Others have noted rates in excess of 50% of jaundice and conjugated hyperbilirubinemia in uncomplicated hyperthyroidism in the presence of congestive heart failure, perhaps suggesting that circulatory congestion or relative perfusion insufficiency is more likely to be the etiology of hepatic abnormalities in less acutely ill patients, whereas direct thyroid hormone-mediated hepatocyte damage predominates in patients with acute thyrotoxicosis [8]. Here, TG is linked to thyrotoxicosis.