Mounjaro: First Month Progress and Setbacks

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.