Відео

Side effects are unpredictable and vary widely from person to person. Some people have severe side effects, and some people have none at all. Common ones are nausea, constipation and diarrhea. While you can experience these side effects at any time during the week, it is more common 1 to 3 days after your injection. It is also more likely to occur when you first move up on your dose. I’ve noticed that more people get side effects when they transition from 0.5mg to 1mg. Best of luck to you!

Unfortunately, you may not have been able to get to a dose high enough to be effective for you for weight loss. I do see several patients that experience nausea at the 1mg dose, but for most, the nausea is temporary and they are able to continue the titration. Probably you would have tolerated a 0.75mg dose (the dose they don’t make) but it may not have worked for weight loss. Since you couldn’t continue due to side effects and no weight loss, you may consider talking to your doctor about trying Zepbound. I’ve seen people have success at lower doses and insurance may cover it since you did already try Wegovy. Also, Zepbound has a slower titration (2.5, 5, 7.5 …). Best of luck to you!

@@veena-usa: Thanks for your insights.

lol

Yes, Zepbound and the other Glp-1’s that I mentioned are all injected once per week. I listened to the video to see where I might have mistakenly said they are injected monthly, but I don’t hear it anywhere. I don’t believe I actually mentioned how often they are injected in this video (I do have an older video that covers it). Sometimes UA-cam provides auto captioning; I wonder if the caption came out wrong.

Oh how awful! I have had a handful of patients experience similar. Some folks have very slow stomach emptying and the food just sits in the GI tract and doesn’t budge. Some patients describe “fermented burps” and others describe “sulfur” taste like yours. Hopefully you can get in touch with your doctor who may move you back down to 2.5mg dose. My patients tell me that very small portions (vs regular size meals) are tolerated better in the beginning. I hope you are feeling better today and especially I hope you can tolerate drinking water so you don’t get dehydrated. By the way, your 10 pound weight loss by 7 weeks is actually much better than you think. Some folks don’t lose any weight on the 2.5mg dose. Your body seems more sensitive to it. Thank you for sharing your experience because it could help others. I wish you a speedy recovery!

Don’t be discouraged. It’s too soon to know if it will work for you. Best of luck!

Thank you!

Excellent!

That’s excellent!

Rybelsus is the tablet version of Ozempic. It is not quite as effective though, but contains the same ingredient, semaglutide. Since you had such a severe reaction to the smallest dose, 3mg, then likely it isn’t a good medicine for you. There are no studies about cutting the tablets in half. There are many other better tolerated medications for treating high glucose. Best of luck to you!

@@veena-usa As I understand, @sunitkewalkhanna1450 was not tolerating probably maximum semaglutide tablet dose of 14mg (as there is no 17mg dose that I am aware of). Tablets strengths are available in 3mg, 7mg, and 14mg. So if 14mg was too much, try 7mg. After some time and change of lifestyle (diet, physical activity) you could try again 14mg dose.

Yes, if she was taking the max dose of 14mg then I agree with you. I think I interpreted it as 17 days. Yes, great advice if on 14mg and not tolerating them reduce back to 7mg!

Excellent! Great early response! Keep up the great work and best of luck!

I’m glad you shared this with everyone. It’s true that it can be a long, slower journey for some. Some folks don’t lose significant weight until they’ve been using it for quite awhile. Hang in there. Best of luck, I’m rooting for you!

I want you to know that when it comes to Mounjaro, there is a smaller percentage of people that are “slow responders.” These are folks that had less than 5% weight loss after 12 weeks. A study showed most slow responders did achieve at least 5% weight loss by week 72. You may still achieve that weight loss! However, for unknown reasons, there are also a very small percentage of people who do not lose weight. If you are getting good sleep, exercising and don’t have other issues mentioned in the video, you can discuss with your doctor about continuing to the 72 weeks to see if you are a slow responder. Best of luck to you!

