Currently, there is no medication approved to reduce the escalation of fatty liver disease. But could there be? And could thyroid hormones be the answer?
A research trial conducted in Singapore has brought us one step closer to developing a medication that can reduce the escalation of fatty liver disease.
What Is Fatty Liver Disease?
Affecting approximately one-third of American adults, nonalcoholic fatty liver disease (NAFLD) is a rapidly growing diagnosis, considered to be the most common cause of abnormal liver function tests worldwide.
Characterized by the accumulation of excess fat in the liver that is not due to drinking alcohol, NAFLD is associated with:
- high cholesterol
- insulin resistance
- and type II diabetes.
A fatty liver is typically divided into two stages:
- Early stage NAFLD – Known as steatosis, the early stage is a simple fatty liver without liver inflammation.
- Late stage NAFLD – Known as non-alcoholic steatohepatitis (NASH), this advanced stage is fat accumulation in the liver with liver inflammation. The inflammation can cause fibrosis, or scars in the liver. NASH can progress to cirrhosis, the permanent hardening and death of liver tissue.
If lifestyle changes are instituted when NAFLD is in its early stage, it can be reversed. However, a fatty liver that progresses to its more advanced stage can have severe, or even fatal, consequences.
Those affected are typically advised to reduce their consumption of sweet beverages and foods high in calories, and exercise for 50 minutes three times a week – but there is no medication currently approved to reduce fatty liver disease escalation.
But could there be?
The Link Between Fatty Liver Disease and Thyroid Hormone
Although the relationship between a fatty liver and thyroid hormones has long been controversial, researchers from Singapore completed a study in 2018 that suggests a thyroid hormone may be a potentially therapeutic avenue for fatty liver disease.
Your thyroid gland is a butterfly-shaped organ located at the base of the neck. It releases hormones that control metabolism and regulate many of your body’s functions.
Thyroid hormones are integral in the regulation of:
- body weight
- fat metabolism
- and insulin resistance.
Because of their role in related physiology, scholars have proposed that thyroid dysfunction likely plays a role in the pathogenesis of NAFLD and NASH.
Results of past studies about the association between thyroid abnormalities and NAFLD/NASH are conflicting – some regard hypothyroidism as a risk factor for fatty liver disease and others have found no conclusive connection between the two.
Despite the lack of a concrete association between thyroid hormones and NAFLD, researchers from Singapore completed a clinical study that could be a game changer in the search for medication to help reduce fat accumulation in the liver.
Dr. Eveline Bruinstroop and Professor Paul M. Yen from Duke-NUS Medical School, in collaboration with the Singapore Clinical Research Institute (SCRI), and Dr. S. Sendhil Velan from the Agency of Science and Technology Research (A*STAR)’s Singapore Bioimaging Consortium (SBIC), found that low dose thyroid hormone supplementation may be beneficial for reducing fatty liver in male diabetic patients with NAFLD.
6 Key Details of the Singapore Study
- Twenty NAFLD patients with stable type 2 diabetes and normal thyroid function were treated with low dose thyroid hormone therapy for 4 months.
- Thyroid hormone is currently used to treat conditions like hypothyroidism, which causes symptoms such as a lack of energy and depression.
- Magnetic resonance imaging (MRI) was performed before and after thyroid hormone treatment to measure the changes in various fat depots, including liver fat content.
- In addition, blood glucose levels were monitored before and after thyroid hormone treatment.
- The low dose thyroid hormone significantly decreased both liver fat as well as overall body fat in the study’s participants without any safety issues.
- Patients who had a larger decrease in liver fat content also showed improvements in their blood sugar levels.
According to Yen, “This pilot study provides a strong rationale for further investigation, development, and testing of thyroid hormone or thyroid hormone analogues in diabetic patients with NAFLD.”
Although this study’s results are encouraging for the millions of people with a fatty liver, we must remember that this was a small, first-of-its-kind trial. More investigation into the potential for thyroid hormone’s use as an NAFLD treatment is warranted.
However, the possibility of a relatively cost-effective, predominantly safe medication’s ability to treat nonalcoholic fatty liver disease is exciting, and a development we will be watching closely.
https://www.a-star.edu.sg/News-and-Events/News/Press-Releases/ID/5935, An Innovative Treatment for Non-Alcoholic Fatty Liver Disease Patients with Diabetes, Retrieved May 28, 2018, Agency for Science, Technology and Research, May 2018.
https://www.endocrineweb.com/conditions/thyroid-nodules/thyroid-gland-controls-bodys-metabolism-how-it-works-symptoms-hyperthyroi, Thyroid Gland: Overview, Bridget Brady, MD, FACS, Retrieved May 28, 2018, Vertical Health, LLC, 2018.
https://www.healio.com/hepatology/steatohepatitis-metabolic-liver-disease/news/online/%7Bf398e55b-ac9c-4046-b5b5-e59eeeef7912%7D/low-thyroid-function-predicts-nash-fibrosis-in-patients-with-fatty-liver, Low thyroid function predicts NASH, fibrosis in patients with fatty liver, Talitha Bennett, Retrieved May 28, 2018, Healio, 2018.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4081681/, Non-alcoholic fatty liver disease and thyroid dysfunction: A systematic review, A. Eshraghian, et al, Retrieved May 28, 2018, World Journal of Gastroenterology, July 2014.
https://www.straitstimes.com/singapore/possible-cure-found-for-medically-untreatable-liver-disease-study, Possible cure found for 'medically untreatable' liver disease: Study, Low de Wei, Retrieved May 28, 2018, Singapore Press Holdings, 2018.