Updated: 8/6/2019

Euthyroid Sick Syndrome (ESS)

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Introduction
  • Apparent alterations to thyroid hormone level with normal thyroid gland function
    • peripheral activity of outer ring deiodinase is ↓
      • normally converts T4 to T3
    • peripheral activity of inner ring deiodinase is ↑
      • normally converts T4 to reverse T3
  • Likely a response to an acute/chronic illness
    • cancer
    • cardiac disease (MI, CHF)
    • CRF
    • sepsis
Evaluation
  • Serology 
    • ↓ total serum T4/T3
    • normal serum TSH
    • ↑ reverse T3

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