Differentiating Euthyroid sick syndrome from other diseases: Difference between revisions

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__NOTOC__
__NOTOC__
{{Euthyroid sick syndrome}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Euthyroid_sick_syndrome]]
{{CMG}}{{AE}}  
{{CMG}}{{AE}} {{Akshun}}


==Overview==
==Overview==
[[Fasting]], [[starvation]], [[sepsis]], [[Physical trauma|trauma]], [[cardiopulmonary bypass]], [[malignancy]], [[heart failure]], [[hypothermia]], [[myocardial infarction]], [[chronic renal failure]], [[cirrhosis]], and [[diabetic ketoacidosis]].
[[Euthyroid]] sick syndrome must be differentiated from other causes of [[hypothyroidism]] on the basis of clinical features and laboratory findings. In [[euthyroid]] sick syndrome, serum [[T3]] is decreased more than [[T4]], the T3RU (T3 resin uptake) is high, and [[Thyroid-stimulating hormone|TSH]] is normal or mildly decreased. In [[primary hypothyroidism]], serum [[T4]] is decreased more than [[T3]], the T3RU (T3 resin uptake) is low, and [[TSH]] is increased. Other causes of [[hypothyroidism]] include transient hypothyroidism, sub-clinical hypothyroidism, central hypothyroidism ([[pituitary]] or [[Hypothalamic|hypothalamic]]) and peripheral [[resistance]] to [[Thyroid-stimulating hormone|TSH]]/[[Thyrotropin-releasing hormone|TRH]].
 
__NOTOC__
 
 
 
*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
*[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].


==Differentiating Euthyroid sick syndrome from other Diseases==
==Differentiating Euthyroid sick syndrome from other Diseases==
*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
[[Euthyroid]] sick syndrome must be differentiated from other causes of [[hypothyroidism]] on the basis of [[History and symptoms template|history and symptoms]] and [[laboratory]] findings:<ref name="pmid19949140">{{cite journal |vauthors=McDermott MT |title=In the clinic. Hypothyroidism |journal=Ann. Intern. Med. |volume=151 |issue=11 |pages=ITC61 |year=2009 |pmid=19949140 |doi=10.7326/0003-4819-151-11-200912010-01006 |url=}}</ref><ref name="pmid11836274">{{cite journal |vauthors=Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE |title=Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III) |journal=J. Clin. Endocrinol. Metab. |volume=87 |issue=2 |pages=489–99 |year=2002 |pmid=11836274 |doi=10.1210/jcem.87.2.8182 |url=}}</ref><ref name="pmid18177256">{{cite journal |vauthors=Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR |title=Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002) |journal=Thyroid |volume=17 |issue=12 |pages=1211–23 |year=2007 |pmid=18177256 |doi=10.1089/thy.2006.0235 |url=}}</ref>
*[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
{| class="wikitable" align="center" style="border: 0px; margin: 3px;"
 
! colspan="3" rowspan="2" align="center" style="background: #4479BA; color: #FFFFFF; " |Disease
*As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].
! colspan="3" align="center" style="background: #4479BA; color: #FFFFFF; " |History and symptoms
 
