Euthyroid sick syndrome history and symptoms

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

Overview

The common symptoms and signs of clinical hypothyroidism are listed in the table below. The appearance of symptoms depends on the degree of hypothyroidism severity:

Symptoms	Constituitional	HEENT	Neuromuscular	Other findings
More common	Fatigue Cold intolerance Decreased sweating Hypothermia Coarse skin Weight gain	Hoarseness Goiter Fullness in the throat and neck	Depression Emotional lability Attention deficit	Macroglossia Obstructive sleep apnea Paresthesia Nerve entrapment syndromes (carpal tunnel syndrome) Blurred vision (central hypothyroidism)
Less common	Puffiness Hair loss Constipation Fever If accompanied by thyroiditis	Sore throat Periorbital edema	Slowed speech and movements	Pituitary hyperplasia followed by hyperprolactinemia Ataxia Myxedema coma (with non-pitting edema) Cardiomegaly Pericardial effusion Ascites Hyperlipidemia Galactorrhea Infertility

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

Other Diagnostic Studies

In euthyroid sick syndrome the thyroid gland appears normal. Therefore, there is no role of thyroid uptake scan in euthyroid sick syndrome.

History and Symptoms

• The majority of patients with [disease name] are asymptomatic.

OR

• The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
• Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. 

History

Patients with [disease name]] may have a positive history of:

• [history finding 1]
• [history finding 2]
• [history finding 3]

Common Symptoms

Common symptoms of [disease] include:

• [symptom 1]
• [symptom 2]
• [symptom 3]

Less Common Symptoms

Less common symptoms of [disease name] include

• [symptom 1]
• [symptom 2]
• [symptom 3]