Articles Vol. 67 No. 9 25/09/2026

THE ROLE OF THYROID HORMONES IN REGULATING LIPID METABOLISM AND ENERGY BALANCE: A NARRATIVE REVIEW

Duong Kim Hon, Ton That Hung Binh, Phan Thanh Tai, Nguyen Kim Vuong
DOI: 10.52163/yhc.v67i9.6754
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Abstract

Objective: To synthesize mechanistic and clinical evidence clarifying the role of thyroid hormones in regulating lipid metabolism and energy balance. The review also evaluates the current therapeutic value and future prospects of selective thyroid hormone receptor agonists.

Methods: A structured narrative review was conducted through a PubMed/MEDLINE search covering 2000–2025. The review focused on keywords related to thyroid hormone receptors (TR), deiodinases, and thyromimetics. Treatment guidelines, randomized controlled trials (RCTs), and systematic reviews addressing lipid and energy metabolism in adults were prioritized for analysis.

Results: Thyroid hormones regulate tissue-specific metabolism through differential receptor distribution, particularly TRβ in the liver, and through local deiodinase activity. In the liver, TRβ signaling promotes LDL clearance and fatty acid oxidation. In adipose tissue, the interaction between DIO2 and sympathetic signaling helps activate thermogenesis. Clinically, overt hypothyroidism is associated with increased LDL-C and triglycerides, which often improve after levothyroxine therapy. Notably, TRβ-selective agonists are emerging as a potential therapeutic option for dyslipidemia.

Conclusion: Thyroid hormones are central regulators of whole-body lipid metabolism and energy balance. Thyroid dysfunction should be considered in the evaluation of dyslipidemia. TRβ-targeted strategies are promising therapeutic approaches, but further long-term safety data are still needed.

Keywords
thyroid hormones; TRβ receptor; deiodinases; dyslipidemia; brown adipose thermogenesis; thyromimetics.
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