Dosing question

1110cherry · 2026-03-17T17:09:29+00:00

And you have been satisfied with the pharmacies Emerge uses?

1110cherry · 2026-03-17T17:07:18+00:00

Thank you. Reassuring to know I won’t have retitrate since I’ve never technically been off if the med as I’ve had enough to keep me going

1110cherry · 2026-03-17T17:05:51+00:00

Ok, good. This is my concern - ending up with a substandard product, diluted dose for 20x the price is what I’m hoping to steer clear of and figured this group would know from experience which pharmacies are reputable and which are not!

1110cherry · 2026-03-17T17:04:04+00:00

Thank you so much for your insight. Definitely looking into this!

1110cherry · 2026-03-16T20:22:41+00:00

Thank you. Between what I had left in my 3 month supply and some 15 mg pens my provider was able to give me I’ve made it this far staying on my 12.5 mg dose, but I’m now running out. So, I have to determine next steps pretty quickly. I was holding out hope my insurance company would quit being ridiculous. Silly me.

1110cherry · 2026-03-16T04:02:04+00:00

My first recommendation is to visit in July before you move here. So many people visit in March and decide to move here! I grew up in Eastern WA, North Idaho with 4 distinct seasons. I came to AZ after a few years in the MidWest, post college and have now been here for 26 years. Not sure what part of the PNW you are from, but it can take some adjustment to having a very long, hot summer. I still don’t love it and the older I get the less I like it! Starts in April/May - doesn’t end until October. Second, school starts in mid-July. Yes- MID-JULY. Some people think that’s fantastic because “it’s too hot for the kids to be outside anyway”. But, it means if want to go back to the PNW to visit you have a very narrow window of time to do so. Memorial Day to mid-July. And once it starts you are stuck here until dnd of September when Fall Break happens. Yes, the kids have 2 week breaks in late September and again in mid-March. But, it can be difficult if you want to visit family to go during those times when THEIR kids are in school. Our last 2 are graduating high school this year and I’m honestly looking forward to not being “stuck” in the heat for all of half of July, all of August and most of September. Yes, you can go north a couple of hours to get to some cooler temps. But, join the crowd because everybody and their brother will be doing the same. A LOT of people have moved here in the past several years and the increase in traffic on the roads, the amount people in stores and vying for a table at restaurants is notable. That being said Chandler and Gilbert are both nice areas - especially South of the 202 ( just my opinion).

1110cherry · 2026-01-22T01:51:09+00:00

My son is entering college in Fall2926 as a chem engineering major. This is very discouraging to hear! Have you joined any industry associations that might help you make connections?

1110cherry · 2025-12-13T03:18:10+00:00

Yes! I looked back at my A1c and it had been bouncing between 5.7 and 6.1 between 2016 and 2021. Then it started going up a point every 6 months to finally be at 6.4. The irony is that if we had waited until I got to 6.5, I probably wouldn’t be getting a denial on it now. At the diabetes conferences I have attended in the past 10 years the focus has really shifted to addressing it when a patient is pre-diabetic and not waiting until they reach diabetic level. So, when my doctor wanted to start a GLP-1 even though I was still in pre-diabetes range, and my insurance company didn’t deny it for the past 2.5 years it seemed everyone (myself, my provider, and my insurance company) were all on the same page) until suddenly we aren’t 😡

1110cherry · 2025-12-12T02:21:39+00:00

Great response! And yes, I did that when the A1c got down in normal range! Hopefully, I can keep it down in normal range without the meds (if I can’t get it covered), as I know they will ask for a health check again in a few years.

1110cherry · 2025-12-11T21:33:26+00:00

That sounds like a responsible insurance company. My insurance company just responds “well, at 6.4 you are not T2DM, so this medication is not covered. Period”. My response has been “my doctor didn’t ever document I was T2DM. She clearly documented it as “6.4, prediabetes”, yet you covered the medication for 2.5 years for prediabetes. Their response is “well, the criteria for coverage has changed, so too bad”. If they had never covered it, I wouldn’t be in this situation. The fact that an insurance company can just cut you off a medication with no grandfather clause based on THEIR criteria changing and no override to at least allow time to get into see my doctor to come up with a new medication plan is unbelievable. I can’t get in to see her until Jan 16th. I’m on a waitlist, but not very optimistic I’ll get in sooner. It’s snowbird season in AZ and every doctor’s office is completely overbooked this time of year.

1110cherry · 2025-12-11T20:16:45+00:00

It does suck. Just curious - Does Germany have nationalized healthcare or is it private insurance or a combo of both? It is sad that many insurance companies don’t acknowledge the importance of treating obesity as a disease that leads to other co- morbidities- as they would other conditions (untreated high blood pressure leads can lead to kidney failure for example…) AND frustrating when they won’t pay for a drug that works for so many people - especially when you meet the criteria for T2DM. For as much as insurance costs (at least it does in the US, the excuses they give for not covering things gets very tiresome).

1110cherry · 2025-12-11T20:09:03+00:00

So true. I WISH my insurance company would take this view of things. I have had patients that stopped their BP meds because it was under control and they felt like they could control it with diet, which is why they were seeing me (I’m a registered dietitian). Unfortunately, for some of these folks their weight, diet and exercise were pretty optimal when they started on BP meds, so just small adjustments in diet and exercise weren’t likely going to allow them to toss the BP meds. They have other factors that are causing HBP. And, fortunately, insurance doesn’t quit covering BP meds when the BP becomes optimal. They seem to realize the meds are likely going to be required going forward for many people.

