THYROID-HORMONES IN ALCOHOLIC LIVER-DISEASE - EFFECT OF TREATMENT WITH 6-N-PROPYLTHIOURACIL

Abstract

The relationship between alcoholic liver disease and circulating thyroid hormones was investigated in 124 hospitalized patients treated with placebo or propylthiouracil (PTU) for a maximum of 46 days in a double-blind study. Serum triiodothyronine (T3) levels on admission were significantly (P < 10-6) and inversely correlated with the severity of alcoholic liver disease. After hospitalization, changes in T3-levels in patients with low admission T3 significantly correlated (P < 0.001) with the degree of spontaneous improvement of liver function (placebo group). Treatment with 300 mg of PTU daily markedly increased the rate of improvement in severely ill patients with low T3 on admission. In this group, serum T3-levels were increased after PTU, but this increase did not correlate with the change in the patient''s condition. The known inhibitory effect of PTU on peripheral deiodination of T4 to T3 apparently is masked by a more marked improvement in liver function in this group. PTU treatment in this group reduced the free T4-index and increased TSH (thyroid stimulating hormone) levels markedly (167%; P < 0.02) toward levels found in hypothyroidism. PTU did not improve the condition of mildly ill patients with normal admission T3-levels nor did it alter free T4-index or serum TSH levels in these patients. Serum T3-levels provide a sensitive indicator of the severity of alcoholic liver disease and of its response to conventional treatment. Serum T3-levels distinguish between a group of patients, in whom low-dose PTU administration results in a beneficial effect and another group, in whom no therapeutic effect of PTU is observed.