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ForumsRetatrutide & Triple AgonistsGlucagon receptor agonism and hepatic lipid oxidation — need advice

Glucagon receptor agonism and hepatic lipid oxidation — need advice

mike_mod Sat, Aug 16, 2025 at 1:49 PM 30 replies 1,870 viewsPage 1 of 6
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mike_mod
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Aug 16, 2025 at 1:49 PM#1

Watching the glucagon co-agonists for the liver endpoints and finding almost nothing written about them that is not a press release.

The question I want answered is whether the liver signal is independent of weight loss or downstream of it, because that determines whether any of this is interesting for someone whose weight is already where they want it.

I would rather have one careful answer than five confident ones.

20 15PharmHunterJen, TomTeleRx, DoseLogDan and 17 others
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BethLabQueen
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Aug 16, 2025 at 1:56 PM#2

Taking the question as asked, rather than the general version of it. The pharmacokinetics explain nearly every practical question asked here. Albumin binding above 99% slows clearance enough to make weekly dosing possible; a terminal half-life near a week means four to five weeks to steady state and therefore a four-week titration interval; subcutaneous bioavailability around 89% means injection site barely matters. Those three facts answer most timing questions before they are asked.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

19 14Dr.PulmRoch, maya_sedona, stefan_berlin and 16 others
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CryptoCarl
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Aug 16, 2025 at 2:03 PM#3
BethLabQueen said:
The pharmacokinetics explain nearly every practical question asked here.

Agreed, and the adaptation point cuts both ways: tachyphylaxis to gastric emptying is why tolerability improves, and it is also why people who were relying on physical fullness feel the effect fade while the appetite effect is still working.

I would rather be corrected than agreed with, if it comes to it.

18 13AussieAnna, BethLabQueen, ChrisMacros and 15 others
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wei_SG
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Aug 16, 2025 at 2:10 PM#4
mike_mod said:
Watching the glucagon co-agonists for the liver endpoints and finding almost nothing written about them that is not a press release.

Adding a me-too, because a thread of one person's experience is not much use.

Last edited: Aug 16, 2025 at 3:10 PM
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Dr.GastroMayo
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Aug 16, 2025 at 2:44 PM#5

Clinical perspective, offered as context rather than as advice.

Glucagon receptor pharmacology in triple agonists (retatrutide), relevant to the glucagon co-agonists: the glucagon component is the most controversial because glucagon traditionally raises blood glucose. So why include it in an anti-obesity drug?

Key insight: glucagon increases energy expenditure (thermogenesis), promotes hepatic lipid oxidation, and reduces appetite through distinct CNS mechanisms. The hyperglycemic effect is counterbalanced by the GLP-1 component's insulin secretagogue action.

Net result: more weight loss through increased expenditure (glucagon) + decreased intake (GLP-1/GIP), with neutral or improved glycemia. An elegant pharmacological balancing act[1].

References:
[1] Day JW, et al. Nat Rev Drug Discov. 2022;21:37-54.
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