Mounjaro / Wegovy with > 5st / 30kg to lose: Thread 4

[VelociraptorsVelociRapping]

Thread 4 (!) of this lovely community. Anyone using weight-loss injections to lose more than 5 stone or 30kg is very welcome to join us.

No discount codes, please - these need to go in the dedicated thread on this board and they will be deleted.

I'm worried it will stall my weight loss ??

I have felt this exhausted since going up from 5mg

Did you weight loss stall when you were on 7.5mg before?

No it didn't

I wish voy did more checkins

You could contact Voy and ask for their advice on this. In the clinical trials people went up doses until they couldn't tolerate a dose and then went down to the dose before that for the rest of the trial. If you're finding the 10mg hard to tolerate then moving back down makes sense. At a lower dose you won't get the peak levels that you're getting on 10mg that is causing the fatigue. If you inject 10mg once a fortnight you'll get the same highest peak level as now, plus a lower level for a longer period of time in the second week. I don't see how that would be helpful.

Very helpful all

Thank you

Seems like 7.5 weekly is the way forward??

How does anyone manage above 10??

Pre-face this by saying I'm on MJ for diabetes so the regime is a bit different, but standard prescribing for diabetics is to wean up to 5mg as normal then stay on 5 till it stops working, if it never stops working then you never move up to 7.5 and 10.......

I did dose 18 last night and still on 5mg and still losing pretty consistently at 2lb a week.

Unless you've noticed a vast decrease in suppression or decrease in loss then I don't think you need to keep moving up.

That's so helpful !!!

I had no idea 🤦🏼‍♀️🤦🏼‍♀️

Coming back to this thread. Thankfully the craziness of Christmas is over. It wasn't too hellish from a ND complex needs child POV either- completely different than the norm but that's not necessarily a bad thing.

Still losing on the MJ. I've been on a 7.5 dose for a while but it seems to be working for me. I'm now officially obese class 2 and have a BMI of under 40. I haven't been this for a long time. I'm also 15kg less than I was when I started this.

As for That Dress it now goes over my head but there's no chance of zipping it up. I suppose that's progress of sorts.

I've stayed on 7.5mg for 3 pens now, as I have continued to have decent suppression and no side effects.

You could continue with the 10mg and see if you begin to tolerate it after a while, or drop back down to 7.5 and see how you go with that.

@hellohellooo Do you know if you have a 10mg pen with doses left just now you can click count and do a 7.5mg dose (45 clicks) from the 10mg pen next time you inject? If 7.5mg then suits you better tell Voy to send you 7.5mg next time.

I think with Voy you need to tell them what pen you want otherwise they just assume you are increasing.

Have a look at the GLP-1 calculator site and enter your injections so far/planned to see how the peaks/troughs are impacted going up or down doses and how long it will take to settle back down into a normal 7.5mg concentration again.

Hello all. Great to see some familiar names checking in after Christmas and well done on the losses!

I'm thinking carefully about how to proceed. I last jabbed on 22 December and was due to have my weekly jab last Sunday, the 29th. Over the weekend, however, I was very poorly with suspected food poisoning (I am fairly sure it was some bad cheese rather than a MJ side effect) and was too ill to jab. I'm now 12 days post my last jab and still experiencing really high suppression. It's hard to know what is the remaining medication in my system (I've checked a GLP1 plotter) and what is the after-effect of the food poisoning. I am within 20lb of the initial goal that I set for myself so I had already started to think about the endgame and my pathway to titrate down, so I think this may be an opportunity. I plan to jab on Sunday, back to my usual schedule, but start simultaneously to stretch the timings between doses and begin counting clicks to titrate back down.

My big NSV is how much I'm enjoying movement, and genuinely wanting to be more active. My children are with STBXH today and it's a beautifully sunny but freezing cold day, so I am about to head out and climb a big hill!

How many clicks is a full dose per week?

A full dose on any pen, turning to the 1 position, is 60 clicks.

30 clicks is 5mg, 45 is 7.5mg, 60 is the full whack on the 10mg pen.

Why did you keep going up if the previous doses worked? That seems a little counterintuitive to say the least.

The pen is only good for 30 days from first use, so if you did go for fortnightly injections as you mentioned above, you would need to bin it when it was still half full.

I’m on 5mg with no plan to increase for as long as the weight loss continues. There’s no need to race towards a maximum dose; just stick to what’s effective.

@WeeklyJab I'm using what they sent me

There has been no communication

@WeeklyJab I think Voy advises/encourages their patients to increase after each pen. It is a subscription service and they simply send out the next higher pen dose each month.

I don't agree with Voys approach (Numan might be similar), @hellohellooo and many others are following what their provider, who are the professionals and they "should" be able to trust, has guided them to do.

Voy are a subscription service I think, so they'll automatically send you the next dose in the standard schedule unless you actively go and change it.

I think with the non subscription providers, each month you need to decide what dose to order, and you usually get offered a dose lower, the same or a dose higher and it's clear that it's your choice.

