Euthyroid sick syndrome

non-thyroidal illness syndromeLow-T3 syndromenonthyroidal illness syndromenon-thyroidal illnessnonthyroidal illnessSick-euthyroid syndromeTACITUS syndrome (non-thyroidal illness syndrome)
Euthyroid sick syndrome (ESS) is a state of adaptation or dysregulation of thyrotropic feedback control wherein the levels of T3 and/or T4 are abnormal, but the thyroid gland does not appear to be dysfunctional.wikipedia
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Inflammatory bowel disease

inflammatory bowel diseasesIBDindeterminate colitis
Outside the hospital setting euthyroid sick syndrome (non-thyroidal illness syndrome) has been assumed closely related with a series of chronic diseases, such as inflammatory bowel disease, chronic fatigue syndrome, and autoimmune disease.
Associated complaints or diseases include arthritis, pyoderma gangrenosum, primary sclerosing cholangitis, and non-thyroidal illness syndrome (NTIS).

Hyperthyroidism

thyrotoxicosishyperthyroidoveractive thyroid
Thyroid storm, on the other hand, represents allostatic failure, where the organism is unable to develop NTIS in the situation of thyrotoxicosis.
In rare circumstances, a low TSH indicates primary failure of the pituitary, or temporary inhibition of the pituitary due to another illness (euthyroid sick syndrome) and so checking the T 4 and T 3 is still clinically useful.

Thyroid storm

thyrotoxic crisis
Thyroid storm, on the other hand, represents allostatic failure, where the organism is unable to develop NTIS in the situation of thyrotoxicosis.
According to newer theories, thyroid storm results from allostatic failure in a situation where thyrotoxicosis hampers the development of non-thyroidal illness syndrome, which would help to save energy in critical illness and other situations of high metabolic demand.

Hypothalamic–pituitary–thyroid axis

thyroid homeostasisHPT axisHPT
Euthyroid sick syndrome (ESS) is a state of adaptation or dysregulation of thyrotropic feedback control wherein the levels of T3 and/or T4 are abnormal, but the thyroid gland does not appear to be dysfunctional. This condition may result from allostatic responses of hypothalamsus-pituitary-thyroid feedback control, dyshomeostatic disorders, drug interferences and impaired assay characteristics in critical illness.

Myxedema coma

Myxoedema coma
Allostatic overload may result in wasting syndrome and myxedema coma.
According to newer theories myxedema coma could result from allostatic overload in a situation where the effects of hypothyroidism are amplified by non-thyroidal illness syndrome.

Sum activity of peripheral deiodinases

SPINA-GDcalculated sum activity of peripheral deiodinases (SPINA-GD)deiodinase activity
Correspondingly, in the majority of cases calculated sum activity of peripheral deiodinases (SPINA-GD) is reduced.
It was also shown that GD correlates with resting energy expenditure, body mass index and thyrotropin levels in humans, and that it is reduced in nonthyroidal illness with hypodeiodination.

Reverse triiodothyronine

reverse T3triiodothyronine, reverse3,3',5'-triiodothyronine
The most common hormone pattern in NTIS (non-thyroidal illness syndrome) is low total and free T3, elevated rT3, and normal T4 and TSH levels, although T4 and TSH suppression may occur in more severe or chronic illness.
The levels of rT3 increase in conditions such as euthyroid sick syndrome because its clearance decreases while its production stays the same.

3,5-Diiodothyronine

3,5-T2
Several studies described elevated concentrations of 3,5-T2, an active thyroid hormone, in NTIS.
In nonthyroidal illness syndrome 3,5-T 2 concentrations are increased.

Thyroid hormones

thyroid hormonethyroxineT4
Euthyroid sick syndrome (ESS) is a state of adaptation or dysregulation of thyrotropic feedback control wherein the levels of T3 and/or T4 are abnormal, but the thyroid gland does not appear to be dysfunctional.

Thyroid

thyroid glandthyroid folliclethyroid function
Euthyroid sick syndrome (ESS) is a state of adaptation or dysregulation of thyrotropic feedback control wherein the levels of T3 and/or T4 are abnormal, but the thyroid gland does not appear to be dysfunctional.

Allostasis

allostaticallostatic changes
This condition may result from allostatic responses of hypothalamsus-pituitary-thyroid feedback control, dyshomeostatic disorders, drug interferences and impaired assay characteristics in critical illness.

Assay

assaysassayingbioassays
This condition may result from allostatic responses of hypothalamsus-pituitary-thyroid feedback control, dyshomeostatic disorders, drug interferences and impaired assay characteristics in critical illness.

