Thread 2 because we have reached our goal weights and we want to maintain not regain. We might be going cold turkey or titrating down or staying on!

[MargoLivebetter]

Can't believe we filled up a whole thread! Welcome to thread 2.

On a positive note to start us off, I've lost 1lb of the two that I gained from my autumnal apple crumble caper. Filling full of resolve and pleased to know I can gain a pound or two (which is of course completely normal) and then lose them again.

Can you please let me know which pharmacies offer pens upto a year without a fee? I didn't think there were any that went up to a year so that's good to know!

Of course they know or at least very strongly suspect! You’ve lost 8 stone in 18 months!

Thanks @MargoLivebetter that's encouraging to hear. I'll use my remaining 7.5 and one of my two 5mg to come off slowly, lowering the dose and maybe lengthening the time between shots. I may keep my remaining pen in reserve as insurance!

@Mysticmaiden The ones I know about are Swift Dr and Pharmulous but there may be others. Simple Online Pharmacy offer 3 months but that’s not great for me because of the pens I need to use up.

I think that sounds eminently sensible @KenIsAnAccessory and if at any point you want to change your strategy you can.
I have recently started doing something quite similar, 8 day gap last time and my next dose due 9 days after the last one.
on day 7 onwards I do get a bit hungry about now, 5pm. So am planning healthy snack of fruit and yoghurt on those days. Meal sizes remaining the same.

Hi, looking for advise. I've read about someone taking 10mg from a 12.5mg pen and thinking to take 7.5mg from the pen next time. How are people doing this? I thought you turn the pen to the 1 in the window and inject until the pen's back to NIL.

I may extend the period of taking the jabs, maybe skip a week - take each fortnight..... just to keep going a bit and having the pen last longer.
It is now very expensive and I've done OK over the last 3 months just don't want to go back the other way.

Hi @loulourip
To get a smaller dose than the pen usually dispenses, you need to count the clicks.
As you pull out the plunger it clicks, and it will click 60 times until you get to the 1, that is a full dose.
So to choose a different dose you need to work out how many clicks to count.

I have always found this chart helpful as it tells you with each sized pen, how many clicks to count for a given dose (It also tells you how much to draw up into a syringe if you are doing it that way instead)

https://monj.co.uk/monj-mounjaro-click-chart/

@loulourip You don’t have to turn it all the way to 1, you can just go part of the way and count the clicks to give you the dose you want.

60 clicks is the full dose, so 12.5mg in this case

For 10mg you would do 48 clicks
For 7.5mg you would do 36 clicks

To figure out the number of clicks:

the dose you want
divided by
the full dose of the pen
multiplied by 60

10 / 12.5 x 60 = 48
7.5 / 12.5 x 60 = 36

You can get more than the standard dose that way too.

Say you wanted to get 15mg out of a 12.5mg pen, it will only click 60 times to give you 12.5mg. So do that. Then you need another 2.5mg to make it up to 15mg.

2.5 / 12.5 x 60 = 12

So change the needle, count 12 clicks and inject. This will give you 2.5mg to top you up from 12.5mg to 15mg.

That's helpful to know :) Thanks

Place marking as I am on maintenance.

Welcome @Azuresky68 - good to see you here. 😀

Can I join? I was on MJ for almost a year, lost 5 stone, have now been off it totally for 2 weeks after slowly going back down the doses.
Definitely felt nervous coming off it, my appetite started to come back as I got down to the lower doses. So far so good though. Although I’m a couple of lbs more than I was at my lowest I did get down to just below my target weight to give me wiggle room. And incredibly I’m the same weight as I was 2 weeks ago.
I feel so much better being slimmer though so hopefully that’s enough to keep me motivated. My blood pressure is much lower.
I really wanted to find out how I do without it. Definitely scary though!

Welcome @Goldstarlight and congratulations on your 5 stone loss and your final exit from MJ. Sounds like maintenance is going great too. Fantastic news 😀

Hellooooooo

Now at goal (I think) as I’m 8 stone 6 at 5 foot 4, which is something I never thought I’d see again.

I have just done my 4th dose on my first 12.5 pen and have a 12.5, a10, a 7.5 and a 5 in the fridge for titrating down.

I honestly have no idea how I’m going to do it. Reduce dose each month? Push for longer than 7 days between jabs, take less from each pen (10 from the 12.5 for example).

I feel like I need someone to just tell me exactly what to do.

Hello @Claudette7934 ! It is all go on here today. Congratulations on getting to your goal. You must be really pleased. You can try various ways and see how you go. You've got loads of MJ left, so you can just pace yourself and not worry. Maybe start either cutting down slowly or extending the days and see how that feels. If you still feel well controlled but able to eat enough not to keep on losing, then stay there for a bit until you feel ready to either extend some more or reduce. You can take it at your own pace and just see how you go. If you get stuck, shout on here, as there is bound to be someone who has run into a similar issue. 😀

NB user name should really be ANOTHER 20 bloody pounds! Be reassured I was not taking MJ when I was only 20 lbs overweight!

@tinyemmy I'm exactly the same as you with the doses, and with the secret jabbing!

@Fromthesidelines re hair loss. My fine hair has now got thin and fine and a bit sparse, especially in some places [ahem!] . I hope that when I eventually stop MJ the follicles will still be there and there will be regrowth. But my nails are fine and fabulous, so I don't think it a general collagen / biotin problem. Maybe it is a specific MJ hair loss thing?

