Elevated liver enzymes

[AngelicUpstart]

Hi, my daughter has Graves and her latest blood test shows elevated liver enzymes, is this because she's on carbimazole. Prior to taking carbimazole her liver function was normal.

[Buddy195 Administrator]

I would advise your daughter to discuss this with her GP/ endo as some hyperthyroid patients talking carbimazole can experience adverse liver symptoms. According to NHS info, it is advisable to look out for the following:

‘Serous Side Effects: the whites of your eyes or your skin turns yellow (this may be less obvious on brown or black skin), dark pee – this can be a sign of liver problems‘

nhs.uk/medicines/carbimazol...

[AngelicUpstart in reply to Buddy195]

Her GP doesn't seem concerned but has referred her to specialist. Thanks.

[pennyannie]

Hello AngelicUpstart :

With the onset of Graves raised liver enzymes can be detected and this is also a known side effect when on the treatment and monitored for and usually a different Anti Thyroid drug - PTU - Propylthiouracil - is prescribed - if deemed necessary.

Graves is an Auto Immune disease - there is no cure - and seems to be poorly understood and badly treated as no 2 peoples journey with Graves is the same -

Some people experience just one episode of Graves - a blip - and the AT drug works well -

others need to stay of the AT medication much longer, and that's ok too -

as all the AT drug does is ' buy the patient time ' while we wait for their immune system response to calm back down and hopefully their thyroid return to normal function without the need for any medication.

whilst others experience totally traumatic symptoms and are unable to tolerate or be managed by the AT drug and definitive treatment - a thyroidectomy - encouraged - and they continue on, living with Graves, but without a thyroid and take medication every day.

Many like myself are treated with RAI thyroid ablation but I wouldn't recommend this treatment and deeply regret I knew nothing about Graves back in 2005 and simply trusted the system in place.

We do now have some research you might like to read :

pubmed.ncbi.nlm.nih.gov/338...

ncbi.nlm.nih.gov/pubmed/306...

There is likely a genetic predisposition to this AI disease with a family member a generation away with a thyroid health issue and common triggers would appear to be stress and anxiety.

If your daughter likes to register and talk through her own issues on this forum, we can help explain and read her blood test results in relation to her symptoms - and offer support as any illness but especially so Graves can be quite isolating.

The most well rounded of all I researched is that of Elaine Moore's books and website ;-

elaine-moore.com

[knitwitty]

Not sure if this is relevant to you but my son prior to being diagnosed coeliac ( another autoimmune disease ) had very raised liver enzymes, the first doctor we saw at the hospital dismissed it as being nothing to do with being undiagnosed and untreated coeliac. Fortunately the consultant who reviewed his case , following a gastroscopy, was more knowledgable and recognised this as a side effect of still eating gluten.

I took a BMJ article outlining the liver enzyme issue with me to his appointment but the doctor we saw wasn't interested, this article had been given to me by a friend who had been a GP for 30 years and she said she was surprised to find it could affect liver enzymes too. If I can track down a link I'll add it to this post.

It might be worth checking to see if your daughter has coeliac disease, but don't restrict gluten containing foods prior to being tested as it can mask the problem.

Good luck.

[JumpJiving in reply to knitwitty]

Can I ask which enzyme?

I've had GGT levels well above the reference range for years - the liver specialist had no idea as to why even after doing scans etc, my GP has no interest, so it's another thing down to me to try to work out. Hadn't considered gluten (TBH, I hope it's not that as my diet is already limited by having to avoid lactose which makes my skin fall off).

Given that my adrenals have packed in and the right adrenal sits right by the liver, I wonder if there might be a link. Once I have gotten a new endocrinologist, I'll see if the new one will do a scan of the adrenals (you'd think the initial endo would have scanned them, but noooo)

[bantam12 in reply to JumpJiving]

My GGT has also been very high for 15years or so, had all the tests, scans and biopsies many times over but still no clue why, my Hep/Gastro just watches in case anything else crops up.

[knitwitty in reply to JumpJiving]

Hi JumpJiving

I think the enzymes that were raised were ALT and AST , it was a number of years ago now, his GP thought that he was drinking heavily at the time but he couldn't drink beer of any kind as it upset his stomach really badly and he's never drunk wine . His GP referred him for a gastroscopy following his very high coeliac antibody tests .

If you decide to ask for an antibody test for coeliac disease ensure you eat lots of gluten contains foods weeks before the antibody test as you can get a false negative result if you don't.

Also some people don't get the usual symptoms ( diarrhoea , constipation, stomach pains, weight loss etc,,,) with coeliac disease it can also manifest as a skin condition dermatitis hepetiformis ( apologies if I've spelled that incorrectly :(.

If you look at the Gluten Free Gorillas forum ( here on Health Unlocked ) they are very helpful regarding Coeliac disease.

I'm not trying to suggest that is what you have but it might be worth ruling it out especially as Graves is also an auto immune condition and if you have one of these you are more susceptible to other AU diseases.