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When GLP-1 medications are contraindicated GLP-1 receptor agonists are contraindicated if you have: A personal or family history of medullary thyroid cancer A genetic condition called Multiple Endocrine Neoplasia type 2 (MEN-2) This warning comes from animal studies where rodents developed C-cell tumors

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Nevertheless, compounds that stimulate mitochondrial oxidative metabolism, including thyroid hormone receptor agonists20, ligands for nuclear receptors that control the expression of mitochondrial genes21 and inhibitors of mitochondrial pyruvate import22, have shown efficacy in the treatment of NASH

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Dosing typically starts lower (0.25-0.5mg) with slower titration due to generally smaller body mass