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Because the liver is responsible for processing such a high volume of compounds, it requires a massive "cleanup crew" to prevent those compounds from damaging the liver's own tissues

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However, patients should be advised to report symptoms suggestive of liver injury, including: Persistent nausea or vomiting unrelated to expected GI side effects Right upper quadrant abdominal pain (which may also indicate gallbladder disease, a known risk with GLP-1 therapy) Jaundice (yellowing of skin or eyes) Dark urine or pale stools Unexplained fatigue or malaise Clinicians should maintain a low threshold for investigating these symptoms with comprehensive liver function tests, including ALT, AST, alkaline phosphatase, bilirubin, albumin, and INR/prothrombin time