! colspan="7" align="center" style="background: #4479BA; color: #FFFFFF; " |Laboratory findings
===Preferred Table===
! rowspan="2" align="center" style="background: #4479BA; color: #FFFFFF; " |Additional findings
{|
|-
|-style="background: #4479BA; color: #FFFFFF; text-align: center;"
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Fever
! rowspan="2" |Diseases
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Goiter
! colspan="4" |Laboratory Findings
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Pain
! colspan="4" |Physical Examination
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TSH
! colspan="4" |History and Symptoms
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Free T4
! rowspan="2" |Other Findings
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> T3
|-style="background: #4479BA; color: #FFFFFF; text-align: center;"
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> T3RU
!Lab Test 1
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Thyroglobin
!Lab Test 2
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TRH
!Lab Test 3
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TPOAb
!Lab Test 4
|-
!Physical Finding 1
| colspan="2" rowspan="3" style="background:#DCDCDC;" |Euthyroid sick syndrome
!Physical Finding 2
|align="center" style="background:#DCDCDC;" |Mild
!Physical Finding 3
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +
!Physical Finding 4
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
!Finding 1
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
!Finding 2
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
!Finding 3
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
!Finding 4
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''''↓'''''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | '''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| rowspan="3" align="left" style="padding: 5px 5px; background: #F5F5F5;" |
* Additional findings of underlying condition
|-
|-
|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 1
|align="center" style="background:#DCDCDC;" |Moderate
|style="background: #F5F5F5; padding: 5px;" |
| +
|style="background: #F5F5F5; padding: 5px;" |
| -
|style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
| -
|style="background: #F5F5F5; padding: 5px;" |
|Normal
|style="background: #F5F5F5; padding: 5px;" |
/↓
|style="background: #F5F5F5; padding: 5px;" |
|Normal
|style="background: #F5F5F5; padding: 5px;" |
/↓
|style="background: #F5F5F5; padding: 5px;" |
|'''''↓'''''
| style="background: #F5F5F5; padding: 5px;" |
|'''↑'''
|style="background: #F5F5F5; padding: 5px;" |
| -
|style="background: #F5F5F5; padding: 5px;" |
|Normal/↓
|style="background: #F5F5F5; padding: 5px;" |
| -
|style="background: #F5F5F5; padding: 5px;" |
|-
|-
|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 2
|align="center" style="background:#DCDCDC;" |Severe
|style="background: #F5F5F5; padding: 5px;" |'''↑'''
| +
|style="background: #F5F5F5; padding: 5px;" |
| -
|style="background: #F5F5F5; padding: 5px;" |
| -
|style="background: #F5F5F5; padding: 5px;" |-
|↓
|style="background: #F5F5F5; padding: 5px;" |
|N/'''''↓'''''
|style="background: #F5F5F5; padding: 5px;" |
|'''''↓'''''
|style="background: #F5F5F5; padding: 5px;" |
|'''↑'''
|style="background: #F5F5F5; padding: 5px;" |
| -
|style="background: #F5F5F5; padding: 5px;" |
|'''''↓'''''
| style="background: #F5F5F5; padding: 5px;" |
| -
|style="background: #F5F5F5; padding: 5px;" |
|style="background: #F5F5F5; padding: 5px;" |
|style="background: #F5F5F5; padding: 5px;" |
|-
|-
|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 3
| rowspan="3" style="background:#DCDCDC;" |[[Primary hypothyroidism]]
|style="background: #F5F5F5; padding: 5px;" |
| colspan="2" align="center" style="background:#DCDCDC;" |[[Hashimoto's thyroiditis|Autoimmune]]
|style="background: #F5F5F5; padding: 5px;" |↓
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
|style="background: #F5F5F5; padding: 5px;" |
Diffuse
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''''↓'''''
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''''↓'''''
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑'''
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
|style="background: #F5F5F5; padding: 5px;" |
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
* May be accompanied by other [[autoimmune diseases]]
|-
|-
|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 4
| colspan="2" align="center" style="background:#DCDCDC;" |[[Thyroiditis]]
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''''↓'''''
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑'''
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
|style="background: #F5F5F5; padding: 5px;" |
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
|style="background: #F5F5F5; padding: 5px;" |
*[[Thyroiditis|Infectious thyroiditis]] associated with neck pain
|style="background: #F5F5F5; padding: 5px;" |
|-
|-
|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 5
| colspan="2" align="center" style="background:#DCDCDC;" |Others
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''''↓'''''
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑'''
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
|style="background: #F5F5F5; padding: 5px;" |
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
|style="background: #F5F5F5; padding: 5px;" |
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
|style="background: #F5F5F5; padding: 5px;" |
* History of [[hyperthyroidism]]
|style="background: #F5F5F5; padding: 5px;" |
* Drug history
|}
 
