Probable tirzepatide-induced acute pancreatitis with 100x elevated lipase in young woman without biliary obstruction | Research

The takeaway

A 32-year-old woman developed acute pancreatitis (lipase 11,645 U/L) 5 weeks after starting tirzepatide for weight loss, with no biliary obstruction on imaging despite incidental gallstones, resolving after drug cessation.

Lipase 100x elevated
A 32-year-old on tirzepatide for weight loss developed acute pancreatitis with markedly elevated lipase (11,645 U/L) without biliary obstruction—a probable drug-related adverse effect

What the researchers found

Age 32; 5 weeks tirzepatide (2.5→5 mg); lipase 11,645 U/L (100x upper normal). Elevated transaminases, ALP, bilirubin. CT: acute interstitial pancreatitis. MRCP: gallstones but no obstruction. Resolved after cessation + supportive care.

Why it matters

With tirzepatide prescriptions surging, clinicians must recognize pancreatitis as a potential side effect—even in young patients without traditional risk factors. The gallstone confound makes this diagnostic challenge realistic.

How the study worked

Detailed case report with imaging (CT, MRCP), laboratory data, and temporal analysis.

What this study cannot tell us

Single case. Gallstones present (confounding). Cannot definitively exclude gallstone pancreatitis despite no obstruction. Causation assumed based on temporal correlation.

How to read the evidence

Detailed case report with imaging and laboratory correlation. Important for safety awareness.

When this study was published

Published in 2025.

The bigger picture

Pancreatitis has been a persistent safety concern with GLP-1 drugs since exenatide. This tirzepatide case adds to the evidence that the dual GIP/GLP-1 class carries similar risk, warranting vigilance especially during dose escalation.

Questions still open

Does dose escalation trigger pancreatitis more than stable dosing?
Should patients with gallstones avoid GLP-1/GIP drugs?
Is the pancreatitis risk higher with tirzepatide than pure GLP-1 agonists?

Common questions

Can tirzepatide cause pancreatitis?

This case strongly suggests it can. A young woman developed severe pancreatitis with very high lipase (100x normal) 5 weeks after starting tirzepatide, resolving after stopping the drug. While her gallstones could theoretically be responsible, imaging showed no biliary obstruction.

What symptoms should I watch for?

Seek immediate medical attention if you develop severe upper abdominal pain (especially radiating to the back), persistent nausea and vomiting, or loss of appetite while taking tirzepatide or any GLP-1 drug. These symptoms may indicate pancreatitis, which requires urgent treatment.

Read the original research

A Probable Case of Tirzepatide-Induced Acute Pancreatitis.

Cureus, 17(6), e85291

View on PubMed ↗Publisher’s paper ↗

Citation

Sumaruth, Yovan; Gopal, Rudramun; Chater, Faris; Dhawan, Saurav; Wild, Tamzin. (2025). A Probable Case of Tirzepatide-Induced Acute Pancreatitis.. Cureus, 17(6), e85291. https://doi.org/10.7759/cureus.85291