Thread by @scottisaacsmd

Thyroid hormones regulate liver enzymes. When the liver is fatty, thyroid hormones don’t work right. #HepaticHypothyroidism

Hepatic enzymes responsive to #thyroid hormones will slow down when the liver is fatty. Thyroid hormone has a dominant effect on HMG-CoA reductase in the liver which regulates cholesterol levels which is why #hypothyroidism causes high cholesterol. #HepaticHypothyroidism

Thyroid hormone regulates fatty acid β-oxidation in the liver. This is a process that breaks down fat for energy. #NAFLD impedes the process in a viscous cycle where liver fat continues to build up, energy levels plummet, unresponsive to thyroid hormone. #HepaticHypothyroidism

Thyroid hormone #T3 regulates de novo lipogenesis – the creation of new fat in the liver. If you have a hypothyroid liver the fat keeps building up. #HepaticHypothyroidism

As free T4 levels drop, the risk of #NAFLD increases incrementally across the spectrum of thyroid disease starting with low normal free T4 progressing to overt hypothyroidism. #HepaticHypothyroidism

Drugs that affect #thyroid hormone signaling in the liver target TRβ:
#Resmetirom
#Eprotirome
#Sobetirome
#VK2809
#HepaticHypothyroidism

Thyroid-related drugs that have been studied in #NAFLD:
#LT4 Levothyroxine
#Triac Triiodothyroacetic acid
#T2 Diiodothyronine
#T1AM Naturally occurring thyroid hormone metabolite
#HepaticHypothyroidism

The liver and thyroid are intimately connected. If the liver is fatty, the hepatic enzymes regulated by thyroid hormones don’t function properly. #HepaticHypothyroidism
aasldpubs.onlinelibrary.wiley.com/doi/abs/10.100…

When you have a hepatic hypothyroidism, thyroid tests are normal and adjusting thyroid meds or taking extra T3 does not work. The symptoms of a hypothyroid liver can be ignored, undiagnosed, and the root cause untreated. #HepaticHypothyroidism

10 Steps to Healing a Hypothyroid Liver #HepaticHypothyroidism
atlantaendocrine.com/blog/10-steps-…