===Use if the above table can not be made===
{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align=center
|valign=top|
|+
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Similar Features}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 1
| colspan="3" style="background:#DCDCDC;" |Transient hypothyroidism
| style="padding: 5px 5px; background: #F5F5F5;"|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;"|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
* May present primarily with [[hyperthyroidism]]
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 2
| colspan="3" style="background:#DCDCDC;" |Subclinical hypothyroidism
| style="padding: 5px 5px; background: #F5F5F5;"|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;"|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑'''
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
* Asymptomatic
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 3
| rowspan="2" align="center" style="background:#DCDCDC;" |Central Hypothyroidism
| style="padding: 5px 5px; background: #F5F5F5;"|
| colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Pituitary
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +
| style="padding: 5px 5px; background: #F5F5F5;"|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| rowspan="2" align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''''↓'''''
| rowspan="2" align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''''↓'''''
| rowspan="2" align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''''↓'''''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↓'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
* Other [[Pituitary hormone|pituitary hormone deficiencies]] signs
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 4
| colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Hypothalamus
| style="padding: 5px 5px; background: #F5F5F5;"|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;"|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
* Other [[Pituitary hormone|pituitary hormone deficiencies]] signs
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 5
| colspan="3" style="background:#DCDCDC;" |Resistance to TSH/TRH
| style="padding: 5px 5px; background: #F5F5F5;"|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| style="padding: 5px 5px; background: #F5F5F5;"|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''''↓'''''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''''↓'''''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''/'''''↓'''''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
* Rare
|}
|}


Latest revision as of 19:22, 25 February 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

Euthyroid sick syndrome must be differentiated from other causes of hypothyroidism on the basis of clinical features and laboratory findings. In euthyroid sick syndrome, serum T3 is decreased more than T4, the T3RU (T3 resin uptake) is high, and TSH is normal or mildly decreased. In primary hypothyroidism, serum T4 is decreased more than T3, the T3RU (T3 resin uptake) is low, and TSH is increased. Other causes of hypothyroidism include transient hypothyroidism, sub-clinical hypothyroidism, central hypothyroidism (pituitary or hypothalamic) and peripheral resistance to TSH/TRH.

Differentiating Euthyroid sick syndrome from other Diseases

Euthyroid sick syndrome must be differentiated from other causes of hypothyroidism on the basis of history and symptoms and laboratory findings:[1][2][3]

Disease History and symptoms Laboratory findings Additional findings
Fever Goiter Pain TSH Free T4 T3 T3RU Thyroglobin TRH TPOAb
Euthyroid sick syndrome Mild + - - Normal Normal ↓ ↑ - Normal -
  • Additional findings of underlying condition
Moderate + - - Normal

/↓

Normal

/↓

↓ ↑ - Normal/↓ -
Severe + - - ↓ N/↓ ↓ ↑ - ↓ -
Primary hypothyroidism Autoimmune + +/-

Diffuse

- ↑ ↓ Normal/↓ Normal Normal/↑ Normal ↑
Thyroiditis + +/- + ↑ ↓ Normal Normal Normal/↑ Normal Normal
Others - +/- - ↑ ↓ Normal Normal Normal/↑ Normal Normal
Transient hypothyroidism +/- - +/- ↑ ↑ Normal Normal ↑ Normal Normal
Subclinical hypothyroidism - - - ↑ Normal Normal Normal ↑ Normal Normal/↑
  • Asymptomatic
Central Hypothyroidism Pituitary + - - Normal/↓ Normal/↓ Normal/↓ ↓ Normal Normal Normal
Hypothalamus + - - ↑ Normal ↓ Normal
Resistance to TSH/TRH - - - ↑ Normal/↓ Normal/↓ Normal Normal ↑/↓ Normal
  • Rare

References

  1. ↑ McDermott MT (2009). "In the clinic. Hypothyroidism". Ann. Intern. Med. 151 (11): ITC61. doi:10.7326/0003-4819-151-11-200912010-01006. PMID 19949140.
  2. ↑ Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE (2002). "Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III)". J. Clin. Endocrinol. Metab. 87 (2): 489–99. doi:10.1210/jcem.87.2.8182. PMID 11836274.
  3. ↑ Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR (2007). "Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002)". Thyroid. 17 (12): 1211–23. doi:10.1089/thy.2006.0235. PMID 18177256.

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