Repurposing levothyroxine for managing metabolic dysfunction-associated steatotic liver disease.

Area of Science:

• Hepatology and Endocrinology
• Metabolic Disorders
• Pharmacology

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) affects nearly half the global adult population, driven by obesity and insulin resistance.
• Effective and affordable treatments are urgently needed for this growing public health crisis.

Purpose of the Study:

• To review evidence supporting levothyroxine (LT4) and thyroid hormone analogs for treating MASLD and metabolic dysfunction-associated steatohepatitis (MASH).
• To explore LT4 as a potential alternative therapy for MASLD management.

Main Methods:

• A narrative review of clinical studies was performed.
• Studies focused on the role of thyroid function and thyroid hormone receptors (THRs) in hepatic steatosis.

Main Results:

• Low thyroid function is linked to increased hepatic steatosis risk.
• Thyroid hormone receptor beta (THRβ) mediates liver metabolism; selective THRβ agonists show early promise for MASLD.
• High cost of new drugs may limit access, highlighting the need for affordable options like LT4.

Conclusions:

• Low-dose levothyroxine (LT4) demonstrates efficacy and safety for MASLD treatment.
• LT4 offers a potentially cost-effective alternative to newer thyromimetic drugs, especially considering its established safety profile.