Archives for 2025

Allulose, Overtraining, and Another Week on Mounjaro 7.5mg

Hello, fellow Type 2 diabetics and anyone else interested in Mounjaro, GLP-1 receptor agonists and welcome to aging fitness freaks of all shapes and sizes. Happy St. Patrick’s Day! This weekly column chronicles my progress on Type 2 diabetes control with the prescription drug Mounjaro,. During the past forty weeks of Mounjaro therapy, I got off Metformin, reduced my blood pressure medicine to half its original dose, and lost around sixty pounds (27.3 kg). Concomitantly, my HbA1c dropped from 7.6% (60 mmol/mol) to 5.4% (36 mmol/mol). Yea, verily, at the ripe old age of seventy-eight, Mounjaro and my associated lifestyle improvements have done me well!

Apart from my personal progress, I like to intersperse subjects related to Mounjaro therapy and Type 2 diabetes here. For example, last week I discussed getting off Mounjaro at some point. As I discover current information I think will be of value to others, I write about it here, sometimes offering opinions on pet subjects like the pharmaceutical industry and their social media cheerleaders. Also, having transformed myself into a gym rat, I often touch on exercise philosophies and equipment with senior citizens like me in mind. Nutrition is an important consideration, too, when managing diabetes, so I often add information in that area, which brings us to this week’s topic: allulose.

Not a Medical Advice Column

But first, I must spout the usual disclaimers. Pictured at left on the way to the nineteenth hole at sunset, I am a 78-year-old pretend amateur metabolic scientist and geriatric gym rat, not a licensed physician, so I can’t legally dispense medical advice. Like, would you even buy a used car from this Turkey, let alone trust him with your health? Oh, hell no! I might tell you what to do because that’s the way I am, but you have only yourself to blame for listening to me. In other words, don’t sue me because something you read here doesn’t pan out for you. Instead, visit your local flesh and blood doctor, or even someone of indeterminate national origin in a white coat on a tele-health screen at a profiteering weight loss salon or compounding pharmacy. They will have the necessary malpractice insurance to protect them when they screw up.

Allulose: A Sugar That Sweetens but Does Not Fatten?

This week, I take a closer look at allulose, especially as it relates to managing Type 2 diabetes and weight loss. If you must sweeten foods, allulose might be a way to do so with minimal impact on your metabolic health. My wife Jenny, a microbiologist and an inveterate ketophile, some of whose distant ancestors were an inbred Irish tribe of Neolithic Era potato farmers and who sometimes identifies herself here as “Artificially Sweetened”, has joined me in sweetening things with allulose. We’ll see where all this leads us.

Allulose, classified as a rare sugar, naturally occurs in small amounts in foods like figs, raisins, and maple syrup. Unlike regular table sugar, it provides just about 0.2-0.4 calories per gram and minimally impacts blood glucose levels. This minimal glycemic response makes allulose particularly attractive for those managing diabetes or pursuing weight loss. Additionally, some studies suggest that allulose may improve insulin sensitivity and promote body fat reduction, both valuable benefits in diabetes management and weight control.

Is It Safe? Is It Better?

Like any sugar substitute, allulose isn’t free of controversies or potential drawbacks. Although generally recognized as safe (GRAS) by the FDA, some individuals experience gastrointestinal issues, like bloating, gas, or discomfort, when consuming large amounts. As allulose is relatively new to widespread use, there’s also limited long-term data available about its continuous safety and effectiveness.

Compared to other popular sugar alternatives, like monk fruit extract and erythritol, allulose is often praised for a more natural taste and superior baking performance. Monk fruit extract is calorie-free and has no glycemic impact, but can impart a noticeable aftertaste. Erythritol similarly provides minimal calories and glycemic response but often produces a cooling sensation that some find unpleasant. Each sweetener thus has distinct pros and cons, influencing their suitability based on individual preferences and health goals.

