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ForumsMASH / Liver DiseaseAlcohol + MASH + GLP-1 — can semaglutide help alcohol-related liver disease? Page 2

Alcohol + MASH + GLP-1 — can semaglutide help alcohol-related liver disease?

Dr.AddMedPHL Mon, May 25, 2026 at 1:39 PM 16 replies 378 viewsPage 2 of 4
VendorMark
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May 25, 2026 at 5:26 PM#6

Adding the numbers, since they settle part of this. For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and subcutaneous bioavailability near 89%. Those four numbers explain most of the questions people ask about timing.

37 7DebRD_ATL, KristenIndy, MarkLI_maint and 34 others
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Dr.LeslieOBGYN
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May 25, 2026 at 6:54 PM#7

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

How much of the between-person variation is pharmacokinetic and how much is just adherence measured badly?

Last edited: May 26, 2026 at 12:54 AM
36 6FranDenver, Dr.BariatricHTX, LindaRN_retired and 33 others
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LibrarianMeg
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May 25, 2026 at 8:23 PM#8
VendorMark said:
For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

Coming at VendorMark’s question from a different direction. Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak. People who dose late are not losing a peak, they are letting the trough fall, and the appetite effect tracks the trough.

35 5julia.endo, JessicaM_2024, TomFromTexas and 32 others
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Dr.AddMedPHL
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May 25, 2026 at 9:52 PM#9

OP back with an update, since a thread like this is useless without one.

Update. I did go to 2.4mg in the end, and the honest report is that it bought me less than the step before it and cost me two bad weeks. Worth knowing rather than worth repeating.

34 4TomFromTexas, mike.trainer_LA, sarah_nash92 and 31 others
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rachel_ABQ
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May 26, 2026 at 4:57 AM#10
LibrarianMeg said:
Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

That is correct as far as it goes, and here is where it stops going. The dose-response is real but shallow at the top. Across STEP 1 and STEP 4 the gap between 1.7mg and 2.4mg is a couple of percentage points of body weight on average, and the average is carrying a wide spread — plenty of people at 1.7mg sit above the 2.4mg mean. If a dose is working and tolerable, "working" is the relevant variable, not "maximal".

48 21Dr.CardioMD, EndoResFellow, PharmacoVig_BOS and 45 others
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