is benign.
While I have had minimal side effects,I have been extremely tired so wouldn't want to take it if I needed my strength for Chemo or Radiotherapy etc.

Sensible information from them. It's always best to ask the prescribers - they know what they're doing especially when it comes to Mounjaro.

Thanks for updating OP. That’s really useful information, I didn’t know it took 2 weeks for the medication to leave your system.

It sounds like you will be stopping MJ before surgery so it should be fine for you but I did read something suggesting that an issue with surgery and GLP-1 medications is the delayed gastric emptying so people need to be nil by mouth longer than usual before the GA.