One potential drawback of allulose is its cost. For example, a three-pound (1.36 kg) bag of Truvia-branded allulose costs $25 at Amazon.com. But the good news is that it is SNAP EBT eligible. For those you outside the U.S. welfare state, this means that low-income families on government assistance can have their allulose, too, courtesy of the taxpayers who currently fund their Coca-Cola and Froot Loops!

Banned in Europe?

Notably, allulose remains banned in the European Union due to concerns raised by a study suggesting possible carcinogenicity at very high dosages. These findings, nevertheless, are controversial and have not been replicated in human studies. Consequently, while the U.S. FDA maintains that allulose is safe, European regulators continue to await more definitive research.

So, Why Do We Crave Sweets, Already?

Exploring the rise of sugar alternatives naturally leads to questions about our inherent craving for sweetness. Historically, humans evolved a strong preference for sweet foods, a survival adaptation that helped find calorie-rich sources during periods of scarcity. In modern societies of dietary abundance, this evolutionary trait contributes significantly to overconsumption, obesity, and metabolic diseases like Type 2 diabetes.

Has our societal sweet tooth intensified in recent decades? The evidence suggests yes. Over the past 50 years, global sugar consumption has skyrocketed, driven by the relentless marketing and ubiquity of ultra-processed foods, sugary beverages, and convenience foods engineered by a profit-hungry food industry. The relentless addition of sugar to everyday products—from breads and sauces to seemingly “healthy” snacks—creates an environment where sugar is virtually unavoidable. This calculated saturation of sugar by the food industry hijacks our brains’ reward centers, reinforcing cravings, perpetuating cycles of craving and dependence, and fueling epidemics of obesity and chronic metabolic diseases.

Our heightened demand for sweetness highlights the importance of finding suitable sugar substitutes like allulose. Understanding the biology behind sweet cravings underscores the value—and necessity—of alternatives that help mitigate adverse health outcomes while satisfying our innate preference for sweetness.

Kinda Like Methadone

But in my mind, a better approach is to wind down those primordial sugar cravings. Our ancient ancestors surely did not breakfast on Cocoa Puffs and Lucky Charms. The modern food industry, with its overwhelming abundance of hyper-palatable, chemically enhanced foods, is the true villain behind the sugar addiction epidemic—a genuine addiction deliberately fostered for corporate profit. Quitting cold Turkey (pun intended) may not be realistic, but each of us can take deliberate steps to reduce reliance on sugar and its substitutes, slowly reconditioning our palates towards healthier, less artificially sweetened foods.

I’ll continue monitoring the latest research and sharing personal insights into my experiences with these sweeteners, aiming to maintain a balanced view of their benefits and potential risks. And, of course, I will continue to openly disparage the food industry, which spends even more money on lobbyists than the defense industry, for the harm it continues to inflict upon public health.

My Week on Mounjaro

As usual, I’ll close out this week’s column by recapping the highlights, lowlights, and numbers of metabolic significance, because what would life be without quantification?

Overtraining? (Or Maybe Just Over-Weeding)

I dialed back my workout routine this past week, but not for any admirable athletic reason—my back decided to protest vigorously after an ambitious weed-pulling session. Who knew gardening was an extreme sport? Despite this grievous horticultural injury, I managed five workouts, though admittedly on the gentler side.

The internal debate was familiar: pamper the injury and languish on the couch, or soldier on and pretend everything’s fine. Choosing the wiser path of “lightly soldiering on,” I cautiously maintained both cardio and resistance exercises, albeit at lower intensity. By Sunday, feeling reasonably recovered, I performed a full, hour-and-a-half routine of stretching and resistance training, prudently easing off on lower-back exercises. Upper-body exercises saw a modest weight increase—because, clearly, moderation is overrated. Today, it’s back to the gym in my lucky green t-shirt to work legs. What could go wrong?

