Pre-visit lab checklist
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You are being evaluated or have a first visit booked.
Checklist for your visit (10 items)
Prepared 2026-09-04 for before a first prescription. Take it to the visit and ask; your prescriber decides what to order.
Labs to ask about
Hemoglobin A1c, and a fasting glucose if one has not been done recently
Establishes where glucose sits before therapy. The diagnostic cut points are under 5.7%, 5.7% to 6.4% and 6.5% or higher.
Source: MedlinePlus: A1C test (https://medlineplus.gov/ency/article/003640.htm) | Read more
Lipid panel (total, LDL, HDL, triglycerides)
A baseline to compare against later. The ADA Standards include a lipid profile in the initial evaluation for people with diabetes.
Source: American Diabetes Association, Standards of Care in Diabetes 2026 (https://professional.diabetes.org/standards-of-care) | Read more
Comprehensive metabolic panel: creatinine with eGFR, electrolytes, ALT and AST
Kidney and liver function before starting give the numbers to compare against if you later become dehydrated or unwell.
Source: American Diabetes Association, Standards of Care in Diabetes 2026 (https://professional.diabetes.org/standards-of-care) | Read more
Complete blood count, if your prescriber orders a baseline panel
Not required by any GLP-1 label. A baseline hemoglobin matters later because anemia can distort A1c.
Source: MedlinePlus: CBC blood test (https://medlineplus.gov/ency/article/003642.htm) | Read more
Questions for the visit
Tell your prescriber about any personal or family history of medullary thyroid carcinoma or MEN 2
That history is a contraindication in every semaglutide and tirzepatide label. It is a question, not a lab test.
Source: Zepbound (tirzepatide) prescribing information, DailyMed set id 487cd7e7-434c-4925-99fa-aa80b1cc776b (https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b) | Read more
Tests that are not routine (so you are not surprised when they are not ordered)
Calcitonin and thyroid ultrasound are not routine tests on GLP-1 therapy
The labels state that routine monitoring of serum calcitonin or thyroid ultrasound is of uncertain value for early detection of medullary thyroid carcinoma. They do say a thyroid nodule found on exam or imaging should be evaluated. Mention any neck lump, trouble swallowing or persistent hoarseness.
Source: Wegovy (semaglutide) prescribing information, DailyMed set id ee06186f-2aa3-4990-a760-757579d8f77b (https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b) | Read more
Routine lipase or amylase is not asked for by the labels
The labels report mean rises in amylase and lipase on treatment and state that the clinical significance of those rises is unknown in the absence of other signs and symptoms of pancreatitis. They ask prescribers to watch for symptoms instead.
Source: Zepbound (tirzepatide) prescribing information, DailyMed set id 487cd7e7-434c-4925-99fa-aa80b1cc776b (https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b) | Read more
Vitamin D testing is not routine for healthy adults
The 2024 Endocrine Society guideline suggests against routine 25-hydroxyvitamin D testing in healthy adults. Ask only if you have a reason, such as a bone condition or a previous low result.
Source: Endocrine Society, Vitamin D for the Prevention of Disease guideline, 2024. PubMed 38828931 (https://pubmed.ncbi.nlm.nih.gov/38828931/) | Read more
Symptoms that change the plan (labs or imaging are done when these appear)
Persistent or severe abdominal pain, sometimes radiating to the back, with or without vomiting
The label language for suspected pancreatitis. Stop and seek care; lipase is drawn then, not on a schedule.
Source: Wegovy (semaglutide) prescribing information, DailyMed set id ee06186f-2aa3-4990-a760-757579d8f77b (https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b) | Read more
Pain in the upper right abdomen, fever, yellowing of the skin or eyes, or pale stools
The labels say that if cholelithiasis or cholecystitis is suspected, gallbladder studies and clinical follow-up are indicated. Imaging is done when symptoms appear, not routinely.
Source: Zepbound (tirzepatide) prescribing information, DailyMed set id 487cd7e7-434c-4925-99fa-aa80b1cc776b (https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b) | Read more
This is a list of things to ask about, built from the FDA labels for the approved products and from published guidelines. It is not a diagnosis, an order set or medical advice. Reference ranges vary by laboratory and interpretation belongs to your clinician. Compounded semaglutide and tirzepatide are not FDA approved and are not interchangeable with the brand products the labels describe.
This is the page to read before a first appointment. It lists what is usually drawn, says where each item comes from, and is honest about the fact that none of it is mandated by the drug labels. The tool underneath builds a version tailored to your situation that you can print.
