Euthyroid sick syndrome (patient information)

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Euthyroid sick syndrome

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Euthyroid sick syndrome?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

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

Overview

Euthyroid sick syndrome is a condition which is seen in severe illness such as burns, malignancy, sepsis, myocardial infarction, pneumonia and cirrhosis.

What are the symptoms of (Euthyroid sick syndrome)?

Signs and symptoms of hypothyroidism associated with euthyroid sick syndrome varies from person to person. Usual symptoms are the following:

What causes (Euthyroid sick syndrome)?

Euthyroid sick syndrome can be caused by any serious illness. The most common causes include:

Who is at highest risk?

Euthyroid sick syndrome is seen in 40% of patients presenting with any major illness. In intensive care unit (ICU) patient's the rate is as high as 70-75%. Other conditions which puts the patients at increased risk include:

Diagnosis

The diagnosis of euthyroid sick syndrome is based on clinical presentation and thyroid function tests.The best initial test is TSH, which in euthyroid sick syndrome can be low, normal, or elevated but not as high as it would be in hypothyroidism. The diagnosis of euthyroid sick syndrome is made when there is a clear severe underlying illness, normal appearing thyroid gland and low T3 with elevated reverse T3. The other thyroid hormones T4, TSH, and TRH all depend upon the severity of the illness. These hormones are affected in variable degrees based on the severity and duration of the underlying illness.

When to seek urgent medical care?

Call your health care provider if symptoms of hypothyroidism appear. If you experience either of the following symptoms, seeking urgent medical care as soon as possible.

Treatment options

In euthyroid sick syndrome emphasis is on rapid correction of underlying disease. Many seriously ill patients have low levels of thyroid hormones but are not clinically hypothyroid and do not require thyroid hormone supplementation.

Where to find medical care for (Euthyroid sick syndrome)?

Directions to Hospitals Treating hypothyroidism

Prevention

The prevention for euthyroid sick syndrome is unknown.

What to expect (Outlook/Prognosis)?

Prognosis of hypothyroidism depends on:

  • Whether the patient is treated or not. In most cases, if underlying condition is rapidly treated, thyroid levels returns to normal levels.
  • If the underlying condition is not treated and T4 level falls below 3 mcg/dL, euthyroid sick syndrome can be fatal.

Possible complications

The complications of euthyroid sick syndrome depends upon other organ systems involved and underlying disease(s). The general complications of hypothyroidism as seen in euthyroid sick syndrome include hypothermia, bradycardia, heart failure, dyspnea, confusion, apathy and psychosis.

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm


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