Bleeding may occur, or it may not. The answer is vague because no one will really know until you try it. It depends on which oral contraceptive you are taking and also depends a lot on your body as an individual. A 5mg dose of Tirzepatide (Zepbound) reduced the hormone level by about 20% so it is possible that the higher you go up on your Zepbound, there may be even more reduced hormone level and more chance of bleeding. Here are a few thoughts I have that you could talk to your doctor about: 1. Switching your birth control to Simpesse which is a 3-month, extended cycle OCP. The interaction with Zepbound will still occur but may have less impact since you will be taking hormones for 3 months straight. 2. There is another extended cycle pill called Amethyst that can be taken continuously for up to a year. However, the hormone content in Amethyst is actually lower than Simpesse, so it wouldn’t be my first choice. 3. Another thought is to use Hailey 1.5/30 (not Hailey FE 1.5/30). This option would be to do it continuously like an extended cycle. This is “off-label” use so your doctor may or may not want to do this. It is used as extended cycle for endometriosis and heavy bleeding due to it’s low estrogen to progestin ratio. While there are even more creative options, I think the best option is to go ahead and continue the OCP that you are taking and see if you have bleeding. Maybe you won’t! Since you would be using a back up method for birth control, it makes sense to try that first. By the way, the first 2 extended cycle pills I mentioned, both contain the hormone, levonorgestrel. This progestin is on the androgenic side. It’s perfectly fine if you are not acne prone. If you are prone to acne, then avoid those options. Best of luck to you!

@@veena-usa omg thank you so much for the reply with all the helpful information. I am currently on OCP that has the hormone drospirenone, which I am sure you already know is a progestin. Estrogen OCP never really helped to stop the bleeding so this was my next option. And you are definitely right, I won’t know what my side effects are until I start the zepbound. My PCP has me starting on low dose zepbound, so I’m low key hoping no bleeding but still will be expecting some side effects. I seriously appreciate your input! Thank you so much 😊

It’s true that Zepbound has possible side effects, especially nausea and constipation for many (but not all) people. It’s risk vs benefit. If you qualify to use this medication then your doctor determined the health benefits of weight loss outweigh the potential risks. This medication is for those that have been unsuccessful in losing weight despite diet changes and exercise program. If this is you, then I would take the plunge and absolutely continue the diet changes and exercise along with Zepbound. Here’s 2 of my recommendations: 1. Smaller meals can help reduce the nausea- that is feedback from many of my patients. 2. Include weight bearing exercise so that you keep your muscle mass during weight loss and lose fat instead of muscle. I hope you are one who tolerates it. I’m rooting for you!

How awful! Looks like it just isn't for you. If you were trying the medication for weight loss, then there is an alternative you may ask your doctor about. It's called Qsymia. If you are a candidate, it may be better tolerated.

Yes, this is correct. Wegovy (weight loss) dose goes higher than Ozempic (T2 Diabetes). But I think max dose of Wegovy vs max dose of Zepbound is fair to compare. They are both FDA approved for weight loss.

Depending on the type of hormone medication you are taking (and the health condition), it may impact your ability to lose weight or it may not. There are many factors involved and your doctor will be able to help determine if the hormone is making it more difficult. I am wondering if it is Wegovy that you have been taking for the past year at highest dose. If so, the good news is that switching to Zepbound may actually trigger better weight loss because it works through 2 different pathways in the body. If you are in the USA and you have tried Wegovy and its not working for you, your doctor can ask your insurance company to cover Zepbound (its called a prior authorization). Even if you and your doctor determine that your medication is making weight loss more challenging, you may still be able to lose some more weight, but it will probably take longer. If your insurance allows you to see a dietician, that may be helpful, just to make sure that part is optimized. Best of luck to you!

OMG... MAYBE THAT IS why mine isn't working. Are you on HRT? I went on 3 weeks ago and now wegovy isn't working. I am on 0.25 dose . I was on 0.25 dose a few months ago and it worked well. Then I stopped due to an accident and I could not drive or workout. I think it isn't working to to HRT for hot flashes.

As for Victoza, 1.8mg is the daily dose for glucose control for Type 2 Diabetes, but it is a mediocre dose for weight loss. The Victoza pen cannot dial higher than 1.8mg, but the Saxenda pen (FDA approved for weight), can dial up to 3mg which is the daily dose for weight loss and weight management. However, even 3mg of Saxenda is less effective for most people vs Wegovy or Zepbound for weight loss.

