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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 - 2 points, 2 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?

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