Relations between serum levels of TSH, TBG, T4, T3, rT3 and various histologically classified chronic liver diseases.

Serum levels of TSH, thyroxine-binding globulin (TBG), T4, T3 and reverse T3 (rT3) were measured in 36 patients with fatty liver disease, 11 patients wih chronic persistent hepatitis, 17 patients with chronic active hepatitis, and 29 patients with liver cirrhosis. TBG was significantly above normal levels in both groups of chronic hepatitis, the slight concomitant T4 and T3 increase was significant only for T4 in chronic persistent hepatitis. A significant decrease in T4 and T3 concentration was found in fatty liver disease and in hepatic cirrhosis. A shift in T4 conversion to rT3 could exclusively be demonstrated for the group of hepatic cirrhosis, reflected by a significant increase in rT3. As our findings indicate normal TSH levels and a lack of clinical signs of hypothyroidism in chronic liver disease, the possibility of diverse regulating changes must be considered.