Weight Loss Considerations (The Brief Version)

My primary motivation for starting Mounjaro was glucose control, but let’s be honest—shedding pounds was a welcome side-effect. To satisfy curiosity (and my ego), here’s the quick-and-dirty summary:

Last June, I tipped the scale at roughly 245-250 pounds (111.4-113.6 kg), sporting an impressive BMI of about 36.3 and visceral fat (the really nasty stuff) of 18 unidentified units reported by my cheap Chinese smart scale. This morning, I clock in at a svelte 183.8 lbs (83.5 kg), with my BMI down to 27.9 and visceral fat reduced to 11 pork units—still not marathon material, but decidedly less crappy fat around the internal organs. Alas, I still have a residual, deflated spare tire around the middle, which would likely require surgery to fix.

I’ve gone from squeezing into 2XL shirts and 42″ waist pants to comfortably sporting larges and the occasional optimistic medium, with pants sizes ranging from 34″-38″ depending on the generosity of the manufacturer’s vanity sizing and “cheater” fabrics.

Mounjaro kick-started this weight-loss escapade, but at this point, lifestyle changes are carrying the baton. With another 25 pounds (11.4 kg) still stubbornly hanging around, my primary focus is preserving muscle mass (not easy on fewer calories) and maintaining glucose control. I’ll take weight loss as it comes, if it comes.

Da Mounjaro Numbers, Already!

This week’s metabolic scoreboard remains stable. My fasting glucose averaged a consistent 94 mg/dL (5.2 mmol/L), identical to last week’s performance. Dexcom’s trusty Stelo biosensor reports an overall weekly average glucose of 100 mg/dL (5.6 mmol/L), so no wild excitement there.

Wrapping It Up

Thanks for tuning into another thrilling episode of my Mounjaro chronicles. Hopefully, you’ve learned something useful—or at least entertained yourself briefly. If you hadn’t heard of allulose before now, consider yourself enlightened. Until next week, stay healthy (and watch out for aggressive weeds).

For an annotated catalog of all my Mounjaro updates, please visit my Mounjaro Update Catalog page.

First Week on 7.5 mg Dose

Greetings, fellow diabetics, pre-diabetics, and any other interested parties! If you are interested in the effects of GLP-1 receptor agonist drugs like Mounjaro and Ozempic, welcome! Here, we follow my progress on Mounjaro, which as this post’s title declares, I have been taking for forty weeks. This week is my first on a higher dose, 7.5 mg/0.5 ml, after dosing at 5.0 mg for the past few months.

If you’re new here, I’m a seventy-eight-year-old self-described curmudgeonly old fart. I was assigned male at birth and I identify as male. As I reported last week, I have the testosterone level to prove it! I remember when there were two genders. Back then, one “identified” as what one was, whether one liked it or not. But I digress, nostalgically pining for a bygone era.

My foremost goal is to control blood glucose, which is paramount for any diabetic. Next, I want to preserve muscle mass. The rapid weight loss linked with these GLP-1 drugs is up to about 40% muscle. At my age, sarcopenia has already caused significant muscle loss. Thus, I do not need to further jeopardize my golden years with frailty due to irresponsible promotion of weight loss. My ultimate goal is to get off Mounjaro when I am stable and my lifestyle adjustments have been set in concrete.

Patient, Treat Thyself!

Before I talk about lifestyle changes, I’ll interject that I am not a doctor. My admonishments here represent my experiences, which I hope will benefit others. Even though I tell you to “do it my way” below, I am not recommending that anyone adopt my approach without consulting their own healthcare team. Much of what I offer here is my personal, cynical opinion. Yet, if what I say makes sense, talk to your doctor and ask whether The Turkey’s advice is right for you!

My lifestyle improvements are the old, familiar diet and exercise. Boring stuff, I know. First, I adopted a low-carbohydrate diet. This dietary approach is essential for diabetics, no matter what bullshit the American Diabetes Association is spewing. They, after all, get funds from Big Pharma, who prefer to keep us diabetic so they can sell us drugs. Next, I exercise six days per week, both resistance and cardio, to keep the muscles and cardiovascular system going. I have increased the protein in my diet to make certain I can build muscle mass. In short, I do not regard Mounjaro as a magic pill. I can’t hope for long-term success in controlling diabetes without making proper lifestyle adjustments while I’m on it, and continuing with them when I’m done with the drug.

