Slow titrating & sub dosing chat/support

[SubDoser]

Thought it would be good to have a specific thread for those of us who are using sub doses to titrate more slowly than average due to managing side effects (or simply preference). If there is already a thread going though please point me in the right direction!

Just been reading through my symptoms on my spreadsheet. I first got sulfur burps (mild) in week 6 - and varying gastro problems for two months after that (worst on bolded weeks - first was diarrhoea that lasted a full week and second was horrible gas - bad sulfur burps - only relieved by vomiting & diarrhoea, thankfully that didn't last the full week. It was really bad one night though). Injection site rash started in week 9 and continued for ten weeks. I remember being over suppressed in week 14 when in London for a concert and had to be super careful to avoid being ill (that was after I had dropped down a bit too).

Haven't had any sulfur burps or injection site rashes for several months now - downside to that is little weight loss too, of course. Those first six weeks were blissful really - felt fine and losing weight...

What week are you on @JunoRoma ?

Yes, I have extra pens @Swissrollover - I've taken two doses out of current pens and have two in my fridge. I also always keep pens refrigerated, even after opening. I wouldn't go out of my way to waste money but I'm not overly concerned that being ahead with pens has meant my ordering has been wrong for max financial efficiency! I will get max four doses out of current pen (may need to top up 4th dose with next pen) and I've discarded out of every pen except for the first and last pen. I won't go past 30 days before discarding.

I'll just have to see how it goes! So Friday I was super suppressed and Saturday and today pretty much back to usual suppression, I think. Definitely sticking at 10 mg though next week though and definitely sticking with no alcohol and actively trying to lose weight rather than just relying on suppression being enough to do all the work.

Think I've just convinced myself to go for a swim for the first time in a long time!

@SubDoserII this is week 17, and is the first time I had experienced any of these symptoms since starting Mounjaro (sharp pains in upper abdomen, horrible-tasting burps, watery stools).

How has this week been for you @JunoRoma ?

@SubDoserII thank you for remembering.

I reduced from 5mg to 4.4mg but sadly another episode of gastric distress started yesterday evening and continued through the night into this morning. The symptoms were a bit milder than last time but I still didn't get much sleep.

I'm going to reduce to 3.75mg next week.

Sorry to hear that @JunoRoma 🙁

Hope that dropping down to 3.75 mg works for you next week and you can get back to a smoother MJ journey soon.

Pen 1 (2.5 mg) - 2.5, 2.5, 2.5, 2.5, 3.2
Pen 2 (5.0 mg) - 4.2, 4.2, 4.6, 2.5, 4.2
Pen 3 (5.0 mg) - 4.2, 4.4, 3.3, 3.75, 3.75
Pen 4 (5.0 mg) - 3.75, 4.2, 4.2, 4.2, 4.2
Pen 5 (5.0 mg) - 4.2, 4.5, 4.6, 4.6, 4.6
Pen 6 (5.0 mg) - 4.6, 5.0, 5.0, 5.0, 5.0
Pen 7 (5.0 mg) - 5.8, 5.8, 6.3, 6.7
Pen 8 (7.5 mg) - 6.9, 7.5, 7.5, 8.1, 8.8
Pen 9 (7.5 mg) - 9.5, 10.0, 10.0, 10.0
Pen 10 (10.0 mg) - 10.0
Pen 11 (12.5 mg) -

It is quite nice to be taking a standard dose out of the correct pen! Still losing weight and happy where I am for now.

Hope everyone else is doing ok?

@SubDoserII I'm glad 10mg is suiting you.
I had to reduce from 5mg to 4.4mg but have managed to stick with 4.4mg for a couple of weeks now with no adverse effects.

Thanks @JunoRoma - glad that you've found a dose that is working for you too!

I went up by my biggest increment so far (0.5 full dose/1.2 mg) (but not as a percentage increase) on Thursday, with no issues, so far at least.10 mg isn't high enough now. Makes me wonder if I am now fine to go up by a full dose, as standard but I'm not prepared to risk that so I guess it is a moot point.

I'm a couple of pens ahead with my ordering and the cost is the same for 12.5/15.0 mg so I've swapped to ordering 15 mg from now on.

