Happy New Year!

This is the latest update in my series chronicling my progress on the Type 2 diabetes drug Mounjaro. At age 78, I have made considerable progress since starting the therapy back in early June 2024. Namely, I have observed reductions in HbA1c from 7.6% (60 mmol/mol) to 5.5% (37 mmol/mol), in fasting morning glucose from ~165 mg/dl (9.2 mmol/L) to ~95 mg/dL (5.3 mg/dL), and in body weight from 245 lbs (111.3 kg) to 188 lbs (85.5 kg). I have completely discontinued two prescription medications, Metformin and hydrochlorothiazide, while reducing my remaining blood pressure medicine by half. My Mounjaro dosage is 5mg/0.5ml, which is the minimum therapeutic dose.

Of course, man does not live by Mounjaro alone. A primary factor influencing these achievements was my serious commitment to decent diet and exercise. Anyone who takes this class of drugs without such a commitment is destined to fail in one way or another. Either they will get off the drug and relinquish their gains or they’ll be on the drug for life. Neither is my intent. I wish to retain the healthy diet, stay active, and forestall the muscle loss and frailty common among us older folks who neglect those areas. Furthermore, I intend to discontinue Mounjaro at some point after I have stabilized, God willing and the Creek don’t rise.

Getting Off

Another collateral goal is to discontinue Lipitor. I am at a minimal dose, 10 mg, but I would prefer to be at the absolute minimum dose of bupkis. Statins are the most often prescribed drugs, but they have been implicated in doing dastardly deeds such as increasing insulin resistance, thus causing Type 2 diabetes. My hope is that through diet and exercise, along with enlightened medical guidance, I can dump this stuff, too. I would appreciate hearing from any of you readers who have successfully dropped statins.

My intent here is to share my results with others who can benefit from bits and pieces they find here. For example, in prior weeks, I have written about various devices I use to track my progress, issues with GLP-1 RA drugs (the class of drugs to which Mounjaro belongs), continuous glucose monitors, and the cost of these medications. I have also editorialized about dangerous practices like the use of these powerful drugs for cosmetic weight loss and the controversy surrounding parasitic compounding pharmacies. If you are interested in looking back through those prior updates, click on the “Health” caption on the gray menu bar above.

I’ll now move to my weekly recap.

My Week on Mounjaro

When I wrote last week’s abbreviated column, I was in the throes of a nasty urinary tract infection (UTI). My doctor had prescribed an antibiotic, which I started taking the night before. I had a low-grade fever and generally felt like hell. Thus, my update was brief to the point of being uninformative, for which I apologize.

Now, I have completed the antibiotic course, and many of the symptoms have abated, although they have not completely resolved. Although the fever is gone and I don’t pee pink, I still am fatigued and still feel burning when I go. I am observing cloudiness in my urine as well. I’ll monitor this situation carefully while I try to ramp up my resumption of normal activities as the week progresses.

Iron Deficiency

One other issue that has popped up is low iron in my blood. I had been getting low readings when I went to the blood bank to donate blood, although not so low that they would not let me donate my rare type. Two months ago, I decided to have the iron tested, and it was indeed low. The doctor recommended supplementation and a two-month follow-up. I have been taking original Feosol 65mg for two months and I just got re-tested. The results were disturbing. Although ferritin was at the low end of the normal range, total iron and iron saturation percentage were out of range and very low. Both of the latter markers had decreased while I was taking the supplement.

“He’s Not Anemic”

Dr. DeLorean hand-waved, stating that ferritin was the important number and since I’m not anemic, I should be OK and can donate blood if I want to. Obviously, I am not a doctor, but my engineering mentality impelled my skepticism. I did not want to ignore a functional iron deficiency. Ferritin is a measure of the body’s storage of iron, but if it is not getting into the blood, something is rotten in the State of Denmark. Looking further, I found that ferritin can be elevated by both acute and chronic inflammation, which can be misleading. The blood draw for the test occurred last Monday at the height of my UTI, suggesting a re-test when symptoms resolve. Furthermore, on Friday I asked DeLorean (via email) to do a C-REP and SED rate to gauge any inflammation that might be causing issues. I have yet to receive a response.

