eMedicine Specialties > Endocrinology > Thyroid

Euthyroid Sick Syndrome: Follow-up

Author: Serhat Aytug, MD, Staff Physician, Division of Endocrinology, Diabetes and Metabolism, CrystalRun Healthcare
Coauthor(s): Lawrence E Shapiro, MD, Chief, Division of Endocrinology and Metabolism, Professor of Medicine, Department of Medicine, Winthrop University Hospital
Contributor Information and Disclosures

Updated: Aug 13, 2009

Follow-up

Further Inpatient Care

Monitor thyroid function test findings during and after recovery from NTI.

Further Outpatient Care

Monitor thyroid function test findings after recovery from NTI.

Complications

Complications depend on the underlying NTI and other organ systems involved.

Prognosis

Prognosis depends on the outcome of the underlying NTI.

Patient Education

  • Patients can be assured that this is a transient phenomenon and that normalization of findings on thyroid function tests is expected with the patient's recovery from NTI.
  • For excellent patient education resources, visit eMedicine's Endocrine System Center. Also, see eMedicine's patient education article Thyroid Problems.

Miscellaneous

Medicolegal Pitfalls

  • Missing the diagnosis of hypopituitarism and hypothyroidism is a potential pitfall in this very common syndrome.
  • Rule out hypothyroidism.
  • Rule out hypopituitarism.
 


More on Euthyroid Sick Syndrome

Overview: Euthyroid Sick Syndrome
Differential Diagnoses & Workup: Euthyroid Sick Syndrome
Treatment & Medication: Euthyroid Sick Syndrome
Follow-up: Euthyroid Sick Syndrome
Multimedia: Euthyroid Sick Syndrome
References
Further Reading
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References

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  2. Beigneux AP, Moser AH, Shigenaga JK, et al. Sick euthyroid syndrome is associated with decreased TR expression and DNA binding in mouse liver. Am J Physiol Endocrinol Metab. Jan 2003;284(1):E228-36. [Medline].

  3. Docter R, Krenning EP, de Jong M, Hennemann G. The sick euthyroid syndrome: changes in thyroid hormone serum parameters and hormone metabolism. Clin Endocrinol (Oxf). Nov 1993;39(5):499-518. [Medline].

  4. Melmed S, Geola FL, Reed AW, et al. A comparison of methods for assessing thyroid function in nonthyroidal illness. J Clin Endocrinol Metab. Feb 1982;54(2):300-6. [Medline].

  5. Gangemi EN, Garino F, Berchialla P, et al. Low triiodothyronine serum levels as a predictor of poor prognosis in burn patients. Burns. Sep 2008;34(6):817-24. [Medline].

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  7. Michalaki M, Vagenakis AG, Makri M. Dissociation of the early decline in serum T(3) concentration and serum IL-6 rise and TNFalpha in nonthyroidal illness syndrome induced by abdominal surgery. J Clin Endocrinol Metab. Sep 2001;86(9):4198-205. [Medline].

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Keywords

euthyroid sick syndrome, thyroxine, thyroid hormones, TSH, thyroid TSH, T3 thyroid, TSH T4, thyroid stimulating hormone, T4 levels, T4 thyroid, sick euthyroid syndrome, triiodothyronine, low thyroid levels, T4 hormone, TSH free T4, thyroxine levels, nonthyroidal illness syndrome, low T3 syndrome, low iodothyronine syndrome, thyrotropin, thyroxine-binding globulin, TBG

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Contributor Information and Disclosures

Author

Serhat Aytug, MD, Staff Physician, Division of Endocrinology, Diabetes and Metabolism, CrystalRun Healthcare
Serhat Aytug, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians-American Society of Internal Medicine, American Diabetes Association, American Medical Association, Endocrine Society, and Pituitary Society
Disclosure: Nothing to disclose.

Coauthor(s)

Lawrence E Shapiro, MD, Chief, Division of Endocrinology and Metabolism, Professor of Medicine, Department of Medicine, Winthrop University Hospital
Lawrence E Shapiro, MD is a member of the following medical societies: American Diabetes Association, American Thyroid Association, and Endocrine Society
Disclosure: Nothing to disclose.

Medical Editor

Steven R Gambert, MD, MACP, Chairman, Department of Medicine, Physician-in-Chief, Sinai Hospital of Baltimore; Professor of Medicine, Program Director, Internal Medicine Program, Johns Hopkins University School of Medicine
Steven R Gambert, MD, MACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physician Executives, American College of Physicians, American Geriatrics Society, Association of Professors of Medicine, Endocrine Society, and Gerontological Society of America
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Don S Schalch, MD, Professor Emeritus, Department of Internal Medicine, Division of Endocrinology, University of Wisconsin Hospitals and Clinics
Don S Schalch, MD is a member of the following medical societies: American Diabetes Association, American Federation for Medical Research, Central Society for Clinical Research, and Endocrine Society
Disclosure: Nothing to disclose.

CME Editor

Mark Cooper, MBBS, PhD, FRACP, Head, Diabetes & Metabolism Division, Baker Heart Research Institute, Professor of Medicine, Monash University
Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD, Professor of Medicine, St Louis University School of Medicine
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.

 
 
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