So, Who’s Getting Off?

I firmly believe that if I can stick with a proper diet and a rigorous exercise schedule, I can eventually ditch the Mounjaro. But my cynical side tells me that Big Pharma will not appreciate that! At retail prices, they’re getting about $1,200 per month for the drug. The global GLP-1 analogues market was valued at approximately $37.4 billion and is projected to grow at a compound annual growth rate (CAGR) of 33.2%. The biggest impediment to continued explosive growth the pharmaceutical industry faces is “early” discontinuation, which translates to unwanted disruptions to the ever-increasing revenue stream. They want us to make a lifelong commitment to their GLP-1 RA drugs.

For whatever reasons—and cost is certainly one of them—many patients discontinue GLP-1 RA drugs in their first year of therapy. In many cases, such patients experience rebound effects, namely worsening glucose control and weight regain. Both are undesirable for me. I want to make sure that my lifestyle adjustments can sustain me when I ditch the Mounjaro. I will not be lazily compliant, staying on this crap for life even if I can afford the cost. I am not one to use crutches when their need has passed.

Keep ‘Em Hooked

Estimates that 50% to 75% of patients stop the drugs within a year confound Big Pharma and the doctors they influence. But to their delight, a recent Journal of the American Medical Association (JAMA) Viewpoint implores that physicians must redouble their efforts toward educating patients about compliance. They declare those non-compliant patients as susceptible to weight regain and loss of other benefits of the drugs. These notions, of course, are partially true, but they are also thinly veiled threats to keep us dependent on the drugs for life—or else!

Do It My Way!

I state unabashedly, sophomorically, and naively that doctors should be encouraging my approach instead of prescribing magic pills and considering that a done deal. Put your patients on these drugs if they have useful short-term effects but eschew the open-ended approach. Reorient people to living well and taking control of their chronic conditions. Encourage them to be active participants in their treatment, so they can get off the drugs. After all, in most Type 2 diabetes cases, it is a crappy lifestyle and crappy habits that got them there in the first place.

If you want to read more about patient non-compliance with GLP-1 drugs, this article in TCTMD provides highlights and comments on the JAMA Viewpoint. Read it with a keen awareness of the “one hand washes the other” nature of the industry.

I’ll finish this discussion with my observation that the medical community is paying much more attention to keeping people on the drugs than assessing potential issues that would suggest discontinuation. I rarely see any passionate healthcare articles imploring doctors to regularly monitor side effects of GLP-1 RA drugs with the intent of stopping them if things go awry.

Now, I’ll move on to my numbers for the week and my overall progress.

Numbers for the Week on Mounjaro

This was my first week on the amped-up Mounjaro dose of 7.5 mg. My average fasting glucose was 94 mg/dL (5.2 mmol/L), about the same as last week. My weight has been nominally stable, with a 0.6 lb loss for the week. Nothing exciting here, so that will do it for another week.

I hope to return next week with more useful information. In the meanwhile, stay healthy!

For an annotated catalog of all my Mounjaro updates, please visit my Mounjaro Update Catalog page.

‘Roid Rage

Greetings to my six readers, who are largely a separate subset of humanity from my six Penn State football readers. Both are elite groups of erudite information-seekers (or they just like my bullshit). Here in this weekly series, I’m all about me — about my progress in dealing with Type 2 diabetes and related metabolic, orthopedic, and genitourinary issues. (That intro should reduce my readership to three!). We hope to show an unbiased approach to reporting both positive and negative effects of Mounjaro, a GLP-1 receptor agonist drug, which I was prescribed in June 2024.

Today, before giving you my boring weekly numbers, I’ll tell you a little about myself and my approach to Type 2 diabetes, then deal with my intriguing testosterone results. Not for the squeamish, to be sure!

If you’re new here I’ll briefly state that I’m documenting what some hack writers would call a journey, a metaphor I disparage when it is used to describe an approach to dealing with an illness. In the words of the late Pearl Williams, a trip around the world is not a cruise.

