Mounjaro
How Mounjaro Works
Mounjaro is a medication that works by effectively increasing your levels of two hormones called GLP-1 and GIP. They are made in your intestines, and they reduce the amount of food that you eat by slowing down how fast food moves through your body, making you feel fuller for longer, and they also send a direct message from your intestines to your brain telling you that you’re fuller than you are, and reducing food cravings.
People talk about it ‘turning down the food noise’; if you’re one of the many people who think about food from the moment you wake, and it tends to dominate your thoughts throughout the day, particularly with frequent urges to raid the fridge or the treat cupboard, you can expect this to reduce a lot. One of my favourite quotes is ‘My food noise wasn’t a noise, it was a food rave. And now it’s a whisper’. The food noise may not disappear completely, but if it does persist it should reduce to the point where it’s very manageable. You can either ignore it, or at least have time to pause and take a deep breath before deciding how to deal with it, usually without resorting to eating.
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Managing side effects on Mounjaro
As with any medication, Mounjaro has potential side effects. Many people don’t experience any side effects at all, and most of those who do experience one or two mild side effects. It is possible that you may have worse side effects and want to stop the medication, but this is unusual. Most side effects can be managed by changing how you eat or taking simple over the counter remedies from the pharmacy, and most people who experience side effects are happy to do this because they are pleased with their weight loss.
Side effects tend to occur during the first few days after your injection and settle down or at least reduce by the end of the seven-day period. They are also stronger at the beginning of a new dose, so your first injection of a higher dose pen may bring a lot more in the way of side effects, but you may well find that by the time you’re reaching the end of the pen, so weeks three to four, your side effects have reduced considerably. If you do get really difficult side effects then it’s worth either reducing your dose back to your previous dose, or staying on this dose for a couple of months to see if things settle down.
Let’s have a look at some of the potential side effects and how to manage them:
Side Effects
Heartburn, Nausea, Vomiting
You can help to reduce this by drinking plenty of water, particularly if you’re vomiting as it’s important to avoid becoming dehydrated. Eating small, regular meals rather than larger meals can help. Sipping herbal teas can help. If heartburn is your main problem, then avoiding high fat or spicy foods can help. You can also use medication to help with this. You can buy simple remedies for heartburn like Gaviscon and omeprazole over the counter. If you have nausea or vomiting, then you can buy some mild medication for travel sickness that may help. If that doesn’t help then you could ask your prescriber or your GP if they would be willing to prescribe some prescription strength anti-sickness medication for you.
Burping, Bloating
‘Eggy burps’ is one of the common side effects of Wegovy, as is bloating. Both are related to excess wind, and for this you could try some indigestion remedies from the pharmacy. My favourite is Rennie Deflatine (the clue is in the name, it deflates you!), but any medication that contains the active ingredient simeticone should help. Please ask your pharmacist for advice.
Constipation
Constipation is a common side effect, but usually easily managed. You can manage it by drinking plenty of clear fluids, increasing fibre in your diet by eating fruits, vegetables and bran, and getting plenty of physical activity as movement helps to propel your stool through your bowel more effectively. You can also take laxatives from the pharmacy if need be.
Diarrhoea
This is a common side effect and is often mild, but it also tends to be one that people worry about more than others, because it can affect your ability to leave your home, travel, go to work etc. If you do get diarrhoea it tends to be mild and it can usually be managed with over-the-counter medication.
Dizziness
If you do experience dizziness, then please don’t drive or operate machinery. In terms of managing it, drinking plenty of fluid and eating small regular meals can help. If you can, lie down for a while until the dizziness passes, which it should do. It’s also worth checking your blood pressure, see below.
Low blood pressure/increased heart rate
This can be a positive! Many people who have weight in the appropriate range to have a prescription for Mounjaro also have high blood pressure, so a medication that reduces both weight and blood pressure can be a bonus. However, if you have normal or low blood pressure, then this can be more of a problem. It’s not a common side effect, but if you experience dizziness as above, then do check your blood pressure. If it’s lower than you expect, then the first thing is to ensure that you stay well hydrated and take simple measures like lying down when needed, and moving slowly from lying to sitting and/or sitting to standing to give your body time to adjust. If this doesn’t resolve things then you could try staying at a lower dose for a while as this may help, or make an appointment to discuss this with one of our doctors or your GP.
Hair loss
Thankfully the type of hair loss you can experience with Mounjaro is mild and temporary, and your hair does generally grow back. In the interim you can consider taking a vitamin/mineral supplement specifically formulated for people with concerns about their hair, or using Regaine, a hair growth stimulant available from the pharmacy.
Fatigue
Fatigue is a tricky one! There’s no specific ‘treatment’ for fatigue, so it’s about managing it. Ensure that you get enough sleep, fuel yourself properly with good food so that you have more energy, and generally look after yourself.
Gall stones
Gall stones are a possibility with any effective weight loss programme, and the faster you lose the weight, the greater your risk of gall stones. If you do get gall stones then your symptoms are likely to be worsening heartburn or abdominal pain specifically affecting the upper right side, just under your ribs, and most likely after a fatty or spicy meal. If you start to develop these symptoms, then please do inform your doctor.
Low blood sugar (hypoglycaemia)
This medication lowers blood sugar. Taking diabetes medication with Wegovy might further increase the risk of getting low blood sugar levels. The warning signs of low blood sugar may come on suddenly. They can include cold sweats, cool pale skin, headache, fast heartbeat, feeling sick (nausea) or very hungry, changes in vision, feeling sleepy or weak, nervousness, anxiety or confusion, difficulty concentrating or shaking. You must speak to a doctor straight away if you are started on new diabetes medication, experience low blood sugar (whether you take diabetes medications or not) or are worried about low blood sugar.
Inflammation of the pancreas (pancreatitis)
If you have severe and ongoing pain in the stomach area, see a doctor straight away as this could be a sign of an inflamed pancreas (acute pancreatitis). This is a very rare side effect of Mounjaro but it needs medical attention if you do have it, and it would mean that your doctor would have to stop your prescription. Patients often ask me ‘how will I know if it’s pancreatitis?’ My simple answer is ‘don’t worry, you’ll know’. It’s typically severe abdominal pain that will prompt you to seek medical help.
Conception, contraception and breast feeding
Women who are overweight or obese and using an oral contraceptive should add a barrier method of contraception or switch to a non-oral contraceptive method for the first 4 weeks of treatment, and for 4 weeks after each dose increase. Discontinue treatment at least one month before planned pregnancy. Mounjaro is not recommended during breast feeding.
