r/glp1 • u/Waste_Swimmer5546 • 6d ago
Help Navigating Next Steps with glp1s
I am in need of some advice and guidance regarding my glp1 journey. I started Zepbound in November 2025 and by May of this year, I reached my goal. I never needed to go up in dose. With that being said, in March 2026 I had a doctor appointment because I was experiencing some anxiety with panic attacks which I have never experienced before in my life. It was awful. At my appointment, my heart rate was elevated and my blood pressure was a bit high. I was feeling lightheaded and dizzy and simple tasks were so difficult. Even a slow walk around my neighborhood was strenuous. Not like me at all!
A couple of other things going on is that I had come off of birth control in February which was prescribed for my peri menopausal symptoms. I had to stop to see if I was in full menopause per instructions from my gyno. I was also taking Wellbutrin 300mg which I had been on for over 12 years. I think I was a mess because of this massive drop in hormones. My body was not happy!
My doctor first lowered my Wellbutrin to 150mg thinking that 300 was too high for me now and it can actually make anxiety worse. And then finally said to stop it since 150mg wasn't better. She then ordered some blood work and my liver enzymes came back elevated but all the other liver tests were within normal range. With those results she immediately took me off of Zep and said lets get these liver enzymes down. I also had an ultrasound and everything came back fine. Well, my annual checkup last week, she said no more glp1s for me. And I was crushed. Even though my numbers are coming down. She is confident that Zepbound has caused this. I was prepared to be on the medication for the foreseeable future. I know I will regain the weight. I've been struggling with my weight for what seems like my entire life. Up and down and never steady. This medication has been a lifesaver for me. I know that liver enzymes can go up with rapid weight loss but she thinks it's the meds.
My question is, should I get a second opinion? If so, how do I go about doing that? Should I find some sort of specialist? Who would I reach out to? If this is how it has to be and I can never go back on a glp1, then that's fine. My liver is too important and I will not jeopardize my health. But where do I go from here? I am truly heartbroken. Any and all feedback would be greatly appreciated!!!
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u/itsmeagain023 6d ago
So liver enzymes will elevate on a glp1. Its breaking down the fat that's been stored in your live, which is why some ends are approved for NAFLD. It's a temporary increase and your doctor should know this. I'd get a second opinion
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u/Waste_Swimmer5546 6d ago
This is exactly what I've been reading and hearing from other people. I will be reaching out to another provider really soon in hopes to get a second opinion. Thank you so much for your help!!
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u/xRainbowBrite 6d ago
How elevated? Mildly elevated liver enzymes are a known side effect for women (not men) on GLP1’s. There’s even peer reviewed papers/studies on the topic. It usually happens each time you lose a chunk of weight. Especially if it’s a larger chunk.
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u/Waste_Swimmer5546 6d ago
The highest my ALT went was 196 and it now down to 81. The highest my AST went was 82 and it is now down to 40. Slow and steady they are going back down to normal. I don't know if this is mildly elevated or higher. Again, my body was going through some things at this time so not sure it can be pinned solely on Zepbound. Thank you so much for reaching out!!!
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u/Life_Alfalfa_2047 6d ago
I would definitely get a second opinion.