Pseudo-journeys are not all I disdain here repeatedly, ad nauseam. Many of my blogging and vlogging compadres characterize obesity as a “chronic, relapsing disease,” a categorization with which I disagree. In fact, that characterization is a regurgitated marketing pitch perpetrated by Big Pharma through their sponsorships of medical studies and the World Health Organization. If it’s a disease, then, by God, we have a drug to fix it. Just fork over $1,200 per month for Zepbound or Wegovy for the rest of your life, and we’ll cure your obesity “disease”. Yeah, right!

Focusing on Glucose First

Nevertheless, my primary focus here is on Mounjaro therapy for Type 2 diabetes blood glucose control. I am currently injecting a 7.5 mg/0.5 mL dose weekly. I won’t bore you with stuff I’ve presented here before. If you are new here, you can read through some of my back issues to see what tools I use for tracking various parameters and how I have changed my lifestyle in this pursuit.

Although I have lost weight, deporking has always been a secondary goal. Since starting on Mounjaro, I have learned that rapid weight loss comes at the cost of lost muscle, so beyond blood glucose control I have now shifted my secondary goal to rebuilding and preserving muscle mass. In prior issues I discussed my exercise program and low-carb, high-protein diet. Regardless of prioritization, this all ties together because more muscle mass will decrease insulin resistance, which will lower blood glucose, as will fat reduction. Still, while I would like to lose another 20-30 pounds, my wish to build muscle is a paramount. I’ll lose the weight, but very slowly.

Many have opined that GLP-1 receptor agonist drugs like Mounjaro are magic pills that automatically fix diabetes and transform fatsos into fashion models. Yet this complex system of human equations is non-linear and multivariate, and there is no magic pill. No therapy comes without cost, both financial and physiological. I’ve also written about how I would like to get off Mounjaro, perhaps by the end of this year. I do not want to be a lifelong addict, especially given the short remaining lifespan of a 78 year-old. But, I am mindful of studies that have shown considerable rebound effects linked to withdrawal from GLP-1 RA drugs like Mounjaro.

Gonad, Go!

In connection with my wish to build and keep muscle, I had my testosterone tested. Last week, I told you about my discussion with Dr. DeLorean (not his real name), whose conjecture was that my total testosterone results would come back between 225 and 350, which would be slightly low to average at my advanced age. But at those levels, he did not feel that supplementation would be appropriate. In any case, I am not seeking to engage in the current vogue of testosterone replacement therapy (TRT). I ordered the testosterone tests “just because”—because I wanted to see if “low-T” would be an impediment to building muscle via resistance training.

Well, the results are in and it seems that my worst fears were unfounded. I am happy to say that Dr. DeLorean—he of little faith—was wrong again! My total testosterone is 745 ng/dL and free testosterone is 69.3 pg/mL. I am encouraged—elated even—by the confirmation of functioning ‘nads. DeLorean’s office called me this morning to tell me that he reacted similarly, saying that 745 is truly remarkable for a man my age. I told the lady on the phone, “I share his wonderment. Now, I must go out and punch somebody!”

Read on; I’ll tell you more about my muscles below in my self-aggrandizing pep talk.

Superman at 78: Building Muscle and Defying Sarcopenia

When I first started on Mounjaro back in June 2024, my primary focus was blood sugar control. What I didn’t anticipate was just how transformative this experience would be—not just in shedding sixty pounds, but in redefining my approach to aging, fitness, and muscle preservation. Now, at 78 years old, I’m not just managing type 2 diabetes; I’m actively building muscle, doing resistance training six days a week, and feeling stronger than I have in decades. And as my recent testosterone results suggest—total testosterone at 745 ng/dL (normal range 250 – 1100), free testosterone at 69.3 pg/mL (normal range 30.0 – 135.0)—I’m operating at levels that would make a much younger man jealous!

