Liver function in cirrhotic patients in the euthyroid versus the hypothyroid state

We recently showed that some decrease in thyroid hormone blood levels can e ffectively and significantly prevent the development of cirrhosis and fulmi nant hepatic failure and decrease portal pressure in three different rat mo dels. This study was conducted to determine whether hypothyroidism has a be neficial effect over euthyroidism on patients with active liver cirrhosis o f different etiologies. The medical files of hypothyroid patients with cirr hosis who were referred to the Tel-Aviv Medical Center between the years 19 80 and 1995 were retrospectively evaluated. Of 3,528 patients with biopsy-p roven cirrhosis and 4,738 hypothyroid patients who were identified, only 46 (25 female, 54%; mean age, 52.3 +/- 9.1) met the eligibility criteria. The patients suffered from cirrhosis (mean, 9.5 +/- 4.3 years; range, 4-23) an d had hypothyroidism (mean, 12 +/- 6 years; range, 4-31). Most patients suf fered from hypothyroidism of unknown etiology (85%), whereas the rest had h ypothyroidism after surgical/iodine ablation of the gland. In the hypothyro id versus the euthyroid state, a significant negative correlation was found between thyroid-stimulating hormone blood levels and both functional and s ynthetic liver function tests (p < 0.001). A significant negative correlati on was also found between thyroid-stimulating hormone blood levels and clin ical deterioration manifested as bleeding varices, the development of ascit es, and episodes of encephalopathy. We conclude that in patients with liver cirrhosis, the liver function in the hypothyroid state tend to be better t han in the euthyroid state. A mild controlled decreased thyroid function ma y be beneficial for euthyroid cirrhotic patients.