I will answer this assuming you are referring to the Ozempic pen that contains 8mg of medication and has a max dose of 2mg (also referred to as the 2mg pen). The pen is blue with a gold and white label and comes in a gold and white box. This answer is for Ozempic pens available now in the USA. Technically, the pen has 74 clicks to reach 2mg. It has 72 clicks if you are starting from the flow symbol. Most clinic and doctor charts online use 72 clicks but only address the smaller pens. I now believe that all the pens actually have 74 clicks, but clinics seem to use 72 -probably because it makes the math easier, and the difference is insignificant. I tried to link the Ozempic 2mg pen "click chart" from the Ozempic Facebook group, but I was unable. You can access that chart on the Facebook group. If you had nausea from your previous dose, you need to discuss with your doctor about either reducing the dose or staying at that dose until the nausea goes away. How many clicks and which pen were you using before when you felt sick? Make sure you talk to your doctor about your side effects so they can guide you with the dose adjustment.

I see that now. I thought the mg referenced by the pen was based on capacity, not the dosage size. Yes, i have the gold label “2mg” pen. I was on it last year and stopped for no good reason, so I went back on it. My doctor wanted me to step up doses like before (.25 then .5, then .75 and ultimately up to 1mg spaced over several weeks). The issue I see now from your video is that 72 is the full dose based on the pen. The charts I saw were saying 18-19 clicks for the 0.25mg dose, so that’s what I did. But now I see that because I have the “2mg” gold pen, the 19 clicks I did was actually equally to starting out at 0.5 mg… twice the amount, and likely why I was vomiting for several days toward the start of each weeks dose…and with headaches. It was too high to start. The chart I needed should have been for the gold pen and stated only 9 clicks for the 0.25 dose. Today starts week four and I did 19 clicks again, so holding steady at the 0.5 now with no more nausea. Someone should make a chart which is color coded for each of the pens on what dose each click is for that pen. At least it’s in the past. And what a way to lose 14 pounds those first couple weeks, haha. At least my blood sugar is back down to about 100. Thanks for the tips!

@jjcmontana yes, it should have been 9 clicks but at least now you are stable on 0.5mg. I’m so glad you are working with your doctor and congratulations on sugars under control! If you Google “Ozempic 2mg click chart” under images, you will find the Facebook Ozempic group click chart. Best of luck!

No kidding?! You are amazing!

It is very frustrating and unfortunately a scenario that happens frequently. When we lose weight due to eating less calories, our body’s metabolism may slow down. Then, if we go back to eating the original amount of calories, not only does the weight go back on, but since metabolism is slower now, weight can go even higher than before. The great thing is that you are healthy and you exercise. I have a possible suggestion for you that is more affordable than Ozempic. It is an oral prescription medication called Qsymia. It is $98 per month without insurance (see their website). Your doctor will be able to tell you if you are a candidate for it. Knowing your history with Ozempic, it may take you a long time to gradually reach your target weight. Realistically, with Qsymia alone, you may be able to lose about 10% of your body weight. Since you are healthy and you exercise, you may be able to lose even more, but be patient and keep up that exercise! It is going to be a marathon, not a sprint -and it will be worth it. Best of luck to you!

Yes! Since you have no negative side effects, move up to 5mg of tirzepatide. I’m not sure what you were at with semaglutide, but if it was less than max dose than it could have been why it didn’t work. For you, weight loss may be a slower process. All of us have unique genetics and some may get weight loss on a low dose but most need a middle or even high dose to see results. I love that you are doing all the right things! Now it’s time to continue your good lifestyle habits, and be patient as you titrate up the dose. At the 2.5mg dose, it’s just not high enough to work for most people. If you are not already doing resistance training, that will help prevent muscle loss when the weight starts coming off. Best of luck to you!

Wegovy didnt work for me and so i switched to mounjaro a month ago…still no diff in appetite ..no side effects…hoping going up to 5mg mite help…no weight loss in 7 months so far…😢

@lindabrown5053 If you just made the switch a month ago and still on 2.5mg, then it’s too soon to know. You do have better odds with Mounjaro though. Hang in there. Best of luck to you!

That’s great to know. I just took my first 2.5 MG Zepbound few days ago, I hope to lose 10-15 pounds in the first month.

Excellent results! It looks like you lost about 3 pounds per week on the starter dose and amazing that you were able to cut down food intake by 30%! Thank you for sharing -great work and unusual results!

