Euthyroid sick syndrome historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]


In 1960s, the first scientific descriptions on transient alterations in thyroid hormones metabolism were given by several authors who described altered half life of thyroid hormones in athletes under training and with adaptation to cold. In the early 1970s, German and US researchers simultaneously described low T3 syndrome in starvation and shortly thereafter reduced T3 concentrations were observed in critical illnesses requiring intensive care such as in patient's with tumor or uremia.

Historical Perspective


  1. Irvine CH. Effect of exercise on thyroxine degradation in athletes and non-athletes. J Clin Endocrinol Metab. 1968 Jul;28(7):942-8. PMID 5665326
  2. Irvine CH. Thyroxine secretion rate in the horse in various physiological states. J Endocrinol. 1967 Nov;39(3):313-20. PMID 4169346
  3. Harland WA, Orr JS. A model of thyroxine metabolism based on the effects of environmental temperature. J Physiol. 1969 Feb;200(2):297-310. PMID 4975334; PMCID PMC1350468
  4. Rothenbuchner G, Loos U, Kiessling WR, Birk J, Pfeiffer EF. The influence of total starvation on the pituitary-thyroid-axis in obese individuals. Acta Endocrinol Suppl (Copenh). 1973;173:144. PMID 4542076
  5. Portnay GI, O'Brian JT, Bush J, Vagenakis AG, Azizi F, Arky RA, Ingbar SH, Braverman LE. The effect of starvation on the concentration and binding of thyroxine and triiodothyronine in serum and on the response to TRH. J Clin Endocrinol Metab. 1974 Jul;39(1):191-4. PMID 4835133
  6. Carter JN, Eastman CJ, Corcoran JM, Lazarus L. Effect of severe, chronic illness on thyroid function. Lancet. 1974 Oct 26;2(7887):971-4. PMID 4138176
  7. Bermudez F, Surks MI, Oppenheimer JH. High incidence of decreased serum triiodothyronine concentration in patients with nonthyroidal disease. J Clin Endocrinol Metab. 1975 Jul;41(1):27-40. PubMed PMID: 807593
  8. Carter JN, Corcoran JM, Eastman CJ, Lazarus L, O'Halloran M. Serum T3 and T4 levels in sick children. Pediatrics. 1976 Nov;58(5):776. PMID 980611
  9. Chatzitomaris A, Hoermann R, Midgley JE, Hering S, Urban A, Dietrich B, Abood A, Klein HH, Dietrich JW. Thyroid Allostasis-Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming. Front Endocrinol (Lausanne). 2017 Jul 20;8:163. doi: 10.3389/fendo.2017.00163. eCollection 2017. Review. PMID 28775711; PMCID PMC5517413
  10. Dietrich JW, Landgrafe G, Fotiadou EH. TSH and Thyrotropic Agonists: Key Actors in Thyroid Homeostasis. J Thyroid Res. 2012;2012:351864. doi: 10.1155/2012/351864. PMID 23365787; PMCID PMC3544290.

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