Elevated Liver Enzymes After Four Months
At 27 years old, weighing 180 pounds and taking no medications, I opted to start Semaglutide four months back, prompting a routine lab work session. Initially, my liver enzyme levels were as follows: AST was 27, ALT stood at 20, total Bilirubin was .5, and Alkaline Phosphatase measured 64. Given my family history of diabetes—both my grandparents had it—I consistently keep an eye on my glucose levels. At the time of this testing, my glucose reading was 105, leading me to begin Semaglutide. Recently, my partner and I agreed to consider starting a family, which led me to stop taking Semaglutide a month prior; I had been on it for three months. Additionally, I discontinued birth control about six weeks ago after nearly nine years of continuous usage. Fast forward to this week, I underwent another round of blood tests to assess my glucose levels again. There was a positive change; my glucose is now at 93, and my A1C is 5.0. However, I was alarmed to discover that my liver enzyme levels had risen significantly: AST now reads 44 and ALT has soared to 114. My total Bilirubin is .8, with Alkaline Phosphatase at 62. The clinic has suggested I schedule a follow-up test in about three weeks, but I am genuinely worried and contemplating whether I should seek additional medical attention sooner. I don’t consume alcohol or smoke, and while I am classified as overweight, I engage in mild to moderate exercise at least three times a week. Historically, my AST and ALT levels have never been elevated, making this sudden increase particularly concerning.
Answers (1)

6/19/2025, 5:01:37 PM
OpenHealth AI
It's understandable to feel concerned about your elevated liver enzyme levels, especially since you've noticed such a significant change in a short period of time. Let's break this situation down to ease your worries while focusing on appropriate next steps.
Summary of Your Situation
- Your liver enzymes (AST and ALT) have significantly increased since you started Semaglutide and stopped birth control, while your glucose levels have improved.
- You are at risk for liver issues given your elevated levels, especially since these are new findings for you.
Understanding Elevated Liver Enzymes
Liver enzymes like AST (aspartate aminotransferase) and ALT (alanine aminotransferase) can increase due to several factors, including medications, weight, diet, and changes in body metabolism. Semaglutide is known to potentially affect liver enzymes, although significant liver enzyme elevation is not very common. Additionally, these changes could be influenced by your recent discontinuation of birth control and any other lifestyle factors.
Immediate Next Steps
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Monitor Symptoms: Keep an eye on how you're feeling. Note any new symptoms such as fatigue, abdominal pain, or jaundice (yellowing of skin or eyes), which could indicate liver distress.
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Dietary Adjustments:
- Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins while minimizing processed foods, sugars, and saturated fats.
- Ensure you stay well-hydrated.
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Exercise Regularly: Continue with your exercise routine, aiming for at least 150 minutes of moderate aerobic activity each week, which can help maintain a healthy weight and support liver health.
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Avoid Alcohol and other Toxins: Since you're abstaining from alcohol and smoking, continue to do so as these can exacerbate liver issues.
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Follow-Up Testing: Attend the follow-up test in around three weeks as suggested. Your healthcare provider can further evaluate trends in liver function and determine appropriate next steps.
When to Seek Immediate Attention
If you experience any of the following symptoms, consider seeking medical advice sooner:
- Severe abdominal pain or swelling
- Persistent nausea or vomiting
- Unexplained weight loss
- Dark urine or pale stools
- Yellowing of your skin or eyes
These indications could point to a more significant liver issue that may require immediate intervention.
Final Thoughts
It's natural to feel anxious about your results, but keeping track of your symptoms and following the outlined steps can help you manage your health effectively. You're taking proactive steps by monitoring your blood work and managing your glucose levels, which is commendable. If your concerns remain or worsen, don’t hesitate to reach out for further evaluation and support.
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