Thread by @scottisaacsmd

Thyroid hormones regulate liver enzymes via thyroid hormone receptors. When the liver is steatotic, hepatic thyroid hormone receptors don’t respond effectively. This results in an intrahepatic hormonal milieu where the liver is essentially hypothyroid. #livertwitter #endotwitter

Thyroid hormone receptor-β plays a key role in hepatic homeostasis including:
✅De novo lipogenesis
✅Fatty acid β-oxidation
✅Mitophagy
✅Mitochondrial biogenesis
✅Cholesterol metabolism
✅Carbohydrate metabolism
#livertwitter #endotwitter

Thyroid hormone receptor-β agonism has demonstrated clinical benefits on hepatic lipid metabolism.
frontiersin.org/articles/10.33…

Hepatic fat reduction with #resmetirom in patients with #NASH reduces symptoms that may be attributed to hypothyroidism, and improves quality of life. #endotwitter #livertwitter
cghjournal.org/article/S1542-…

#Hypothyroidism is associated with a 25% increase in the risk of nonalcoholic fatty liver disease on top of traditional risk factors obesity, diabetes, metabolic syndrome, and dyslipidemia. #NAFLD #livertwitter #endotwitter

Thyroid hormones regulate hepatic lipid metabolism through HMG-CoA reductase and energy production via fatty acid β-oxidation. #NAFLD #livertwitter #endotwitter

Advances in cell imaging, autophagy and metabolomics have created detailed and comprehensive picture of thyroid-hormone-mediated regulation of hepatic lipid metabolism at the molecular level. #livertwitter #endotwitter nature.com/articles/nrend…

Thyroid hormones regulate lipogenesis, cholesterol synthesis and the reverse cholesterol transport pathway. #NAFLD #livertwitter #endotwitter
aasldpubs.onlinelibrary.wiley.com/doi/abs/10.100…

Thyroid hormone mediates effects on the liver at the transcriptional and post-translational levels and via #autophagy, the body’s way of cleaning out damaged cells. #endotwitter #livertwitter

Impaired thyroid hormone conversion, elevated reverse T3 and rT3/T3 ratio in #NAFLD #NASH comes from a predominance of deiodinase-3 over deiodinase-1 in an injured liver. #livertwitter #endotwitter

Thyroid hormone analogues and mimetics are being studied for the treatment of metabolic diseases involving the liver, such as #NAFLD. #Resmetirom #livertwitter #endotwitter
thelancet.com/journals/lance…

#NAFLD symptoms can be misdiagnosed as a thyroid disorder and mistreated by functional medicine with gluten-free diets and T3 medications. Treating NAFLD can alleviate fatigue and other symptoms attributed to the thyroid. #livertwitter #endotwitter