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In this form the sulfate of P-APS is reduced to sulfite by the free thiol (reduced) group of Sulfur Assimilation The reduced sulfur is finally transferred from the carrier to O-acetylserine (OAS) forming cysteine : O-acetylserine + H2S (or carrier-S-S-) cysteine + acetate The OAS is formed from serine and acetyl-CoA: serine + acetyl-CoA O-acetylserine + CoA This whole process is illustrated as follows: This is summarized in Fig

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The mechanisms by which methimazole and/or PTU cause hepatotoxicity are not clarified completely yet, but it seems that these mechanisms might be different between currently available antithyroid drugs.29 Furthermore, the risk factors that render patients more susceptible to antithyroid drugs-induced hepatic injury are not fully recognized