Have you experienced eggy or sulphur-smelling burps since you started using Mounjaro? You are not alone. Many people using Mounjaro for diabetes or weight loss report frequent burping and passing gas with a foul rotten egg smell. While these symptoms might be bothersome, they are, for the most part, of little consequence. They can be managed.

In this guide, we explain the reasons Mounjaro gives you sulphur burps, how to relieve the symptoms, and when you should contact a doctor. This is all based on the best health guidance obtained from UK pharmacists and health care professionals.

What Is Mounjaro?

Mounjaro (tirzepatide) is an approved medication used for managing Type 2 diabetes, and more recently, for weight loss. It is a dual GIP and GLP-1 receptor agonist which means it helps to clinically lower blood sugar levels and also helps to control appetite. 

Mounjaro slows down gastric emptying and digestive processes which leads to prolonged feelings of satiety and aids in the reduction of calorie intake. This is a fundamental strategy in diabetes management and is also a great way to assist with weight loss. Nevertheless, Digestive System Slowdown also results in discomfort.

What Are Sulphur Burps?

Known as ‘sulphur burps’, these burps are the result of gastrointestinal tracts breaking down certain proteins. This results in the production of Hydrogen Sulphide Gas, which is a by product of degrading protein rich foods such as eggs, meat, and garlic as well as certain cruciferous vegetables (Broccoli and Cabbage). 

The symptoms of a gastrointestinal tract that is gas producing more frequently than the norm is the result of sudden increase in speed of the system, changes to the gut microbiome, and possibly new dietary patterns. New medications, such as Mounjaro, are also suspected to be a culprit.

Why Does Mounjaro Cause Sulphur Burps?

Too many Mounjaro users self report the medication as the cause of their sulphur burps.  

1. Delayed Gastric Emptying

The changes in speed of gastric emptying that Mounjaro causes can result in even more gas producing stomach fermentation. This is a good thing in that it helps with appetite and blood sugar control, but it also causes more hydrogen sulphide gas to be produced which can lead to more burps.  

2. Changes in Gut Bacteria

Certain gut microbiome changes can cause less gas production in the gut. These changes, especially with more sulphur gas producing bacteria, may occur naturally when the stomach empties slower.

3. Dietary Factors

The Mounjaro medication combined with a high protein and/or high sulphur food diet is likely to result in increased gas formation. This includes eggs, meat, dairy, garlic, and onions.   

4. Dose & Individual Tolerance

Increasing or taking higher doses of Mounjaro can increase the medicine’s side effects of digestion. In particular, those with a history of gastrointestinal tract disorders, especially the IBS or GERD, can suffer much more.  

The burps are a side effect of the medicine, but in most circumstances, they are temporary, and with the passing of time, your body will adjust to the medicine.  

How Common Are Sulphur Burps with Mounjaro?

In the first month of taking tirzepatide along with Mounjaro, users reported several gastrointestinal side effects, including nausea, burping, and bloating. Although clinical studies do not mention sulphur burps, they are reported in patient forums as a side effect during the initial 4-6 weeks, and this side effect gradually improves.  

Unique to each individual, a person’s gastro intestinal system, including system/medicine, diet, and lifestyle will ultimately define the extent of their side effects.

Common Triggers That Make Sulphur Burps Worse

Some habits and meals may make sulphur burps worse when taking Mounjaro:  

• High sulphur foods such as eggs, red meat, broccoli, cauliflower, garlic and onions.  
• Carbonated drinks, like soda, sparkling water, and beer, promote gas retention.  
• Sorbitol and xylitol, used as sweeteners, may cause gas and bloating.  
• High-fat and greasy meals, especially when taken with Mounjaro, slow down the digestive process.  
• Excessive burping may be caused by swallowing air, which happens when people smoke or chew gum.  
• Rapidly eating hinders the proper breakdown of foods.   

Understanding and reducing these triggers is the first step to handling the problem.   

How to Relieve and Prevent Sulphur Burps on Mounjaro

The good news is that practical changes to your lifestyle and eating habits can make handling sulphur burps much easier.  

1. Modify Your Diet

For the first few weeks, reducing or eliminating sulphur-heavy foods will likely help symptom relief.

Mounjaro suggests the following important foods: 

• Sources of lean protein (such as chicken, fish, and lentils) 
• Non-cruciferous fresh fruits and a wide range of vegetables 
• Whole grains, light soups, 

Incorporate smaller, more frequent meals into your diet, as opposed to larger, more infrequent meals, to facilitate the digestion process.

2. Stay Hydrated

Adequate Mounjaro water intake will encourage the smooth removal of excess gas and will promote digestion so as to aid in gas retention.

3. Eat Slowly & Mindfully

Mindful eating also helps you avoid swallowing excess air which is a cause of gas.  

4. Avoid Carbonated Drinks

Herbal tea and water are good substitutes for carbonated drinks. Peppermint and ginger tea are excellent choices because they relieve gas and help with other stomach discomfort.  

5. Use Probiotics

Probiotics can help diminish gas smells by helping balance your gut microbiome. Look for pharmacy recommended products containing Lactobacillus or Bifidobacterium as these are the most common strains.  

6. Over-the-Counter Remedies

For the remaining gas symptoms, you can ask your pharmacist about:  

• Antacids to neutralise stomach acid and help with gas
• Simethicone which is used for gas relief and bloating  
• Charcoal which is used for gas and foul odour gas absorption for a short time.  

You should also ask your pharmacist or a doctor before using a gas absorbent.  

7. Adjust Mounjaro Dose (If Needed)

If severe burping or nausea is present, your prescriber may suggest altering the time you take your Mounjaro injection or adjusting the dose. You should never change the dose on your own.  

When to Worry & See a Doctor

Burping gas is primarily harmless, however, on rare occasions it may be a sign of something more serious. Contact a healthcare professional, either a physician or a pharmacist, when you experience: 

• Prolonged or progressively worse burping, persistent out-of-the-box lifestyle modifications do not help resolve symptoms.
• Severe stomach cramps, pain, or distention.
• Persistent nausea and vomiting.
• Unintended weight loss.
• Vomiting blood or stool (or rectal bleeding) that is blood.

Infection, gastroesophageal reflux disease, or delayed gastric emptying (gastroparesis or other conditions) may explain some of the symptoms above. These and other similar conditions usually require direct clarification from a practitioner.

Your GP may also find it appropriate to assess testing for an H. pylori infection, other testing for food intolerances, and related issues.

UK-Specific Advice from Pharmacists

Recommendations from UK pharmacists state that UK residents using Mounjaro may consult under the Pharmacy First service at their community pharmacy.

• Community pharmacists are able to assist you with safe diet modifications, prescribing over-the-counter medications to assist with symptoms and determining when to seek a GP referral. 
• Unmonitored self-prescription of herbal remedies can also cause serious adverse interactions.  
• Because Mounjaro is a prescription medication, you should expect to have professional oversight while using it.

Sulphur-based belching is a consequence of the digestion slowing down, gas increasing. Both are adverse effects of Mounjaro.

Control Sulphur Burps on Mounjaro

Sulfa burps are annoying but typically are not of major concern. Understanding how Mounjaro works gives you some insight on helpful dietary and self-care routines. 

At Oldfield Pharmacy and other places, we believe that the safe and effective provision of self-treatment options is an expression of self-care and the result of interprofessional collaboration. 

If you need help with Mounjaro treatment, the local pharmacist and GP are good options to obtain tailored assistance, as the remaining options may also cause administrative side effects.