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T4 is the most abundant member of the beta-thymosin family in mammalian tissue and the principal G-actin sequestering molecule in eukaryotic cells, present in blood platelets, wound fluid and essentially all nucleated cells

Skin changes and temperature dysregulation leading to loss of turgor, dryness and therefore itching and surface breaks are common in cirrhosis and the use of moisturizers to improve hydration and maintain barrier integrity is always the first step toward reducing pruritus (4)

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Chemically, ALA contains a dithiolane ring that can undergo reduction to dihydrolipoic acid (DHLA) in the body