Long-term semaglutide (3+ years) — looking for input

Previously posted:

did you have any side effects that affected your labs? I've heard some people get elevated lipase/amylase on sema?

Good question. My lipase was actually mildly elevated at my 3-month check (72 U/L, upper normal is 60) but my doctor said this is common with GLP-1 agonists and doesn't indicate pancreatitis unless you're having symptoms (severe abdominal pain radiating to back). By 6 months it had come back down to 48.

I did NOT have any vitamin deficiency issues, but I take a daily multivitamin, B12, and vitamin D as a precaution since I'm eating significantly less food. My doctor recommended this proactively.

the real question is how do you feel? like beyond the numbers. Because I'm 4 months in and the lab improvements are great but mentally I feel like a different person. The brain fog from high blood sugar is GONE.

DUDE. Yes. The mental clarity is something I didn't expect and nobody talks about. It's like someone wiped the fog off a windshield. I'm sleeping better, I have more energy, my joints don't ache anymore, and honestly my mood is better too.

My wife says I'm "back to the person she married." That hit hard ngl 🥲

The mental clarity thing is likely directly related to your glucose normalization. Chronic hyperglycemia causes neurocognitive effects that most people with T2D don't even realize they have because it developed so gradually. When your blood sugar normalizes, it can feel like waking up from a fog.

Also the CRP reduction (inflammation marker) is associated with improved mood and cognitive function. Systemic inflammation is linked to depression and brain fog in multiple studies.

Your results are a perfect example of why metabolic health matters so much more than the number on the scale.