Since on DXA the liver is considered lean mass and the liver mass decreased up to 50% with dual agonists, this could explain the 40% lean mass loss number from human trials
For example, the rs738409 variant in PNPLA3 , which has been linked to hepatic fat accumulation and metabolic dysfunction-associated steatotic liver disease, has also been associated with changes in taxa involved in fatty acid metabolism, including Bacteroidetes, Gemmiger , and Oscillospira ( GPR35 gene expression have been associated with increased abundance of Ruminococcus gnavus and hepatic fat accumulation, suggesting a potential link between host receptor signaling, gut microbial ecology, and liver metabolic phenotypes (Wu et al., 2023)
1 Originally FDA-approved for type 2 diabetes, GLP-1 RAs also lead to sustained weight loss and have revolutionized diabetes and obesity management
Otherwise, one should wait and resume the usual dosing schedule
By combining GLP-1, GIP, and glucagon receptor agonism, retatrutide simultaneously reduces energy intake, increases energy expenditure, and corrects insulin resistance and lipid flux
BIIB021, an orally available, fully synthetic small-molecule inhibitor of the heat shock protein Hsp90