PMR and Mounjaro

[Janet57]

I’ve had PMR for some years. My weight has yo yo’d. I had tried to limit carbs with some success, and lost 3.5 stone on WW - but put it all back on. I love cooking, love food and always feel hungry. I am considering Mounjaro as I know two people who have used it successfully. What I’m asking here is anyone with PMR/ on steroids (I’m currently on 3mg) taking Mounjaro and also if there are any known interactions. Thank you 😊

[DorsetLady PMRGCAuk volunteer]

See this - nothing major -

drugs.com/interactions-chec...

This is a previous post on same subject -

healthunlocked.com/pmrgcauk...

[Janet57 in reply to DorsetLady]

Thanks Dorset Lady, I’ll look at these 😊

[123-go]

Hello, Janet57. More reading here for you to dip into:zoe.com/learn/why-am-i-hung...

[Janet57 in reply to 123-go]

Thank you

[piglette]

As DorsetLady points out steroids and Mountjaro are not happy companions. I assume your friends who are taking it are not taking drugs for other reasons as well, as there do seem to be counter indications in some cases.

[Janet57 in reply to piglette]

Thank you for that

[piglette in reply to Janet57]

Think carefully about taking drugs!!

[Janet57 in reply to piglette]

I will Piglette.

[PMRpro Ambassador]

This is the professional advice for Mounjaro and pred which indicates there are problems with blood glucose control

drugs.com/drug-interactions...

It is emerging that the use of these drugs for weight loss isn't as simple as you might think.

[Janet57 in reply to PMRpro]

Thank you PMRPro - I’m doing the research and wouldn’t start anything like this without my GPs advice (he’s a good one 😉

[PMRpro Ambassador in reply to Janet57]

YOu have seen all the stuff here about cutting carbs? It also helps reduce the craving hunger by smoothing out the blood sugar levels that trigger insulin release and BS levels to plummet.

[tangocharlie in reply to PMRpro]

From what I've read and heard I'd be inclined to think it could work well but I don't know anyone who has tried it. I've been trying to research it as I've done a lot of reading on low-carb eating and I thought this question would come up sooner or later. Firstly, these injections work on that bit of the brain that regulates appetite and reset it, and people on steroids do have increased appetite, so that could be useful. Seconly the key seems to be that you use time on the semaglutide to change your habits and switch to low cab eating, which shoud in theory be easier if you are freed from the cravings. I've read this link a couple of times now and it seems to be saying that caution needs to be taken because steroids increase glucose level , which we already know, so might not be as effective for people on steroids. So I'm confused, surely that is an endorsement to take the Mounjaro/Wegovy etc? Isn't it just warning that it might not be as effective if you are also on steroids? Tim Spector says these drugs can work well if and only if people change their eating habits as a result. Otherwise they will just put the weight on again if they stop the injections. That's my understanding of what it saying, that it might not work. The NHS would do far better if it gave people CGMs to learn how to lower their blood sugars rather than giving out expensive presciptions to people who don't then change their diet - that will just bankrupt the NHS

[Janet57 in reply to tangocharlie]

Many thanks for your reply. It’s a complex situation and there’s a lot to think about. I’ve an appointment at the health centre in the week so will discuss it there.

[Kendrew]

Hi Janet57,

Really well done on your previous weight loss.... you obviously found a successful way to achieve this with the help of weight watchers.

I know only too well the struggle many of us have to maintain a healthy weight whilst on steroids and I have (and still do) work hard to achieve this.

You mentioned constantly feeling hungry, so these are a few strategies that I've found, that help me to keep hunger at bay:-

- I always have a good breakfast.

20g of porridge made with skimmed milk & a tablespoon of ground linseed mixed in. I then top with some fresh raspberries, blackberries and blueberries. I also have a chopped up orange with a teaspoon each of sunflower and pumpkin seeds and a tablespoon of organic natural live yogurt.

It's not necessarily very low carb but it does keep me full until lunchtime.

Lunch is often something with eggs, like an omelette or poached eggs.

Dinner will be chicken or fish (I love fresh tuna and salmon) with a homemade salad or vegs such as cauliflower and broccoli.

- I eat lots of protein because that keeps me fuller for longer.

