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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