Does Levothyroxine have any effect on the liver?

[Mima_2017]

I'm afraid my case isn't completely straightforward, and this is a really long post, but I'd love some advice from anybody out there on where to go next.

I had a craniotomy for colloid cyst with obstructive hydrocephalus in July 2014. It was a success, but since then I have been uncomfortably swollen, digestion has been difficult and I'm often still dizzy with what feels like pressure in the head.

Six months after surgery I saw a team of endocrinologists who suspected some problems with the pituitary, but six months after that they decided that my problems were unrelated to the pituitary (I'm still not clear on the reasons behind this decision, but I think it's because hormone levels weren't sufficiently out of whack to merit pituitary dysfunction). And the cocktail of Desmopressin, Femoston 2 and Levothyroxine had increased the swelling and initiated pain/burning around the knees and pain in the feet. The Levo didn't help my thyroid levels. I also tested mildly positive for autoimmune soon after, and already showed a low white blood cell count following surgery, but don't know if any of this is related.

I still feel pretty awful and get incredibly tired, even working just three days a week, so I got the (rather unenthusiastic) GP to check my bloods six months ago. The TSH had dropped further to 0.89 and T4 is still low, but doesn't qualify for full clinical hypothyroidism. I saw the endo who felt that the drop in TSH indicates a problem with the pituitary or hypothalamus. My scans one year post surgery were so good that the neurologists/neurosurgeons no longer regularly monitor me, so I'm not sure whether any of this is linked to my head. I still get headaches and nose bleeds, but not so crushing that I'm in bed with them.

A consultant prescribed Propranolol as it had helped someone else with hypothalamic dysfunction and similar symptoms, but within five days I had swollen more - possibly because it can worsen hypothyroidism, or possibly because it impacts the liver (I'd only just managed to get my liver enzymes back in range after years of being slightly elevated, and I'm not sure what they are now). So I stopped taking it.

The endo has suggested a small dose of levothyroxine, but if the swelling is caused by liver problems rather than hypothyroidism, I don't want to make it worse again. I'm having acupuncture which definitely helps, but recently the effects are only lasting for a few hours rather than days, so I'm wondering whether I need to take the Levothyroxine too. The acupuncturist feels that the problems are hormonal, exacerbated by any kind of stress, with fluid build up (especially that in the abdomen) then causing the pain in the legs etc. And another alternative practitioner has given me some agnus castus to try to help correct any imbalance between oestrogen and progesterone.

If anyone has had similar experiences or can shed any light on where I go next, that would be amazing and massively appreciated. Thank you so much for reading my post!

[Clutter]

Mima_2017,

I very much doubt that Levothyroxine causes liver problems or raises liver enzymes otherwise we'd all require liver function tests in addition to thyroid function tests.

Low-normal TSH with low T4 indicates either secondary hypothyroidism (pituitary dysfunction) or tertiary hypothyroidism (hypothamic dysfunction). Treatment is Levothyroxine to replace low thyroid hormone.

As your digestion isn't good it would be a good idea to have ferritin, vitamin D, B12 and folate tested as low/deficient levels can cause musculoskeletal pain, fatigue and low mood similar to hypothyroid symptoms.

[helvella Administrator Thyroid UK in reply to Clutter]

I have had several Liver Function Tests since being diagnosed hypothyroid - on the basis that the GP felt it best to check.

[Clutter in reply to helvella]

Helvella,

I had one in 2011 when having TFT but none via endocrinologist at hospital or GP since being put on Levothyroxine.

[smudger1 in reply to Clutter]

Ever since I have been in thyroxine, even change in GP's, they have all annually checked liver and kidney function. But they still hold TSH result as their bible!

[SeasideSusie Remembering in reply to helvella]

Wow helvella , you seem to have a very thorough GP. In 43 years of being hypo mine hasn't been tested.

However, I have recently been prescribed a maintenance dose of antibiotics (3 tablets a week) because of my lung disease. I found out from members of the British Lung Foundation forum that an ECG and liver function test should be carried out before starting and liver function tests done regularly as this AB can affect the liver. I mentioned it to my GP, after I had started them, and got tested for both (they were fine) and I asked about regular liver tests and he's now marked my record that I can go along every 3 months to get them done. If I hadn't found out that information for myself I wouldn't be tested! But that's par for the course at my surgery so no surprise

[bantam12]

High doses of Levo can affect liver enzymes (plenty of info on Google) I get liver function tested several times a year as mine are elevated ( I'm not on high doses of Levo ).