Mounjaro Noob: A Cautionary Tale

Cool_Healed

Well-known member
Late bloomer when it comes to Type 2. Tried Metformin for about a quarter of a year before switching gears to Mounjaro. My doc did warn me that Mounjaro's side effects can be a bit more intense, and that I really needed to be on top of my blood sugar checks. I gave a confident nod, but then promptly forgot. After all, I didn’t bother with testing while on metformin, and things seemed fine.

First couple of weeks with the injections were smooth sailing, just a weird feeling a few hours post-injection. But after the third shot, I ate breakfast but totally skipped lunch and supper because I simply wasn't hungry.

Later that night, my kiddo came in, and I asked her to crank up the space heater 'cause I was shivering. I was thinking, I must just be cold, right? Heater aimed at my desk while I kept typing away, waiting for the warmth to kick in.

But nothing. An hour flew by, and I was still shaking like a leaf. Why so frigid? I even poked around my stomach, wondering if something was bleeding in there. Felt alright.

Super thirsty too, so I wandered off to the kitchen for a diet soda. On the way, my daughter asked me to make some popcorn, and I had to decline, saying I wasn't feeling too hot.

The one smart thing I did was loop my daughter in and ask her to keep an eye out for any weirdness. She was the one who pointed out that my shivering might be the new med. Honestly, it hadn't even clicked. I hopped in a hot shower to warm up, even though I didn't really *feel* cold.

While standing there in the shower, I looked up the side effects. Nausea? Nope. Diarrhea? Nope. Indigestion – isn't that the same as nausea? Whatever, nope. Pancreatitis... please no. No tummy pain, at least.

Around page three, I saw a note: Mounjaro itself doesn't cause hypoglycemia. Good to know. But it can kill your appetite, and *that* might lead to low blood sugar.

Bingo. I skipped two meals, remember?

So I Googled hypoglycemia symptoms. Shakes – check. Racing heart – check. Pale face – yup, shaving mirror confirmed. Crap.

Mayo Clinic time. Needed sugar, stat. We were fresh out of sugary drinks, of course. Got out of the shower, got dressed, and texted my daughter to bring me a popsicle. Sugary overload, but I forced it down. Ten minutes later, sprawled on the couch, I asked her for a spoonful of straight sugar, which I also choked down. And then I forced myself to eat a real meal (surprisingly hard when you have zero appetite).

Slowly but surely, the shakes faded. But, being the genius I am, I then ordered some glucose strips online so I could monitor my blood sugar. They showed up a few hours later, and I spent a good five minutes puzzling over the instructions before realizing the strips were as useful as a chocolate teapot without a glucose meter. I somehow thought you could dip the strips in your blood and read them like a pH test.

I've since stocked up on glucose tabs, got a proper monitor, and make myself eat three squares a day whether I want to or not. No repeats since, so I dodged a bullet.

Be like Gallant and listen to your doctor's instructions when taking Mounjaro. Don't be like Goofus (me) and just do whatever without thinking.
 
Alright... it might have been a minor case of hypoglycemia, but the fact that you were so clear-headed the whole time makes me think probably not. Sounds more like hunger, plain and simple. Feeling cold in the early weeks is common. Forgetting to eat, also very common. If you're diabetic but not on insulin, the odds of that starting dose of Mounjaro plus skipping two meals actually causing symptomatic hypoglycemia are pretty low. Getting a glucose meter is a good move, but you might want to ask your doc about a CGM (continuous glucose monitor).

Also, even if it *was* low blood sugar, a popsicle would have been plenty to fix it. If you still felt bad, it was likely just hunger. Mounjaro doesn't stop you from getting hungry, it just makes you less hungry and slows down digestion.
 
Haha, newbie mistake! Sorry for laughing, that sounds awful, but good for you for figuring it out and taking care of yourself :)

It's way easier to adjust as you go when you're in decent shape to begin with rather than scrambling to fix things. You can still have smaller meals – overdoing it isn't great, since your stomach empties slower now.

There's a lot on this forum and others about maximizing the good and minimizing the bad with this med. Since you are dealing with T2D, you need to be extra careful. Jot down some basics – we all forget: drink tons of water, deal with constipation before it gets bad, maybe consider supplements if your energy drops.

Glad you solved the cold mystery :)
 
You really should have been testing your blood glucose since your diagnosis, honestly.

I'm glad you figured out it was probably low blood sugar making you cold. But also, just so you know, extreme coldness is a known side effect of the med itself. I got hit with it within 8-10 hours of my first shot and it hasn't really gone away, even after almost a year.
 
I started three weeks ago, the starter dose, and my appetite has vanished. Plus, waking up with killer nausea/dizziness and the whole package of digestive problems. Only made it two weeks before I had to stop and see if it's really the Mounjaro or not. :( I'm clearly not the sharpest tool in the shed either.🤝
 
Thanks for the advice, SnackRN! I'll definitely chat with my doctor about the CGM. I was pretty out of it, but maybe it wasn't as bad as I thought. Still, better safe than sorry, right?
 
I agree it's important to monitor blood sugar.
Cool_Healed said:
I have since stocked up on glucose tabs, got a proper monitor, and make myself eat three squares a day whether I want to or not. No repeats since, so I dodged a bullet.
Glad you've learned to eat regularly now!
 
For those just starting out, don't panic if you don't see results immediately. I've seen many people lose slowly at first, then it picks up. Everyone's body reacts differently.
 
A1c of 4.6? That's amazing!
SnackRN said:
For those just starting out, don't panic if you don't see results immediately. I've seen many people lose slowly at first, then it picks up. Everyone's body reacts differently.
Very true. Some see fast weight loss, others see the real wins with blood sugar and other health markers first.
 
That's encouraging to hear! I'm hoping for both weight loss *and* better blood sugar, so fingers crossed! Maybe I'll post some progress pics in a while!
 
The metformin-first approach is sensible - letting the metformin establish a baseline before adding Mounjaro gives you a cleaner read on what each medication is contributing. The 'added to' rather than 'switched to' distinction matters for understanding the effect of each component separately.
 
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