Mounjaro Archives - Page 17 of 18

Mounjaro: No Catchy Title Yet

Posted on July 8, 2024 Written by The Nittany Turkey

Five weeks into Mounjaro therapy, and still without a cool title for this sub-blog. The YouTube channel names for similar ventures suggest that I need a fancy moniker to match the likes of: A Little Less Lisa, Countess of Shopping, Downsized, Fit Fat Fun, On the Pen with Dave, Mounjarbro, etc., etc., ad nauseam. I will give you some more thoughts about YouTubers and then touch on my progress. Finally, I will relate a story that has me on the verge of going legal with the medical system.

As for YouTubers, they talk about their “weight loss journey” and give tips to those who are too lazy to do their own research, hoping to impel them to follow them down the primrose path while earning a little YouTube scratch. As you will see later, some doctors are just as bad as the “influencers” when it comes to prescribing drugs without considering the context. But for now, I need to pick on the YouTubers.

Pushing Drugs

“Monetizing channels” is the way of YouTube, where you can pick a popular topic like Mounjaro, which is all the rage at fat salons and shady telehealth profiteers, make some videos, and get compensated for it based on the almighty YouTube algorithm. Why not cut in on the Mounjaro action while talking about yourself? Woo-hoo! And while you are at it, why not pass along dangerous tips about how to obtain the drugs from on-line sellers or telehealth operators and then divide doses? Loosing (sic) weight is a big money business. Everywhere you turn, someone is authoring a book, selling a diet plan, producing a video, or now more than ever, pushing drugs.

While Eli Lilly & Company, manufacturers of Mounjaro, might ordinarily be grateful for all the free publicity, they are not amused. Many of these YouTubers proselytize the use of compounding pharmacies to obtain generic, compounded versions of tirzepatide to an audience of people ill-equipped to vet them. I seriously doubt that any of them have investigated where the ingredients for the compounded tirzepatide come from. (I have seen one compounding pharmacy’s video which shows it being reconstituted from a powdered form; however, does anyone know who makes the powder? Is it made under tightly controlled conditions?). On June 20, Eli Lilly wrote an open letter to the public, published on their shareholder website and on social media decrying the use of potentially dangerous generic alternatives.

Naturally, the Internet weight-loss crowd ganged up on them, declaring rampant self-interest and accused Lilly of making too much money. We’re capitalists here, you know, fellas and fellatrixes. You are just mad that they are trying to take your cheap tirzepatide away so you will not loose wait (sic).

Are Compounding Pharmacies Safe?

Tough question. Many compounding pharmacies perform worthwhile services, but others are shady. While Lilly might have overstated its case, how do you ensure that you are getting a pure drug that stays pure? The FDA has spot-inspected compounding pharmacies who participated in their risk-based volunteer inspection program. Many came out clean, but some notable findings were a toaster oven being used as a sterilizer, a dog bed near a sterile workstation, and workers not wearing gloves while formulating medicines. Pet hair, dander, and human skin create dust, a transport mechanism for pathogens just waiting for a suitable medium to land in to multiply and mess you up. So, you better know a lot about the compounding pharmacy you choose and its sources of the medicine you will inject into your body.

The well-known case of a compounding facility in Massachusetts a decade ago underscores the need for scrutiny of sources. The lab supplied a contaminated methyl prednisolone compound to joint and back pain clinics around the country. Seven hundred fifty people in twenty U.S. states were affected and more than sixty people died. In Michigan alone, eleven people died. The lab and its principals were found guilty of falsifying inspection records, resulting in a fifteen-year jail sentence for the bigshot. That ex post facto resolution does nothing for the families of the those who perished from the fungal meningitis infections caused by the tainted drug, which was manufactured under unsanitary conditions. Read the synopsis from the CDC here.

