This article is more than 5 years old. Information may no longer be current.
Treatment with methimazole in hyperthyroidism may normalize liver function tests
Patients with hyperthyroidism and abnormal liver function tests can be safely treated with methimazole and can also expect to have normalization of increased alanine aminotransferase and aspartate aminotransferase levels.
Catalina Poiana, MD, PhD, of the department of endocrinology at Carol Davila University of Medicine and Pharmacy in Bucharest, Romania, and colleagues evaluated 77 patients with newly diagnosed overt hyperthyroidism between 2012 and 2014 to determine the changes in liver function tests when these patients are treated with methimazole.
All participants were started with methimazole 10 mg to 60 mg daily, which was gradually tapered. At baseline, 6 weeks, 4.5 months and 10 months after starting treatment, thyroid-stimulating hormone, free thyroxine, alanine transferase (ALT) and aspartate aminotransferase (AST) were measured.
At baseline, 32.5% of participants had abnormal liver function tests; of these patients, 36% had ALT elevation only, 16% had AST elevation only and 48% had both ALT and AST elevation. At 6 weeks, there was a rapid significant decrease of ALT and AST median serum levels in those with abnormal liver function tests. At the other follow-up evaluations, researchers observed no significant differences in ALT or AST levels between the abnormal and normal liver function test groups.
At 10 months, 89.2% of participants had normal ALT and AST levels compared with 10.8% with elevated ALT or AST. Eighteen percent of participants with initially normal levels had AST or ALT serum levels higher than the upper limit of normal compared with 11.1% of those with initially increased levels.
“Our data show that [methimazole] treatment can be safely administered in hyperthyroid patients with abnormal [liver function tests] and normalization of increased AST and ALT levels should be anticipated,” the researchers wrote. – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.