Wow! I’m with Family Chemist, I had no idea Voy just ratcheted people through the doses.

Sorry, @hellohellooo . I have to order each pen and select the dose so didn’t realise you just got what you were given with Voy.

@hellohellooo some things to consider when using the pens

You don't need to increase your dose until you want to. Only increase when you find it difficult to keep to your weekly calorie deficit for a couple of weeks as suppression can come and go.

For any strength of pen each full dose is 60 clicks / 0.6ml. You can "unofficially" take partial doses by adjusting the number of clicks or using a syringe and adjusting the ml (google 8mm 1ml 32G and buy from a medical supplier not amazon). If unsure of the maths ask here.

desired dose / pen dose * 60 clicks = number of click

e.g. 7.5 / 10 * 60 = 45 clicks

I have a spreadsheet click chart I can send you if you pm me your email address.

Each pen holds 3ml. Enough for 5 full doses on days 0,7,14,21,28 so within the 30 day limit. The pen locks after around 257 clicks (including priming) so you can't get to the 5th dose. Access using either hard twist or a syringe (never use a needle more than once).

If you are taking partial doses you could potentially have enough for a 6th dose on day 35. It breaks the discard after 30 day rule, but I am personally ok with that if I keep my pen in the fridge. You need to assess the risk for yourself.

Stick with the 7 day dosing schedule for regular injections unless you speak to your provider (although I'm not sure how supportive Voy actually is at giving individual advice - they should be at the prices they charge! - if you are looking at other suppliers check out monj. co.uk for a list of safe registered pharmacies, prices and trust pilot ratings). If you miss one/want to change injection day the instructions in the box will guide you.

If you are not sure of anything ask here, there are a lot of supportive users on this thread who have gained knowledge over time and you will too. Just be careful and think through any unofficial advice given to assess for yourself if it is low or higher risk as some posters are less risk adverse than others.

@WeAllHaveWings

How kind to share all this

I'm amazed at how little I bloody know after four months

@WeeklyJab I think voy are being reckless by doing that

I am going to contact them now

So I can not really jump down to 5mg
After taking 10mg for 5 weeks can I?

Sorry so many questions

I have never titrated downwards, but taking into account you can stop the medication any time you want, what is the worst that will happen? You get hungry!!!

If you go back down to 5mg it will take 2-3 weeks to settle back down to 5mg levels (graph is using the GLP1 plotter I linked to above - shows 4 weeks of 10mg increasing, then 4 weeks of 5mg)

It is the weekly calorie deficit that makes you lose weight not the MJ dose - it just helps you stay in that calorie deficit longer term. If you find 5mg isn't giving you the suppression you need will you be able to engage some short term willpower to see you through it settling down before trying to increase again if you need to (either to 7.5mg or somewhere between 5mg and 7.5mg if you had unpleasant side effects previously with 7.5mg).

I don't know if your body will have become adjusted to 10mg levels and 5mg might not work the same way for you now that it did on the way up, but with the fatigue as bad as it is, to me, it is worth a try. If you are like me you have a long journey ahead with MJ and a couple/few weeks to see if you can find a better balance between suppression/side effects would be worth it. Unfortunately how your body is going to react to a lower dose is individual/unknown.

The trick will be what pen strengths to order while working out what dose is going to work best for you, and keeping options open to increase without waiting another month/for another pen if you lose suppression going back down.

Hopefully there will be someone else on the thread who has titrated back down and can share their actual experience.

Alternatively, if you don't get any joy with Voy, you could perhaps try calling another provider and tell them what has happened, the unsustainable side effects you are experiencing, that you want to leave Voy and use them (you don't need to place an order until you are sure you do actually want to change and are out of your Voy subscription) and see what they recommend as your next steps. I use Oushk and although I haven't had to call them personally their facebook fan club seem to say they are good at support when needed.

@WeAllHaveWings so kind to share all this

Super helpful 🙏🙏🙏🙏🙏

Weight loss is slow but steady here. Averaging about 1.5lbs a week (although that's definitely helped by my bigger losses at the start, probably 1lb a week ish now).

Christmas was so different to usual for me, I just didn't have the cravings that I normally have, I wasn't worried about having all of the 'what if I want this' snacks and I hardly touched what we did have in. I ate the sit down meals, had a small portion of dessert but the 'I'll eat this cos it's Christmas ' just wasn't there.

I decided to go up to a 7.5mg pen for my next dose and thinking I'll do not a full 7.5mg dose. My suppression is still pretty good on 5mg (3rd pen I think currently) and there are days where I really struggle to eat enough so I think 7.5mg might be too big a jump.

Wondering about doing an in the middle (so 6.25). I've read about counting clicks. Does anyone know how many that would be? And also - on the second time I use that pen - does it count the missing clicks to 60 and then I start at 0 for the rest of that dose each time or do I just do 4 doses of the number of clicks. I understand what I'm asking but that's a terrible explanation!