Be Careful and Do Your Homework

Other incidents have occurred with compounded drugs since then, according to the FDA. I am not trying to steer you away from a cost-saving alternative to brand-name medicine, but I do want to scare you enough to impel you to protect yourself against potentially harmful suppliers and products, emphasizing once again that you are injecting this stuff into your body. Any microbial, fungal, or even inorganic contamination is dangerous. For the “damn the torpedoes, full speed ahead” weight loss crowd, please proceed cautiously. And if you don’t wish to heed my advice, fine. In the words of Davy Crockett to the people of Tennessee after losing his U.S. Senate bid, “You may all go to hell, and I’ll go to Texas.”

Not a Mounjaro ‘Journey’

But I digress. Back to the damn “journey” characterization. Well, sheeeit, this ain’t no journey. It is pharmacotherapy with side-effects, not a whoop-de-doo fun excursion on the Tirzepatide Highway. It comes with risks that are not to be minimized by sugar-coated commentary or videographic bubbling over someone’s weight loss. Still, for the hell of it, and to make some light of the crap that is out there, I am thinking of catchy names for my weekly blasts. How about “Tirzeppity Doo Dah”? Wait, that won’t work for some of you wokers, being a politically incorrect reference to Disney Studios’ much maligned “Song of the South”. So, how about “Constipatient”, honoring one notable, common side-effect of Mounjaro. Not catchy enough? Can I propose “The Snows of Kilimounjaro”? Sorry, Ernest. Hemingway is rolling over in his grave over that abuse of his 1936 short story title. Decisions, decisions!

If I was a YouTuber, I would exhort you to leave your own suggestions in the comments below, hit the “like” button, and make sure you subscribe to the channel. Those actions all play directly into their compensation algorithm. However, here, where I am not in it for the money, I will merely ask you to cough up any bright ideas. The author of the winning suggestion will receive — um… uhhh… nothing I can think of.

Before I leave this ridiculous subject, one more comes to mind: “Mounj Veneris”. OK, now that’s out of my system. On to some more serious subjects.

Week’s Progress on Mounjaro

I amped up the exercise during the week, which I believe might account for some of my 2.6-pound weight loss. That’s fourteen pounds in five weeks, an unsustainable rate I hope to slow down. I bought a set of 52.5-pound adjustable dumbbells, because my 25-pound set limited my workouts. Do not laugh and call me a lightweight, you anabolic steroid shooting bodybuilders out there! I’m an old fart not seeking to look like a gorilla, but just wanting to maintain the muscles I have, which are imperiled by rapid weight loss.

While this is a known issue, particularly for “seniors” (i.e., old farts), YouTubers either dismiss it with the generalization, “when you lose weight, you always lose muscle along with the fat”, or they say, “eat more protein”, but they rarely say anything about strength-building exercises. As for me, I hope to forestall the sarcopenia journey, even though even my doctor handwaves, “you lose muscle as you age, anyway.”

Glucose and BP

Moving right along, my glucose average for the week was 103 mg/dL, down from 108 last week. This is equivalent to an HbA1c value of 5.2 — very encouraging! For the past thirty days, the average has been 112, so I am very appreciative of the downward trend. Much of the improvement results from eliminating lots of crap from my diet, which is aided by the Mounjaro. I am no longer thinking of what I am going to eat next while I am eating something, and I no longer have sugar cravings. (Never have I craved sugar itself, just sneaky sugar-laden crap like cereal. However, I will admit to having a donut or two when provided at a meeting or function).

Blood pressure was up for the week. I can loosely relate it to some intestinal cramps that kept me awake on June 26, which I have been experiencing mildly since then. Before that episode, I was averaging 115/65. On the day after the Night of the Cramp it was 140/85. Since then, the average has been about 130/80. While it might be bullshit correlation, I am wondering whether the cramps in da kishkas were related to Mounjaro. We will see how this plays out.

Bad Blood Revisited

Last week, I told you about my abnormal blood test that revealed a steep decline in kidney function. I also told you that my doctor advised me not to panic, ordering a re-test in a month. I prefer the term “proactivity” over “panic”. If something is going wrong, I want to hop on it. I had mentioned that my dehydrating hike might be implicated in the kidney decline — causing acute kidney injury (AKI) — which might mean that it can improve if I maintain decent hydration. Or it might not. So, I went looking for other potential issues relating to drugs I am taking, including Mounjaro.

