Many patients with hyperthyroidism (or hyperthyroidism for short) often have their liver function checked by their doctor when they visit the doctor. Why is this? Because hyperthyroidism can have adverse effects on the liver, such as abnormal liver function, hepatomegaly, or even jaundice. The causes of hyperthyroidism combined with liver damage are complex, and one of the causes is autoimmune damage. Because most hyperthyroidism is an autoimmune disease, it is caused by lymphocytes synthesizing antibodies against their own thyroid cells. Since they can synthesize antibodies that “attack” thyroid cells, it is entirely possible that they can synthesize antibodies that “attack” their own liver cells, thus causing liver damage. In addition, elevated thyroxine can also directly damage liver cells, leading to abnormal liver function. This can even lead to jaundice and cirrhosis, collectively known as hyperthyroidism. Some patients with hyperthyroid liver damage may have abnormal liver function before the disease; others develop abnormal liver function after treatment with anti-thyroid medications. Their etiology varies. Clinical manifestations of hyperthyroid liver damage: Most patients have no obvious characteristic manifestations. When liver damage is mild, patients may show mild digestive disorders, such as anorexia, poor appetite, diarrhea, and discomfort or vague pain in the liver area. Examination reveals hepatomegaly, pressure pain or percussion pain in the liver area, or there can be no obvious symptoms of liver damage. In severe cases, jaundice may appear, such as yellow urine, bulbar conjunctiva, generalized yellow skin staining, hepatosplenomegaly, and obvious abnormal liver function. Many scholars believe that it is closely related to the patient’s age, disease duration and condition. Those who have a long disease duration, are old and have severe disease and have not received reasonable treatment for a long time are prone to liver damage. It is worth noting that hyperthyroidism symptoms and signs and liver damage are sometimes complex. In some elderly patients, symptoms and signs of hyperthyroidism are not obvious, but symptoms of liver damage are the main symptoms, such as weakness, poor appetite, nausea, diarrhea and yellow urine, which are easily misdiagnosed as hepatitis. However, the treatment of conventional liver protection is often ineffective. Treatment: Mild hyperthyroidism liver damage is not an indication for discontinuation of anti-thyroid drugs. If the patient has a normal appetite and no jaundice, medication can still be continued. The dose of antithyroid medication should be slightly reduced to 2/3 to 3/4 of the usual dose, such as methimazole or propylthiouracil at 30 mg and 300 mg per day, respectively, which can be reduced to 20 mg and 200 mg per day. Also add liver-protective drugs such as glucuronide 3 tablets once, 3 times a day; and/or liver-protective tablets 3 tablets once, 3 times a day. Closely monitor the patient’s appetite, weight, jaundice and transaminases. Also strengthen nutrition, the majority of patients will have improvement of transaminases. Some scholars believe that the main cause of hyperthyroidism liver damage is autoimmune damage, so the treatment suggests using glucocorticoids as early as possible. For those with mild liver damage, add small doses of glucocorticoids while reducing the dose of antithyroid drugs. That is, 15-30 mg of prednisone per day is given while continuing methimazole or propylthiouracil (20 mg and 200 mg per day, respectively). Along with glucocorticoids, potassium and calcium should be supplemented with oral potassium chloride 0.5 to 1 g/time, 3 times a day, Calcium D600 1 tablet a day, and active vitamin D, such as Rohypnol, one capsule a day. For severe liver damage, the author recommends the use of glucocorticoids as the main therapeutic drug, and then anti-thyroid drugs after liver function has returned to normal. And the patient is recommended to be hospitalized. In the selection of antithyroid drugs, methimazole is recommended if the liver function abnormality is mainly elevated liver enzymes, and propylthiouracil is recommended if the liver function abnormality is mainly cholestatic. Hyperthyroidism liver damage should be taken seriously and liver function should be monitored during the initial consultation and treatment, especially during the first 4 months of treatment. If liver damage is treated actively and properly, the prognosis is good. Many