Pen 1 (2.5 mg) - 2.5, 2.5, 2.5, 2.5, 3.2 (5)(5)
Pen 2 (5.0 mg) - 4.2, 4.2, 4.6, 2.5, 4.2 (5)(10)
Pen 3 (5.0 mg) - 4.2, 4.4, 3.3, 3.75, 3.75 (5)(15)
Pen 4 (5.0 mg) - 3.75, 4.2, 4.2, 4.2, 4.2 (5)(20)
Pen 5 (5.0 mg) - 4.2, 4.5, 4.6, 4.6, 4.6 (5)(25)
Pen 6 (5.0 mg) - 4.6, 5.0, 5.0, 5.0, 5.0 (5)(30)
Pen 7 (5.0 mg) - 5.8, 5.8, 6.3, 6.7 (4)(34)
Pen 8 (7.5 mg) - 6.9, 7.5, 7.5, 8.1, 8.8 (5)(39)
Pen 9 (7.5 mg) - 9.5, 10.0, 10.0, 10.0 (4)(43)
Pen 10 (10.0 mg) - 10.0, 10.0, 10.0, 11.2
Pen 11 (12.5 mg) -
Pen 12 (15.0 mg) -

Hope everyone else is getting on ok?

Could I ask a question please
I have a 2.5mg which is no 3 for me , felt no need to increase until now
Would like to increase to the 3.75 and then order my next pen at 5mg
How many clicks would that be for my 2.5 pen please , thanks all

Clicks = (desired dose/standard pen dose) x 60
Clicks = (3.75/2.5) x 60 = 90 clicks (0.9 ml) of a 2.5 mg pen for a 3.75 mg dose

Many thanks @SubDoserII

In my fourth week on 5mg I developed unpleasant gastric side effects so I reduced the dose to 4.4mg, which resolved the issue.

In the fourth and fifth week on the reduced dose of 4.4mg I was finding it less effective (less satiety, getting hungry sooner after meals) so this evening I've increased to 5mg again. I'm really hoping the side effects don't return. 🤞🏻

How are you getting on @JunoRoma ? Hopefully well this time on 5 mg?

Pen 1 (2.5 mg) - 2.5, 2.5, 2.5, 2.5, 3.2 (5)(5)
Pen 2 (5.0 mg) - 4.2, 4.2, 4.6, 2.5, 4.2 (5)(10)
Pen 3 (5.0 mg) - 4.2, 4.4, 3.3, 3.75, 3.75 (5)(15)
Pen 4 (5.0 mg) - 3.75, 4.2, 4.2, 4.2, 4.2 (5)(20)
Pen 5 (5.0 mg) - 4.2, 4.5, 4.6, 4.6, 4.6 (5)(25)
Pen 6 (5.0 mg) - 4.6, 5.0, 5.0, 5.0, 5.0 (5)(30)
Pen 7 (5.0 mg) - 5.8, 5.8, 6.3, 6.7 (4)(34)
Pen 8 (7.5 mg) - 6.9, 7.5, 7.5, 8.1, 8.8 (5)(39)
Pen 9 (7.5 mg) - 9.5, 10.0, 10.0, 10.0 (4)(43)
Pen 10 (10.0 mg) - 10.0, 10.0, 10.0, 11.2, 10.7 (5)(48)
Pen 11 (12.5 mg) -
Pen 12 (15.0 mg) -

I took 10.7 mg this evening - simply because I only had 0.64 ml left in my 10 mg pen. I could top up using the 12.5 mg but decided against that. I did consider just trying going straight up to 12.5 mg. Clearly didn't though and went the other way!

Suppression not great still, but I don't want it to be too great (even if I'm not ill). It is such a fine balancing act. I think I do need to go up to 12.5 mg. Maybe next week I'll be brave and try it. More than that though I need to sort out my food organisation and prep. Still one step forward one step back on that. Frustrated with myself.

@SubDoserII Second attempt at 5mg is going fine so far but it's early days. Last time the side effects started in the fourth week on that dose. I'm planning to be quite careful about hydration and food choices for the next four weeks while the 5mg dose levels stabilise.

Will you take a full dose from the 12.5mg pen next week or titrate up more gradually? Perhaps at higher doses this might be less crucial, as the relative increase of the dose (in % terms) becomes smaller?

I think I’ll go straight up to 12.5 mg now, next week. Unless something changes this week. I could definitely do with being more cautious with what I eat in preparation - a bit of fear might be the push I need!

That was what I was thinking - the % rise is less now.

I’ve got too used to maintaining now rather than losing. How is your weight loss going @JunoRoma ?

I've lost steadily over the past 6 months, between 0.5kg and 1kg per week. I'd like to lose another 5kg.

Hey can someone help me please. I’ve order a MJ pen at 2.5mg I’m wanting to micro dose as I have a massive fear of being sick. How would I just start with 0.75mg?

