Thyroid Dysfunction in the Critically Ill

last updated: November 8, 2016

Orlando Debesa

Euthyroid Sick Syndrome (aka Non-thyroidal illness)

- the thyroid is not the problem (eg. treat underlying problem)

- when someone is sick you don't need thyroid hormone, so T4 is dumped into rT3 (inactive form)

  • TSH: normal / low

  • FT4: normal / low

  • T3: very low

  • rT3: high (hallmark)

TSH values during critical illness

... but I would more especially commend the clinician who, in acute diseases, by which the bulk of mankind are cutoff, conducts the treatment better than others.
 
Hippocrates, 400 BC