Sick Euthyroid Syndrome Thyroid Hormone Adaptation Syndrome

Thyroid function can be suppressed during severe illness and may not represent abnormal thyroid function. Serious illness has been shown to affect laboratory tests of thyroid function

(sTSH, T4, thyroglobulin), but there is no clear evidence this reflects a disease state (Chopra, 1997). Because these changes appear to have no direct adverse effect on the patient's overall clinical state, this condition is labeled "sick euthyroid syndrome." In broad terms, sick euthyroid syndrome is more of academic interest than clinical. Administration of T4 to a seriously ill individual does not improve outcome for most patients, although evidence suggests that high doses of T3 immediately after cardiac surgery may be beneficial (Wiers-inga, 2005). The physician should remember the rare patient whose thyroid disease is uncovered by serious illness. If a seriously ill patient is not responding as expected (e.g., difficulty in weaning from ventilator support), checking thyroid function may be appropriate, although any interpretation of results should be reviewed by a clinician experienced in interpreting thyroid tests in seriously ill patients before intervention. Patients with preexisting thyroid dysfunction will continue to require thyroid therapy during a severe illness. However, individuals who were euthyroid at presentation generally do not require or improve with thyroid replacement therapy.

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