What labs should I ask for? Doctor only did basic panel — what worked for you?

ICU nurse here. PLEASE tell your doctor. I've seen patients come in for emergencies and we have no idea they're on a GLP-1. It matters for anesthesia (aspiration risk — GLP-1s slow gastric emptying), it matters for imaging contrast, it matters for a LOT of things. Write it down if the conversation feels awkward. "I've been using semaglutide from a compounding pharmacy for 7 months." Done. Any decent doctor will just update your chart and move on. The ones who lecture you aren't worth keeping anyway.

I told my PCP after 4 months. His reaction? "Ok, that explains the labs. Let me add lipase monitoring and a thyroid panel to your next draw." That was literally it. No lecture, no judgment. Most doctors these days are well aware of the compounding situation and frankly just want accurate information. Also your ALT going from 58 to 22 is your liver fat reducing. That's NAFLD reversing in real time. Document everything.

Update for anyone following this — I called my PCP's office and left a message with his nurse explaining the situation. He called me back personally and said, and I quote, "I figured it was something like that. I'm not here to judge, I'm here to keep you healthy. Let's get you set up with proper monitoring." He added lipase, amylase, TSH, free T4, and a renal panel to my next labs. Honestly feel relieved. Should've done this months ago.

This is the best outcome. Proper monitoring makes everything safer. For the record, here's what I think everyone on GLP-1s should have checked every 3 months minimum: - CMP (comprehensive metabolic panel) - Lipid panel - A1C - CBC - Lipase & amylase - TSH - CRP or hs-CRP - Vitamin D, B12, ferritin (every 6 months at least) The reduced food intake on these meds means micronutrient deficiencies sneak up on you. Better to catch them early.