Abnormal Lab Results in Phase 3 Participant

[fatbegone]

This guy is in one of the phase 3 retatrutide trials. He recently had abnormal lab results. I think he said previously he's on the 12mg dose. He's hoping (as are we who are on reta) that it's not due to reta.

Thread by @eecklund on Thread Reader App

@eecklund: Clinical trial update. As of today, it's been 28 days since I last took Retatrutide. I was asked to suspend the last three doses due to abnormal hepatic function labs, indicating liver damage, and CBC lab...…

threadreaderapp.com

 

[indolent]

I wonder if this sort of exception is why (see other recent thread) EL isn't playing up Reta in their corporate/investor communications.

 

[fatbegone]

I wonder if this sort of exception is why (see other recent thread) EL isn't playing up Reta in their corporate/investor communications.

My gut feeling is it's not due to reta. I feel like it would have manifested in the phase 2 trials if it were due to reta. But maybe that's just me really not wanting it to be the reta.

 

[keangkong]

Ouch. I’m at the liver doctor’s office due to greatly elevated liver enzymes that were higher than when I started and which are not caused by fatty liver, a disorder that I do not have.

 

[dogmom]

I've been on reta for over a year. I have to get labs every 3 months because I've an autoimmune disorder and I'm on an immuno suppressant than can cause liver issues. I haven't had any changes since starting reta. Just my personal anecdote.

 

[MsGizmo]

Rapid or extreme weight loss can cause abnormal hepatic function by triggering a massive mobilization of fats from adipose tissue to the liver, which can lead to non-alcoholic steatohepatitis (NASH) and even liver failure in some cases. However, a controlled and gradual weight loss, especially for obese individuals with fatty liver disease, often improves liver enzymes and reduces liver fat. The key is to avoid rapid weight loss, with a recommended rate of no more than 1.6 kg (3.5 lbs) per week.

Aggressive non-alcoholic steatohepatitis following rapid weight loss and/or malnutrition - PMC

While non-alcoholic steatohepatitis is a slowly progressive disease, patients may rarely present in acute liver failure. We describe six patients who developed severe hepatic dysfunction following rapid weight loss or malnutrition. Rapid weight loss ...

pmc.ncbi.nlm.nih.gov

We must always remember that being obese is a health risk and losing weight too fast is a health risk. I don't know how long this person was on reta or how much weight he lost. Rushing to blame the drug itself is a bit premature.

 

[fatbegone]

Rapid or extreme weight loss can cause abnormal hepatic function by triggering a massive mobilization of fats from adipose tissue to the liver, which can lead to non-alcoholic steatohepatitis (NASH) and even liver failure in some cases. However, a controlled and gradual weight loss, especially for obese individuals with fatty liver disease, often improves liver enzymes and reduces liver fat. The key is to avoid rapid weight loss, with a recommended rate of no more than 1.6 kg (3.5 lbs) per week.

Aggressive non-alcoholic steatohepatitis following rapid weight loss and/or malnutrition - PMC

While non-alcoholic steatohepatitis is a slowly progressive disease, patients may rarely present in acute liver failure. We describe six patients who developed severe hepatic dysfunction following rapid weight loss or malnutrition. Rapid weight loss ...

pmc.ncbi.nlm.nih.gov

We must always remember that being obese is a health risk and losing weight too fast is a health risk. I don't know how long this person was on reta or how much weight he lost. Rushing to blame the drug itself is a bit premature.

This might be the cause. This person started the reta trial in early May of 2024 at a weight of 355lbs. In March of 2025 his weight was 176lbs, a total weight loss of 179lbs in 10 months. That's an average weight loss of 17.9lbs per month, or about 4.5lbs per week. That's insanely fast and way more than the 3.5lbs you mentioned.

 

[IshimaruKenta]

Let me ask this stupid question. Do the scientists who create these drugs ever make changes due to the trial outcomes? Or does the formula stay the same the entire time?

 

[Airborne Daddy]

Ouch. I’m at the liver doctor’s office due to greatly elevated liver enzymes that were higher than when I started and which are not caused by fatty liver, a disorder that I do not have.

What's greatly buddy? More than double?

 

[Airborne Daddy]

This might be the cause. This person started the reta trial in early May of 2024 at a weight of 355lbs. In March of 2025 his weight was 176lbs, a total weight loss of 179lbs in 10 months. That's an average weight loss of 17.9lbs per month, or about 4.5lbs per week. That's insanely fast and way more than the 3.5lbs you mentioned.

Or maybe an above average drinker. Weird my old knees be killing me 2 days after last pin.

 

[indolent]

Let me ask this stupid question. Do the scientists who create these drugs ever make changes due to the trial outcomes? Or does the formula stay the same the entire time?

I think the drug is one molecule. So I don't think they can make changes, as such. Maybe to the dosage/administration protocol. But perhaps I'm wrong.

 

[MsGizmo]

Let me ask this stupid question. Do the scientists who create these drugs ever make changes due to the trial outcomes? Or does the formula stay the same the entire time?

I think if they make a change to the "recipe" of the drug they need to start the trials all over because its a new drug.

 

[Morbius]

There could be rare liver problems due to reta, and it could simultaneously be a generally safe wonder drug.

Almost no meds are entirely without risk.

Details matter.

We'll find out the whole story eventually. 🤞

 

[keangkong]

I think if they make a change to the "recipe" of the drug they need to start the trials all over because its a new drug.

And they need to start at stage 1 trials.