I could find only positive information about Mounjaro forestalling the progression of chronic kidney disease (CKD), and I was not cherry picking. This concurs with my doctor’s knowledge of the subject. However, I did find two drugs I was taking that might have exacerbated the CKD. The first, hydrochlorothiazide, I had already discontinued. The second, omeprazole, used to control gastroesophageal reflux disorder (GERD), is a problem. My gastroenterologist prescribed the drug for long-term use at twice the OTC dose. I have been taking it for six months. Recently, I found an observational study in Pharmacology that implicated the drug (brand name Prilosec), in AKI, particularly among us over-65, over-medicated, over-the-hill senior old farts. Later, I found an overview of PPIs and CKD progression in a 2023 review in Cureus, via the NIH.

Prilosec Lawsuits

According to Drugwatch, AstraZeneca, manufacturer of Prilosec, agreed in October 2023, agreed to settle about 11,000 Prilosec and Nexium lawsuits for $425 million dollars. The lawsuits, along with similar kidney injury based Prevacid lawsuits, were combined into a multidistrict litigation in New Jersey federal court. Drugwatch’s legal partners are currently not accepting [any more] Prilosec lawsuits.

Suing the manufacturer is not something I could do, and it is not my style. In my case, I am was taking generic omeprazole, so who am I going to sue? Some lab in India? On the other hand, two doctors, my gastroenterologist, and my primary care physician, who prescribed this crap for long-term use need to do some ‘splaining. How much damage has been done and how it can be related to omeprazole will determine what I do from here.

Taking Action on My Own

Without discussing any of this with my primary care doctor, in whom my confidence regarding proactivity and attention to detail is decreasing, I discontinued the omeprazole. While I have scheduled the one-month re-test he wanted for the end of this month, I also scheduled some testing for today on my own. I want to stay on top of the kidney situation, setting up an appointment with a nephrologist sooner rather than later if things are going south. Do I sound like Chicken Little? In my mind, forewarned is forearmed. Permanent kidney damage is playing for keeps at the highest possible stakes.

Is it any wonder why I tell people to be seriously watchful and knowledgeable about what they are putting in their bodies when doctors cannot even be trusted to keep track of drug effects properly? Overmedication is a scourge, and failure to understand interactions between medications, other medications, still more medications, in combination with a patient’s chronic conditions is a genuine problem.

What about SGLT-2 Inhibitors?

My doctor says he currently has twenty to thirty patients on Mounjaro, his preferred drug for type two diabetes (T2D). However, another class of drugs, called SGLT-2 inhibitors, piqued my interest when I consulted him about doing something more for my worsening T2D. The SGLT-2 inhibitors are oral drugs such as Jardiance and Farxiga, which are well documented to have a positive effect on kidney and heart function while controlling glucose and promoting weight loss. However, one scary side-effect is Fournier Gangrene, a life-threatening necrotizing infection of the perineum (the area between the genitalia and the anus, or the “taint” in street vernacular). Gangrene in the feet is another rare risk. Unpleasant, to say the least.

Three of my friends are taking Jardiance. One has reported no issues. One is newly on the drug for congestive heart failure, an on-label use for non-diabetics. Too soon to get any good data. The third, however, has been taking Jardiance for diabetes for years. He was hospitalized earlier this year for a foot ulcer that became gangrenous. Amputation was a strong possibility, but he managed to avoid that awful fate and recovered completely.

When I mentioned SGLT-2 inhibitors to my doctor in the same conversation in which he promoted Mounjaro, he brushed me aside. Without touching on either the positive kidney effects or the potentially negative side-effects, we quickly moved back to Mounjaro. If this is merely closed-mindedness or lazy preference for a single drug, it is bad enough. I certainly do not want to think there is more to it than that.

Mounjaro Person or Jardiance Person?

In today’s hyperpolarized society, exacerbated by YouTube/Instagram/Facebook tribalism, one must either be a Mounjaro person or a Jardiance person. We cannot engage in constructive discourse to weigh the pros and cons of both. When doctors are subject to the same prejudices and biases as we patients, how does that help us get the best treatment for ourselves?

