Mounjaro Madness

Last week, I wrote about my first week on the vogue drug Mounjaro, manufactured by Eli Lilly & Company. I described my negative experience seeking a decent diabetic support group that was not completely obsessed with weight loss. This blog seeks the truth, not pop wisdom. Realizing that alienating the obsessive weight loss community will cause my readership to evaporate, I continue to avoid the subject of “how much, how fast?”. If you’re in that camp and you’re looking for a feel-good blog that will provide validation for your $1,200/mo., this ain’t it. Stop reading now!

My second week on the Mounjaro starter dose of 2.5 mg just ended. I have had no side-effects worthy of note. My average blood glucose is decreasing, although my dietary adjustments account for some of that, as well as the 7.6-pound weight loss I have experienced. I suspect that most of the latter is water weight loss, as the Mounjaro seems to produce a diuretic effect.

So, there isn’t much to report regarding weekly progress, but then again, I’m on the starter dose. I understand, subject to error in my interpretation, that 5 mg is the minimum therapeutic dose for Mounjaro, and I expect to get there at some point. The same documentation says increase to 5 mg after the first month, but I’ll stick with 2.5 for at least the second month. I’m old, I have co-morbidities up the yingyang, and I’m not anxious to start with the adverse effects. Hell, if I can accomplish what I want to accomplish on the 2.5, I’ll stay at 2.5!

Not a Miracle Drug

I want to dispel the notion that Mounjaro is a “miracle drug”, which will automagically bring your A1c and weight back to spec. That is bullshit. Mounjaro might help, but it will still require arduous work on your part. When I see people on Facebook or YouTube talking about how they can now have their pineapple margaritas with a clear conscience, it annoys the hell out of me.

If a responsible doctor who is integrally involved in your long-term health management prescribes Mounjaro, you must be prepared to do your part. You will need to ensure that your diet is adjusted. If you do not, serious side-effects will ensue, aside from defeating the purpose of taking the damn injection in the first place. For example, if you do not keep up with daily protein and exercise requirements, the weight you lose will be more muscle than fat.

Another undesirable side-effect is kidney damage relating to dehydration. You must diligently ensure that you are well hydrated. This is not an option, borne of the folk wisdom of the gratuitous weight-loss crowd that “water flushes the fat.” It is necessary for your survival. Have I made my point?

If these are things you don’t want to read because you’re only interested in losing weight at all cost, you’re in the wrong place. However, the the drugs in this class (GLP-1/GIP-1 uptake agonists) have proven to be valuable adjuncts to lifestyle modifications in controlling Type 2 diabetes. My major advice is to discuss everything with your doctor and resist falling into “influencer” traps.

Dose-Splitting

I’ll shift gears to take another look at the latest on-line lunacy, dose-splitting. Perhaps spurred on by supply shortages or by a desire to economize on those $1,200 monthly payments not covered by insurance, people are sharing information about how to stretch doses. For example, they buy 15 mg Mounjaro pens and make three 5 mg doses from them. Are these people nuts? Who is guiding them? I have seen no fewer than five YouTube videos providing amateur, hearsay instructions to willing “influencees”. The blind leading the blind.

This is fully analogous to idiots wanting to save money on an electrician, thinking that watching a YouTube “How to Install Your Electric Vehicle Charger” will give them the knowledge necessary to perform the task. In the YouTube world, where the Dunning-Kruger Effect abounds, idiots counsel idiots, and good information must be weeded out. However, if you’re too stupid to know what good information is, you’re certainly too damn stupid to do the wiring for a 60-amp, 240-volt continuous load branch circuit. Go ahead, burn your house down! But I digress.

Just Nuts and Bolts, Right?

Much like the mantra of “it’s only wires and screws” intoned by the incompetent amateur electrician, you see similar ignorance from the amateur pharmacist weenies. You’ll do the equivalent of burning your house down if you play follow-the-leader with YouTube bullshit about “How to Be a Compounding Pharmacist Without a Degree.” However, it won’t be your house. It will be you!

