Liver cirrhosis (or under function) and T4 therapy requirement - new paper

[diogenes]

I hope few if any people here find this relevant but just in case this applies to a poster, I'm reporting the paper here:

Front. Endocrinol., 18 April 2018 | doi.org/10.3389/fendo.2018....

Increased Requirement of Replacement Doses of Levothyroxine Caused by Liver Cirrhosis

Salvatore Benvenga, Giovanni Capodicasa, Sarah Perelli,Silvia Martina Ferrari, Poupak Fallahi and Alessandro Antonelli

[Jazzw]

It’s an interesting read, diogenes , although a pity, as so often happens, they’re obsessed with TSH readings.

But what I’m wondering, reading this... can I infer that liver dysfunction might be a cause of mild hypothyroidism in some instances, or is that a leap too far? It sort of made me wonder whether there’s a link, although I can’t put my finger on which bit made me think that. There were a few too many big words.

And would liver cancer have the same effect as liver cirrhosis (I’m guessing it would)?

It rings a sad bell to me. My husband, my herband after she went through gender reassignment was eventually diagnosed hypothyroid in the last 3 years of her life (but never had a TSH that went higher than 7). She found it increasingly hard to find a levo dose that made any difference and only T3 seemed to help.

She was diagnosed with metastatic cancer, unknown primary, 2 weeks before her death but I know that her liver was completely riddled with metastases (and no, she rarely touched alcohol, ate really healthily, exercised regularly) and I’ve often wondered just how long she’d had cancer—possibly for quite some time. So was it the cancer all along—was that a factor in the development of her hypothyroidism? I’ll never know and perhaps it’s daft to speculate, but we have a son and I find myself wondering occasionally about inherited tendencies (usually late at night when sleep eludes me...). She had gynaecomastia too—a good thing when you’re transgendered but of course we’d put that down to the oestrogen she took. But again, was that linked to liver dysfunction instead?

More questions than answers. But thanks for posting.

[LAHs]

Thanks for posting diogenes, very interesting but a bit difficult for me to understand without researching every paragraph. However my humble contribution is that I have always loved wine, not beer, champagne nor the heavy duty drinks like whisky et al, just wine. I used to have wine with my dinner every night and loved it. Since having thyroid cancer, a total thyroidectomy and the ensuing medications I have not been very interested in drinking alcohol with my food. I still pour a glass and enjoy about half of it but sometimes don't even want to finish it. I am a big believer in listening to your body and I have been quite sure for a long time that my liver is "telling me to give it a break", it has enough to do now processing externally derived T4 (and T3) without struggling to throw out the alcohol toxins. This works out quite well actually since the decrease in what I spend on wine offsets the expense of my thyroid meds (NDT).

[diogenes Remembering in reply to LAHs]

My total 100% sympathy for you! If at all possible one should go into later life in a rather pickled condition: it prolongs a more pleasant existence; look at rollmops!