Why some people only need 2.5mg.and others need 15mg

[WaterInMajorca]

Just wondered if any knows, or has any thoughts on, why some people get great suppression on 2.5mg, while others don't get it til 15mg? Why some have side effects and others don't?

I've heard a few theories but not sure I agree.

I'm asking as someone who is on 10mg and has no side effects so far. 2.5mg was like a placebo or sugar sweet for me. I'm the same with other meds too - paracetamol may as well be a polo mint or tic tac. If I have a headache I need the powerful stuff!

Why are.some.bodies less responsive to.lower doses of mj, do you think?

It is interesting, I started with a high bmi and shot up the doses thinking I'd be someone it just doesn't work for. 12.5mg hit me like a train, cannot finish a small meal. Just ordered my 3rd 12.5 pen.

I think I'm getting withdrawl symptoms when it wears off, less stable, more anxious, ravenous and crave carbs, which all calms down with my next jab! Doesn't bode well for the future and I definitely have concerns when I will try to taper off. I have 12lbs left to hit my target. What about you?

In response to other comments, I started at bmi 32.4, I have diabetes in family so definitely need more insulin and so can tolerate a higher dose, as we have lower levels than a standard person. I have also been a slow loser, only 1lb a week even with a strict calorie deficit. Are others on a higher dose and insulin resistant also slow losers?? Most of it was diet related earlier on and now the losses are more consistent and often on the higer dose.
I also get vivid dreams, sometimes scary ones too!

I wasn't surprised that my body seems to get used to the dose after two/three weeks. I seem to take a fair bit of knocking out/numbing with sedation, local and general anaesthesia, compared to my height and weight. Nope, still awake. Nope, can still feel that. Yep, can still eat that. 😅

I also didn't feel much on 2.5mg. 5mg worked for a few weeks then I was ready for 7.5mg and so on... I am now on 15mg and maintaining here for about 6+ months. It does mostly work still so I'm thankful for that. I'm not losing anymore though but this is ok as I have mostly reached goal.

I am not sure why I have had to titrate up every month. As someone else mentioned not having any effect from codine, I've always been the same. It never had any effect on me. I used to suffer with sciatica and if I needed pain killers I would ask for tramadol and would need a high dose as the prescribed amount didn't do anything.

Perhaps it is insulin resistance. A lot of people in my family had type 2 diabetes. I suspect I wouldn't have been far off getting it myself if I didn't have an MJ intervention.

Would be interesting if they do research into this!

I guess like others say that some people are more sensitive, it’s a medication like any other. When my mum was alive there were so many medications she couldn’t tolerate including paracetamol. If she’d had the jabs I imagine she’d have felt really sick on 2.5mg. Maybe some people have a weaker liver? No idea

I'm staying on a low dose and don't get side effects, so I don't think that really fits with the theory that those who don't get side effects need higher doses.

It's quite deliberate on my part to take the lowest possible dose and avoid side effects. Some people seem to chase complete appetite loss and let the drugs do all the work for them, rather than using it as a booster to stick to a healthy eating plan.

For context, I have for decades, cooked from scratch, had good knowledge about what is healthy etc, but gain weight easily and have a tendency to eat too much and have too many treats. I have never been an emotional eater, I have never binged and I have always exercised well. While my weight would go up and down within certain parameters, since hitting peri menopause my appetite has been uncontrollable with really strong cravings for sweet food and perhaps with reduced metabolism as well, I put on an extra stone on top of my usual upper weight limit. Size 16 clothes were getting tight!! That was the worst I had been in my life. It was clearly hormonal. I has hoped HRT would settle things, but it didn't change my appetite/cravings. A low dose of MJ seems to be the magic missing ingredient, along with HRT to restore normality for me. I was given a Lindt bunny last night. I have worked from home all day and not touched it until about half an hour ago, where I carefully weighed out 30g to have with a decaf coffee. I really enjoyed it, but had no desire to eat any more, indeed, the 30g portion seemed perhaps slightly too large and next time I will have less. I get hungry at meal times, I get really hungry when I do back to back body pump and an hour's swim. I want that to happen. I should feel hungry after all that exercise!!

Are you me @PurpleCoo ?! Very similar history and experience (except hrt)

Honestly thought I'd be one to stay on lower doses for as long as possible but I'm on 7.5 and everytime by dose 3 I'm back to my old ways. Never had any symptoms. Tbh I've been the same with recreational drugs and alcohol need a lot to feel anything. So annoying 🫠

@PurpleCoo ah , you are me!!! Except I dont have a sweet tooth at all

Interestingly I’ve gone back up to 5 after a month on 2.5 (titrating down). 2.5 felt pointless to me, but having been on that lower dose for 5 weeks the 5 has given me huge suppression again, which it hadn’t been for last few months. Funny business.

This is so interesting! I started a thread similar to this tonight. Started at 32 BMI, no real suppression, am now on the maximum dose and starting to put on weight!! I went down to 28.5, now 29 as I’ve been craving sugar and I have never had a sweet tooth before. It’s taken nearly 9m to lose 10kg and now I’m slowly putting it back on again. I’ve not had any side effects either throughout.

