Side Effects Appearing Suddenly After 3 Months on Mounjaro?

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Drehimpuls

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Hi all! I've been on Mounjaro for roughly 3 months and the results have been great. I'm still at 5 mg and had no side effects up to now. Since mid-July I've dropped from 112 kg to 95 kg.

Sadly, I've also done nearly everything that people warn you NOT to do: shedding weight too fast and eating and drinking too little. 😅

These last few days I've had a pressure sensation in my upper abdomen. Yesterday I even felt slightly nauseous. Right now I keep feeling like my stomach is full, yet I'm also hungry since it's actually empty. On top of that, I have to burp all the time, and pretty forcefully.

Is this a "normal" side effect, or should a doctor check it to rule out pancreas or gallbladder issues?

And if so, which blood tests should I request? I had blood work in early September with many different tests, and all values were in the optimal range. Unfortunately, neither my gallbladder nor my pancreas was checked, even though I explicitly asked for it.
 
Did you open a fresh vial recently? Is this from a doctor or the grey market? Could you have injected more than your intended dose? I ask all of this because your symptoms suggest a larger amount of medication in your system than you're accustomed to. It sounds like what most people experience in week one when they have sides.
 
If pain is among your symptoms, then yes, a trip back to the doctor is warranted. What you're describing, though, sounds like ordinary GI trouble, which can appear without warning. Try taking Omeprazole every day for a week and see whether that begins to settle things down.
 
If we assume these are harmless GI sides, the cause might be tirz accumulating in your body even though the dose itself hasn't changed.

For me, no GI side effect is constant. They flare up, settle down, and sometimes return. For example, I can feel painfully bloated like a whale, but it passes before my next meal or drink.

What I reach for with GI sides:

A PPI for heartburn (as @chewonmysac mentioned above)

Pepto Bismol (bismuth subsalicylate) for a range of GI sides

Alka-Seltzer for several different sides ("heartburn, acid indigestion, and stomach aches")

simethicone for bloating / stomach pressure / fullness (Gas-X)

Zofran/ondansetron (requires Rx) for nausea

When the symptoms don't improve, I hold off on the next dose until they do.
 
Drehimpuls said:

I still have plenty of Pantoprazole blister packs left over. Hopefully those will be enough.
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Nobody in this community, myself included, can offer medical advice about this kind of thing. That said, if it is severe enough, seeing the Doc before you start stressing over tests seems like a sensible move.

GI issues are frequent and typically fade over time.

I'm with @chewonmysac here: if what you're feeling goes beyond mild gas pain or indigestion, or comes with a fever, a visit to your doc could be worthwhile.

@Calm Logic offered some solid advice-

The fact that you have this.. seems like a good sign

Hi all! I've been on Mounjaro for roughly 3 months and the results have been great. I'm still at 5 mg and had no side effects up to now. Since mid-July I've dropped from 112 kg to 95 kg.

Sadly, I've also done nearly everything that people warn you NOT to do: shedding weight too fast and eating and drinking too little. 😅

These last few days I've had a pressure sensation in my upper abdomen. Yesterday I even felt slightly nauseous. Right now I keep feeling like my stomach is full, yet I'm also hungry since it's actually empty. On top of that, I have to burp all the time, and pretty forcefully.

Is this a "normal" side effect, or should a doctor check it to rule out pancreas or gallbladder issues?

And if so, which blood tests should I request? I had blood work in early September with many different tests, and all values were in the optimal range. Unfortunately, neither my gallbladder nor my pancreas was checked, even though I explicitly asked for it.
Click to expand...
 
Drehimpuls said:

Hi all! I've been on Mounjaro for roughly 3 months and the results have been great. I'm still at 5 mg and had no side effects up to now. Since mid-July I've dropped from 112 kg to 95 kg.

Sadly, I've also done nearly everything that people warn you NOT to do: shedding weight too fast and eating and drinking too little. 😅

These last few days I've had a pressure sensation in my upper abdomen. Yesterday I even felt slightly nauseous. Right now I keep feeling like my stomach is full, yet I'm also hungry since it's actually empty. On top of that, I have to burp all the time, and pretty forcefully.

Is this a "normal" side effect, or should a doctor check it to rule out pancreas or gallbladder issues?