(Chicken, fish, nuts & seeds, eggs, etc)

- I also drink lots of water each day which definitely helps (often when we think we're hungry, we're actually thirsty, and just need a drink)

So now, I very rarely feel hungry.

I personally would never consider taking a weight loss medication unless I'd been diagnosed with a specific medical concern that required it and even then, only if all other options had been exhausted.

Although these weight loss medications are invaluable to many, including some people who are at serious risk to their health because of their excessive weight, I personally don't feel they should ever be seen as an 'easy option' for those of us who just want to be slimmer, quicker. (I'm definitely not suggesting that's you so please don't think I am.)

No medication is ever 'safe', and Mounjaro is no exception. It too will have side effects.

You successfully lost a significant amount of weight before, and although it took time, I personally feel that slow & steady is always the safest way to do it.

You may of course have very sound reasons for not wishing to take the same path again, but some of the points I've raised may be worth considering before you make a choice..

This is just my opinion to give you another perspective on the situation, and obviously whatever you decide to do will be the right thing for you.

Good luck with whatever decision you finally make, and I hope you're successful.

[Janet57 in reply to Kendrew]

Kendrew , thanks for taking the time to reply with some valuable advice. I eat a lot of the right things but just too much.. I could write a diet book 😂. Your breakfast is a good idea and sounds lovely. I might try that and see how it goes. You’re right, it is a big step taking a weight loss drug. I had a full knee replacement last year and it went well but I piled on the weight as I couldn’t exercise. Now I’m back doing Aquacise and just had a golf lesson to re-start golf which I previously loved. Weight has always been an issue so I wish I could crack it permanently. Thanks again for your kindness and advice 😊

[Kendrew in reply to Janet57]

I do understand completely. If something prevents us from undertaking our usual exercise then that definitely inhibits further weight loss....or at least, slows it down significantly.

Pre steroids, my normal weight was around 9st 0lbs. It's now 9st 7lbs and no matter what I do, it currently won't drop any lower. An increase of 7lbs after 6yrs on prednisolone, isn't a major issue, but my whole body shape has changed. Fat distribution is no longer evenly spread across all parts of my body, and sits annoyingly round my middle (just as we're told its likely to do when taking steroids)

It's so frustrating, but we mustn't give up trying, and you're clearly not, so well done.

You seem to be actively exploring your options....something I always do before making any decision..... and this forum is the perfect place to gather opinions from other members and receive advice from our knowledgeable 'ambassadors.

PS. Haha! I'll have a copy of that diet book too please, when it's published!! 😂😂

[Rabbit090 in reply to Janet57]

Just as another point of view, I have been pretty successful losing the weight I wanted in a very short time although it is rather a lot of work!

I have followed the advice here about cutting carbs, but I also make sure I eat to a calorie deficit as I also know it’s quite easy to eat larger portions than you might intend.

I use an app called MyFitnessPal that helps me monitor the number of calories (and nutrients!) in the food I eat. I picked a calorie limit of 1300 per day and keep under that. It also helps me understand how many carbs are in the foods I eat as well as sugars and sodium so I’ve set limits for those as well. I can also track my calcium and protein intake as those are also a struggle for me. It’s surprising how hard it is to get enough protein - even eating it at every meal

It also links up with other apps like my Fitbit app so I can make sure I get enough exercise as well. I hate exercise but it really is the key to all of this, in my opinion. Nothing controls blood pressure and weight as well!

Like I say, it’s a lot of work and not for everyone, but it’s something that works for me.

[Janet57 in reply to Rabbit090]

Thank you for your advice. I’ve got a lot to think through 😊

[Karenjaninaz in reply to Janet57]

Although I never had a weight issue my body became the same way as you described. I can only tolerate moderate, short exercise like stationary bike, treadmill and NuStep elliptical. That has started removing the offending padding as I taper to 6 mg pred.

