Rankings / Hormones & Endocrine

Resmetirom (Rezdiffra)

Hormones & Endocrine · Liver-selective THR-β agonist

Tier B

Reviewed by Read Off Label · Last reviewed · How we grade

autophagythyroidmitochondrialprescription
6.8 / 10
Tier B
Ev 8 Bn 8 Sf 5

Bottom line

Read Off Label grades Resmetirom (Rezdiffra) as B (6.8/10) based on strong evidence, high benefit magnitude, and a med-risk safety profile.

Madrigal Pharmaceuticals.

Studied, labeled, or reported-use context: 80-100 mg PO once daily (weight-based) — Rx; not individualized guidance.

What the evidence says

Madrigal Pharmaceuticals. First-ever approved drug for MASH/NASH — landmark approval after decades of failed candidates (e.g., obeticholic acid, elafibranor, selonsertib). Target population: MASH with F2/F3 fibrosis, ~6-7% of US adults. Prescribed by hepatology; expensive (~$47K/year list). Particularly relevant for biohacker readers given the strong overlap between metabolic syndrome and liver fat that Attia and others discuss frequently.

Mechanism

Liver-selective thyroid hormone receptor beta (THR-β) agonist; activates hepatic lipid catabolism, mitochondrial biogenesis, and autophagy without systemic hyperthyroid effects; first FDA-approved drug targeting metabolic dysfunction-associated steatohepatitis (MASH)

Studied, labeled, or reported dose & route

80-100 mg PO once daily (weight-based)

This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.

Citations

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Common questions

What does the evidence show about Resmetirom (Rezdiffra)'s effects?
Read Off Label rates the evidence for Resmetirom (Rezdiffra) as Strong and the benefit magnitude as high, producing an overall grade of B (6.8/10). Madrigal Pharmaceuticals.
What safety findings are reported for Resmetirom (Rezdiffra)?
Resmetirom (Rezdiffra) has a med risk profile in the database. Med (diarrhea, nausea common; modest LDL/lipid changes; mild reversible LFT elevations; pregnancy contraindicated) Legal status: Rx (FDA-approved March 2024 for noncirrhotic MASH with moderate-advanced fibrosis F2/F3).
What doses or routes are reported for Resmetirom (Rezdiffra)?
80-100 mg PO once daily (weight-based) This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
How does Resmetirom (Rezdiffra) work?
Liver-selective thyroid hormone receptor beta (THR-β) agonist; activates hepatic lipid catabolism, mitochondrial biogenesis, and autophagy without systemic hyperthyroid effects; first FDA-approved drug targeting metabolic dysfunction-associated steatohepatitis (MASH)

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.