Mounjaro, advice on re ordering please.

[Thesofathatwas]

Hi!
Ive been on MJ for 7 months now, I’m up to 10mgs now.

The nausea is horrendous so I have to work myself up to take the jag.
All doses, from day 1 I have had awful nausea so not just 10mgs.

Its around 10 days between each jag.

As I’m ordering every 6 weeks or so, not every 2 weeks when they send me the reminder to re order, my supplier is questioning now advising I go down a dose, the nausea has been with every single dose though.

Also, I had zero loss over 4 months on 5mgs and 7.5mgs. So, severe nausea, not eating and zero loss.

I’ve lost 4lbs in 2 months on 10mgs so want to carry on.
How do I navigate this?
(also can’t afford every 2 weeks, I’m spreading the cost to make it easier to afford it)

Sorry, but I’m really confused with your post and why you’re taking MJ in this particular way? Have you got other health conditions and/or been advised to do this by your prescriber?

Usually you’d re-order a new pen every 4 weeks or so and take a dose every 7 days. Do you understand how MJ builds up in your system?

Put your info into this plotter website and you can get a visual of how much MJ is in your system. It might help you work out if your current dosing is right for you.

https://glp1plotter.com

You also need to eat a high protein/low carb diet and stick to a calorie deficit. Mine is below 1400 cals daily.

What’s your daily diet like in terms of food eaten and calories consumed? Have you tried cutting out certain foods to see if it helps the nausea? Is the nausea constant every day or only the first day after jabbing?

I’ve found that some foods that were fine pre-MJ taste differently now and I avoid anything very carb heavy or fatty. So no chips! 😂

@Thesofathatwas sounds like you have had such a difficult time on Mounjaro.

Taking higher doses every 10 days means you are having bigger spikes when you do inject which can make side effects worse.

I'm afraid I tend to agree with your provider, if nausea is now severe dropping down the doses and also getting back to a 7 day schedule, which will balance out your levels and reduce the spikes, sounds like the right move.

You will know it is all about calorie deficit. Logically anyone not losing weight is either not in calorie deficit or may have a medical issue that deserve further investigation. You could log and track everything you eat and drink for a month. If you are genuinely in deficit take it to your GP and ask for advice.

Perhaps Mounjaro just isn't the right drug for you, maybe consider Wegovy. While it is another GLP1, some people tolerate it better, you never know it might make a difference and be more suitable for you. You have given Mounjaro a good try, and you shouldn't have to feel this miserable for months just to get a small amount of weight loss. I won't even mention the expense!

Good luck going forward.

I agree with the others here. This drug is designed to be taken every 7 days so you should be better on a lower dose weekly than a higher one every 10 days which leads to spikes and troughs of blood levels.
If you are that nauseous you may also, inadvertently, be eating wrongly or not enough and making the nausea worse - I find, if I have nausea, it is usually when I am too empty so eating little and often helps me but it is very much trial and error.
You need to work with your provider, listen to their advice and use the medication as directed to establish what is best going forward.
Good luck

Agree that a lower dose every 7 days makes much more sense. If you aren't losing weight then have you seriously reviewed what you're eating? Are you actually in a calorie deficit?

Consider restarting on a very low dose.

I had terrible side effects when I first took mounjaro about 15 months ago, though I gave up after the first dose of 7.5, when I was so ill that I thought I'd have to go to A&E. I tried dropping down doses, but it made no difference: my body seemed to need a complete break.

I've recently restarted, but I took note of all the recent (albeit anecdotal) knowledge of people who are microdosing.

I started on 30 clicks of a 2.5mg pen (equivalent to 1.25mg) and only only side effects was had extremely mild, occasional, nausea but food the noise disappeared completely. After 4 weeks I increased to 40 clicks, stayed there 2 weeks/2 doses, then to 50 clicks for 2 weeks, then to the full 2.5mg 4 weeks ago. I've still had no side effects other than the occasional mild nausea and I have great food suppression. I plan to stay at 2.5 until it's no longer working at all, then I'll only increase by 0.5mg, stay there as long as that works and so on. I'm buying 5mg pens 5 weekly so I'll sometimes take breaks from ordering whilst I use excess pens up. It's not an issue restarting on a 2.5 pen when you're taking so little.