Despite the all-clear given my Dr. DeLorean, I will pursue this further. Thinking I might have absorption issues, I scheduled a follow-up with my gastroenterologist for the end of the month. In my mind, my GI system is the root of all bodily evils. Although I showed no overt anemia in a CBC taken in November, any of my myriad GI conditions — or even Mounjaro’s effect on the digestive system — could be decreasing absorption of the necessary mineral or causing slow bleeds that, being subclinical, do not show up as anemia.

My GI doc is an old curmudgeon with glowing red cheeks, suggesting rosacea from niacin use, and he’s cranky, just like I am, so my visits with him are always entertaining. As you know, when I write about doctors here, I use pseudonyms. I call my gastroenterologist Dr. Scrooge. (I would change to Dr. Grinch, but he’s red, not green). Stay tuned to these reports for more information on my iron deficiency and its potential gut connection, and for an account of my fun encounter with Dr. Scrooge.

Mounjaro Numbers for the Week

In a topsy-turvy week spent taking antibiotics and recovering from a painful UTI, I didn’t expect much. Average glucose was 106 mg/dL (5.89 mmol/L), while fasting morning glucose averaged 98 mg/dL (5.44 mmol/L). I lost four pounds during the week, no doubt due to the UTI, the appetite suppression caused by the nitrofurantoin antibiotic, and my overall malaise. This is neither a desirable nor a sustainable pathway to further weight loss.

Here’s hoping I have a better week this week! I’ll be back next week with all the news that’s fit to print, and some that isn’t. Until then, I wish you all a happy, healthy, and prosperous 2025!

Plumbing Problems

Welcome to another week of egocentric bloviations regarding my progress on Mounjaro. This week’s edition will be brief because I am not feeling well due to plumbing problems. My human plumbing is in disarray from aging pipes and opportunistic bacteria.

I somehow contracted a urinary tract infection (UTI). For anatomical reasons, women tend to get more of these than men. I never had one. My wife, being a UTI veteran, was surprised to learn that. Well, I’ve got one now, and it’s no fun at all.

Everything was moving along well last week until Saturday. While I was doing my workout, I felt pain in my bladder area. Then came frequent, urgent, painful urination. I grabbed an AZO test, which tested positive for leukocytes. I also had pink pee, presumably from blood, and I was getting chills. So, I texted Dr. DeLorean, who in turn prescribed an antibiotic called nitrofurantoin, which I’ll take twice a day for a week. He said I should feel relief in 24-36 hours into the therapy. I sure as hell hope so.

The Week on Mounjaro

Christmas week was a good week, with average morning glucose of 95. My weight was down 2.4 pounds for the week. I am pretty sure that’s because of the UTI.

For the coming week, my glucose measurements will be unreliable, because nitrofurantoin has an effect on them.

I hope I’ll be back in the groove for next week’s update. Sorry this one was so short!

Too Many Christmas Cookies through the Years

With the holidays ahead of us and no notable Mounjaro progress, I’ll lighten up this week’s edition. You’re all too busy with family, food, fun, and the spirit of the season. My brief report will first share some good news from my physiatrist. I’ll also fill you in on my geriatric workout program. Then, I’ll close with the Mounjaro Week in Numbers.

Physiatrist Findings

I awarded the pseudonym Dr. Rabbit to my physiatrist because our initial visit was a brief, “wham bam thankya ma’am” encounter. There, he looked at my back MRI, listened to my description of left leg numbness and pain, and scheduled a nerve conduction test and EMG to determine the source of my leg symptoms. Those prescribed tests happened this past week.

I’m happy to report that the diagnosis is simply an irritated sensory nerve. Dr. Rabbit’s assessment described it as a moderate case without complications. Thus, no surgery is required or desired. If I don’t do anything to further irritate the nerve, the pain and numbness will eventually abate. This assessment took all of fifteen minutes, thanks to the doctor with the well-earned moniker.

