What laboratory tests are recommended after being on Wegovy (semaglutide) for a month?

Laboratory Monitoring After One Month of Wegovy (Semaglutide) Therapy

No specific laboratory tests are routinely recommended after just one month of Wegovy (semaglutide) therapy, but monitoring renal function, liver enzymes, and blood glucose may be prudent in certain patients with pre-existing conditions.

Recommended Laboratory Monitoring

While there are no formal guidelines specifically addressing laboratory monitoring after one month of Wegovy therapy, the following approach is recommended based on the available evidence:

For Most Patients:

• No mandatory laboratory tests are required at the one-month mark for patients without pre-existing conditions
• Initial monitoring should focus on clinical response and tolerability rather than laboratory parameters

For Patients with Specific Risk Factors:

1. Patients with renal impairment:

   • Serum creatinine and estimated glomerular filtration rate (eGFR)
   • Especially important in patients with baseline eGFR <60 mL/min/1.73m²

2. Patients with liver disease:

   • Liver function tests (ALT, AST, alkaline phosphatase, bilirubin)

3. Patients with diabetes:

   • Blood glucose monitoring
   • Consider HbA1c if significant changes in glycemic control are suspected

Monitoring Timeline

• Baseline (before starting): Complete metabolic panel, renal function tests
• One month after initiation: Clinical assessment for adverse effects; laboratory tests only if indicated by symptoms or pre-existing conditions
• Three months after initiation: More comprehensive laboratory assessment may be considered

Common Adverse Effects to Monitor Clinically

At the one-month visit, clinical assessment should focus on:

• Gastrointestinal symptoms (nausea, vomiting, diarrhea, constipation, abdominal pain) 1, 2
• Changes in appetite and food intake
• Weight loss progress
• Signs of dehydration if significant gastrointestinal symptoms are present

Special Considerations

• Diabetic patients: Monitor for hypoglycemia, especially if taking insulin or insulin secretagogues 3
• Patients with diabetic retinopathy: No specific laboratory tests, but ophthalmologic follow-up may be appropriate 3
• Patients with gallbladder disease history: Be vigilant for symptoms of gallbladder issues 3

When Additional Testing May Be Warranted

Consider additional laboratory testing at the one-month mark if:

• Patient reports significant gastrointestinal symptoms affecting hydration status
• Patient has pre-existing renal impairment
• Patient is taking medications that may interact with semaglutide
• Patient shows signs of unexpected adverse effects

Long-term Monitoring Considerations

While not necessary at one month, longer-term monitoring (3-6 months) should include:

• Comprehensive metabolic panel
• Renal function tests
• Lipid profile (semaglutide may have beneficial effects on lipid parameters)
• HbA1c in diabetic patients

The evidence supports that semaglutide is generally well-tolerated with predictable side effects that are primarily gastrointestinal in nature 4, 1. The most important monitoring at the one-month mark is clinical assessment of these side effects rather than routine laboratory testing.