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Related Experiment Videos

Levothyroxine-induced liver dysfunction in a primary hypothyroid patient.

M Ohmori1, K Harada, S Tsuruoka

  • 1Department of Clinical Pharmacology, Jichi Medical School, Tochigi, Japan.

Endocrine Journal
|December 2, 1999
PubMed
Summary

Levothyroxine (T4) can cause liver dysfunction in some hypothyroid patients, as seen in this case study. Switching to triiodothyronine (T3) resolved the liver issues, suggesting T4 as the cause.

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Area of Science:

  • Endocrinology
  • Hepatology
  • Clinical Pharmacology

Background:

  • Levothyroxine (T4) is a common treatment for hypothyroidism, favored for stable oral absorption.
  • Liver dysfunction is a rare but potential adverse effect of levothyroxine therapy.
  • This case investigates a patient experiencing elevated aminotransferases during T4 treatment.

Observation:

  • A patient with primary hypothyroidism developed significant liver dysfunction after initiating levothyroxine (T4) treatment.
  • Serum aminotransferase levels normalized upon discontinuation of levothyroxine.
  • The patient later tested positive for antibodies to T4.

Findings:

  • Clinical presentation and laboratory data strongly suggest levothyroxine-induced liver injury.
  • Administration of triiodothyronine (T3) did not precipitate liver dysfunction in the same patient.

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  • The presence of anti-T4 antibodies may indicate an immune-mediated reaction.

    • Implications:

    • This case highlights the importance of considering drug-induced liver injury in patients on levothyroxine.
    • Triiodothyronine (T3) may be a safer alternative for select hypothyroid patients who develop liver dysfunction with T4.
    • Further research into the mechanisms of levothyroxine-induced hepatotoxicity and the role of antibodies is warranted.