Conventional Western medical treatments for liver damage caused by hyperthyroidism:
1. Mild hyperthyroid liver damage is not an indication for discontinuing antithyroid drugs. If the patient has a normal appetite and no jaundice, medication can continue. However, the dosage of the antithyroid drug should be slightly reduced to 2/3 to 3/4 of the usual dose. For example, the usual daily treatment doses of methimazole or propylthiouracil are 30 mg and 300 mg, respectively. In this case, the dose can be reduced to 20 mg and 200 mg daily, respectively. Simultaneously, add 3 tablets of hepatoprotective medication, such as aldehyde lactone, three times a day; and/or 3 tablets of liver-protecting tablets three times a day. Closely monitor the patient's appetite, weight, jaundice, and transaminase levels. Meanwhile, to enhance nutrition, most patients experience improvement in transaminase levels.
2. Some scholars believe that the main cause of hyperthyroid liver injury is autoimmune damage, therefore recommending prompt treatment with glucocorticoids. For mild liver injury, a small dose of glucocorticoids should be added while reducing the dosage of antithyroid drugs. That is, continue using methylimidazole or propylthiouracil at 20 mg and 200 mg daily, and prednisone at 15 mg to 30 mg daily. While using glucocorticoids, potassium and calcium supplementation is also necessary. Potassium chloride 0.5-1 gram per dose, three times a day, can be taken orally, along with one tablet of Caltrate D (active vitamin 600 D) daily, such as one tablet of rocalamine daily.
3. For patients with severe liver damage, the authors recommend using glucocorticoids as the primary treatment, followed by antithyroid drugs after liver function returns to normal. Hospitalization is recommended. When choosing an antithyroid drug, if the abnormal liver function is mainly due to elevated liver enzymes, methylimidazole is recommended; if the abnormal liver function is mainly due to bile deposition, propylthiouracil is recommended.
4. Attention should be paid to liver injury caused by hyperthyroidism. During the first treatment, especially in the first 4 months, liver function should be monitored. If the liver injury is treated aggressively and appropriately, the prognosis is good.