Back to Serious Workouts

With the knowledge that I would not be further compromising a dire situation, I amped up my cardio and resistance training. I do three sessions of one-and-one-half hours at the gym, which I alternate with three home workout days. I augmented my home exercise equipment to enable some decent home workouts: adjustable dumbbells and kettlebell, adjustable workout bench, two sets of Therabands (pussified and advanced), a TRX setup, a Swiss ball, and (oy vey!) a yoga mat. (Who knew?). I’ve been getting my money’s worth with them, too. I also use my trusty 1985 Schwinn Airdyne stationary bike and a set of inside stairs, so I don’t need to buy a stair climber. A 1.5-mile (2.4 km) path through my neighborhood allows me to walk with the bears and the HOA commandos. Thus, I have lots of good exercise option to keep my well-aged ass in gear.

On top of the gym and home exercises, I will do a moderate hike in the woods once a week. I’ll take full advantage of the favorable weather while it lasts. (Hiking on summer days in Central Florida can be brutal, with summer heat and humidity seemingly arriving earlier every year). Last Tuesday, I covered 7.5 miles (12 km) at a sub-twenty minute per mile pace. That’s about what I consider optimal for a weekly hike at the advanced age of seventy-eight (same age in metric time units, alas! – LOL!). Last week’s hike was on mostly dry trails with no bushwhacking required. (I’m letting my cut-up legs heal from the last bushwhacking episode a couple of weeks ago!) Getting some sun and fresh air, along with increasing my endurance are the dual objects of the weekly hike. Plus, I always enjoy communing with nature and exploring new trails.

Gym Visit

I just returned from the gym, where I am a consistent overachiever. I continually seek new ways to make maximal use of the available equipment and to pester the staff and their clients. To assuage the sting of the latter, I brought them an ample collection of Christmas cookies this morning.

My message tee shirts provide amusement to the exercise physiologists, physical therapists, and their largely geriatric collection of clients. My favorite one reads, “IT’S WEIRD THAT I’M THE SAME AGE AS OLD PEOPLE!”

Anyway, being a hiker, I like to play with the treadmills, creating hill programs to work on my endurance. This morning for my finale, I did twenty minutes with speeds up to 3.7 mph (~6 kph) and hills up to 12% grade. I had achieved my target maximum heart rate for several minutes; when I entered the cool-down phase, I noted that my pulse dropped rapidly to below 100, a good indicator of the efficacy of these workouts.

And with that completely self-aggrandizing commentary, I’ll segue into my progress (or lack of same) for the week on 5 mg of Mounjaro.

Mounjaro Week in Numbers

The theme of this series of updates is how Mounjaro is working for me. But I’m feeling more and more like I’m doing the work and Mounjaro is just an expensive crutch. Would I have accomplished as much without it? Probably not. It has certainly served a useful purpose. Eventually, I want to do this without pharmaceutical intervention. So, for now, I’m still calling this a Mounjaro update.

Speaking of pharmacology, since I started on Mounjaro, I have stopped taking Metformin and I have cut my Losartan dose in half. “We’ll see” how close I can get to my goal of no drugs at all.

So, without further ado, my morning glucose was 96.6 mg/dl (5.37 mmol/L), while average glucose was 102 mg/dl (5.67 mmol/L), both up slightly from last week. I’ll blame that on Thursday’s Korean lunch with prodigal med student daughter, in town for the holidays, and on Saturday’s Penn State feast. The former gave me a sharp spike to about 160 mg/dl (8.89 mmol/L); however, my friend Mike, who is also a carb watcher, hosted the latter. The food was tasty, but it did not spike my glucose.

My weight was stable for the week. Otherwise, nothing significant to update.

Putting a Ribbon and a Bow on It

That’s all for another week. I wish you all a very Merry Christmas and a Happy Hanukkah, as appropriate. Don’t eat too many Christmas cookies or too much Christmas goose. You can goose somebody at the office party, though.

I’ll be back next week to ring in the New Year with more tales of Beni on Mounjaro. Thanks for dropping by!