[Janet57 in reply to Karenjaninaz]

Well done - it’s not easy

[Claribel55]

Hi Janet57. Although I am not on steroids as it turned out my stiffness and aches were not PMR I have found the late Dr Michael Morley’s plan - The Fast 800 - to be magnificent at achieving - and more importantly keeping - weight loss. Whilst not exclusively low carb it was originally formulated to reverse the start of type 2 diabetes and follows the Mediterranean diet. If you subscribe on the Web and then download the app after it’s a one off payment for the 12 week plan and then a monthly charge for ongoing use of the app. Not cheap but also probably no more when spread out than the cost of weekly visits to WW or SW. I did not have too much to lose (around 2 stone) which I did within the 12 weeks and have kept it off for 6 months since. I followed their 5:2 for the 12 weeks (if you have more to lose they might recommend 800 calories every day for the 12 weeks) but the meals are delicious and mostly quick and easy as well as nutritionally balanced. They even provide a shopping list for you!! After years of SW with low fat everything it was a revelation to be encouraged to eat full fat yogurt, avocados etc and still have consistent weight loss!! Good luck to you on whichever route you choose.

[Janet57 in reply to Claribel55]

Well done - sounds like it’s been very successful for you. Thank you for your advice.

[Muzerate]

I've been on it. Normal side effects and lost weight. Just trying to keep it off now.

[Janet57 in reply to Muzerate]

Thank you - would love to hear your progress.

[Muzerate in reply to Janet57]

Hi, I bought my mounjaro through a company who offer ongoing support and exercise classes. It wasnt the cheapest but they offered a hood service. Any problems you could email them and someone would call back within a few hours. I was only on it for 3 months, but during that time, I lost 19lbs. I came off because I was having gastric problems, which are a well-known side effect, and I decided to go it alone after that. I've managed to lose more weight and am now trying to maintain. It's not easy and I'm resigned to constant dieting. I eat a lot of protein and Im trying to get in the habit of regularweight training to build muscle. . The suppliers were aware of my steroids, and my GP was informed. No problems with the 2 drugs and I feel so much better for losing the weight. Good luck to you x

[Janet57 in reply to Muzerate]

Thank you - well done for losing the weight and keeping going 😊

[Potemkin]

Hi Janet - I've had a look at this recently and now seem to be inundated on my feeds with the different companies selling it. I know people who have had success but don't know anyone who has got to the point of coming off them yet - a lot seem to accept they might be on it for life. That's the bit lat puts me off. I haven't got as far as asking the Dr. It certainly is an attractive option but for me I've decided it's not the one. However we are all different. Why don't you talk to your Dr

It sounds like you know what to do - I do too but it's hard. For me being consistent is the key. I get hungry about 2 hours after I've eaten and I eat protein high meals. I'm now working on deciding if I'm actually hungry and if not trying not to eat.

I did Second Nature which is a holistic programme run by a nutritionist and looks at why you eat. I found that very useful. In some parts of the UK you can be referred by your GP. I also follow Dominique Ludwig who advocates protein to keep you full. There are some wonderful recipes especially if you like to cook, also ones for those who aren't so keen. I haven't done the fasting really as I take my Pred around 9:30 so am breaking the fast.

I do think that Drs accept we will put on weight with Pred which isn't encouraging but it seems people on here do lose. It is an extra hurdle though.

Maybe now you are back exercising that will help your mindset. I find when I do that it helps me to eat better. Good luck.

[Janet57 in reply to Potemkin]

Thank you for your response and the information you provided. I’ve lots to think about.

[Pixix]

I’ve been on crutches for 11 weeks and inevitably the weight is rising! I did the keto diet & lost a stone in 7 weeks2 years ago,& the fast 800 looks like my next try. Good luck, S x

[Janet57 in reply to Pixix]

Thank you. Good Luck to you too.

[Pixix in reply to Janet57]

Thanks!

[Pippah45]

Quite a few years back (before PMR) I did a paid for Low Carb plan and lost plenty so I knew it was what worked for me. For me it is getting in the right head space for it and finding what keeps me from hunger pangs. I stick to berries for the only fruit I eat and have 100gs for breakfast with yogurt and double cream topped with a granola of some sort or another - often home made. That sets me up till lunch. I have recently got to within half a stone of the weight I left school at which I am pretty happy with as this is my 80th year.

[Janet57 in reply to Pippah45]

Well done - you’re right, the mindset is critical. You’ve done so well and I thank you for your advice 😊

[Marmille]

good morning. I have been using compound trizepatide for a while. On 4 mg of prednisone. No issues

[Janet57 in reply to Marmille]

Thank you for your reply - that sounds positive. 😊

[Aoakleymoore]

I just started Mounjaro 3 weeks ago. I’m on 1/2 mg of pred. I still have an appetite at this point.