Waaa waaa waaa

I have a possible solution for you! I have been telling my patients to reach out to their doctor to temporarily switch to Ozempic. It is FDA approved for Type 2 Diabetes and it is similar to Trulicity. In fact, the data shows a small advantage with A1c control using Ozempic vs Trulicity. There is currently no back order on Ozempic and it is fully available in all strengths. You can call your doctor and ask to switch temporarily for a month or two until Trulicity is back in stock. Best of luck to you to find a pharmacy with Trulicity or getting the switch to Ozempic!

Semaglutide (Wegovy /Ozempic) has a very low risk of triggering elevated liver enzymes. If it occurs, it is often transient and does not always indicate liver damage. Tirzepatide (Zepbound / Mounjaro) does not seem to cause elevated liver enzymes that I am aware of.

What?! You basically lost over 5 pounds per week with only the starter dose? I’m curious: did you experience side effects -like nausea? Did you also get glucose control at that dose? I am trying to figure out if there is a gene variation that causes the medication to work so well at the starter dose for a handful of people and not at all for most. Maybe you really hit the gym and cut the carbs too? Well congratulations! You are probably making folks jealous!

If you have uncontrolled hypothyroidism, then losing weight will be a challenge. The reason I mentioned it in the video is just in case someone has undiagnosed or uncontrolled hypothyroidism. If you are taking medication to correct your hypothyroidism, and your TSH is in proper range, then you will be able to lose weight using Wegovy just as anyone else. You will always need to make sure your thyroid stays in proper range. It will be dangerous for your thyroid to be too high or too low and too low results in weight gain. By the way, the TSH number is inversely related to thyroid level (the lower the number, the higher the thyroid hormone level). Lastly, since Wegovy can slow stomach emptying, it has the ability to cause the concentration of levothyroxine to be slightly higher, but it is not usually significant.

I was prescribed Metformin (Oral) 500MG and Ozemphic 0.25/0.5. I couldn’t decide so I took both of them home but I need to decide by this weekend, which one I will start taking. Any recommendations?

It depends on several factors. The vast majority of patients with Type 2 Diabetes start out with Metformin. However, Ozempic is now also considered an option for first line treatment. If you are not overweight and / or will have difficulty continuing Ozempic due to the price, then I would start with Metformin. You can always add Ozempic on top of Metformin after your body gets used to Metformin. This is a common combination. If you are significantly overweight in addition to Type 2 Diabetes and your insurance coverage allows Ozempic at a reasonable price that you can afford, then I would opt for Ozempic. Depending on your A1c, you may need to eventually be on both medications -but you should not start them simultaneously due to gastrointestinal upset during the titration period for both of these.

@@veena-usa Thank you 🙏

Yes, you can take Wegovy long-term. In fact, in the US, it is approved as long-term maintenance for weight control.

Darn, that's too bad. It is not for you then and Zepbound may result in the same side effect. There is another medication called Qsymia that is a daily, oral pill. You might discuss with your doctor to see if you are a candidate.

Congratulations on 45 pounds lost and A1c 5.6! Slow is perfectly fine! I hope many people read your comment. Sometimes it takes a long time to lose the weight. Unfortunately, alopecia is an uncommon side effect of Mounjaro and affects females more than males. It sounds like fasting and intermittent fasting were your success. Those that are able to maintain intermittent fasting are often successful with weight loss and it leads to less insulin resistance (according to a meta-analysis published in 2022) so you become healthier. If you can keep the weight off without using any medication and only fasting / intermittent fasting, then excellent for you! That is the best way to live! You are an inspiration and thank you for sharing your journey!

@veena-usa thank you! I forgot to mention I have a continuous glucose monitor which is a game changer letting me know what foods I can enjoy without sugar spikes above 130 after meals unless I eat fruit. Thank you for this channel

CGM is revolutionary. A great way to control glucose without medication.

Your comment is important because it is similar to feedback I hear regularly. The downside to losing weight and then gaining it back is that metabolism can slow down after significant weight loss. This can make it harder to lose weight again and maintain weight loss. You are on the right track to try Zepbound. Don't be discouraged; just keep titrating up on the Zepbound. It will be challenging though because it is often unavailable. I am not sure if you have a support system. It will be well worth it to work with a weight loss program. In addition, on the Zepbound website, you can sign up for "Tips, Facts and Inspiration" because they want you to be successful. You can still lose that weight -it will be a bit more challenging now and will take longer. Hang in there!

