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How can my hypothyroidism be treated if I have a liver disease?

Q: I am a 65 years old woman who has been diagnosed with non-alcoholic liver cirrhosis 5 years ago. Since then, I have been taking a strict bland diet and was in almost good health. But last year I was diagnosed with hypothyroidism and since then I have been facing problems. Due to my liver disease, the thyroid hormone replacement medicines prescribed by the doctor are not working at all. There is no use of increasing the dose as well. The doctor says that this is happening because the liver has to further process the thyroid medications I take in order for them to work, which is not happening in my case. How can this problem be treated? Please advise.

A:I notice that you have non-alcoholic cirrhosis and that your medication for under active thyroid is not working. Cirrhosis of the liver produces new liver cells, which continue as immature cells and unfortunately are not very effective in taking over the functions of the healthy cells. In several instances, non-alcoholic cirrhosis has an auto-immune basis, which essentially means a condition where a chronic inflammatory process in the body targets one or more organs in the body. You could well have this auto-immune basis to your cirrhosis, where your thyroid gland has also got affected besides the liver. The treatment to be effective one needs to suppress the auto-immune mechanism by using the drugs called steroids alongside your thyroxin supplement. There are several tests, which can be done to prove auto-immune disorder and I advise you to consult a specialist immunologist for proper investigations and treatment.

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