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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMASH / Liver DiseaseHas anyone dealt with alt normalization rates on glp-1?

Has anyone dealt with alt normalization rates on glp-1?

laura_annarbor Fri, Jan 9, 2026 at 9:24 PM 23 replies 1,414 viewsPage 1 of 5
laura_annarbor
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Jan 9, 2026 at 9:24 PM#1

Fatty liver on an incidental scan two years ago and nobody followed it up. Now that I am losing weight I would like to know what to re-measure.

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.

So the question, as narrowly as I can put it: whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.

Numbers rather than impressions, if you have them.

37 7labquiet_amy, emily_PDX, Dr.SleepRoch and 34 others
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JennaRN
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Jan 9, 2026 at 10:21 PM#2
laura_annarbor said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Baseline: "Moderate hepatic steatosis, liver span 17.2cm, echogenic texture consistent with fat infiltration"
Month 8: "Mild steatosis, liver span 15.8cm, improved echogenicity"
Month 14: "Minimal to no steatosis, normal liver span 14.5cm, normal echotexture"

My liver literally shrank and de-fattened. The ultrasound tech said she's seen this pattern increasingly in GLP-1 patients and it's remarkable how consistently the fatty liver resolves.

Last edited: Jan 9, 2026 at 11:21 PM
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SleepDoc_PDX
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Jan 9, 2026 at 11:18 PM#3
JennaRN said:
Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 9 months on GLP-1 therapy:

MarkerBaselineCurrentNormal Range
ALT78257-56 U/L
AST612110-40 U/L
GGT68379-48 U/L
ALP1087544-147 U/L

FibroScan also improved — liver stiffness from 8.5 kPa to 6.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.

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SkepticalSean
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Jan 10, 2026 at 12:15 AM#4
laura_annarbor said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

This matches mine closely enough to be worth saying so out loud.

Last edited: Jan 10, 2026 at 4:15 AM
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VanRx_Mike
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Jan 10, 2026 at 5:43 AM#5

From the other side of the consultation, briefly.

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 324 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 10 months: CAP dropped to 237 dB/m (minimal steatosis) and stiffness normalized to 6 kPa. Hepatologist says the liver is essentially healing itself as the metabolic stress resolves.

GLP-1 agonists may become first-line NASH therapy. The Phase 3 data on semaglutide for NASH is very promising.

Last edited: Jan 10, 2026 at 8:43 AM
33 3mike_mod, SarahChen_PharmD, sarah.morrison and 30 others
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