I've only lost 1.7kg so far, but I'm eating so well, effortlessly--lots of healthy protein, veg, fruit, small amount of wholegrain carbs and loads of water. I'm disabled and recently tore a tendon so can't exercise much until that heals, hence the very slow weight loss. I'm tracking calories (I couldn't do this when my side effects were so severe last time around) and will tweak them to hopefully manage slightly higher weight loss, especially when I can exercise a little again.

Spacing out the doses the way that you do means that you get really big spikes, which will definitely make your side effects worse than they would be on proper weekly doses. That doesn't mean that 10 mg every week is right for you - but whatever dose you need to get enough appetite suppression without hideous side effects. If I were you, I would reduce the dose a little when moving to weekly, and then take it from there.

It is biologically impossible not to lose weight when you're in a decent calorie deficit. You are saying that you spent months not eating, but had zero loss. You know that this isn't true. Did you have a couple of days a week where you couldn't eat, but then made up for lost time on other days? I'm not judging - but this does not add up, and I'm sure you know it. Track your calories, and do it properly, weighing everything you eat. You'll soon figure out where you slip up that way.

Best of luck!

When you feel you were not eating/nauseous and not losing much weight you were probably feeling pretty rotten, resting when you could and so not burning so many calories.

I agree that by taking a relatively high dose spaced out your body isn't used to the medication highs. If you imagine the drug in your body on a graph the peak of your mountain a day or two after you have jabbed will be high and then falling for 9 or so days before another high peak that your body isn't used to.

When I felt nauseus/had eggy burps (taking 5mg) I did the opposite taking 3mg slightly more frequently which you can imagine has a lower peak on that graph and more consistent levels of medication in the body.

The goal of taking Mounjaro isn't to drag yourself through feeling rough/nauseous and eating a piece of toast at night. You should be aiming for a dose that dials down the food noise but leaves you with a bit if hunger/interest in food at mealtimes so you can eat 3 meals a day or 2 meals and a snack (for most people I know some people do one meal a day but if they do it shouldn't be a slice of toast!). Aside from any unrelated issues you should feel well the vast majority of the time and have energy. If you are not losing weight eating 3 meals then calorie count and reduce the calories slightly.

You need to follow a healthy nutritious diet with Monjaro as a tool to help you stick to it and not go too far off track rather than a tool to help you not eat.

A few things. I think you’d be better with a weekly lower dose. Secondly re: the weight loss I think you need to track all food for a month, not eating and not losing weight for 4 months is odd and needs medical investigation with your supplier. 4lbs weight loss in 6 months with ongoing nausea really sounds like the medication isn’t working, you’d expect to lose 4lbs in 2-4 weeks.

You can calculate your TDEE using an online calculator, a deficit of around 500 calories a day is approx 1lb a week loss.

Can you set out, A) your current weight and goal weight, and height and B) what you are eating in an average day

Metabolic syndrome coupled with menopausal hormone storms are an absolute fucker when trying to loose weight.
It just will not budge.

Mounjaro has been utterly life changing, having the compulsion to eat switched off is how “normal” people must feel around food.

With the drastic decrease in calorific intake, upping of fibre, protein, nutrients and ceasing to eat UP foods I would feel great if I didn’t feel so so nauseous all the time.
I track, I weigh foods, I have literally cut most carbohydrates, batch cook from scratch, freeze portion controlled meals, eat twice a day, limited snack fruit (to keep blood sugar up). zero alcohol, 3 litres of water a day.
The weight does not budge. Calorie intake based on TEE is around 1000 cals a day. I know if I eat 1000 cals a day I will rapidly gain weight. I stick to around 800-900 a day.

Should have had the jag on Friday and have been working myself up to it because I know the next week will be just miserable.

I’ll do it in the morning and just put up with it but will go down a dose next order. The nausea won’t go though I know it.