[Janet57 in reply to Aoakleymoore]

Thank you for your reply. I wish you well and hope you get the results you are looking for. There’s a lot to think about 😊

[carolpatriarco01]

I have been on 3mg per day of prednisone for 2 years and on OZEMPIC almost 2 years now. No problems. Definitely less of an appetite. I have type 2 diabetes and the OZEMPIC has brought my A1 C that was 9 down to 7.

[Janet57 in reply to carolpatriarco01]

Thank you for your reply - your medical condition required treatment. I’m not diabetic so I feel a bit guilty even thinking about it for weight loss only.

[artfingers]

As PMR Pro says, it can affect your blood sugar, as is also true with Ozempic and Wegovy (Semaglutides). I have been on Ozempic for six months with no issues even though I have hypoglycemia. It's crucial to be monitored by your rheumy or doctor closely (I have blood tests every three months) and to pay attention to glucose levels. I'm only on 4 mg prednisone (split dose) but even so struggled to keep weight off despite walking 3 miles almost daily, and a careful diet. Mounjaro is supposed to be the better drug for losing weight but comes with similar warnings. My A1C was borderline but if you are in the U.S., I found this year Ozempic was covered by my Medicare Advantage. Before that I had to drive to Canada to get it for a fourth the price as here. My friend who is diabetic just got Mounjaro covered by his insurance (BCBS) again, in the U.S. I have lost 15 pounds. My cholesterol also has gone down. I rarely drink alcohol anymore (no desire).

[Janet57 in reply to artfingers]

Thank you for sharing this information with me. If I do go ahead it will be with the GPs advice and monitoring. It is available on NHS but only to those with a number of weight related conditions. If I didn’t qualify for that it’s £140 per month. A lot to think about. 😊

[Mumdadlove]

I have spoken to my rheumatologist about this, I have gained 3 stones, I now get breathless have a wheeze, my joints hurt, I struggle with the stairs, my heart races, now on BP meds and pre diabetic, all having a big impact on my heart and other organs, I also have idiopathic intercranial hypertension(the best thing for that is to loose weight) my rheumatologist has no problem with the weight loss jab and wrote it in the letter to my GP, he is known and very respected on this site, so I think if you have issues from the weight gain that is impacting your health that it is ok to try as long as monitored

[Janet57 in reply to Mumdadlove]

Thank you for your reply, that’s very interesting and helpful. 😊

[PMRflare]

Hand in there, Janet57! I, too, am a little “avoir des poids” and was finding it hard not to gain weight while dealing with side effects of Prednisone. My doctor and I chatted and she said to give it a try, which I did. I had been slowly losing weight and taking the GLZp-1 stopped that loss. I never reached the final dosage and found I felt better after quitting. I have now resumed my “slow losing” and do not regret stopping. It is terribly expensive and for me ineffective. I am sure everyone’s experience is different but I just decided to keep my own control. You can be successful: just decide on a plan that is good for you and not limiting all the things you enjoy. Too many diet plans out there have us practically starving. A number of the previous writers have shared some good ideas.

I have had PMR since the beginning of 2024. Started at 15 mg, then 20 mg then 25mg. Nothing was working until I was upped to 40mg and finally some relief. Since then I was down to 9 last summer and flaring when I joined this group. Thank you wise individuals who explain proper tapering! I am currently tapering to 8.5 mg. Aside from the miserable myriad of side effects, I am doing okay. Just yearning to get off the pred and feel myself again.

Best wishes to you and the other contributors. It is wonderful to have all this wisdom available - I am very appreciative here in Nova Scotia, Canada (age 79).

[Janet57]

thank you for your reply. I’m glad your tapering is going well, but take care not to try to go too fast - it won’t work. It’s what you need to manage the inflammation that PMR brings to your body. This group has been so helpful to me during my PMR journey. I’ve got some research to do and I’ll be in the health centre in the week to discuss next steps and whether that might include Mounjaro. Nova Scotia - how lucky to be living in such a beautiful part of the world. It’s on my bucket list.