Week 12 labs: fasting glucose down, ALT up?

Sep 14 1042 views 16 posts

The part people forget when they're comparing Mazdutide trial reports: week 12 labs are where things stop moving in the same direction, and the numbers don't always cooperate.

Common pattern in a 48-week blinded Mazdutide trial — fasting glucose 104 → 91 mg/dL, A1c 5.7 → 5.4, weight down 6.8 kg by that point. Appetite noticeably lower, no vomiting. CRP dropping too, which reads as a good sign on paper.

Then the surprise: ALT drifting up, 24 → 41 U/L, and AST 20 → 28. Site coordinators tend to wave it off with "within range," which is technically true and also not really an answer.

Worth knowing before comparing notes with anyone further along: is that early enzyme bump just the usual arc — up a little around week 12, settled by week 24? Or is it more tied to how fast the weight comes off? Curious if anyone past the halfway mark in a blinded trial saw the same thing and what happened by the next draw.

The part people forget when comparing options: liver panels drift. ALT 22→38, AST 19→27 at week 12, ALT 31 by week 24 — that's the pattern that keeps showing up. Common surprise: the trials are still blinded, so nobody knows who's in which arm, and those numbers alone don't settle much.

Rapid weight loss alone acn bump ALT, especially if it’s >5% in 12 weeks. Your 6.8 kg fits.

My CRP dropped too, but ALT stayed flat. Maybe the glucagon part affects liver fat differently?

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Flat ALT here as well. Did your ultrasound show any liver fat change? Mine wasn’t repeated.

The week 36 numbers from a different Mazdutide trial (not the one everyone's posting about): ALT went 19→44 by week 16, then 44→26 by week 28. The trial doc noted weight loss was fastest weeks 8–16, and the enzymes tracked that curve, not the drug levels as far as we know. CRP dropped 3.1 to 1.4 too. No alcohol change. Made me think it's metabolic/liver-fat mobilization rather than injury. Not saying ignore it, but watching the week 24 trend is what stopped the spiraling.

Did you check GGT? Mine was the outlier.

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GGT normal, but ALP dipped slightly. The coordinators told me not to chase every marker. Easy for them to say.

Week 8: ALT 26→33. Week 24 feels far.

Same week 8 ALT jump showed up in the labs — 22 to 44 — then it settled back to 28 by week 16. Looks like one of those trends that needs a second draw before anyone panics.

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Been there—my ALT threw a tiny tantrum mid-trial, then chilled. Trend line > single dot.

For what it's worth, i’m deep in my own plateau, so I get why every lab feels like a clue. One thing that helped me stop spiraling: I started logging the 72 hours before each draw—sleep, hydration, whether I’d lifted heavy, alcohol, even a long hike. My ALT was up 9 points after a brutal leg day plus two short-sleep nights, then flat at the next draw. Did anything unusual show up in your pre-draw week? That’s the only new variable I’d chase.

One thing I started tracking: what I did 48–72h before the draw. My week 12 ALT was up too (19→36), but I’d done two heavy lower-body sessions and was way under on water. Week 20, similar weight loss, ALT back to 23. Not saying that’s your story—labs are noisy—but I now add workout intensity, hydration, and sleep to my lab note. Did you happen to have a hard training block or a rough sleep week before that draw? The glucose/A1c direction looks like the bigger signal to me.

I track ALT against weekly weight delta, not just what happened 48–72h before. Mine: week 8 ALT 24, then down 2.3 kg in 10 days and week 10 ALT hit 39. By week 14 loss slowed to 0.5 kg/wk and ALT was 25. So the spike followed my steepest loss slope, not a single bad day. What did your kg/week look like between the week 8 bump and the week 12 one? That’s the column I’d check next.

ALT isn’t liver-specific. Mine bumped at week 12 and I eventually matched it to a hard training block + low-protein week, not the med. I now log ALT next to resistance sessions, protein g/kg, and sleep, not just weight delta. Bump resolved by week 16. Did your training load or protein intake shift around that draw? If not, that’s a different signal.

mine spiked too, I blame the week 12 chaos and my snack drawer.