And if so, which blood tests should I request? I had blood work in early September with many different tests, and all values were in the optimal range. Unfortunately, neither my gallbladder nor my pancreas was checked, even though I explicitly asked for it.
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When your doctor has concerns, an abdominal ultrasound could be ordered:



/community-link/thread/3408/

nonyabizznez said:


The pancreas and gallbladder result should come as great news if you've been on a GLP or have experienced rapid weightloss.

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These issues showed up fairly recently — at some point within the past few days. My injection day is Sunday, but the symptoms were clearly present well before I took today's shot.

One factor that could matter: on Friday I had alcohol and, for the first time in 3 months, I ate way too much. I put away at least a bag of chips, some gummy candies, and several pizza rolls. Just like the old days.

On Thursday our child threw up. That said, I believe my own symptoms had already begun before that.

Also, today I used my first Gray tz pin ever. But as I mentioned: the discomfort and sides were already there before today.
 
If you'd rather be cautious, your doctor could order bloodwork for pancreatic markers (lipase, amylase) along with cholestasis markers (GGT, ALP, direct bilirubin), plus an abdominal ultrasound.
 
My GGT came back at 26 (at my lab the cutoff is under 64).

ALP was 31 (the limit at my lab is below 50).

Direct bilirubin 0.52 and indirect 0.93 (my bilirubin has always run high, since I was a toddler. My doctor told me it isn't anything to worry about). Direct should be under 0.25 and indirect under 0.75.
 
Drehimpuls said:

These issues showed up fairly recently — at some point within the past few days. My injection day is Sunday, but the symptoms were clearly present well before I took today's shot.

One factor that could matter: on Friday I had alcohol and, for the first time in 3 months, I ate way too much. I put away at least a bag of chips, some gummy candies, and several pizza rolls. Just like the old days.

On Thursday our child threw up. That said, I believe my own symptoms had already begun before that.

Also, today I used my first Gray tz pin ever. But as I mentioned: the discomfort and sides were already there before today.
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Alright, earlier it sounded like you were using only the brand-name product. So today you injected 5 mg of grey tirz? My assumption is that neither the vial nor the kit was tested, and that the only testing was a COA supplied by the vendor — is that right?
 
Calm Logic said:

Alright, earlier it sounded like you were using only the brand-name product. So today you injected 5 mg of grey tirz? My assumption is that neither the vial nor the kit was tested, and that the only testing was a COA supplied by the vendor — is that right?
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My MJ is the real thing, prescribed by my doctor. That said, today I injected my first grey tz. As I mentioned, the side effects had already started before today.

The vendor is well known and reliable, highly regarded and fairly expensive, and testing for M, P and endos was done (by the vendor). I filtered as well, and other users have reported positive experiences.
 
If just a single vial from the entire batch was tested (and "batch" is a loose concept when it comes to grey), intra-batch variability can be a problem — for example, some vials may be overfilled more than others. intra-batch variability Absent third-party testing, my habit is to begin any new vial or kit with a microdose.

A second possible factor is that API quality may differ between name brand and grey, which in theory could lead to more side effects, at least early on.
 
Yeah, I understand. But like I said, the side effects had already been building up beforehand. Even before my first vendor pin today, I was already feeling them for at least a few days.

That first pin today was purely a coincidence.
 
Drehimpuls said:

Yeah, I understand. But like I said, the side effects had already been building up beforehand. Even before my first vendor pin today, I was already feeling them for at least a few days.

That first pin today was purely a coincidence.
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The next time you have an appointment with a doctor, it would be worth requesting a prescription for something like Zofran (ondansetron) to keep on hand, in case nausea or similar side effects come up.
 
Looking ahead, split dosing is something I'd suggest as a way to ease side effects too — for example, 2.5 mg of tirz twice weekly rather than 5 mg once weekly. That's the approach I use with reta, and split dosing is common among people here (in fact, that's where I picked up the idea).

I switched back to weekly dosing not long ago, and the sides returned with a vengeance. So until I'm on a lower weekly dose, I'll stick with split dosing.

Rebound hunger — a hunger surge at the dose trough — can also be warded off by split dosing, and it tends to show up on day five of a tirz week.
 
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