Based on the questions I've been asked, it is clear that in my previous blog about low thyroid I confused some people about the relationship between NAFLD/NASH (MASLD/MASH) and hypothyroidism or low levels of thyroid hormone.
Let me be clear. You cannot cure your liver disease by taking meds to raise your thyroid hormone levels.
This is disappointing because low levels of thyroid hormones within the liver is associated with our disease process. The value that Resmetirom brings to the party is that it is a highly specialized molecule that selectively binds to thyroid receptors in the liver without affecting other tissues.
If Resmetirom is approved by FDA there will be more discussion of the role that thyroid plays in liver disease. As patients it is important that we have a proper perspective from which to understand things that will be in the press should that happen.
The role that thyroid plays in liver disease is not often discussed despite that fact that it is estimated that 30% of liver patients have low thyroid. This matters because thyroid has a lot of functions throughout the body. Low thyroid contributes to increased mortality and is an important mediator of multiple important bodily functions so we recommend discussing it with your doctor as it is often overlooked. Just be aware that you can't just blast it with thyroid pills. As with all liver issues it needs to be managed as an element of the problem.
For the science minded here are a few papers that discuss the issues in great detail.
https://journals.lww.com/hep/fulltext/9900/thyroid_hormone_action_and_liver_disease,_a.521.aspx
https://academic.oup.com/qjmed/article/95/9/559/1574610?login=false
