Does retatrutide (glucagon-like peptide-1 (GLP-1) receptor agonist) affect testosterone levels?

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Effect of Retatrutide on Testosterone Levels

There is currently no evidence that retatrutide directly affects testosterone levels, though monitoring hormonal parameters may be prudent given its metabolic effects.

Mechanism of Action and Hormonal Effects

  • Retatrutide is a triple-hormone-receptor agonist that targets glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-1 (GLP-1), and glucagon receptors, primarily developed for obesity treatment 1
  • Current clinical studies on retatrutide have focused on weight loss outcomes and gastrointestinal side effects, with no reported direct effects on testosterone levels 1, 2
  • GLP-1 receptor agonists have been shown to affect certain hormonal pathways, including stimulation of growth hormone secretion, which could theoretically influence the hypothalamic-pituitary-gonadal axis indirectly 3

Metabolic Effects and Potential Indirect Impact

  • Retatrutide produces substantial weight reduction (up to 24.2% at the 12mg dose over 48 weeks), which could indirectly affect testosterone levels through changes in body composition 1
  • Obesity is associated with functional hypogonadism, and weight loss through various interventions can improve testosterone levels by normalizing gonadotropins 4
  • Lifestyle modifications including weight loss have been shown to increase testosterone levels, though these increases are typically modest (1-2 nmol/L) 4

Monitoring Considerations

  • For men with or at risk for hypogonadism, testosterone levels should be routinely measured as part of cardiovascular risk assessment 4
  • Sex hormone-binding globulin (SHBG) levels can be elevated with certain medications that affect metabolism, which can influence total testosterone measurements while free testosterone may remain unchanged 4
  • When evaluating testosterone levels in patients taking medications that affect metabolism, both total and free testosterone should be considered for accurate assessment 4

Clinical Implications

  • For patients with obesity who may have functional hypogonadism, the weight loss effects of retatrutide might potentially improve testosterone levels indirectly 4
  • Patients with hypogonadism display procoagulant imbalances that are not worsened by testosterone replacement therapy, suggesting careful monitoring of both metabolic and hormonal parameters is important 5
  • In patients taking medications that affect multiple metabolic pathways like retatrutide, regular monitoring of hormonal parameters would be prudent, especially in those with pre-existing endocrine conditions 4

Gaps in Current Evidence

  • There are no specific studies examining the direct effects of retatrutide on testosterone or other sex hormone levels 1, 2
  • Future research should include comprehensive hormonal assessments in patients taking retatrutide to better understand its potential effects on the hypothalamic-pituitary-gonadal axis 2
  • Comparative studies between retatrutide and other GLP-1 receptor agonists regarding hormonal effects would provide valuable clinical information 2

References

Research

Retatrutide showing promise in obesity (and type 2 diabetes).

Expert opinion on investigational drugs, 2023

Research

GLP-1 Receptor Agonists Induce Growth Hormone Secretion in Healthy Volunteers.

Diabetes therapy : research, treatment and education of diabetes and related disorders, 2023

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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