Retatrutide Increasing A1C?

Z

Zara_79

Well-known member
I've been using Retatrutide for about 2 months, currently at 4mg weekly for the last month. I'm pretty happy with the fat loss and changes to my body composition – around 3/4 of a pound each week without a big change to strength training. However, my recent labs showed my A1C went up to 5.4 from 5.1. The 5.1 was after several months on Tirzepitide at a low dose of 1.5mg weekly. Before any GLP-1 drugs, my A1C baseline was 5.4-5.5 for about 10 years. My fasting glucose was 87, which is lower than my typical baseline in the mid-90s. Could the glucagon receptor agonist be slightly increasing my blood sugar?
 
Yes, compared to tirzepatide, it could. Research shows tirzepatide often leads to a greater decrease in A1C than retatrutide.

Glucagon's job is to release stored glycogen as glucose, so retatrutide *can* potentially raise blood glucose, hence the higher A1C. However, many people on retatrutide see an overall A1C reduction because of less food intake, particularly carbs. It seems like that isn't happening for you, but it's not necessarily a bad thing.

An A1C of 5.5 is considered normal and not an indicator of metabolic issues. Slight fluctuations in A1C below 5.7 don't always tell the whole story. Consider asking your doctor about measuring insulin sensitivity; it's often a better indicator of metabolic health than minor A1C variations within the normal range. Also, keep in mind that reducing visceral fat is beneficial for metabolism itself. If your waist size is decreasing, that's a positive sign.
 
I'm with Shape-Boss on this – it's a process and with time, based on studies and what people are seeing, you'll probably see those numbers come back down to where they were.

To answer your question, a glucagon receptor agonist *should* raise glucose levels by boosting glycogen breakdown and gluconeogenesis in the liver. But, theoretically, the added GLP-1 and GIP support at the same time *might* lessen those effects. I've read pretty much every study I could find on this, and only one measured glucose markers as early as 12 weeks. The rest waited until 24 weeks, so they missed the chance to see if glucose goes up initially. All those studies looked at type 2 diabetics with high A1Cs and glucose, so they had plenty of room for improvement.
 
Thanks, Shape-Boss and Tone_Life – very helpful. My situation is different from the typical Retatrutide trial participant, or any GLP drug trial participant. I'm trying to achieve an optimized state and have been experimenting with peptides for a year under medical supervision because my doctor is using me as a test case to measure the effects on an otherwise healthy individual. I'm using Retatrutide for two reasons: to lose fat and for longevity to achieve a metabolic ideal. I have problems with sleep/stress that cause some mild insulin resistance. However, Retatrutide has already reduced my fasting insulin from 9 to 5 in two months. I've also seen a 15-point drop in LDL cholesterol (even while on a statin), so there are real benefits aside from weight loss.

I'm a dedicated strength trainer, and I started at 207lbs with 19.1% body fat. Despite being strong and fit at 49, I have stubborn belly fat around my lower abs. I've lost 2 inches in that area and my waist has shrunk by 2 inches in 2 months, losing about 1 lb per week. I'll continue Retatrutide at 4mg weekly for another 3 months and then retest. I know there are varying opinions on A1C within the "normal" range, but I'm aiming for a consistent 4.8-5.0. My diet is as optimized as possible, but I experience nighttime cortisol spikes that elevate my glucose levels (confirmed with a CGM).
 
You can probably eliminate that fat, but I'm not sure about aiming for an A1C that low. 5.5 is perfectly fine. There's no solid research proving that dropping it to 4.8-5.0 provides any additional benefit.
 
I'm planning to start Ozempic next month and decided to get a DEXA scan beforehand to establish a baseline, plus I'm a data geek. Did anyone get a DEXA scan before starting or at some point while on a GLP-1 med? If so, how often are you getting them, and are you seeing significant body composition improvements?
 
I'm also curious about the DEXA scan results, Tracy_1986. I remember reading some stuff about GLP-1s potentially affecting testosterone levels in men, which could impact muscle mass. It might be something to keep an eye on. I saw this article about GLP-1s and men's health: another forum
 
Thanks for the link Tone_Life! That's good to know. I'll definitely be monitoring my testosterone levels as well. Hopefully, the DEXA scans will give a clearer picture of any muscle loss.
 
You must log in or register to reply here.
Back
Top