I don’t think you should be trying to space out doses until you are securely in the maintenance phase. Maybe you should reduce down to 7.5mg and take every 7 days.

However it’s probably best to talk to your supplier about your side effects.

You can reduce your dose without waiting for your new pen.

The usual British injection pen has 60 clicks in a full dose.

You can calculate the dose in 1 click (of a 10mg pen) by doing 10 divided by 60 = 0.1666

Then I tend to estimate on the calculator to find the clicks I need e.g.
(10 / 60) x 45 = 7.5
(10 / 60) x 42 = 7

Can't you just drop back down to a lower dose? I have just dropped back to 2.5 after a couple of months on 5, because 5 was making me feel so tired that it just wasn't worth it.

No wonder you are feeling ill with the big gap, you are getting big spikes of the medication.

@Thesofathatwas another vote for restarting again at a lower dose every 7 days based upon what you have told us. Absolutely agree that your nausea won’t be helped by a 10 day spacing. I’d there a reason you’re up at 10mg? How much have you lost since starting? You could make it more cost effective by taking weekly lower doses from a higher dose pen - but your supplier might think you’re already doing this if they are suggesting you drop down a dose - they’re in the business of taking money from you regularly and a 10 day doser doesn’t give them that opportunity. I’d also ask, are you moving enough? Do you drink enough water? 800-900 calories a day really isn’t sustainable long term and ideally the goal is to revamp your habits/relationship with food so you can wean yourself off MJ and not gain weight once you are. My BMR is 1340 (which is way lower than I thought before my MJ weight loss journey) but that’s just to exist - it doesn’t include movement etc. if you are logging everything you eat and are genuinely only consuming 800/900 cals it is possible your body has gone into starvation mode. 1lb of fat is 3500 cals so you’d need a deficit of 500 cals every day to lose a lb in a week. It’s a slog even with MJ but ensure you are considering everything - how much oil/butter you cook with, every condiment/salad dressing etc - it’s quite easy to forget these when logging food. If you are logging absolutely everything and not losing weight on a diet of max 6300 cals a week I’d definitely consider investigating further why.
Good luck!

OP, do you think you have low muscle mass? I wonder if you should try and find out. If you do, a very low calorie diet will make your metabolic disease worse in the long run.

How much protein are you eating and are you doing resistance exercise?

Also to be clear - weight loss from MJ is from eating less. So need to be on lowest dose where you can stick to your diet plan…

are you saying you're eating 900 calories a day and not losing weight?? If so, please go to the doctor immediately!

Honestly OP, I think you’ve got this really wrong.

You’re not meant to take a high dose every 10 days and as everyone else has pointed out, you’re getting a massive spike about 12 hours after taking it. No wonder you’re feeling so sick.

You’re binging on the drug in a similar way to binge drinking alcohol.

Also, you’re meant to eat healthy meals, not deliberately starve yourself.

Why are you injecting every 10 days, who told you to do that?
What do you actually eat that means you’re only having 800-900 cals a day? Are you counting absolutely everything?

No need to go down next order, just give yourself 45 clicks ie 3/4 for the dose. You want to work out what is the minimum dose that helps you stick to your food plan.

I agree with other posters that if you really are only eating 900 calories a day (including enough protein ie 100g a day and mostly whole foods), and yoU are not losing weight then you need to either speak to your supplier (mine does a doctor appointment for £30, Swift) or speak to your GP.

I also think that if you are eating that low in terms of calories you need to take special care not to lose muscle mass as that will make your metabolic issues so much worse. Broadly need to lift weights with a progressive overload, ie lift heavy and keep on trying to increase the load.

How much do you weigh OP?

I would he very concerned that no weight has shifted when you are starving yourself on 800-900 calories a day! That is a minuscule amount. Your dosing is also very odd. Who told you to take it every 10 days?

Are you genuinely tracking what you eat? Weighing it correctly?

If you are 100% sure you have been honest, then I suggest you stop and take yourself to the doctors immediately for further testing.