@@veena-usa thank you so much! this is so encouraging. I will check out the site as well.

This is actually surprising. I have never had feedback from a patient like this before. You did very well at the starter dose and 4 weeks is not long enough to plateau. I don’t actually have a good explanation. Is it possible that this pen got left out of the fridge past the 8 weeks? Or did the pen get exposed to heat? I’m hoping someone else reads this comment and knows something that I don’t know. I wish I could be more helpful but I’m stumped.

The same happened to me!!!

@veena-usa : I don't know about how the pharmacy handled it but I've refrigerated the pen since I got it. I don't know if I should wait to see what happens with a new pen or ask my doctor to switch to the 1mg dose.

@@zivotugrckoj : What did you end up doing to solve the issue?

Your doctor will not increase your dose until you’ve completed 4 weeks at 0.5mg. Yes, I think you should ask your doctor to increase you to 1mg after the 4 weeks. Now another person commented that the same thing happened- so odd.

Compounded tirzepatide should (in theory) be the same or very similar to the brand name Mounjaro or Zepbound because they will contain the same active ingredient. I’m only familiar with sterile compounding regulations in the U.S. so I can’t speak to one’s produced outside the U.S. When compounding pharmacies fill an order for a patient, it is not supposed to be for the exact same strength and dosage form that is commercially available. They are allowed to compound something with a similar strength /dose that the patient would not be able to get commercially. The device to inject will also be different. The compounded products are not FDA approved but should provide same or similar results.

Thank you!

Your welcome!

Wow! Congratulations! You are one of the amazing few that responded early.

did you work out and eat healthy, or was it just the medication?

You are actually a success! Here is why: your A1c has dropped to 6.2, you limit carbs to 60g per day (you’re amazing) and you already lost weight on the 1mg dose of Ozempic! The reality with these medications is that you can lose up to 15-20% of your starting weight. Losing even 5% of your body weight can give significant health benefits. You are headed in the right direction and will probably do even better when you start your 2mg dose. Best of luck to you!

I did not have any drop in glucose levels or hba1c , did not lose any weight for over a year on ozempic. Just had terrible pain and stomach issues.

You’re welcome!

First of all, congratulations on only 20g carbs per day and sugars in control! Assuming you are getting the 7 hours of sleep, not under daily stress and you are exercising, then you could consider asking your doctor to switch to Mounjaro. It controls glucose levels just as well as Ozempic and studies show better weight loss. I don't want you to have to share too much private info here, but take a look at the other medicines you take and talk to your doctor or pharmacist to determine if any of these have weight gain as a common side effect. Assuming you don't have an issue with another health condition or medicine causing the weight, then my best luck to you to fill your first Mounjaro prescription. It is hard to find, but looks like the right direction for you.

​@@veena-usaI have the exact same issue I've been doing everything right one meal a day walk for exercise I eat one meal a day I'm constantly moving I sleep really well and I do sleep 7 to 8 hours a night I'm never tired but just frustrated I went from a 3X pants to One x pants so I'm losing inches but it's frustrating not seeing it on the scale I go to see my doctor next month I am going to request the Manjaro with hopes it will move the scale a little faster any suggestions and thank you for your content.

Don’t be discouraged! Pause for a minute and congratulate yourself for going down 2 pant sizes! Additionally, not everyone has the determination to do time restricted eating and OMAD is the strictest version so I know you are determined. Here is what may be happening: you may be experiencing something called “Body Recomposition.” This is when you lose fat and gain muscle at the same time. This is a good thing and muscle is denser than fat and weighs more than fat. This causes your body to be thinner and more toned. This will only happen if you are exercising and apparently you are doing it well. That said, I am glad you will be meeting with your doctor. Hopefully you will be able to have a good discussion to go over everything (all of your health conditions, medications…). Yes, I think it will be appropriate to ask for Mounjaro (or Zepbound) if your weight fits the criteria. Best of luck to you!

Excellent question! 7.5mg is the only strength that does not have a corresponding dose in Wegovy titration. Wegovy doubles from 0.5mg to 1mg and Mounjaro does a slower titration from 5mg to 7.5mg to 10mg. Wegovy uses 5 steps to reach max dose and Mounjaro uses 6 steps. By the way, so far, there have not been any published equivalency studies so we are estimating and assuming corresponding doses.