It's always nice to hear about people with similar experiences 😀

I’m jealous!! I ate two the other night despite being on a high dose and have never in my life craved sugary chocolate. My previous healthy eating (albeit eating too much), has gone out the window since I’ve been taking this and all I want it salt, sugar, fat, carbs. I’ve completely gone off vegetables but am trying to force some down each day before I eat anything else.

It's interesting. I get bad headaches and migraines. Codeine doesn't work for me either, nor do most over the counter meds like migraleve. I reckon even the whole bottle of paracetamol wouldn't do much for me!

Also find this a really interesting conversation.
Have got insulin resistant PCOS and MJ has provided me what my body has been missing all along.
I’ve tried to keep to the lowest dose possible to enable me to eat but not really crave things, I’m on month 6 and on my second 10mg pen, also did 2 months on 7.5mg. Have some reservations about going up again, what happens when my body adjusts to the 15mg and it stops having an effect?
I mean I’m in it for the long haul, kind of curious to see what happens. I’ve lost a staggering quarter of my starting weight and am .2 away from being a healthy bmi. It’s been so good to let me focus my mind on eating whole foods and getting really good nutrition in. I’ve enjoyed every step. Only
side effects have really been feeling freezing (not uncommon for me) and some hair loss.
I think in order to maintain my weight I need to be on this forever in some way.

Gosh, that sounds like a really unusual response and the opposite of what it's supposed to be. I only seem to want 'clean' food and got super excited yesterday when I remembered I had a homemade cauliflower, sweet potato and spinach dhal I made and froze. I'm not even veggie, but I'm just so into veg and pulses right now, and also plain nuts from the whole foods section. The thought of eating a gooey chocolate brownie really turns my stomach. I'm on day 7 of my current injection as well.

If you are on a high dose, it's not even that you aren't at a therapeutic dose yet... It doesn't sound like it is working for you sadly. Strange how we are so different (people in general I mean)

Gosh, that sounds like a really unusual response and the opposite of what it's supposed to be. I only seem to want 'clean' food and got super excited yesterday when I remembered I had a homemade cauliflower, sweet potato and spinach dhal I made and froze. I'm not even veggie, but I'm just so into veg and pulses right now, and also plain nuts from the whole foods section. The thought of eating a gooey chocolate brownie really turns my stomach. I'm on day 7 of my current injection as well

I would say that far from Atarins response being the opposite of what it’s supposed to be (according to you) her response to MJ is actually more real/common than the one you’ve had to the MJ (which is very similar to mine).

Re the chocolate brownies/easter bunnies etc - the WLI boards are full of posts where posters mention still craving sweet things but in my mind that’s where the lifestyle changes we need to put in place with these medications come into play, and we start learning how to deal with the craving for when we’re no longer on the medication.

If you are on a high dose, it's not even that you aren't at a therapeutic dose yet... It doesn't sound like it is working for you sadly. Strange how we are so different (people in general I mean)

You have absolutely no right (and no basis) to decide if the medication is working for someone or not and did you deliberately set out to come across as being so superior when you share your experience of Mounjaro?

@Weepixie - I think you are over reacting here. @PurpleCoo was only trying to be thoughtful and sympathetic, and pointing out how we all respond differently. Your last para was pretty confrontational when no offence was originally intended.

Apart from that it’s been an interesting thread …

I can’t tolerate more than 2.5mg, been on it for 12 weeks and lost 25lbs. Had to have a week off after three weeks of 3.75mg, it made me really unwell. BMI 32, was 36 when I started.

The lack of effect for me could have something to do with me having historically low blood sugar? Possibly this is making crave the sugar at the moment. I have a high tolerance for painkillers (paracetamol has little effect), I also tolerate alcohol a bit too well.

It is very frustrating and consoling that others are experiencing similar things too, you usually only hear about the success stories.

@KindaFruita I apologise if you read my post as confrontational, that was absolutely not my intention. I was also trying to be thoughtful and considerate and point out how we all respond differently. Reading back this morning, I now realise how it could have been misconstrued. I obviously didn't mean the medication isn't working for you full stop... You wouldn't have been on it for so long if it wasn't!! I meant it's not working in stopping the cravings for sweet things specifically like it is working to do that for me 🤦‍♀️ Which is the context of the conversation we were having.

@weepixie I also apologise if you took my post the wrong way. I disagree that I think I am superior... I have no control how I respond to the medication... I have explained to KindaFruta what my intended message was.

In fairness I like all food 🤦‍♀️😂🤣

I wish I liked food less, it's what got me here in the first place. Cakes were my downfall though.

There is...you don't draw the full 2.5mg. So instead of doing 60 clicks to get 2.5mg, do 30 clicks and draw 1.25mg

Or indeed, 24 clicks to get 1mg if that’s what the person wants, so you would get 5 x 1mg doses out of 2 x 2.5mg pens or 10 doses out of a box of 4 pens (think 4 pens per box?).

I'm so glad I’ve seen this thread. I thought it was just me. I’ve lost nothing in the last 6 weeks of mounjaro (started at 2.5ml, now on 5ml)
No side effects, appetite still the same, zero weight loss. I was on the verge of giving up.