Liver problems from carbimazole?

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Hi,

I was diagnosed, again, with an overactive thyroid in March, levels were quite high and I was put straight onto 20mg, this didn’t work so It went up to 40mg for 4 weeks. Back down to 20mg now.

Shortly towards the end of this time I had one of the worst sickness bugs i think I’ve ever had, ended up in the walk in centre as I had severe pain in my liver, it was dismissed as muscular, I previously had my gallbladder out so I was kind of aware of the pain in that area as being more liver than muscular. 6 weeks later I have now been told that it is my liver and it is inflamed, partly due to a virus and the carbimazole medication. I still get these twinges in my liver, I don’t have any other alarming symptoms, like bloating, yellow skin etc. My GP isn’t too concerned but is doing a follow up blood test in a few weeks to monitor my liver function and has said to wait until my next endocrine appointment. 

I’m really not sure what I should do next. Of course I’m concerned and thinking the worst (which I’m sure most people do). I don’t know whether it is best to carry on with my carbimazole or request that it’s changed, and if so should I just ask my GP to change it now? Will my liver get better? Has anyone else experienced this? I’m kind of at a point where I’m uncertain what to do as my GP didn’t seem too concerned and I am unsure when my next endo app is. Any advice is appreciated or even opinion of what you would do in this situation.

Thank you. 

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8 Replies

  • Posted

    Hi, it is difficult to comment without any test results. I am assuming that your thyrotoxicosis was severe if your Carbimazole dose had to be increased. 

    There is a documented link between thyrotoxicosis and liver dysfunction. This paragraph below is from the article: Hepatic Dysfunction in Hyperthyroidism (Mai, 2011). I can send you the link if you like. 

    "Thyroid hormones are glucuronidated and sulfated within the liver and subsequently excreted into bile; in addition, these hormones maintain the metabolism of bilirubin by playing a role in the enzymatic activity of glucuronyltransferase and by regulating the level of ligandin, a major organic anion-binding protein. Therefore, it is not surprising that hepatic dysfunction is commonly observed in patients with thyroid disease."

    When I was first diagnosed with thyrotoxicosis my liver values were abnormal before even starting treatment with Carbimazole. (I was prescribed 30mg.) Of course, taking a high dose of Carbimazole will have some effect on the liver and I assume that your doctors have done a benefit/risk analysis before opting to continue your treatment.  

    Your liver values should improve as your thyroid values normalise. Hopefully you Carbimazole dose will be reduced as well putting even less strain on your liver. 

    Regarding changing medication, the alternative would be PTU (Propylthiouracil). which requires a much higher equivalent dose compared to Carbimazole and can cause serious liver problems in some patients.  https://patient.info/medicine/propylthiouracil-tablets

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    • Posted

      Hi, I actually got my results and my function is easing back to normal. Haven’t got much pain anymore literally a few twinges. I have thought if this happens again, or if thyroid goes overactive again that I might ask for alternative treatment- removal or the iodine treatment. 
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  • Posted

    Hello there. The liver does repair it's self . Mind was also bad . But is ok again now. And it's a worry. If your gp isn't to worried.don't you worry. You could aways ring the secretary up at the hospital.

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    • Posted

      Hi thank you for the reply. I actually got results back today and my Liver function is heading back to normal. They think it was caused by an infection as opposed to the medication. 
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  • Posted

    Hi Please go back to your GP and get an URGENT appointment with the endocrinologist.  I say urgent because for your own peace of mind it is better for you to be seen within the next 7 to 14 days.  I am a very recently retired nurse who was diagnosed with Graves disease in January,  You should be having regular blood tests anyway.  Ask to what degree your liver has been affected  I would have thought that your medication would have been changed if there were any major changes in the liver and if they have not done this WHY NOT You have every right to have a second opinion if you do not feel confident in your present endocrinologist.  Good luck I am sure things will go well.  A partial thyroidectomy will stop your thyroxin levels crashing....that is what I am going to request if the Graves disease comes back when I stop the carbimazole  and 80mg of propranolol.
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    • Posted

      Hi thank you for the reply. My liver function is a lot better and they think it’s avtually caused by an infection rather than the medication. I think this is why I wasn’t taken off originally.
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  • Posted

    Thanks all for your replies. I have been back today for another bloody test so I will see what happens when I these get back. I don’t want to go onto other medication but would like to see if I can look into other options. I am concerned that I wasn’t taken off medication straight away. 
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