This is something you are injecting into your body. Any contamination is a potentially large medical problem. Recall the 60 Minutes story about the compounding pharmacy in Michigan whose back pain injections killed people due to mold contamination while packaging the drug. If it can happen to the big boys with their expensive lab facilities, what about the kitchen table home pharmacy?

I saw one “influenceress” providing detailed dose-splitting instructions. She was going on about sterilizing a crappy-looking, battered table on which she was doing her compounding, while a dog walked around her, impatiently waiting to be fed. He had a bemused look on his canine face. “What the hell is she doing now?”

Paid “Influencers”

I love the term “influencer” because watching those clowns on YouTube, Instagram, TikTok, etc., I feel influenced to throw up. (No, it’s not the Mounjaro doing that, although nausea and vomiting are documented side-effects. I’ll need to wait for my dose to be increased to experience those fun features.). No, I’m just disgusted thinking that lazy minions’ decision processes are influenced by these unqualified commercial mini-enterprises. There is no regulation of the misinformation passed around as fact, and therein lies the problem.

YouTube has no problem allowing the crap I mentioned in the previous section, which could prove to be a large, general health risk. Neither do they care about the erroneous do-it-yourself amateur electrician videos. Yet they’ll take down political misinformation, as if that was life-threatening. Something’s gotta give with these unfettered “influencers.”

Annoyingly, I watched a woman who claims to be a flight attendant on Mounjaro doing her commentary while feverishly applying make-up. Who the hell wants to watch that? Does it give her street cred with the gratuitous, cosmetic weight-loss crowd? Seriously, you must be a combination of bored, lazy, and ignorant to watch that crap for any longer than it takes to click the “back” button.

Unbiased?

Well, it turns out that big pharma has not left the “influencer” stone unturned. I read an article in the Wall Street Journal recently that described payments of between $10,000 and $50,000 to so-called influencers to promote Ozempic, a sister drug. So, the “unbiased” personal testimony you harken to when you play “follow the influencer” might not be so unbiased after all. (I doubt that the manufacturers will consciously fund the geniuses who promote dose-splitting, though).

Frigging “influencers” also derive commercial revenue based on the YouTube algorithms. The more subscribers they get, the more videos they produce, the more “likes”, etc. all count toward their compensation. Only idiots believe that what they see on YouTube is straight-from-the-heart, altruistic, brotherly/sisterly advice from those who have been there. It is a commercial venture, and Mounjaro, Ozempic, Wegovy, Zepbound, and their cousins are big money keywords.

And don’t get me going on the annoying unscripted, rambling dialog, where the audience is addressed as “you guys” and videos begin with “Let’s get started!”. Harrumph!

Mounjaro Customer Cohort

The other evening, I received a call from my pharmacy. The young, female voice asked me whether I wanted to be a part of the manufacturer’s customer feedback program: “You’re taking a drug called Mounjaro. The company who makes it has a program for customers, which would involve one fifteen-minute phone conversation every month or so. Are you interested in participating?” I agreed to participate.

I am certainly curious as to what Eli Lilly has in mind with this Mounjaro customer feedback program. Will it be one-sided? Will they push me and my doc to increase doses or try to influnce us in other ways? I note on Lilly’s website that they offer the services of their own tele-health doctors, so I’m wondering whether that will factor in somehow. If you have participated in this program and can amplify on this information, please leave a comment. Enquiring minds want to know.

I will report any interaction with Eli Lilly and its Mounjaro customer feedback program here as my relationship with them progresses. Interestingly, though, before the phone call ended, I told the pharmacist’s mate that my participation in the program was contingent upon overcoming the supply issues associated with Mounjaro. She said, “Your refill is on or after June 23. I can reserve one for you so you’ll be sure to get it.” Perhaps participation in this program will pay off.

I’ll be back here next week with more comments about Mounjaro and the Mounjaro community. In the meanwhile, I continue to seek good information.