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ForumsMASH / Liver DiseaseMy liver enzyme journey — ALT from 98 to 19 on semaglutide Page 4

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 4 of 6
Dr.LeslieOBGYN
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May 28, 2026 at 8:32 PM#16

From the other side of the consultation, briefly. The distinction that resolves most of these threads is between what is true on average and what is true for one person. Both are real; they answer different questions and get quoted as if they were the same one.

20 18Dr.BariatricHTX, LindaRN_retired, tommy_boulder and 17 others
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lisa_labSD
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May 29, 2026 at 1:49 AM#17

One concrete data point for the thread. Worth stating the units and the reference range whenever you post a number here. A large fraction of the apparent disagreement in these threads is two people using different units and both being right.

Ask again with the specifics and you will get a better answer than this one.

21 19maya_sedona, stefan_berlin, Dr.EM_Chicago and 18 others
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Dr.CardioMD
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May 29, 2026 at 7:06 AM#18

A narrower follow-up, since the general answer is now clear:

Was that from a primary source or from a summary of one?

22 20tony_orlando, Dr.NephBHM_UK, kim_atl_prep and 19 others
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james_edin
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May 29, 2026 at 12:22 PM#19
lisa_labSD said:
Worth stating the units and the reference range whenever you post a number here.

This is where I part company with the consensus forming above. Steady state is the thing most people miss. The terminal half-life is about a week, so every dose step takes four to five weeks to fully express itself. Judging a step at day ten is judging the ascent, not the plateau, and it is the single commonest reason people escalate before they needed to.

23 21oliver_london, tane_welly, Dr.PathRoch and 20 others
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mike_mod
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May 29, 2026 at 5:38 PM#20

Moderator note: the sourcing question belongs in the vendor section and has been split out. Thread quality here is what the rules are for. Keep it up.

45 18PurityPaulOR, MaxMetOK, MounjBrad and 42 others
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