 

[keangkong]

What's greatly buddy? More than double?

Here are my July 7 results:



The other things that were tested on July 7 were fine. That includes bilirubin, which tested out of range on August 7 on two measures.

Since I take atorvastatin (Lipitor), an ALT reading of up to three times normal is not much cause for concern. However, the level exceeds that.

Here are my results from August 7:


The August 7 results are somewhat better.

The doctor advised me to stop taking retatrutide but opined that the likely cause was the atorvastatin (Lipitor). He said to continue taking the tirzepatide; that it is unlikely to be the cause. The cardiologist lowered my atorvastatin dose yesterday.

I'm debating whether to stop taking the retatrutide. I did schedule, on my own, another blood test for September 2. My inclination is that if that if the ALT & AST are no more than 3 times normal levels to keep taking the retatrutide. I suspect that the cause of the elevated enzymes is the rapid defattening of the liver. "We hypothesize that in our patient, tirzepatide use resulted in rapid mobilization of fat from the liver and was responsible for the elevation in liver enzyme levels." (Sohal, Aalam MD1; Casanova, Luis BSc1; Kowdley, Kris V. MD, FACG1,2. A Rare Case of Tirzepatide-Induced Hepatotoxicity. ACG Case Reports Journal 11(10)😛 e01484, October 2024. | DOI: 10.14309/crj.0000000000001484.) It seems retatrutide would be more likely to cause rapid defattening of the liver than tirzepatide because it generally gets rid of more liver fat. When tested a month ago at the gastroenterologist's office, I did NOT have fatty liver although the doctor said he suspected that I had it previously.

If I stop taking retatrutide, my weight loss is likely to stop and I believe that I'll likely gain 10-20 pounds. The dose of tirzepatide that I can tolerate (and which I continue to take) is too low to provide great results. I'd like to lose to 12 more pounds and then stop. I'd then have a BMI of 23.5.

I'm also worried that I'm coming up with intellectual strategies for disregarding the advice of a specialist.

 

[peptidepower77]

My gut feeling is it's not due to reta. I feel like it would have manifested in the phase 2 trials if it were due to reta. But maybe that's just me really not wanting it to be the reta.

There are been a few people that have left the trials due to elevated liver enzymes on Reddit. Mine have been creeping up too. ChatGPT says it's likely due to liver stress since reta is likely reducing liver fat, and that can cause transient liver stress. My ALT was at 33 before starting reta, it's closer to 100 now. 150 is where I pull the plug, so I'm checking weekly at this stage. I had a full body MRI last year that said I had a lot of liver fat, so that's plausibly what's happening. I also haven't really lost significant weight either, so it's not due to a massive amount of fat flux in my case.

Also, liver enzymes show active stress, they don't show previous stress. When people say they don't have fatty liver because their liver numbers are fine, that may not be true. If the liver fat isn't stressing the liver, it won't necessarily show elevated enzymes. Only way to know for sure is to have an MRI, ultrasound, or a fibroscan. My liver enzymes were normal before the MRI, and it was only then I learned I had fatty liver.

Also concerning to me is I routinely track my fasting insulin. It went from 10 down to 7 down to 3.6 while on Tirz. After switching to Reta it's gone up as high as 35, but currently it's about 25. Whether that's transient either, I don't know. But that's new, and unexpected.

 

[Airborne Daddy]

Here are my July 7 results:

View attachment 8461

The other things that were tested on July 7 were fine. That includes bilirubin, which tested out of range on August 7 on two measures.

Since I take atorvastatin (Lipitor), an ALT reading of up to three times normal is not much cause for concern. However, the level exceeds that.

Here are my results from August 7:

View attachment 8462
The August 7 results are somewhat better.

The doctor advised me to stop taking retatrutide but opined that the likely cause was the atorvastatin (Lipitor). He said to continue taking the tirzepatide; that it is unlikely to be the cause. The cardiologist lowered my atorvastatin dose yesterday.

I'm debating whether to stop taking the retatrutide. I did schedule, on my own, another blood test for September 2. My inclination is that if that if the ALT & AST are no more than 3 times normal levels to keep taking the retatrutide. I suspect that the cause of the elevated enzymes is the rapid defattening of the liver. "We hypothesize that in our patient, tirzepatide use resulted in rapid mobilization of fat from the liver and was responsible for the elevation in liver enzyme levels." (Sohal, Aalam MD1; Casanova, Luis BSc1; Kowdley, Kris V. MD, FACG1,2. A Rare Case of Tirzepatide-Induced Hepatotoxicity. ACG Case Reports Journal 11(10)😛 e01484, October 2024. | DOI: 10.14309/crj.0000000000001484.) It seems retatrutide would be more likely to cause rapid defattening of the liver than tirzepatide because it generally gets rid of more liver fat. When tested a month ago at the gastroenterologist's office, I did NOT have fatty liver although the doctor said he suspected that I had it previously.

If I stop taking retatrutide, my weight loss is likely to stop and I believe that I'll likely gain 10-20 pounds. The dose of tirzepatide that I can tolerate (and which I continue to take) is too low to provide great results. I'd like to lose to 12 more pounds and then stop. I'd then have a BMI of 23.5.

I'm also worried that I'm coming up with intellectual strategies for disregarding the advice of a specialist.

Hopefully that's temporary and maybe s soon u won't need the statin cuz the glp1s will take care of ur triglycerides and cholesterol. Meso guys see the liver values go up like that from oral steroids then after they stop 6 weeks later levels come down.