It’s always difficult when life-changing drugs come with uncomfortable side effects. We see it all the time with crucial medicines such as blood pressure tablets and statins.
With weight-loss jabs, though, it can feel especially cruel. I see more patients with what many now call ‘Mounjaro cramps’ – griping stomach pain, often with a desperate rush to the loo.
Spending about £300 a month on the drugs, only to then find you can’t tolerate them, is, I understand, deeply disappointing. But with these drugs, Mounjaro and Wegovy, digestive side effects are the norm rather than the exception.
Nausea, vomiting, diarrhoea and constipation are each thought to affect at least one in ten people taking them, and stomach pain is common too. These are not the most dangerous side effects. Much less commonly, the jabs can trigger gallstones or pancreatitis, but the everyday side effects are what wreck quality of life, and in my experience they are the most typical reason that people stop taking them.
Some patients tell me the cramps and toilet dashes are worth it for weight loss that eluded them for years. But others can’t handle the pain and quit, leaving them at risk of all the health complications linked to obesity.
These jabs mimic a gut hormone that slows the rate at which the stomach empties – that is part of how they keep you feeling full. But it also means food lingers in the stomach, which can bring on bloating, nausea and cramping, and leave the bowels swinging between diarrhoea and constipation.
Symptoms are generally worst when you start taking them, and each time the dose goes up – which occurs regularly in the first six months. Sometimes the vomiting and diarrhoea are so severe that patients ring the surgery convinced they have a terrible stomach bug, only to realise their mistake when it happens again after the next injection.
I see more patients with what many now call ‘Mounjaro cramps’ – griping stomach pain, often with a desperate rush to the loo, writes Dr Ellie
The single most important fix is to take the jabs with a doctor rather than an online shop. This isn’t only about getting help once side effects strike – it’s about preventing them.
Both Mounjaro and Wegovy start at a low dose and step up gradually. Online providers tend to be rigidly protocol-driven, pushing patients up the dose levels on a schedule, regardless of how they feel. As a result, many end up on high doses quickly, and side effects follow.
With proper reviews, a doctor can keep you on the same dose if the medication is working or side effects are starting, or even bring down the dose. That often heads off the worst of it.
Some of my patients never increase the dose – if they are losing weight, there is no need, and taking it slowly makes them less susceptible to problems.
Next, think about when you inject. The jabs are weekly, taken on the same day each time, and side effects usually kick in about a day later. Choosing the right day can make all the difference.
Some of my patients inject on a Friday so they can ride out the side effects at home over the weekend. Others would rather be distracted by work, and inject earlier in the week to enjoy a symptom-free weekend.
However, a food diary can potentially ease the suffering, revealing reveal what triggers problems.
Smaller, nutritious meals, eaten slowly and stopping as soon as you feel full, also give a sluggish stomach less to cope with.
It is important that patients do not ignore pain that is severe or won’t settle, particularly if it spreads to your back, sits under your right ribs or comes with persistent vomiting. That needs urgent medical attention, as it can signal pancreatitis or gallstones. And if you are being sick or have diarrhoea, keep drinking fluids.
Finally, there is a huge emotional side to these drugs. For people who have struggled all their lives, they can be life-changing. That makes it all the harder when the journey is unpleasant, or not the miracle they hoped for.
So having honest expectations about what side effects you can put up with is perhaps the most important thing of all.
Rather than worry about how it looks, get on with saving her life
I was shocked to read research that suggests many men would not perform CPR on women. Last week I wrote about how heart problems have always been considered male issues, but they impact the genders equally.
Now this research shows that when women do suffer a sudden cardiac arrest – when the heart stops beating – they may be less likely to receive life-saving CPR. It involves chest compressions to keep the blood moving while waiting for an ambulance to arrive. But according to St John Ambulance, the first aid charity, around a third of men say they would be hesitant to carry out CPR on a woman for fear of being accused of inappropriate touching or being filmed by bystanders.
Research shows that when women suffer a sudden cardiac arrest, they may be less likely to receive life-saving CPR
I understand the hesitancy, but this squeamishness could be costing lives. So let me be clear to any man reading this who finds themselves in this position: women will always be thankful for you saving their lives, even if it involves touching their breasts.
Your questions answered
I’ve started getting hay fever symptoms even though it’s autumn. What could be the cause?
One of the most likely causes of an autumn allergy reaction that is similar to hay fever is mould spores. These are microscopic seeds released by fungi that travel through the air.
They become more common in warm, damp weather – for example, during the transition period between summer and autumn.
Many people are allergic to these spores, while there are those who suddenly develop this reaction late in life.
Another allergy-triggering cause could be house dust mites – minuscule creatures that live in dust. As the temperature falls, people stop opening their windows, and so dust – and the accompanying mites – build up in the house.
The good news is that the drugs – antihistamines – used to combat the pollen allergies that cause hay fever are also effective against mould spore and dust mite allergies.
These over-the-counter tablets can tackle mild to moderate allergy symptoms such as itching and sneezing. However, it is important that sufferers take them every day to prevent symptoms building up.
But patients can stop taking antihistamines when their allergies settle down – both mould spore and dust mite reactions tend to ease in the winter months.
There are also over-the-counter nasal sprays, available in most high street pharmacies, that can reduce the inflammation in the nasal passages that triggers many allergy symptoms.
However, it is possible that these symptoms are not necessarily down to allergies. Colds and Covid are all on the rise in the UK at the moment, months earlier than they usually appear, and they can trigger similar symptoms too.
Do you have a question? Email DrEllie@mailonsunday.co.uk
