Happy New Year!

This is the latest update in my series chronicling my progress on the Type 2 diabetes drug Mounjaro. At age 78, I have made considerable progress since starting the therapy back in early June 2024. Namely, I have observed reductions in HbA1c from 7.6% (60 mmol/mol) to 5.5% (37 mmol/mol), in fasting morning glucose from ~165 mg/dl (9.2 mmol/L) to ~95 mg/dL (5.3 mg/dL), and in body weight from 245 lbs (111.3 kg) to 188 lbs (85.5 kg). I have completely discontinued two prescription medications, Metformin and hydrochlorothiazide, while reducing my remaining blood pressure medicine by half. My Mounjaro dosage is 5mg/0.5ml, which is the minimum therapeutic dose.

Of course, man does not live by Mounjaro alone. A primary factor influencing these achievements was my serious commitment to decent diet and exercise. Anyone who takes this class of drugs without such a commitment is destined to fail in one way or another. Either they will get off the drug and relinquish their gains or they’ll be on the drug for life. Neither is my intent. I wish to retain the healthy diet, stay active, and forestall the muscle loss and frailty common among us older folks who neglect those areas. Furthermore, I intend to discontinue Mounjaro at some point after I have stabilized, God willing and the Creek don’t rise.

Getting Off

Another collateral goal is to discontinue Lipitor. I am at a minimal dose, 10 mg, but I would prefer to be at the absolute minimum dose of bupkis. Statins are the most often prescribed drugs, but they have been implicated in doing dastardly deeds such as increasing insulin resistance, thus causing Type 2 diabetes. My hope is that through diet and exercise, along with enlightened medical guidance, I can dump this stuff, too. I would appreciate hearing from any of you readers who have successfully dropped statins.

My intent here is to share my results with others who can benefit from bits and pieces they find here. For example, in prior weeks, I have written about various devices I use to track my progress, issues with GLP-1 RA drugs (the class of drugs to which Mounjaro belongs), continuous glucose monitors, and the cost of these medications. I have also editorialized about dangerous practices like the use of these powerful drugs for cosmetic weight loss and the controversy surrounding parasitic compounding pharmacies. If you are interested in looking back through those prior updates, click on the “Health” caption on the gray menu bar above.

I’ll now move to my weekly recap.

My Week on Mounjaro

When I wrote last week’s abbreviated column, I was in the throes of a nasty urinary tract infection (UTI). My doctor had prescribed an antibiotic, which I started taking the night before. I had a low-grade fever and generally felt like hell. Thus, my update was brief to the point of being uninformative, for which I apologize.

Now, I have completed the antibiotic course, and many of the symptoms have abated, although they have not completely resolved. Although the fever is gone and I don’t pee pink, I still am fatigued and still feel burning when I go. I am observing cloudiness in my urine as well. I’ll monitor this situation carefully while I try to ramp up my resumption of normal activities as the week progresses.

Iron Deficiency

One other issue that has popped up is low iron in my blood. I had been getting low readings when I went to the blood bank to donate blood, although not so low that they would not let me donate my rare type. Two months ago, I decided to have the iron tested, and it was indeed low. The doctor recommended supplementation and a two-month follow-up. I have been taking original Feosol 65mg for two months and I just got re-tested. The results were disturbing. Although ferritin was at the low end of the normal range, total iron and iron saturation percentage were out of range and very low. Both of the latter markers had decreased while I was taking the supplement.

“He’s Not Anemic”

Dr. DeLorean hand-waved, stating that ferritin was the important number and since I’m not anemic, I should be OK and can donate blood if I want to. Obviously, I am not a doctor, but my engineering mentality impelled my skepticism. I did not want to ignore a functional iron deficiency. Ferritin is a measure of the body’s storage of iron, but if it is not getting into the blood, something is rotten in the State of Denmark. Looking further, I found that ferritin can be elevated by both acute and chronic inflammation, which can be misleading. The blood draw for the test occurred last Monday at the height of my UTI, suggesting a re-test when symptoms resolve. Furthermore, on Friday I asked DeLorean (via email) to do a C-REP and SED rate to gauge any inflammation that might be causing issues. I have yet to receive a response.

Despite the all-clear given my Dr. DeLorean, I will pursue this further. Thinking I might have absorption issues, I scheduled a follow-up with my gastroenterologist for the end of the month. In my mind, my GI system is the root of all bodily evils. Although I showed no overt anemia in a CBC taken in November, any of my myriad GI conditions — or even Mounjaro’s effect on the digestive system — could be decreasing absorption of the necessary mineral or causing slow bleeds that, being subclinical, do not show up as anemia.

My GI doc is an old curmudgeon with glowing red cheeks, suggesting rosacea from niacin use, and he’s cranky, just like I am, so my visits with him are always entertaining. As you know, when I write about doctors here, I use pseudonyms. I call my gastroenterologist Dr. Scrooge. (I would change to Dr. Grinch, but he’s red, not green). Stay tuned to these reports for more information on my iron deficiency and its potential gut connection, and for an account of my fun encounter with Dr. Scrooge.

Mounjaro Numbers for the Week

In a topsy-turvy week spent taking antibiotics and recovering from a painful UTI, I didn’t expect much. Average glucose was 106 mg/dL (5.89 mmol/L), while fasting morning glucose averaged 98 mg/dL (5.44 mmol/L). I lost four pounds during the week, no doubt due to the UTI, the appetite suppression caused by the nitrofurantoin antibiotic, and my overall malaise. This is neither a desirable nor a sustainable pathway to further weight loss.

Here’s hoping I have a better week this week! I’ll be back next week with all the news that’s fit to print, and some that isn’t. Until then, I wish you all a happy, healthy, and prosperous 2025!