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SICK EUTHYROID SYNDROME

Endocrinology

SICK EUTHYROID SYNDROME

1. In significant illness the body does not require T3 and converts T4 to reverse T3 (rT3, inactive compound).
2. Low T4 + low T3 + low TSH + high rT3 in a hospitalized patient.
3. DDx - secondary/tertiary hypothyroidism.
4. To differentiate sick euthyroid vs. secondary/tertiary hypothyroidism => order rT3 + image the sella.
5. Do not do TFT in sick patients unless the sickness is due to thyroid storm.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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