Liver & Fatty Liver Health
Fatty Liver (MASLD) and the Resmetirom Update
What a fatty liver report means, how doctors check for liver scarring, and where the THR‑β medicine resmetirom fits in care for MASH.
Clinically reviewed by Dr. Anil Kumar Nayak ·
What a fatty liver report means
Fatty liver means there is extra fat in the liver. MASLD stands for metabolic dysfunction-associated steatotic liver disease. It describes liver fat linked with metabolic risk factors such as type 2 diabetes, excess weight around the waist, high blood pressure or abnormal blood fats. NAFLD was the previous name. MAFLD is a related term you may also see in reports or online.
MASH is a form of MASLD in which liver fat is accompanied by inflammation and liver cell injury. It was previously called NASH. Some people develop fibrosis, which means scarring. Advanced scarring can progress to cirrhosis. Your clinician will also ask about alcohol, medicines and other possible causes of liver disease.
Ultrasound showing an example of fatty liver by Hellerhoff. Original photo · CC BY-SA 3.0 · Resized and converted to WebP.
How doctors check for liver scarring
- Bring your ultrasound report, recent AST and ALT results, platelet count or complete blood count, and a list of medicines and supplements. An ultrasound can show liver fat. Your clinician uses additional information to assess scarring.
- Your clinician may calculate a FIB-4 score from your age, liver enzymes and platelet count. It helps decide whether to repeat the tests later or arrange a liver stiffness test. Scarring can be present even when liver enzymes are in the normal range.
- If further testing is needed, elastography such as FibroScan measures liver stiffness. Your clinician can interpret the result and advise if a liver specialist or further tests would help.
Eating, activity and follow-up
- Build meals around vegetables, dal or beans, whole grains in suitable portions, and other protein sources that fit your usual meals. Try cooked vegetables and dal with a roti or a modest serving of rice. Choose water in place of sugary drinks and have fried and highly processed foods less often.
- Build up regular activity at a pace you can maintain. Walking or cycling and muscle-strengthening activities are options. If you have a foot ulcer, discuss safe activity with your care team before starting.
- If weight loss is appropriate for you, discuss a gradual goal you can maintain. Work with your care team on blood sugar, cholesterol and blood pressure, and ask whether to avoid alcohol given your liver results.
Resmetirom and the THR‑β update
Resmetirom (Rezdiffra) activates thyroid hormone receptor beta (THR‑β) in the liver. This receptor helps regulate how the liver handles fat. The July 2026 U.S. prescribing information describes its accelerated approval alongside diet and exercise for adults with MASH, moderate to advanced fibrosis (stages F2 to F3) and no cirrhosis. The approval was based on improvement in liver tissue findings. Confirmatory studies are required to establish clinical benefit over time.
The approval described above applies in the United States. A liver specialist can check whether you fit the treatment group and what is authorised and available in India. If treatment is appropriate, the clinician reviews your medicine list, including statins, and plans liver blood tests and follow-up. Diarrhoea and nausea can occur. If you take resmetirom and notice yellow eyes or skin, or new pain in the upper right of your abdomen, contact your prescriber urgently.
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