Having covered my progress, having bashed YouTubers and their drug pushing, and having exposed my doctors and their own brand of drug pushing, I will now terminate this post. I hope you are finding these weekly epistles interesting and worthwhile.

I have babbled long enough. See you here next week.

Mounjaro: First Month Progress and Setbacks

Posted on July 1, 2024 Written by The Nittany Turkey

As of yesterday, I completed four weeks on the diabetic drug Mounjaro (generic name: tirzepatide), with some encouraging results. However, I also received some alarming blood test results that could be a setback. This blog does not sugar-coat the Mounjaro experience (pun intended), so I present the good with the bad.

For those of you who are just joining us, I am an old fart nearing the conclusion of my eighth decade on the planet. Yeah, I’m old, which most of those Mounjaro/Zepbound/tirzepatide patients you will find on social media are not. They seem to range from 20s to 60s, so we septuagenarians, with our own finicky problems and comorbidities, are rare birds, indeed. However, everyone is welcome to read and comment here, regardless of age. I promise that there will be no age prejudice, and I will not disrespect my audience by calling you “you guys”. Besides, my wife thinks my mental age is thirteen or fourteen. However, I will continue to throw stones at what I believe to be flagrant misuse of the drug, which is in short supply for us legitimate users.

Social Media Travesty of the Week

Before I get to my progress, I need to share my curmudgeonly outrage over an individual I saw on YouTube proselytizing the use of tirzepatide. He was young, healthy, and fit. I wondered, “What the hell is this guy doing taking this drug?” As the video developed, it became clear that he is some kind of personal trainer, and he puts his clients on the drug. (How and where they get it might involve shady internet doctors and compounding pharmacies). And then, the capper: he uses it himself to go from 10% body fat to 5% when he wants. The theory espoused by this long-haired gym rat is that we must mimic our primordial ancestors: fatten up in the winter and be lean and mean in the summer. But I digress. This is a completely ridiculous and dangerous pied piper who will lead many children out of Hamlin into the mountains.

Mounjaro Madness Indeed

No, I am not condemning the on-label use of Zepbound/tirzepatide for weight-loss for the morbidly obese. But as I have noted before, the preponderance of people throwing money at this drug for recreational use is disturbingly squeezing the supply for legitimate users with 40% body fat or Type Two diabetes who desperately need Zepbound or Mounjaro. This recalls young studs buying Viagra or having it passed out at orgies, which is also a “thing”, but without the supply squeezing aspects at this point, as sildenafil is ubiquitously available. In summation, the use of tirzepatide to erase one’s last 5% of body fat smacks of recreational use, no doubt by the anabolic steroid crowd.

Eli Lilly, the manufacturer of Mounjaro and Zepbound, is taking steps to curtail the distribution of counterfeit and other third-party tirzepatide. Perhaps this will either slow the frivolous distribution of the drug or it will create a robust black market.

All right. End of rant.

Progress for the Week

My glucose measurements for the past week averaged 108 mg/dL. The biggest two-hour postprandial spike was after our Thursday Colombian restaurant lunch, replete with fried plantains, white rice, bean soup, and carne asada. That spike was just up to 151 mg/dL. Meanwhile, my non-diabetic wife hovers between 80 and 98. Muy bueno, and when I grow up, I want to be just like her.

The weight loss continues. I lost five pounds during the past week. I want that to slow down, because too rapid weight loss causes all kinds of issues. For example, my skin is much less elastic at my age, for one annoying cosmetic feature. Also, and more importantly, looking back to last week’s post, we have seen that Mounjaro can dangerously accelerate dehydration. Keeping my weight loss at a sane level of one to one-and-a-half pounds per week is my goal. Weight loss is secondary to controlling the killer within me. To put it another way, not controlling diabetes is tantamount to prolonged and painful suicide.

And speaking of dehydration, this brings me to my unsatisfactory lab results.

