Some of the side effects, like nausea, sulfur burps, acid reflux, constipation & even appetite suppression, come from the delayed gastric emptying feature of MJ. This is a real physical phenomenon that happens and it happens most effectively in the early days of taking MJ. Every time you titrate up in doses, the delayed gastric emptying feature will kick in a little more again.
But in time, once you are settled on a dose for 4 weeks and longer, you’ll reach a steady state of the dose in your system. Once consistency on that dose happens, there won’t be any more ramping up of the delayed gastric emptying phenomenon.
Homeostasis of your ordinary digestive speed starts to set back in. In rats, they learned that Delayed GE went away in only two weeks; as humans, our mileage may vary. They tested this by giving Tylenol and seeing how long it took for the liver to receive and metabolize it.
So here’s the good and bad news about delayed GE ending: first, Delayed GE is what causes or contributes to so many of the side effects we hear about. It causes acid reflux when food doesn’t leave the stomach and you lay down at night. The acid and food sitting there too long generates a feeling of nausea. It can also go icky and make you vomit. It slows peristalsis in the guts, causing slow motility and in some cases, constipation. It also naturally makes you not hungry, because you’re literally physically full. So what this means is, when delayed GE goes away, YAY for there’s an end in sight to those side effects, if you had them!
On the other hand, Delayed GE results in lower blood sugar numbers. Because the body’s intestines are not getting sugar dumped into them rapidly, and bc you stop eating food prematurely compared to before. You’re ingesting fewer carbs to process by default, as the delayed GE feature has you ingesting less overall.
What this means is, as delayed GE (and associated side effects from it) diminish, you may see your blood sugar rise back up a bit.
Not understanding this is alarming to people staring at our blood sugar numbers and going “wait, what happened? Why is Mounjaro suddenly not working? Am I going to become an A1C of 10 again?” But the blood sugar rise is not even close to equaling what it was before. The delayed GE feature is real, and has an effect on blood sugar, but it’s not HUGELY significant. It’s not the central mechanism of action that makes Mounjaro work.
Delayed GE is NOT required in order for the drug to still work. All the research states this. The drug works in the absence of Delayed GE.
Now you can still experience suppressed appetite once Delayed GE goes away; a large part of that is due to the GLP-1 receptors being hit inside your brain. And inside your tongue. These receptors being hit tells you that you’re not hungry. You’re full. And if you are lucky, it also tells you that unhealthy food tastes like 💩.
This is real and it also happens to rats, so it’s not some human psychosomatic social mumbo-jumbo. Your body will stop preferring high carb, high fat foods. Your tastes will change. Some people say “what happened? I used to be a fan of this soda drink and I can’t even handle more than 2 sips. My old favorite junk food snack tastes awful and doesn’t hit right!” This is why. GLP-1 receptors are all over your body and inside the tongue and they say “Your preferences are changed now,” as the Mounjaro molecule hits them.
This isn’t 100% true for 100% of people. But if you are already experiencing these things, it will likely be the case for you that they’ll continue, even if at a diminished level as time goes on.
In the meantime, if you have diminished appetite, be proactive and decide how you will handle it. Do not just eat based on your gut instinct; that can be misleading. You could end up under nourished and dehydrated. Don’t allow that cascadeof bad things to start. Be prepared. Make a plan and determine how you will successfully get what you need for optimal nutrition & hydration and execute your plan.
For me, I didn’t need any protein shakes until I moved up to 12.5 & 15mg. My appetite suppression then hit and I decided to research some good shakes. I’ve got some kachava protein powder shakes. I blend a handful of blueberries, some coconut water which has electrolytes, some other mix-ins like probiotic yogurt. I’m blown away by how good it is. One shake with two scoops makes me feel stuffed and sometimes I have to give some to my husband to finish off.
But I do not worry about what I’ll do if I don’t want to eat. I have a remedy and it’s ready to go and it gives me lots of nutrition and an excellent glucose number. You can do the same things for other side effects and be prepared to set your anxieties at ease. Below are some popular remedies collected from group members about how to handle common side effects.
“Gastrointestinal Adverse Events of TZP in the long duration may not be significantly correlated with dose. In fact, GI AEs remain the most common AEs of TZP, but their severity is mostly mild (39) and decreases over time (26). The mechanism by which Tirzepatide causes Gastrointestinal Adverse Events has not been fully elucidated and may be related to the activation of GLP-1R in the central nervous system (40), but no conclusive evidence is available.”
Occurrence of nausea, vomiting and diarrhoea reported as adverse events in clinical trials studying glucagon-like peptide-1 receptor agonists: A systematic analysis of published clinical trials
Diabetes, Obesity and Metabolism
https://dom-pubs.onlinelibrary.wiley.com/doi/full/10.1111/dom.12824
Adverse Effects of GLP-1 Receptor Agonists
Rev Diabet Stud, 2015