Starvation

starvedstarvingstarve
The classical phenotype of this condition is often seen in starvation, critical illness, or patients in the intensive care unit. Causes of classical euthyroid sick syndrome include a number of acute and chronic conditions, including pneumonia, fasting, starvation, anorexia nervosa, sepsis, trauma, cardiopulmonary bypass, malignancy, stress, heart failure, hypothermia, myocardial infarction, kidney failure, cirrhosis, diabetic ketoacidosis, surgery, infection, brain injury, shock, cancer, and HIV.

Intensive care medicine

intensive carecritical carecritical care medicine
This condition may result from allostatic responses of hypothalamsus-pituitary-thyroid feedback control, dyshomeostatic disorders, drug interferences and impaired assay characteristics in critical illness. The classical phenotype of this condition is often seen in starvation, critical illness, or patients in the intensive care unit.

Triiodothyronine

T 3 T3triiodothyronine (T3)
The most common hormone pattern in NTIS (non-thyroidal illness syndrome) is low total and free T3, elevated rT3, and normal T4 and TSH levels, although T4 and TSH suppression may occur in more severe or chronic illness.

Thyroid-stimulating hormone

TSHthyroid stimulating hormonethyrotropin
The most common hormone pattern in NTIS (non-thyroidal illness syndrome) is low total and free T3, elevated rT3, and normal T4 and TSH levels, although T4 and TSH suppression may occur in more severe or chronic illness.

Allostatic load

allostaticallostatic overloadallostatic stress load
Allostatic overload may result in wasting syndrome and myxedema coma. This classical pattern results from type 1 allostatic load, i.e. a stress response resulting from lacking energy, oxygen and glutathione.

Glutathione

glutathione metabolismglutathionylGSH
This classical pattern results from type 1 allostatic load, i.e. a stress response resulting from lacking energy, oxygen and glutathione.

Pregnancy

pregnantfirst trimesterpregnant women
An alternative phenotype with a largely inverse hormonal pattern is seen in several physiological and pathological conditions including pregnancy, obesity, endurance training and psychiatric diseases.

Obesity

obesemorbidly obeseoverweight
An alternative phenotype with a largely inverse hormonal pattern is seen in several physiological and pathological conditions including pregnancy, obesity, endurance training and psychiatric diseases.

Pneumonia

bronchopneumoniabronchial pneumoniaNecrotizing pneumonia
Causes of classical euthyroid sick syndrome include a number of acute and chronic conditions, including pneumonia, fasting, starvation, anorexia nervosa, sepsis, trauma, cardiopulmonary bypass, malignancy, stress, heart failure, hypothermia, myocardial infarction, kidney failure, cirrhosis, diabetic ketoacidosis, surgery, infection, brain injury, shock, cancer, and HIV.

Fasting

fastfastsfasted
Causes of classical euthyroid sick syndrome include a number of acute and chronic conditions, including pneumonia, fasting, starvation, anorexia nervosa, sepsis, trauma, cardiopulmonary bypass, malignancy, stress, heart failure, hypothermia, myocardial infarction, kidney failure, cirrhosis, diabetic ketoacidosis, surgery, infection, brain injury, shock, cancer, and HIV.

Anorexia nervosa

anorexiaanorexicanorexics
Causes of classical euthyroid sick syndrome include a number of acute and chronic conditions, including pneumonia, fasting, starvation, anorexia nervosa, sepsis, trauma, cardiopulmonary bypass, malignancy, stress, heart failure, hypothermia, myocardial infarction, kidney failure, cirrhosis, diabetic ketoacidosis, surgery, infection, brain injury, shock, cancer, and HIV.

Sepsis

septicaemiablood poisoningseptic
Causes of classical euthyroid sick syndrome include a number of acute and chronic conditions, including pneumonia, fasting, starvation, anorexia nervosa, sepsis, trauma, cardiopulmonary bypass, malignancy, stress, heart failure, hypothermia, myocardial infarction, kidney failure, cirrhosis, diabetic ketoacidosis, surgery, infection, brain injury, shock, cancer, and HIV.

Injury

traumainjuriesphysical trauma
Causes of classical euthyroid sick syndrome include a number of acute and chronic conditions, including pneumonia, fasting, starvation, anorexia nervosa, sepsis, trauma, cardiopulmonary bypass, malignancy, stress, heart failure, hypothermia, myocardial infarction, kidney failure, cirrhosis, diabetic ketoacidosis, surgery, infection, brain injury, shock, cancer, and HIV.