The usual baseline panel
| Test | Why it is drawn | Basis |
|---|---|---|
| Hemoglobin A1c | Sorts no diabetes, prediabetes, diabetes; sets the monitoring schedule; baseline for later comparison | ADA initial evaluation; MedlinePlus cut points |
| Fasting glucose | Corroborates the A1c; free on a fasting CMP; sets the low end for people on insulin or a sulfonylurea | ADA; label hypoglycemia warnings |
| Lipid panel | Cardiovascular risk is part of the reason for treatment; baseline for later comparison | ADA Section 10; Wegovy CV indication |
| Comprehensive metabolic panel | Kidney function and electrolytes (the labels' one re-check), liver enzymes, proteins | Label section 5.5 (Wegovy) and equivalents; ADA |
| Complete blood count | Anemia is common and makes A1c unreliable; baseline hemoglobin | Common practice; MedlinePlus A1c caveats |
| TSH | Only with thyroid history, levothyroxine or symptoms. Does not address the C-cell warning | Not in any label; ATA guideline for those on levothyroxine |
| Vitamin B12 | With metformin, acid reducers, vegan diet, bariatric history or age over 50 | ADA (metformin); NIH ODS risk groups |
| Ferritin | With heavy periods, low hemoglobin or MCV, restricted diet | Common practice; WHO thresholds |
| Pregnancy test | Commonly requested before the first dose in anyone who could be pregnant | Not label-mandated; labels say discontinue if pregnancy recognized |
What is deliberately not on the list
Three tests get asked for and are not routine, and the sources are explicit.
Calcitonin and thyroid ultrasound. Each label says routine monitoring of serum calcitonin or thyroid ultrasound is of uncertain value for early detection of medullary thyroid carcinoma, and may lead to unnecessary procedures. The calcitonin page quotes the paragraph in full.
Lipase and amylase. The labels report that both rise on average in treated people and say the clinical significance of a rise without symptoms is unknown. They ask for symptom watch, not a schedule. See lipase and amylase.
Vitamin D. The 2024 Endocrine Society guideline suggests against routine 25-hydroxyvitamin D testing in healthy adults. Test with a reason (bone disease, malabsorption, treated deficiency), not by default. See vitamin D.
If any of these appears on your baseline, that is your prescriber's choice and gives a personal reference point. It is not something a label asked for, and a normal result should not be read as clearing the corresponding warning.
The questions that matter more than the labs
The labels' hard requirements are answers, not tests.
- Personal or family history of medullary thyroid carcinoma or MEN 2. A contraindication in every label. Find out before the visit; "thyroid cancer" in a relative is usually a different type, and the prescriber needs to know which.
- Insulin or a sulfonylurea on your medication list. Triggers the hypoglycemia warning and possibly a dose change.
- Past pancreatitis. Not a contraindication, but the labels' pancreatitis warning makes it a first-visit topic.
- Past gallstones or gallbladder surgery. Sets the symptom plan.
- Diabetic retinopathy. The labels ask that people with a history of it be monitored for progression when glucose improves quickly; that is an eye exam, not a lab.
- Contraception and pregnancy plans. The semaglutide two-month washout and the tirzepatide four-week oral contraceptive rule both start here.
- Diuretics, ACE inhibitors, ARBs, SGLT2 inhibitors. These change how risky a dehydrated week is and are the reason to ask for a sick-day plan.
- Whether the product is compounded. Compounded semaglutide and tirzepatide are not FDA approved and are not interchangeable with brand products; the labels quoted on this site describe the brand products.
Practical notes for the draw
Book it for the morning, fasting, so the glucose and lipids can be read as fasting values and the TSH (if drawn) is at its most consistent. Drink water. Take your usual medicines unless told otherwise. If you exercised hard the day before, mention it; AST and creatine kinase rise after heavy exertion. Ask for a copy of the report, or access to the portal, and keep it: the lab tracker exists so the baseline is still findable a year later.
Build your own list
The tool below takes your stage and conditions and produces a printable checklist of labs to ask about, questions for the visit, tests that are not routine, and symptoms that would change the plan. Every line carries its source. It does not diagnose anything and it does not tell your prescriber what to order.
For what happens after the baseline, see the monitoring calendar. For where a compounded program fits, the FormBlends GLP-1 overview describes theirs; the GLP-1 Starter site covers the first weeks in detail.
Questions people ask
If no label requires labs, why does my prescriber want them before starting?
Because a baseline turns every later result into information. The labels ask prescribers to monitor kidney function when someone becomes dehydrated, to watch glucose in people on insulin or a sulfonylurea, and to evaluate thyroid nodules and gallbladder symptoms. Each of those is easier with a before number. The ADA Standards also list these tests for the initial evaluation of anyone with diabetes. What the labels do not do is dictate the panel, which is why panels differ between prescribers.
What should I bring to the first visit besides the labs?
The list of everything you take, including supplements and acid reducers; your family history of thyroid cancer with as much detail as you can get; any history of pancreatitis, gallstones or kidney disease; your contraception; and, if you have them, recent results from another clinician so tests are not repeated. The checklist tool on this page turns those facts into the questions worth asking.
Sources
- Wegovy (semaglutide) prescribing information, DailyMed set id ee06186f-2aa3-4990-a760-757579d8f77b, revised June 2026 Accessed September 4, 2026.
- Zepbound (tirzepatide) prescribing information, DailyMed set id 487cd7e7-434c-4925-99fa-aa80b1cc776b, revised September 2026 Accessed September 4, 2026.
- American Diabetes Association. Standards of Care in Diabetes 2026 (Section 4, Comprehensive Medical Evaluation and Assessment of Comorbidities) Accessed September 4, 2026.
- Demay MB et al. Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline. 2024. PubMed 38828931 Accessed September 4, 2026.
Canonical URL: https://formblendslabs.com/guides/pre-therapy-lab-checklist. Written by the FormBlends editorial team. This page is educational and is not medical advice; see the medical disclaimer.