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:

Overview

Laboratory findings consistent with the diagnosis of euthyroid sick syndrome include low T3, increased reverse T3 and variable proportions of T4 depending upon the severity of the disease. Patients having reduced concentration of T4 suggest progression of the underlying nonthyroidal illness. Complete thyroid function test should be done which includes TSH, free T3, total T3, reverse T3, free T4, and total T4.

Laboratory Findings

Laboratory findings consistent with the diagnosis of euthyroid sick syndrome include:

Euthyroid sick syndrome	Laboratory test
Mild euthyroid sick syndrome	Low T3 Normal T4 Normal fT4 Normal TSH Elevated reverse T3
Moderate euthyroid sick syndrome	Low T3 Normal T4 Normal to elevated fT4 Normal to elevated TSH Elevated reverse T3
Severe euthyroid sick syndrome	Low T3 Low T4 Low TSH Normal to low fT4 Elevated reverse T3