Sorry I mean 1.25

Clicks = (desired dose/standard pen dose) x 60
Clicks = (0.75/2.5) x 60 = 18 clicks (0.18 ml) of a 2.5 mg pen for a 0.75 mg dose
Clicks = (1.25/2.5) x 60 = 30 clicks (0.30 ml) of a 2.5 mg pen for a 1.25 mg dose

That's great!

Hey lovely thanks so much for this!! I inject 0.75 this morning I’m just terrified of the sickness so felt the best way for me! Does anyone know if I could inject it again on Wednesday if I’m feeling ok? So it would be 1.5 for the week?

I think you'll be fine trying that @CaitlinRo - as you're well below the first standard dose anyway. The official line is no though, of course.

Half life is about 5 days. You may want to try a GLP-1 plotter.

https://glp1plotter.com/

This one is free (but you cannot keep your data, as no account) or you could get the Shotsy app and record everything in there and keep a record.

I've put on three graphs for you - 0.75 mg and then nothing for week, 0.75 mg and then another 0.75 mg on day 4, 1.5 mg and then nothing for the week - to compare max dose in system.

Pen 1 (2.5 mg) - 2.5, 2.5, 2.5, 2.5, 3.2 (5)(5)
Pen 2 (5.0 mg) - 4.2, 4.2, 4.6, 2.5, 4.2 (5)(10)
Pen 3 (5.0 mg) - 4.2, 4.4, 3.3, 3.75, 3.75 (5)(15)
Pen 4 (5.0 mg) - 3.75, 4.2, 4.2, 4.2, 4.2 (5)(20)
Pen 5 (5.0 mg) - 4.2, 4.5, 4.6, 4.6, 4.6 (5)(25)
Pen 6 (5.0 mg) - 4.6, 5.0, 5.0, 5.0, 5.0 (5)(30)
Pen 7 (5.0 mg) - 5.8, 5.8, 6.3, 6.7 (4)(34)
Pen 8 (7.5 mg) - 6.9, 7.5, 7.5, 8.1, 8.8 (5)(39)
Pen 9 (7.5 mg) - 9.5, 10.0, 10.0, 10.0 (4)(43)
Pen 10 (10.0 mg) - 10.0, 10.0, 10.0, 11.2, 10.7 (5)(48)
Pen 11 (12.5 mg) - 12.5
Pen 12 (15.0 mg) -

Gone up to 12.5 mg now, biggest increase in terms on mg (but obviously not % increase). Presuming it is ok, next increase will be to 13.75 mg (in at least 4 weeks time). I doubt I will be brave enough to go straight up to 15 mg when the time comes, even though I would like to test that I am ok with a standard increase of 2.5 mg ...to prove that I only really needed to sub dose at the start of the journey.

Now to get a proper grip with diet and exercise and get out of maintenance mode and back into weight loss mode.

Pen 1 (2.5 mg) - 2.5, 2.5, 2.5, 2.5, 3.2 (5)(5)
Pen 2 (5.0 mg) - 4.2, 4.2, 4.6, 2.5, 4.2 (5)(10)
Pen 3 (5.0 mg) - 4.2, 4.4, 3.3, 3.75, 3.75 (5)(15)
Pen 4 (5.0 mg) - 3.75, 4.2, 4.2, 4.2, 4.2 (5)(20)
Pen 5 (5.0 mg) - 4.2, 4.5, 4.6, 4.6, 4.6 (5)(25)
Pen 6 (5.0 mg) - 4.6, 5.0, 5.0, 5.0, 5.0 (5)(30)
Pen 7 (5.0 mg) - 5.8, 5.8, 6.3, 6.7 (4)(34)
Pen 8 (7.5 mg) - 6.9, 7.5, 7.5, 8.1, 8.8 (5)(39)
Pen 9 (7.5 mg) - 9.5, 10.0, 10.0, 10.0 (4)(43)
Pen 10 (10.0 mg) - 10.0, 10.0, 10.0, 11.2, 10.7 (5)(48)
Pen 11 (12.5 mg) - 12.5, 12.5, 12.5 (3)(51)
Pen 12 (15.0 mg) -
Pen 13 (15.0 mg) -

Noticing after this third dose of 12.5 mg that is it working more. I had a couple of glasses of wine last night (took dose mid afternoon) and a full dinner and some cherries and chocolate after dinner. Got quite burpy when I went to bed and ended up vomiting what must've been most of my dinner. Definitely didn't feel really ill like I have done before when I've vomited, so it was a mild warning but even so - just what I needed - a kick up the arse in terms of what I am eating & drinking.
This morning I couldn't finish my breakfast.
I was going to go up to 13.75 mg after four doses on 12.5 mg but doubt I will now. We'll see!