keangkong
GLP-1 Specialist
- Member Since
- Sep 2, 2024
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I wanted to warn folks about a low probability event: an adverse liver reaction to a GLP-1 drug.
For background, my doctor said that I most likely experienced a drug-induced-liver injury (DILI). I have no noticeable symptoms but do have ALT levels 10 times the upper limits or normal and also elevated AST and bilirubin levels. He doesn't know which drug is the cause but believes the most likely cause is Lipitor, which I've stopped taking along with retatrutide. Per doctor's order, I continue to take tirzepatide. (I'm a little skeptical that it's the Lipitor since I've been on Lipitor for 20 years. DILIs from Lipitor usually start much sooner although there have been other cases where the injury occurred much later).
As a result, I've been researching drugs I take. I found the articles below information about what medical journals believe to be liver problems caused by tirzepatide. I should emphasize that liver problems with tirzepatide are extremely rare (far less common than with Lipitor, for instance).
To research DILI by drug in general, the best source is probably LiverTox.
Abdullah, et al. (2024). Tirzepatide-Related Acute Liver Injury. Eur. J. Case Rep. Internal Med., 11(9), 004813 [24-year old female teacher; 6 months to onset].
Ahmed, et al. (2025). A Rare Case of Tirzepatide-Induced Hepatitis - Causality Assessment With the RUCAM Criteria. Annals Internal Med., 4(1) [female in her thirties; three months to onset].
Berihun, et al. (2023). A Rare Case of Tirzepatide-Induced Liver Injury. Am J. Gastroenterology, 118(10S), S2282 [37-year old woman; 2.5 months to onset]. This appears to be same person/incident described in Sohal, et al. (2024). A rare case of tirzepatide-induced hepatotoxicity. ACG Case Reps. J. 11(10), e01484.
LiverTox on Tirzepatide (C).
Phox, et al. (2025). Tirzepatide-Induced Liver Injury - A Rare Medication Side Effect. ACG Case Rep. J. 12(4), e01661 [76-year old female; eight weeks to onset].
Sohal, et al. (2024). A rare case of tirzepatide-induced hepatotoxicity. ACG Case Reps. J. 11(10), e01484 [37-year old female; 2 1/2 months to onset]. This appears to the same incident reported in Berihun, et al. (2023). A Rare Case of Tirzepatide-Induced Liver Injury. Am J. Gastroenterology, 118(10S), S2282.
For background, my doctor said that I most likely experienced a drug-induced-liver injury (DILI). I have no noticeable symptoms but do have ALT levels 10 times the upper limits or normal and also elevated AST and bilirubin levels. He doesn't know which drug is the cause but believes the most likely cause is Lipitor, which I've stopped taking along with retatrutide. Per doctor's order, I continue to take tirzepatide. (I'm a little skeptical that it's the Lipitor since I've been on Lipitor for 20 years. DILIs from Lipitor usually start much sooner although there have been other cases where the injury occurred much later).
As a result, I've been researching drugs I take. I found the articles below information about what medical journals believe to be liver problems caused by tirzepatide. I should emphasize that liver problems with tirzepatide are extremely rare (far less common than with Lipitor, for instance).
To research DILI by drug in general, the best source is probably LiverTox.
Abdullah, et al. (2024). Tirzepatide-Related Acute Liver Injury. Eur. J. Case Rep. Internal Med., 11(9), 004813 [24-year old female teacher; 6 months to onset].
Ahmed, et al. (2025). A Rare Case of Tirzepatide-Induced Hepatitis - Causality Assessment With the RUCAM Criteria. Annals Internal Med., 4(1) [female in her thirties; three months to onset].
Berihun, et al. (2023). A Rare Case of Tirzepatide-Induced Liver Injury. Am J. Gastroenterology, 118(10S), S2282 [37-year old woman; 2.5 months to onset]. This appears to be same person/incident described in Sohal, et al. (2024). A rare case of tirzepatide-induced hepatotoxicity. ACG Case Reps. J. 11(10), e01484.
LiverTox on Tirzepatide (C).
Phox, et al. (2025). Tirzepatide-Induced Liver Injury - A Rare Medication Side Effect. ACG Case Rep. J. 12(4), e01661 [76-year old female; eight weeks to onset].
Sohal, et al. (2024). A rare case of tirzepatide-induced hepatotoxicity. ACG Case Reps. J. 11(10), e01484 [37-year old female; 2 1/2 months to onset]. This appears to the same incident reported in Berihun, et al. (2023). A Rare Case of Tirzepatide-Induced Liver Injury. Am J. Gastroenterology, 118(10S), S2282.
