Euthyroid sick syndrome (patient information)

Euthyroid sick syndrome
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for Euthyroid sick syndrome?
Prevention
What to expect (Outlook/Prognosis)?
Possible complications
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Euthyroid sick syndrome is a condition which is seen in severe illness such as burns, malignancy, sepsis, myocardial infarction, pneumonia and cirrhosis.

What are the symptoms of (Euthyroid sick syndrome)?

Signs and symptoms of hypothyroidism associated with euthyroid sick syndrome varies from person to person. Usual symptoms are the following:

• Fatigue and weakness
• Weight gain
• Puffy face
• Cold intolerance
• Joint and muscle pain
• Constipation
• Bradycardia
• Depression
• Irregular menstrual periods in women
• Infertility

What causes (Euthyroid sick syndrome)?

Euthyroid sick syndrome can be caused by any serious illness. The most common causes include:

• Sepsis
• Malignancy
• Trauma
• Surgery
• Burns
• Bone marrow transplantation
• Metabolic disorders
• Other Inflammatory conditions
• Any major condition of
  • Heart: Myocardial infarction
  • Lungs : Pneumonia
  • Kidneys: Chronic renal failure
  • Liver: Cirrhosis

Who is at highest risk?

Euthyroid sick syndrome is seen in 40% of patients presenting with any major illness. In intensive care unit (ICU) patient's the rate is as high as 70-75%. Other conditions which puts the patients at increased risk include:

• Congenital hypothyroidism
• Surgical removal of part or all of the thyroid gland
• Radiation therapy of the thyroid
• Some medications, such as amiodarone, propylthiouracil, methimazole and Lithium.
• Age over 50 years
• Female

Diagnosis

The diagnosis of euthyroid sick syndrome is based on clinical presentation and thyroid function tests.The best initial test is TSH, which in euthyroid sick syndrome can be low, normal, or elevated but not as high as it would be in hypothyroidism. The diagnosis of euthyroid sick syndrome is made when there is a clear severe underlying illness, normal appearing thyroid gland and low T3 with elevated reverse T3. The other thyroid hormones T4, TSH, and TRH all depend upon the severity of the illness. These hormones are affected in variable degrees based on the severity and duration of the underlying illness.

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm