I have long wondered about a possible connection between thyroid disorders and liver function tests. The following is anecdotal evidence, primarily involving myself and another family member ( who shall remain nameless). When all was well in thyroid test/function land, our liver enzymes were in the normal range. However, when I or this other unnamed individual had a dosage change or were feeling poorly, i.e, in the very hypothyroid range, our liver enzymes were elevated. I have also read comments on other thyroid cancer websites expressing the same concern- or, " my thyroid function tests are indicating a very hypo condition, and my liver enzymes tests are elevated. Is there a connection?"
It was difficult for me to find credible, emphasis on the word credible, sources on the relationship between the thyroid and the liver. This is the best quote that I found concerning thyroid and liver function: " A complex relationship exists between thyroid and liver in health and disease. Liver plays an essential physiological role in thyroid hormone activation and inactivation, transport and metabolism. Conversely, thyroid hormones affect activities of hepatocytes and hepatic metabolism. " This quote is from an article published in Endocrinol Invest. 2020 July; 43(7): 885-899 by E. Piantanida, S. Ippolito, D. Gallo and others. In other words, if one has trouble with the thyroid gland, there may be some problems with the liver and vice-visa.
So as not to alarm anyone, I did find an article specific to the relationship of liver function tests and thyroid function tests. This article came to the conclusion that both hypothyroidism and hyperthyroidism can affect liver function tests. The objective of this study was to try to determine if there is a correlation between the effect of thyroid dysfunction on liver function tests. So, basically, both liver function tests and thyroid function tests can be affected by the other. Abnormal readings may indicate disease in either organ, or it may not. At the end of one of the papers I read there was a blanket statement that " more studies are needed, and so on..." I always assume that more studies are needed on just about everything! Our thyroid glands affect every single organ in the body. That little butterfly shaped organ sure can cause a lot of trouble for those of us who have had thyroid cancer or have thyroid disease of any type.
I, along with my family member, have long noted the relationship between how well we are doing with our thyroid function and the results from liver function tests. For me personally, I try to pay extra close attention to my liver function tests due to the fact that I do not have a thyroid gland. I depend solely on my thyroid hormone medication to keep my body functioning properly. When my last ( latest) endocrinologist reduced my thyroid hormone dosage, I worried about how it would affect my liver enzymes. I am having blood work this week ( for another reason) , but I will ask my family physician to please check my liver enzymes as well as my thyroid function tests.
I do not see my new endocrinologist until the middle of next month. I am not sure what she will do as far as adjusting my thyroid hormone dose, as this will be the first time that I have seen this endocrinologist. I am hoping that this physician will discuss my treatment plan with me and listen to my concerns. I have a list of objectives to discuss with this physician- on what I would like done in regards to my treatment. I understand that this endocrinologist is the expert- but like with my endocrinologist who recently retired- I want to be able to discuss how I am feeling and treatment options before any medication changes are made. In my opinion, the doctor patient relationship should be a partnership. I really appreciate a physician who listens to how I am feeling, and takes that under consideration along with the lab result numbers. As I have often said, we thyroid cancer patients are not just a set of numbers. We have feelings and ideas about our treatments and what works best for us.
To recap, it has been my experience, and from other anecdotal reports, that being hypothyroid can indeed manifest in somewhat higher than normal liver function tests. Of course, one must consult with one's physician to rule out any liver disease or thyroid disease. Living without a thyroid is sort of a "tightrope walking" experience. The slightest changes in thyroid hormone dose can impact how a patient feels. I think the majority of thyroid cancer patients have had several dose changes over the course of our disease. It does take a period of time to adjust to these changes, but sometimes another dosage change or even changing the type of thyroid hormone drug prescribed, is necessary for us to feel well.
