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My 8‑week Mazdutide titration – what to expect with nausea and liver fat loss

Posted by chris_sleepnerd in Weight Loss & Metabolic - 13 points, 6 comments.

I started Mazdutide about eight weeks ago after a friend mentioned the dual GLP‑1/glucagon thing and I thought the added hepatic fat boost might help the stubborn liver fat I saw on my recent scan, so I began at 3 mg once a week and added 1 mg each week until I hit 7 mg, which is where I’m sitting now, and I’ve been logging everything in my spreadsheet – weight, fasting insulin, weekly HRV, and my morning glucose.

The first two weeks I felt a classic GLP‑1 nausea, mostly after dinner, and I had to push my carb intake earlier in the day to keep it down, but by week three the nausea settled and my appetite dropped enough that I was eating about 500 kcal less without feeling like I was starving, which showed up as a 4 lb loss by week four and a slight uptick in my HRV.

What surprised me more than the weight was the liver echo reduction I saw on a follow‑up ultrasound at week six – the radiologist noted about a 12 % drop in hepatic fat, which could be the glucagon side doing its thing.

I’ve had mild injection site redness a few times, but no diarrhea, and my fasting insulin has fallen from 13 to 9 µU/mL, so I’m intrigued but still cautious. Has anyone else seen a similar liver response or needed to adjust the titration schedule? I’m thinking about staying at 7 mg for a few more weeks before testing a jump to 9 mg.

Comments

  • sofia_n: I’ve been on a GLP‑1/ glucagon combo (I think it was tirzepatide) for a couple months and anecdotally noticed a similar dip in liver echo – the radiologist mentioned “a modest reduction” after about six weeks at 10 mg weekly. I also got the typical early‑stage nausea that quieted after I shifted my larger carbs to lunch, and my appetite dropped enough that I was unintentionally in a 400–500 kcal deficit. My fasting insulin dipped a bit too, though I keep an eye on liver enzymes just in case. Hav
  • chris_sleepnerd: I’m at 7 mg now and still haven’t pulled a liver panel, so your point about ALT/AST is spot on, I’ll order a baseline next week and monitor every four weeks; your 10 mg level at week six is higher than my dose, but the echo trend sounds similar, so maybe it’s dose‑dependent; I’m curious how you’re timing the labs, after the first month, or only when the enzyme bumps up?
  • derek572: I haven’t pulled a liver panel after starting yet, but I’ll schedule one next month to see if ALT/AST track with the echo change. In my own case the echo improved and my fast insulin dropped a bit, but I’m keeping an eye on the enzymes. How have your levels been shifting?
  • chris_sleepnerd: Thanks for the enzyme plan, smart move. My echo at week six showed a 15% reduction in fat, but I haven’t done panels yet either. I’m tracking glucose trends more closely now since HRV spiked last month. If your enzymes stay stable, would you share what range you’re seeing? Curious if GLP-1 effects on liver enzymes align with fat loss in your case.
  • amber464: I usually grab a baseline at week 4 then repeat every 4 weeks regardless of how I feel – it catches any slow drift before it spikes. If ALT/AST jump I pull labs a week earlier to see if it’s a transient thing or needs a dose tweak.
  • chris_sleepnerd: Got it, I’ll add a week‑4 baseline scan for next cycle and keep the 4‑week repeat schedule. I’ve been watching ALT; it’s sat at 22 U/L now but spiked to 38 at week 5 after the 5 mg bump, so I’ll pull labs at week 6 just to be safe before I push to 8 mg. Thanks for the heads‑up.

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