After a year on Mounjaro I feel bad-hypoglycaemia

[Delphinee]

I’m hoping to hear from anyone who’s taken Mounjaro— especially long-term users.

I started it about a year ago and, so far, I’ve lost around 28 kg which I’m really pleased about. However, over the past few weeks I’ve been having episodes of hypoglycaemia— dizziness, shakiness and feeling really off.

Has anyone else experienced this while on Mounjaro?
I was on 7.5 mg, reduced to 6 mg but now I am not injecting.

I don’t have diabetes but the lows feel quite scary at times, and I’m not sure whether it’s just the way the med is working or something I should be pushing more with my doctor.

All experiences, tips or thoughts gratefully received

I would definitely push it with your doctor, have you been diagnosed with hypoglycemia? There are other conditions that can cause similar symptoms, that definitely needs treating.

I have no experience of using mounjaro, but have done several weight cuts for sport and I get hyponatremia (low salt) which causes the same dizziness, heart palpitations, sweating and generally feeling of being really ill. Not saying that is what you have, but I would definitely push it with your Dr.

This is quite common, just keep some glucose tabs handy. Dextrose or similar, can get them off amazon. It does even itself out.

Quite common especially when you go up a dose.
I found electrolyte tabs help as well as low electrolytes can make you feel poorly too. Salt stick were the brand I used.

I had hyponatremia before which could add to tirzepatide. I make sure I have salt and I take electrolytes. I have CGM which i think shows lower results than Accuchek, but still I am at low levels but more importantly I feel really bad

I've had it and I get low blood pressure it was 110/60 checked by nurse 3 weeks ago, compared to pre mj high bp 145/92. The dizzy, light headed symptoms were especially when i got to bmi 25 or previously when i was bigger and didnt eat often, everything was worse when I got to normal bmi, I also had zero energy and just laying about when I wasn't working. When I was at bmi 25 I'd moved up to 15mg having previously been prediabetic and needing the higher doses as they wore off quickly, but suddenly the doses were super strong, could only eat 700-900 cals a day with forcing myself. Stayed on it a month and lost 6lbs and was like a zombie. Then I started dropping down the doses, 12.5mg 2 weeks was too strong, then moved to 10mg was ok first but then after a month too strong so went to 7.5mg but was snacking more so went again to 10mg but that was super strong. Best thing I did was move to wegovy, no dizzy spells or shaking and I'm still on low cals and losing weight but have bags more energy, sleeping better and have way less hair loss. Im now 9st 1.9lbs bmi 22.9 but wegovy 1.7mg is strong so I'll drop down. All I could suggest is drop down the doses or switch to wegovy esp if you're at maintenance as it doesn't have the GIP receptor agonist so it's less blood sugar reducing than mj which is what causes the symptoms. I still have some blood sugar control as I don't crave carbs or sweet foods. I'm no longer prediabetic either so makes sense why doses too strong for me.
Been on mj since Oct 24 then wegovy started 3 weeks ago

Thank you @Mysticmaiden! My symptoms are as yours. It has hit me totally unexpectedly, 7.5 mg was fine until all of the sudden it wasn’t. I skipped one injection, and either do 5 mg next week or, as you suggested, move to semaglutide.

I've also been on MJ a year and similar with the blood pressure, unsure about the blood sugars.

I had a NHS health check on MJ and they checked HB1AC, wonder if you could ask for tests. I found the GPs quite interested in the meds but maybe it depends on the GP.

Also speaking to the prescribing pharmacy could be helpful, some of them have GPs as well.

What are you eating? That’s the key here, not how many mg you take

Do you take any other medication, apart from electrolytes?

Since shedding 14 stone (on my own for the first couple of years, then helped by Mounjaro for the last 17 months) I've gradually needed to stop all my other diabetes and blood pressure medications, halve my dose of atorvastatin, and reduce my daily dose of levothyroxine to 200mcg after needing 350mcg every day since 1986.

So in my personal experience it hasn't been the mounjaro that has caused problems, instead it has resolved several chronic health problems, to the extent that the medications I'd been taking for decades started to cause problems, which included dizziness and general discombobulation. Which is why I'm taking the time to respond, in case it can remind someone else to check if their old prescriptions are still necessary after they've improved their general health.

It might be worth investing 50 quid in a continuous blood glucose monitor, that will last for 14 days and give you an insight into how your glucose levels vary. This is the one I get on prescription, they are normally quite reliable, (though nowhere near as exact as the finger prick glucose tests). https://www.pharmacyonline.co.uk/medications/freestyle-libre-two-plus-sensor/

Do you have one of those arm cuff monitors to test your blood pressure at home? Because dizziness can also be caused by low blood pressure. I had to stop taking amlodipine after losing the first 60kg, and just recently started feeling dizzy and a bit weird. Last month I did my biannual blood pressure test (7 consecutive days of testing 3 times each morning and evening, recording each result and calculating the averages for morning readings, evening readings and the week's average) the weekly average was 108/58 with 27 of the 42 diastolic readings below 60, a couple were below 50. I sent the week's readings to the GP and got a swift response telling me I no longer needed blood pressure medication and must stop taking the ramipril. A couple of weeks later I no longer feel dizzy.

I feel it would be a shame if people got the impression that mounjaro causes hypoglycemia, and were put off trying it as a result. It has been a miracle for me. I only wish it had been available back in 1990!

It also seems like a good opportunity to remind people that if you shed a ton of weight and completely overhaul your eating habits you might find the medications you've been taking for decades starting to cause problems, because they will still be working, attempting to solve problems you no longer have and causing new ones you might not have expected.

On Mounjaro I can fast between 4pm and 11am every day, and have had no hypos at all since stopping all the other diabetes drugs. It's not possible to fast for 19 hours if you are on a slow release daily insulin injection, or taking empagliflozin to flush extra sugar out your kidneys.

They can be really scary! I’ve been on mj over a year, but got mine at the beginning of the journey. I kept waking up in the night sweating, shaking and feeling faint. As others have said, the best thing has been carrying glucose tabs, having electrolytes, and I started having more sugar (sugar in my tea, a biscuit or two) and it helped a lot. I’ve found I can still get around shot day, but mainly if I’m going up a dose now

@stealthsquirrelnutkin , yes, I do have Abbott’s CGM (Libre 2), and since in non diabetic it may not bee too accurate also Accuchek. My blood pressure is ok, and I’m not on any other medications. I am really surprised that it hit me after a year, especially that I had almost no adverse events before.
It could be, when there is more post marketing data, labelling will be updated with hypoglycaemia in non-diabetic as an AE, obviously after causality assessment.