@MargoLivebetter I think one of the most fascinating (anecdotal) things about this whole collective experience is how we have each taken control of our own sitution and journey. As we started and then increased doses, we've individually adjusted doses according to side effects, and according to the level of suppression and weight loss, and in response to live events such as holidays or birthday meals when we wanted a little more appetite. Some of us have never gone beyond 5mg, others didn't experience much suppression until 10mg or beyond. It's the same with titrating down. There are remarkably few of us who have followed the clinical trial protocols to the exact letter (including most of us taking the bonus dose or using a pen beyond 30 days). I wonder whether having private prescriptions (and paying for them) gives us more feeling of agency and control then when something is dispensed by a GP with a firm directive of x amount y times per day.... ?? Interesting.

@Witchyandtwitchy @RightImDoingThis @MagnoliaTreePetals interesting about set points... I've never found much scientific evidence that a body set point exists. I think when we're losing weight we sometimes 'settle' for a bit, but for me, that also seems to co-incide with other changes happening, so I go weeks without losing weight but my body composition changes and my measurement change - sort of like it is catching up. However, I do think that our metabolism can have a 'set-expectation'. So it's not that our body wants to be a certain weight, but more that our metabolism has an expectation of when it will be fed and what it will be fed. Our gut microbiome, in particular, has an influence on this. The sugar loving bacteria shout out loud for sugar (because that is what keeps them fed) maybe that's what has previously stopped us from being able to maintain a stable weight? Being on MJ, AND changing what we eat, changes the balance of bacteria, so the sugar demanding noise is reduced. I've got all fingers crossed that careful management of how I come off MJ, plus a year good eating habits ingrained, has changed my gut microbiome and will ensure that I CAN manage the expectation (craving) of what I eat, how I eat and when I eat, for the long term.

Also, re diabetes / pre-diabetes (I can't remember who was posting about it). I think mine has reversed, but then that's when I also was actually sick (on a dose of 5mg).

I'm back down to 2.5mg, stretching out the doses 8 days, 9 days, 10 days. Then I plan to try one month on and one month off. I think that way I will get a better sense of appetite returning and how I control it, with the safety net of a month of a low dose of MJ if there has been sustained weight increase.

Hi I decided to start tapering down from 15mg to 12.5, then 12, then taken 10.5 on Saturday morning. I did it this way because 15 was far too strong suppression for me and I could barely eat 700-900 cals a day for the full 5 doses, I was even silly enough to take the bonus on the 15, which equated to 17mg, had nausea, exhaustion, lethargy, luckily no GI side effects, just layed about like a zombie, didn't want to do anything and moody.
Anyway i had another 15mg in fridge that my prescriber said to take every 10 days, well i wasnt going to do that because I felt terrible on the first pen, so instead I counted clicks to take 12.5 and was going to stick to that all month and was expecting lots of hunger at the end of the week, because I went up for that reason, but I was still super full and tired and not eating much, so next week did 12, again too strong, then tried 10.5..it's still strong and today im 5 days after jabbing and just managed 1300 cals.
Last few days it's been 1100 a day even with doing 5hrs DIY over last 2 days and regular exercise since last week.
I also have 2 x 10mg pens in fridge, hoping to go down to a low dose at least maybe 5mg but may just come off complete because I've had lethargy and feeling cold since day 1 and I'm bmi 23.9 now so don't need to stay on it. I was prediabetic when I started so there is that worry.
I've seen podcasts which all say tapering down yields better maintenance results than going cold turkey and my prescriber advised to go down slowly.
If I was you and didn't want to lose anymore, I'd use the 12.5 to go down to 10, it's 48 clicks and you can get 6 doses if you use the bonus dose. Then go down further with the remaining pens with counting clicks.
If you are happy with 12.5 for now and the suppression, use that pen up first and stay on it then go down. You could extend the days, but several pharmacies advise to do this only on the lower doses 5 and below, no idea why!

I think the set point relates to habits. If you go on a diet and then go back to how you were eating pre-diet then you will go back to the previous weight. If you spend a period of time cementing new habits so that you can maintain the weight then you have moved your set point. I am hoping that spending time at this weight with this habit will mean I know how to eat and it becomes habitual and then maybe eventually I will come off mj but retain the habits. That said I think there is more to mj and my helps the body work better so it might be that I need to eat less / differently when not on mj

Interesting pharmolous do. I found them very quick as a new customer

so they will let you go back on 2.5 with a low bmi up to a year ?

@MagnoliaTreePetals just to say that I really didn't want to say anything against the professional advice you are getting, and I 100% agree that practically the advice is the right way to go, to taper down, AND to develop good habits, and for your body to adjust itself.

Yes - this is what they said to me:

“We support long term maintenance on Mounjaro with no abrupt BMI cut off as long as the medication continues to be effective in maintaining the weight and safe in ensuring the BMI doesn't dip into below 20.

Our maintenance approach is personalised to the patient and aims to put the patient on the lowest effective dose with regular support and guidance. Once the individual reaches their goal weight, we would recommend tapering down in steps of 2.5mg until reaching a dose that is effective in maintaining the weight without causing further weight loss. The plan is flexible and you can move up or down in steps on 2.5mg each time, if necessary.

We allow our patients to resume the medication after stopping for a period of up 12 months. As long at the information is communicated and documented in their notes, there won't be a requirement to meet the original BMI of 30 or higher.”

Pharmulous here I come! I will be trying to get that message in writing from them and then might give no Mounjaro a whirl.

re hair I read that ferritin of under 80 can cause hair loss. I think I have lost about half the circumference of my pony tail. My ferritin was measured at 75 so I started on 2 x 210mg of ferrous fumerate a day plus an over 50s multivitamin and high dose B12 and vitamin D. I started feeling less tired after two weeks, in three months I got my ferritin up to 125 and I seem to have a lot of short hairs starting to grow back. I got the iron tablets over the counter from my pharmacist- each tablet is about 5 times stronger than what you would get in a multivitamin.