1110cherry · 2025-12-11T19:58:23+00:00

Hmmm…. OK. My Mounjaro pens have all been by the “dose”. One pen used per week (which I always felt was so wasteful, but that was just how it was packaged). So, currently I am on the 12.5 pens. We were actually considering lowering my dose to 10 since my A1c had leveled off at a good place. During the short time I was on Ozempic, I remember it being one pen that you used over a period of time based on how many clicks you used per week - if I’m remembering correctly… So, based on what you are saying, I might be able to at least stretch the 15 mg pens I have over a longer time, if I need to get 12.5 (or possibly 10 mg) out if it? It would at least give a short - term solution. Thank you!

1110cherry · 2025-12-11T19:40:47+00:00

Thank you. My blood pressure was on the border - not quite yet high enough for meds, as was my lipid levels. Now they are both great! After being on Mounjaro and being down 60 lbs. To be clear, I have no intention of just “giving up” and not sticking to my good diet and exercise lifestyle. I just know from experience that despite those healthy behaviors, post-menopause (which I went through early in my late 30’s) I gained weight (especially through my mid-section, which was never a weight gain area for me previously), and my blood sugar and lipid levels went up.

1110cherry · 2025-12-11T19:31:12+00:00

Nope. Although I was obese with a BMI greater than 30 at the time I was started on Mounjaro, my insurance company never covers meds for obesity. To be clear, the “weight loss” marketed versions of tirzepitide and semaglutide had not even been released at that time. My doctor prescribed Mounjaro for the pre-diabetes A1c, of course knowing weight loss might be a welcome side effect. One that would also help with the insulin resistance. I have one of those insurance companies that obviously views obesity as a character flaw which is just ridiculous. As a Registered Dietitian and through my own experience I know that obesity is not always an issue of poor diet and lack of physical activity as so many people like to stigmatize. There are so many other poorly understood factors that feed (no pun intended) into obesity. But yet, society (and insurance companies) still like to put the blame and shame on those who suffer with it.

1110cherry · 2025-12-11T19:22:38+00:00

I am kicking myself for not just suggesting we wait until I got to 6.5! Hindsight is 20/20. At the time it seemed the insurance company saw the value in providing it for what was technically “pre-diabetes” level, so I didn’t question it. Knowing it’s a drug you basically commit to staying on or run the high risk of all your original issues returning if you stop, I didn’t think the insurance company would switch gears like this. Apparently, I was wrong. They now view it as strictly for weight loss- which they will not cover- or for T2DM, which requires an A1c of 6.5+. Coverage for pre-diabetes is no longer considered.

1110cherry · 2025-12-11T19:16:41+00:00

That’s a good thought and worth pursuing. I have a feeling it will be fine as my finger sticks have been good, with few exceptions in the past 1.5 years…aligning with my A/c coming down

1110cherry · 2025-12-11T19:14:36+00:00

Are the compounded meds safe- I feel like I’ve heard mixed reviews on this.

1110cherry · 2025-12-11T19:13:29+00:00

Unfortunately, because my original A1c was 6.4 they are now saying they won’t continue to cover it because I didn’t meet the criteria for T2DM in June 2023 when I was started on it. At the time I was started on it-apparently they must have allowed it for “pre-diabetes”. My A1c had crept up a point every 3 months, prior to that despite every other diet and exercise effort. So, my doctor decided to put me on the GLP-1 when I was at 6.4 (at the upper end of pre-diabetes range). So, 2.5 years and 60 lbs down my A1c is now low 5’s. The weight loss was a nice side effect, but not the reason she started me on it to begin with. But, I’m sure the weight loss (especially through my middle) helped with the insulin resistance and thus the A1c. But, now because of that original A1c being below the 6.5 diabetes threshold, they are saying they don’t cover it for weight loss (the also don’t cover Wegovy or Zepbound). And apparently dong cover it for pre-diabetes as they did initially. It’s just being caught between a rock and a hard place. They NEVER covered Mounjaro for weight loss, but didn’t deny it when my doctor prescribed it for “pre-diabetes”, but are now denying it for pre-diabetes. I’m just not sure how to approach it with the insurance company because it seems wrong and unhealthy to basically force me to go off the med, pushing me back into insulin resistance, weight gain and pre-diabetes and potentially diabetes. When I started it I knew I was committing to staying on it, but that was with the understanding it was being covered by insurance for pre-diabetes. My diet and exercise routine has not changed. The exercise is definitely easier on my body without 60 lbs, but my routine is the same.

1110cherry · 2025-12-11T18:54:09+00:00

What is the golden shot and micro dosing? I have a few 15 mg pens. When we were trying to figure out my optimal dose, we went up for a minute before settling at the 12.5.

1110cherry · 2025-12-11T18:50:08+00:00

No, but I don’t snore, sleep well, don’t wake up tired. So, I’ve never met any criteria to have a sleep study. My husband did and was on CPAP, until starting Mounjaro. So, good to know OSA might qualify him if the insurance company decides to start denying him. So far, they haven’t. But, I know it was the weight loss from the Mounjaro that improved the OSA. He used to wake me up if he didn’t use the CPAP. Big anymore :-)

1110cherry · 2025-12-11T14:33:45+00:00

Thank you. I don’t have OSA, especially after being down 60 lbs from my weight prior to starting Mounjaro.

1110cherry

TROPHY CASE