GPT and thyrotoxicosis: Clinically, the patient's confusion appeared to improve slightly, in parallel with the reduction in fT4 levels, consistent with some resolution of thyrotoxicosis. However, shortly after initiation, the patients’ LFTs started to become deranged, with alanine aminotransferase (ALT) rising to 286 U/L, and alkaline phosphatase (ALP) rising to 602 U/L (Table 1).