Bad Blood

One of my old fart comorbidities, one that correlates strongly with diabetes, is chronic kidney disease (CKD). I had been at Stage 3A, but as of my blood test last Friday, I had descended into Stage 3B. My creatinine had increased significantly. Also worthy of note was the CPK (creatine phosphokinase), which was moderately elevated. The latter test relates to muscle damage and muscle loss, which is a concern for us older-than-Mathuselah dudes and dudettes who take Mounjaro, according to studies. It can affect our kidneys, which cannot filter all the toxic by-products of muscle destruction from the blood.

You might recall that I had a dehydrating hike (I covered it last week). Dehydration is certainly dangerous for kidneys, especially those that are already compromised. It is possible that the dehydration caused an acute kidney injury, and this crappy creatinine value was the result. Neither my doctor nor I blame the rapid increase on Mounjaro. However, as I confessed last week, I am an idiot. I am not invincible and immortal as I thought I was in my twenties when I did whatever I pleased with no consequences. Now I am an old man, one who needs to take care of himself because decades later I am suffering the consequences I never thought about in my youth. Setting myself up for potential acute kidney injury is about as stupid as it gets.

Addicted to Mounjaro?

Am I ignoring potential adverse effects of Mounjaro? No suspension of disbelief here by attempting to cling irrationally to a drug that has done me lots of good. Throughout this experience, I have not turned a blind eye toward the side-effects, but I understand that aspect of our psyche — part of the underlying mechanism for addiction. “Don’t take away my Mounjaro,” I heard myself saying, “even if it screws up my kidneys and I die!” Then, I became more introspective. No, if there was even a shred of evidence in the literature that Mounjaro can destroy kidneys, I would be out the door faster than a guy who pays with a counterfeit hundred-dollar bill at a Mafia-run whorehouse. (Not adjusted for inflation).

On the contrary, a perusal of the literature is encouraging on the kidney front. Researchers are concluding that Mounjaro and sister drugs forestall the progression of chronic kidney disease instead of exacerbating it. However, there is no guarantee against stupidity of the sort I exhibited bushwhacking in 97-degree weather while taking a drug noted for its dehydrating effects. And, oy vey, at the same time, I was taking hydrochlorothiazide, a diuretic, which I have discontinued since then.

Regarding the potential for muscle loss, I have amped up my protein intake and my strength exercises. Of course, this could relate to the elevation in CPK. However, I will need to watch the creatinine and adjust protein intake if it continues its upward trajectory.

Retest in a Month

My doctor feels that there is no need to panic over the creatinine number. He is aware of my dehydration and its potential to distort the numbers, so he wants to re-test in one month to see where the numbers are headed. In the meanwhile, I will keep on doing what I am doing.

That will do it for this month. I hope you are finding these weekly accounts interesting. And no, I won’t exhort you to click the like button below and subscribe to my ‘channel’ like they do on YouTube. Unlike those “influencers”, I do not do this for money; I just want to share my experiences with others who might find them meaningful. I will continue to write these weekly recaps of my trials and tribulations and I thank you readers for taking the time out of your schedule to read my humble posts.

I wish all of you in the U.S. a Happy Independence Day and all of you in Canada a Happy Canada Day!

I’ll be back next week with more progress reports, observations, and curmudgeonly comments.

Mounjaro: Week Three

Posted on June 24, 2024 Written by The Nittany Turkey

I write a lot, and I enjoy doing it. Recreational writing ventures include a regular column in my club newsletter, the Penn State football portion of this blog, and now, this weekly feature regarding my foray into the use of the diabetic control drug (and vogue weight-loss sensation), Mounjaro. Writing about it also provides a record of my experiences for personal reflection, a weekly diary, as it were. Having completed my third weekly injection, I am here to provide observations and some opinions about the drug and its popular culture.

Recapping the past two week’s posts, I told you about my frustrations with the on-line so-called support community and with the drug’s availability. Nine out of ten vlogs and blogs center on the weight-loss aspects of the drug, even though at this point, the Unites States FDA approved Mounjaro for diabetes control but not specifically for weight-loss. (The FDA approved a relabeled version of Mounjaro called Zepbound for weight loss only). Last week, I mentioned that some YouTubers have received monetary compensation from big pharma for their efforts in promoting sister drug Ozempic and I disdained the practice of dose-splitting.

