Introduction
Euthyroid sick syndrome is a clinical condition characterized by low thyroid hormone levels in clinically euthyroid patients with nonthyroidal systemic illness
-it can be precipitated by stresses such as chronic liver failure, renal failure, malnutrition, fasting, starvation, anorexia, diabetic ketosis, and sepsis
-The first testing abnormality to manifest is low T3 level
Symptoms & Signs
No signs or symptoms of thyroid dysfunction
Diagnosis
Patient’s setting: critical illness, chronic illness, ICU admission etc
No clinical manifestations of thyroid dysfunction
Labs: TSH: Normal or low
T4 : Normal or low
T3, total and free : Low
Reverse T3 (rT3): High or normal
Treatment:
-Treat the underlying nonthyroid illness
-Thyroid hormone replacement is not beneficial