Mounjaro and blood-sugar crashes - anyone else had this?

[SecretNameforMN]

I have a huge amount of weight to lose, and took my first 2.5 Mounjaro jab 9 days ago. (I am not diabetic and take no medication.) Two hours afterwards I was plunged into a massive "hypo" crash, followed by a fit of uncontrollable trembling, blurred vision, confusion, and most frightening of all, an overwhelming feeling of sheer panic, which, I was later told, was caused by my body releasing a massive amount of adrenaline in response to the rapid and massive drop in blood-glucose. This lasted 3 hours!

After that, for the next six days, every time I ate a meal I reacted the same way. The shaking fits combined with a panic attack lasted between 3 and 5 hours. Five days after the jab I had an attack that lasted a horrific 17 hours. I was nearly out of my mind with distress caused by the adrenaline coursing through me uncontrollably. Afterwards I felt completely depleted and exhausted like never before.

I phoned the clinic who supplied it, and was told a pharmacist would call me back but he never did. I then got an emergency appt with my GP who explained that it was a known side-effect, and is listed online under the Mounjaro side effects list. There was no antidote so she put me on Valium to stop the shakes and I had to use Rescue Remedy as well. It was a week of hell during which I was unable to function, just spent the whole time managing the violent reaction. Needless to say, the pen went straight in the bin.

I was just wondering if anyone else on here had experienced the same thing, or am I totally unique?

I can feel a bit trembly if I haven’t eaten in a while but that’s quite a normal bodily reaction. I had dinner last night that I finished around 9pm, went for a walk and a swim this morning and hadn’t eaten until 12:30.
i usually eat at 1 and then 8ish but i was feeling a bit like I needed something at 12 so made an early lunch. I wasn’t feeling hungry but knew my body needed it.
The reaction you had was extreme and I don’t think I’ve heard about anyone else having such an extreme experience. Glad you’re feeling better now, WLI are definitely not for everyone in the same case as all other medications, they will always have side effects in some people.
Beat of luck with your weight loss journey going forwards, there are keto threads on here if you’re not already following them.

She only gave me a week's worth, so I would have to go back to her and get another week if it carried on - which it hasn't.

It's put me right off any WLI. I am going to do without and just stick to keto, which blunts the appetite just the same. I just wanted to lose faster.

Have you been prescribed Valium before?

Is there a history of anxiety?

This is timely. I’ve been on Mounjaro for 14 months have lost almost 6 stone and at target so I’m titrating down. I’m now on 5mg after coming down from 10mg to 7.5 mg etc.

Friday at 4am I had the most horrific panic attack (not something I’ve had before so it was scary) and ended up calling NHS 111 option 2. I was then called by my GP Surgery that morning who made me an appointment for that afternoon, I’ve been prescribed sertraline and have been signed off work for 4 weeks with a strong recommendation I stop taking MJ. The mental health advisor I saw at my surgery said she’s seeing it a lot with people on it. I don’t want to panic anyone as I’ve been on it so long I’m finding it so strange it’s affecting me like this now. But like the advisor said, what if any pleasure have I derived from food since October 2024? I’ve also quit smoking the last 2 months (slipped up there the last 2 days, hating it but need to calm down).

I do have some other contributing factors as to why I’m depressed (many bereavements over the years and I recently lost my 16 year old dog and miss her terribly) and I have a stressful job (admittedly I only work 3 days a week though). But I’ve basically slept most of the weekend and have very low energy now. I’m managing through by trying to eat little and often and topping up with orange juice.

I didn’t want to come in here and start a thread as I find this forum very helpful (I lurk mainly) but what you described sounded very similar especially with the shakes.

I wish you the best on your weight loss journey. I don’t really want 4 weeks off especially over this stressful period at work but I’m trying to care for myself now and not rush back til I feel I can cope.

I'm diabetic, but I've never had anything like that on Mounjaro.

I was on MJ for about 8 months - it made me not hungry and I was eating less than 1200 kcals a day most days but didn’t lose any significant weight. Kept getting told to eat more but it made me feel so nauseous. It was expensive and frustrating. I had a similar reaction (although not as severe - maybe because I am already medicated for my anxiety?) to this at the beginning.

All the people saying anxiety isn’t a know side effect / that Valium isn’t prescribed often - what??? Valium (diazepam) is still regularly prescribed for panic. I have long term MH and run a support group for others and it’s pretty common.