Today, I will talk about my continuing Mounjaro experience, especially one nasty side-effect that we do not talk about at the dinner table: constipation. Another one that I will touch on is dehydration. But first, the good part.

Progress after Third Week on Mounjaro

Recall that my dose of 2.5 mg is the “starter” dose of Mounjaro. For most people, the minimum therapeutic dose is 5 mg. After the first month, many move up to that dose. However, I chose to remain at 2.5 mg for the second month. I am an old fart with several significant gastrointestinal co-morbidities, along with my diabetes. I am wary about the rush-to-market testing not being thoroughly predictive enough for geriatric use. This decision to remain at 2.5 was mine, not my doctor’s.

Tomorrow, I will discuss my thoughts with my doctor. I want him to order a set of blood tests—nothing too elaborate—a SMAC-25 as a baseline for repeat and follow-up in six months, which will coincide with my next annual physical exam. I want to make damn sure that this stuff is not doing anything bad to my liver, kidneys, my muscles, and my kishkas in general.

Weight Loss, or Lack of Same

My weight loss stabilized and was flat for the week, no major surprise due to a couple of things. For one, I had been taking hydrochlorothiazide (HCTZ) as an adjunct medication for control of high blood pressure. However, since starting Mounjaro and adjusting my diet, my average morning BP is less than 120/70. Therefore, I discontinued the HCTZ with my doctor’s concurrence. HCTZ is a diuretic; in view of my dehydration, I expected to gain a little rebound water weight. Thus, it is no surprise that my weight remained unchanged since last week. I’ll note, though, that dehydration and rehydration caused a two-pound drop and increase during the week.

Glucose Control

This is the area I am most interested in, as diabetes is a killer. Many of its symptoms are occult, and we do not discover the damage this disease has wrought until it is too late. Crappy diets and metabolic syndrome exacerbate the situation. My alarm over a recent A1c report impelled me to use Mounjaro, despite the possible negative side-effects.

I am happy to report improved glucose control. My morning fasting glucose readings had been over 140 mg/dL prior to Mounjaro. During the past week, I averaged 98. Today, for example, I measured 92 before and 98 an hour and forty-five minutes after the meal. Whether or not I can attribute this completely to Mounjaro is muddled by my associated dietary changes. I will describe those next.

Dietary Changes

A well published benefit of Mounjaro is appetite suppression, given its dual effects of slower digestion and increased satiety. These “features” make it easier to change one’s diet to lose weight. So, what did I change?

I am eating smaller meals, less junk, and more fiber and protein than previously. My insulin resistance makes it problematical to consume lots of carbs, which I had been doing before the Mounjaro excursion. Sneakily, I was eating lots of cereal to provide the fiber I needed to keep the kishkas running, and of course, this caused weight gain along with glucose spikes up the ass for the past year or so. Now, I have a protein breakfast accompanied by a glass of psyllium fiber supplement to provide the fiber. I anal retentively track my meals with an app called MyFitnessPal, which ensures that I stay on track.

My protein target is ninety grams per day. It is especially important while taking Mounjaro to ensure adequate protein in the diet, because especially among us old farts, weight loss attributable to the drug often involves loss of muscle mass. Protein in the diet and resistance exercise are necessary to avert this damaging consequence. Furthermore, muscle destruction, called myolysis, can cause kidney damage, to compound the felony. So, I do what is necessary to keep the protein up and I am increasing my exercise.

Whether these changes result from the power of suggestion or the drug itself is a subject for debate. I would hope that they are permanent for me, so I can discontinue the drug at some point. Recall that I am at the starter dose of Mounjaro, which is half the recommended minimum therapeutic dose.

Some Mounjaro Side-Effects

In Economics 101, we learned the “TANSTAAFL Principle”, which posits that There Is No Such Thing as a Free Lunch. With Mounjaro, too, you will not be able to have your cake and eat it, too. (Mixing food and sugar metaphors and puns is fun for this old fart, but I digress). Aside from the price you pay at the pharmacist, trade-offs exist in return for your diabetes control and weight loss. You should prepare for them and do what is necessary to minimize them.