But let’s be clear: numbers are only part of the story. Strength training has become the linchpin of my success, and if there’s one message I want to emphasize to my readers, it’s this—unabated muscle loss is not inevitable as we age. Too many people resign themselves to frailty, thinking sarcopenia is just part of growing older. They give in—they concede. With the right approach—progressive resistance training, adequate protein intake, and consistent effort—you can not only preserve muscle but actively build it. I’m living proof of that. According to my cheap, Chinese smart scale, skeletal muscle has increased over seven percent since I started this non-journey.

Keepin’ It Real

Beyond shooing away sarcopenia, resistance training accompanied by a decent, high-protein diet devoid of crap food is essential to anyone on Mounjaro or other GLP-1 RA drugs. It takes hard work and mental commitment, particularly if you want to get off the needle at some point. I don’t want to be on Mounjaro for the rest of my life, but I do want to be physically active and eating properly for the rest of my life. Again, GLP-1 receptor agonists are not magic pills. Please do not regard them as a replacement for an active, healthful lifestyle!

My workout routine is no joke. I train six days a week, two hours a day, focusing on resistance exercises with dumbbells, barbells, kettlebells, and machines, ensuring a mix of free weights and joint-friendly movements. I also incorporate some cardio—not excessive, just enough to support cardiovascular health without compromising muscle gains. And I try to squeeze in a 5-7 mile hike every week or so. This approach has allowed me to keep my strength and prevent the dreaded muscle loss often linked to rapid weight loss and aging. If you’re losing weight, especially with GLP-1 receptor agonists like Mounjaro, you must be diligent about resistance training. Weight loss without strength training will strip away not just fat, but muscle—something we can’t afford as we age.

Putting It All Together

Of course, none of this happens in isolation. Nutrition plays an enormous role. I’ve dialed in my protein intake, ensuring I get at least 1.2 to 2.0 grams per kilogram of body weight. I supplement wisely—creatine monohydrate for strength, collagen protein for joint health, and Feosol Complete for iron absorption. Hydration is non-negotiable, and I prioritize sleep and recovery to let my body rebuild and adapt. At 78, I can’t afford to take shortcuts, and frankly, I don’t want to. The discipline of this lifestyle is part of what keeps me thriving.

Looking ahead, my goal is simple: continue proving that aging does not have to mean decline. I provide these updates not just to document my progress, but to inspire others—whether you’re in your 50s, 60s, 70s, or beyond—to take control of your strength and longevity. Don’t settle for frailty; severe muscle loss is not inevitable. Commit to training, proper nutrition, and an active lifestyle. Move yo’ ass from Planet Fatness to Planet Fitness! You heard it from the Turkey, if anyone asks

And if my testosterone results tell me anything, it’s that I’m doing something right! And my balls still work. That’s something, a-ight!

So, am I a seventy-eight-year-old Superman? Well, maybe not. But I feel pretty damn close—and if I can do it, so can you. Let’s keep pushing, lifting, and proving that age is just a number.

This Week’s Numbers on Mounjaro

Still on the minimum dose of 5.0 mg, my average fasting blood glucose for the week was 93 mg/dL (5.17 mmol/L), down from 98 mg/dL (5.44 mmol/L) last week. My body weight (unlike my remaining belly) remained flat at 187.2 lbs (85.1 kg). My only dietary transgression during the week was a Waffle House hamburger I choked down at my step-grandson’s sixth birthday. Next week, I’ll be moving up to the 7.5 mg dose of Mounjaro.

With HbA1c at 5.4% (36 mmol/mol) and skeletal muscle increasing as a percentage of body weight, Mounjaro therapy is taking me in the right direction. I am emphasizing the strength training because I believe it is essential at my age and I want to encourage others to feel its benefits. If I am to be a cheerleader, it will be to promote healthy lifestyle instead of pushing drugs. And if I can do it, you sure as hell can!

Au Revoir…

As always, I hope these updates have provided you with encouragement and information for your own non-journey! I’ll be back next week with more insights into dealing with Type 2 diabetes along with commentary about GLP-1 receptor agonists like Mounjaro. In the meantime, be healthy!