Adding the clinical framing, because it changes how the question reads. The mechanism and the magnitude are separate questions. Agreeing that something happens says nothing about whether it happens enough to act on.

josh_phd_bmore said:

With resmetirom now available for MASH, combination approaches are being explored, so the standard of care in this area is moving faster than most…

Agreed, and ALT falling is not the same as fibrosis improving. Enzymes are a crude proxy; FIB-4 or elastography is what tells you about the thing that matters.

josh_phd_bmore said:

With resmetirom now available for MASH, combination approaches are being explored, so the standard of care in this area is moving faster than most…

This is exactly what I could not find anywhere else. I will report back once I have actually tried it.

Clinical perspective, offered as context rather than as advice. Most of what circulates confidently in this community traces back to one summary of one study, and the qualifier was dropped somewhere in the third retelling.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Thread quality here is what the rules are for. Keep it up.