patients with hyperthyroidism (referred to as hyperthyroidism) often have their liver function checked by their doctor when they visit the doctor. Why is this? Because hyperthyroidism can have adverse effects on the liver, such as abnormal liver function, hepatomegaly, or even jaundice. The causes of hyperthyroidism combined with liver damage are complex, and one of the causes is autoimmune damage. Because most hyperthyroidism is an autoimmune disease, it is caused by lymphocytes synthesizing antibodies against their own thyroid cells. Since they can synthesize antibodies that “attack” thyroid cells, it is entirely possible that they can synthesize antibodies that “attack” their own liver cells, thus causing liver damage. In addition, elevated thyroxine can also directly damage liver cells, leading to abnormal liver function. This can even lead to jaundice and cirrhosis, collectively known as hyperthyroidism. Some patients with hyperthyroid liver damage may have abnormal liver function before the disease; others develop abnormal liver function after treatment with anti-thyroid medications. Their etiology varies. Clinical manifestations of hyperthyroid liver damage: Most patients have no obvious characteristic manifestations. When liver damage is mild, patients may show mild digestive disorders, such as anorexia, poor appetite, diarrhea, and discomfort or vague pain in the liver area. Examination reveals hepatomegaly, pressure pain or percussion pain in the liver area, or there can be no obvious symptoms of liver damage. In severe cases, jaundice may appear, such as yellow urine, bulbar conjunctiva, generalized yellow skin staining, hepatosplenomegaly, and obvious abnormal liver function. Many scholars believe that it is closely related to the patient’s age, disease duration and condition. Those who have a long disease duration, are old and have severe disease and have not received reasonable treatment for a long time are prone to liver damage. It is worth noting that hyperthyroidism symptoms and signs and liver damage are sometimes complex. In some elderly patients, symptoms and signs of hyperthyroidism are not obvious, but symptoms of liver damage are the main symptoms, such as weakness, poor appetite, nausea, diarrhea and yellow urine, which are easily misdiagnosed as hepatitis. However, the treatment of conventional liver protection is often ineffective. Treatment: Mild hyperthyroidism liver damage is not an indication for discontinuation of anti-thyroid drugs. If the patient has a normal appetite and no jaundice, medication can still be continued. The dose of antithyroid medication should be slightly reduced to 2/3 to 3/4 of the usual dose, such as methimazole or propylthiouracil at 30 mg and 300 mg per day, respectively, which can be reduced to 20 mg and 200 mg per day. Also add liver-protective drugs such as glucuronide 3 tablets once, 3 times a day; and/or liver-protective tablets 3 tablets once, 3 times a day. Closely monitor the patient’s appetite, weight, jaundice and transaminases. Also strengthen nutrition, the majority of patients will have improvement of transaminases. Some scholars believe that the main cause of hyperthyroidism liver damage is autoimmune damage, so the treatment suggests using glucocorticoids as early as possible. For those with mild liver damage, add small doses of glucocorticoids while reducing the dose of antithyroid drugs. That is, 15-30 mg of prednisone per day is given while continuing methimazole or propylthiouracil (20 mg and 200 mg per day, respectively). Along with glucocorticoids, potassium and calcium should be supplemented with oral potassium chloride 0.5 to 1 g/time, 3 times a day, Calcium D600 1 tablet a day, and active vitamin D, such as Rohypnol, one capsule a day. For severe liver damage, the author recommends the use of glucocorticoids as the main therapeutic drug, and then anti-thyroid drugs after liver function has returned to normal. And the patient is recommended to be hospitalized. In the selection of antithyroid drugs, methimazole is recommended if the liver function abnormality is mainly elevated liver enzymes, and propylthiouracil is recommended if the liver function abnormality is mainly cholestatic. Hyperthyroidism liver damage should be taken seriously, and liver function should be monitored during the initial consultation and treatment, especially during the first 4 months of treatment, and the prognosis is good if liver damage is treated aggressively and appropriately.