Anxiety in this context is a side effect of the rapid change in blood sugar - the stress hormones (cortisol, adrenaline) are released to try to raise blood sugar. You then get all the lovely anxiety as a result: palpitations, shakes, brain fog, inability to think clearly as your body is prioritising blood flow to heart and lungs - the perfect environment for your brain to get stuck in panic. The diazepam is to suppress the bodies reaction by enhancing the effect of GABA (calming) and slow the flow of stress hormones so break the cycle.

sending love OP it’s bloody hard xx

It has the opposite effect on me - it’s stabilised my blood sugars 🤷. I used to get crashes, after 28 weeks, not one

no, and no.

Do you take regular pain relief by any chance?

I’m sorry you had such a terrible reaction. I know from our other thread how anxious you were about trying it, which I guess wouldn’t have helped. It must have been a really scary week.

I’m the exact opposite, it does what it’s meant for me and stabilises me. I’ve not had a single sugar crash in six months And it’s been amazing.

maybe you could try wegovy?

So the Op was extremely anxious about the side effects before starting on the WLI?

One of the symptoms of low blood sugar are anxiety. So to the person trying to say that's all it is is wrong. Your anxiety symptoms confirm the blood sugar.
I went on a low carb diet (second nature) and had something similar. I ended up in A&E. The docs thought it was reactive hypoglycaemia but I'm still waiting for the tests. Eating normally again has largely resolved it. I had always had trouble with feeling hangry and shaky between meals and didn't realise it wasn't normal. From your description I think I'll avoid the jab!
Hope you feel better once it wears off. I can appreciate how terrifying it felt xx

If you’ve low blood sugar all it takes is a glucose sweet and it’s resolved, within minutes, most people on mounjaro know this.

Absolutely, but if you've never had that problem before amd don't know what it is it's a terrifying feeling. The drop put me into panic attacks and its very hard to think clearly when that happens. Especially hard if your are out and don't have anything on hand to eat.

Glucose tabs/ fast acting sugar aren't great for me because I'll react off them again, I have to have protein alongside to get me out of the cycle.

But if the person is on keto (which I am) that one glucose sweet knocks them out of ketosis, and ensures there will be no weight loss for several days until the body gets back into ketosis. If that person took glucose tablets every day for a fortnight, say, plus a high-fat keto diet, she would gain weight.

Apologies, I thought we were discussing mounjaro?

You are definitely not alone. It's actually not a common side effect in people who are not diabetic so I was told. In people who are diabetic it is much more common.

I had a, thankfully milder than you, episode on a couple of occasions when I was first taking it. Solved very quickly by eating a biscuit (which was all I had on me at the time). I think mine was caused by over exertion on not enough food to be honest rather than the mj and my GP thinks so too.

Regardless of whether you are on keto or not, you need glucose/sugar if you have a drop in blood sugar like this. Not addressing the problem can be serious and much more dramatic than putting on a couple of pounds of water weight.

For me, I don't get it any more thank goodness. It wasn't a nice feeling.

I should have added one glucose tab won’t know anyone out of keto. You need much more than that. Keto is low carb, below 20g to 50g of carbs per day, based on individual needs, One dextrose tab has less than 4 g and normally sorts the issue fairly immediately. None the less this isn’t about being in keto. But if it was, then it would not be something that knocks you out of it.

Clearly there is very much a history of anxiety here, before starting MJ. Hence Valium being dished out so quickly.

An horrific experience for you. Do you think it was the combination of Keto and MJ that caused it?

I've certainly experienced low blood sugar, especially at the start of MJ, but now almost 18 months on, it is rare and was never that severe.

Glad you are back to normal now and good luck with the continued weight loss.

I work for 111 as a call handler and can confidently say that you are not alone. Some people can have very dramatic side effects from GLP-1 medication.

I have been obese my entire adult life and resorted to weight loss surgery 2 years ago and wholeheartedly support the use of GLP-1s for medical weight loss (if it was just as simple as eating less, no one would be obese and there wouldn’t be a multi-trillion dollar weight loss industry). However, it is still early days of Mounjaro etc off label usage and long term effects are not yet known. For this reason, I cannot recommend strongly enough that if you’re going to use them, make sure you are HIGHLY monitored by actual Clinicians (GP, RN, ANP, Pharmacists) while taking them. Please, please, PLEASE do not just buy it off Stacey from Facebook because it’s cheap. If the company you’re getting it from doesn’t provide CLINICAL support, go elsewhere. You cannot put a price on your health.

OP, I hope you’re doing ok now. As a side effect of my WLS I get something called Dumping Syndrome which is a bit like this (I call it “Lying-on-the-bed-and-praying-for-death); palpitations, sweats, nausea and diarrhoea so I can empathise.