Below, I describe two common and notable adverse effects, which are constipation and dehydration. Some users suffer nausea or vomiting, two quite common side-effects I have not experienced. The published information for Mounjaro describes many other potential effects, some unbelievably bad. Therefore, you should diligently read the package insert and consumer materials and discuss them with your doctor to understand what you are getting into here. And do not for a moment think that you can just play with Mounjaro as a cosmetic, no-consequence drug without potentially serious side-effects. If you’re just seeking to lose a few pounds, it is not worth the risk.

Constipation

Nobody likes to talk about it, but most of us have experienced this unpleasant condition, a notable and common side-effect of Mounjaro. Man, it sucks! I keep the fiber up, but things just do not move through there like they used to. I have also used Miralax and Senekot. My guess is that they worked a little, and that without them, I would really be up the shit creek without a paddle. (So to speak).

This cannot be good over the long term, and I must wonder about the increased potential for intestinal blockages. The on-line so-called support group solutions are ridiculous, including the exhortation to eat watermelon. Completely worthless! I will discuss this subject with my doctor tomorrow to see if he has any bright ideas.

Dehydration

You MUST maintain your hydration while taking Mounjaro, or else! Kidney damage is irreversible. You drink lots of water with Mounjaro to ensure that does not happen. The idiotic weight loss community justifies the personal inconvenience of diligently pursuing increased hydration with the moronic maxims, “water burns fat” and “water flushes fat”. OK, I’ll give them their fantasies. Any port in a storm! Employ whatever reasoning you choose, but just do it! DO NOT obsessively celebrating “loosing” on the scale by regarding dehydration as legitimate weight loss. Hydrate diligently and intelligently. Your kidneys will thank you.

Ants: “Your a idiot!”

As I mentioned, I was taking hydrochlorothiazide for blood pressure control. This, in combination with the Mounjaro, cause excessive dehydration. I can typically tell when my hydration is low by how prominent my veins are in my arms and legs, and during the past couple of weeks on Mounjaro, it has been low. Couple this with my decision to do a strenuous hike last Tuesday in “feels-like” temperatures of high 90s Fahrenheit, and you have a recipe for disaster. I had to lay down during the hike to rest for a while, as my heart was pounding due to hypovolemia and the heat. A few harvester ant stings added insult to injury. Perhaps they were driving home an oblique hymenopteran message: “dumbass!”.

I brought along two-and-a half liters of water for that hike, which was only three-and-a-half miles, but it involved some heavy bushwhacking. I drank all that water. Furthermore, in the days before the hike I drank lots of fluids. Still, I became seriously dehydrated and felt crappy for days. My doctor confirmed that dehydration can occur with sudden onset while taking Mounjaro. One reason for this is that the satiety effect suppresses thirst as well as hunger, so people forget to drink water. So, please heed my warning!

Summing Week Three on Mounjaro

This concludes my weekly observations. I am hoping that my observations regarding side-effects like constipation and dehydration, as well as my modest short-term successes on a low dose of Mounjaro, will help guide you in making your personal decision to collaborate with your physician in determining whether “Mounjaro is right for you”.

I want to add that while social media has its place, it does not replace your legitimate doctor. (I add the qualification “legitimate” because weight-loss boutiques and less than scrupulous teledocs are now prescribing terzepatide to anyone, just for the asking). Too many people who get most of their information on social media are too lazy to do the real research necessary to make their own decisions. Social media posts run the gamut from highly informative to complete misinformation, with some “influencers” dangerously verging on practicing medicine without a license. To avoid legal trouble, most will provide a disclaimer. Take it seriously! You must not rely on “influencers” to make your health decisions, which should be a collaboration between you and your physician(s). Watch the influencers’ posts for amusement, take note of any interesting tidbits, and then talk to your doctor.

That’s it for now. I will return next week with more observations and paths forward.

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