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ForumsMASH / Liver DiseaseMy liver enzyme journey — ALT from 98 to 19 on semaglutide Page 3

My liver enzyme journey — ALT from 98 to 19 on semaglutide

DerekSJ_a1c Wed, May 27, 2026 at 9:10 AM 29 replies 552 viewsPage 3 of 6
Dr.AddMedPHL
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May 27, 2026 at 6:07 PM#11
Dr.SleepRoch said:
The liver data is among the strongest non-weight findings in the class.

All true, with one condition: that curve is for people who reached the dose on schedule. Anyone who slowed the ladder for tolerability is on a different, flatter curve, and comparing yourself with the published mean will make you feel like a non-responder when you are not.

15 13FitDadDave, RunnerRach, TrialNerd_Beth and 12 others
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NicoleRaleigh
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May 27, 2026 at 11:25 PM#12
TrialTracker_MD said:
Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

This answered a question I did not know how to ask.

16 14MikeFit_NJ, InsuranceTom, WendyG_ATL and 13 others
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JessicaM_2024
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May 28, 2026 at 4:42 AM#13
Dr.SleepRoch said:
The liver data is among the strongest non-weight findings in the class.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.

Last edited: May 28, 2026 at 5:42 AM
17 15mike_mealprep, NicoleRaleigh, james_edin and 14 others
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lucas_SP_BR
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May 28, 2026 at 9:59 AM#14

Adding the numbers, since they settle part of this. With resmetirom now available for MASH, combination approaches are being explored, so the standard of care in this area is moving faster than most threads assume.

Last edited: May 28, 2026 at 11:59 AM
18 16KarenAZ_mom, zoe_NC, Dr.ObesityLA and 15 others
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Admin
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May 28, 2026 at 3:16 PM#15

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Carry on.

19 17PeptideSynthNJ, Dr.KarenChen, Dr.NateNeph and 16 others
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