Euthyroid sick syndrome laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]
Overview
Laboratory findings consistent with the diagnosis of euthyroid sick syndrome include low T3, increased reverse T3 and variable proportions of T4, FT4 and TSH depending upon the severity of the disease. Patients having reduced concentration of T4 suggests progression of the underlying nonthyroidal illness. Complete thyroid function test should be done which includes TSH, total T3, reverse T3, free T4, and total T4.[1][2][3][4][5]
Laboratory Findings
Laboratory findings consistent with the diagnosis of euthyroid sick syndrome include:
| Euthyroid sick syndrome | T3
(80-180 ng/dl) |
T4
(4.6-12 ug/dl) |
FT4
(0.7-1.9 ng/dl) |
TSH
(0.4 to 4.0mIU/L) |
Reverse T3
(90 to 350pg/mL) |
|---|---|---|---|---|---|
| Mild euthyroid sick syndrome | ↓ | N | N | N | ↑ |
| Moderate euthyroid sick syndrome | ↓ | N | N/↓ | N/↓ | ↑ |
| Severe euthyroid sick syndrome | ↓ | ↓ | N/↓ | ↓ | ↑ |
| Recovery | N/↓ | N | N | N | N/↑ |
Other tests that can be done include:
- Complete blood count: Will show anaemia
- Electrolytes: Hyponatremia (from water retention).
- Hyperlipidemia
- Serum creatinine (reversible increase)
References
- ↑ Golombek SG (2008). "Nonthyroidal illness syndrome and euthyroid sick syndrome in intensive care patients". Semin. Perinatol. 32 (6): 413–8. doi:10.1053/j.semperi.2008.09.010. PMID 19007679.
- ↑ Frączek MM, Gackowski A, Przybylik-Mazurek E, Nessler J (2016). "[The relation between the low T3 syndrome in the clinical course of myocardial infarction and heart failure]". Pol. Merkur. Lekarski (in Polish). 40 (240): 380–3. PMID 27403906.
- ↑ Van den Berghe G (2014). "Non-thyroidal illness in the ICU: a syndrome with different faces". Thyroid. 24 (10): 1456–65. doi:10.1089/thy.2014.0201. PMC 4195234. PMID 24845024.
- ↑ Murakami M (2012). "[Nonthyroidal illness (NTI)]". Nippon Rinsho (in Japanese). 70 (11): 2005–10. PMID 23214076.
- ↑ Lee S, Farwell AP (2016). "Euthyroid Sick Syndrome". Compr Physiol. 6 (2): 1071–80. doi:10.1002/cphy.c150017. PMID 27065175.