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HealthRX.com · Printable lab tracker

Wegovy liver-test tracker: ALT, weight and gallbladder signs

Start with your baseline ALT, the lab's normal limit and any fatty-liver or fibrosis result, then line up each liver panel with your Wegovy dose and weight. The sheet keeps the gallbladder warning signs and the fibrosis questions next to the numbers.

Companion to “How Wegovy Affects ALT: What Semaglutide 2.4 mg Does to Liver Enzymes” · healthrx.com/how-wegovy-affects/alt · Facts checked 2026-10-18

Before the first dose

Baseline ALT and AST, with date
Your lab's upper limit of normal for ALT
Known fatty liver, MASH or fibrosis resultFIB-4, elastography or biopsy, with date
Alcohol per week, and medicines or supplements that can affect the liver
Weight at the start of Wegovy

Liver panel results over time

Bring the lab's printout too: reference ranges differ between labs.

DateWegovy doseWeightALTASTBilirubin or ALP, if doneUpper-right belly pain?

What the evidence shows

  • In a 52-week semaglutide weight trial, a raised ALT returned to normal in 25% to 46% on semaglutide versus 18% on placebo.[1]
  • Those ALT changes were no longer significant once weight change was taken into account.[1]
  • In Wegovy trials, some ALT and AST rises were linked to other causes such as gallstones.[2]
  • Gallstones were reported in 1.6% of adults on Wegovy injection versus 0.7% on placebo in the weight trials.[2]
  • In the teen weight trial, ALT at 5 or more times the upper limit of normal occurred in 3% on Wegovy and 0% on placebo.[2]

Call your healthcare provider for

  • Pain in the upper stomach, yellow skin or eyes, fever, or clay-colored stools: possible gallbladder problem.[2]
  • Severe stomach pain that will not go away, with or without vomiting: stop Wegovy and call right away.[2]

Questions about my liver

  1. What is my fibrosis risk from FIB-4 or elastography, separate from my ALT?
  2. If my ALT goes up, which other tests come first: ultrasound, bilirubin, ALP or GGT?
  3. How often should my liver panel be repeated while I am losing weight?
  4. Could alcohol, a statin or another medicine explain a change in my ALT?
  5. Do I need hepatology follow-up even if my ALT becomes normal?
Sources for the facts on this sheet
  1. Newsome P, Francque S, Harrison S, Ratziu V, Van Gaal L, Calanna S, Hansen M, Linder M, Sanyal A. Effect of semaglutide on liver enzymes and markers of inflammation in subjects with type 2 diabetes and/or obesity. Aliment Pharmacol Ther 2019. PMID 31246368. https://pubmed.ncbi.nlm.nih.gov/31246368/
  2. Novo Nordisk, via DailyMed. Wegovy (semaglutide) injection, for subcutaneous use, and Wegovy (semaglutide) tablets, for oral use: prescribing information and Medication Guide. Effective 2026-06-18. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b

This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.