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Last update 08 May 2025

Euthyroid Sick Syndromes

Last update 08 May 2025

Basic Info

Synonyms

EUTHYROID SICK SYNDROME <LOW T3/ LOW T4 SYNDROME>, EUTHYROID SICK SYNDROME LOW T3 LOW T4 SYNDROME, Euthyroid Sick Syndrome

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Introduction

Conditions of abnormal THYROID HORMONES release in patients with apparently normal THYROID GLAND during severe systemic illness, physical TRAUMA, and psychiatric disturbances. It can be caused by the loss of endogenous hypothalamic input or by exogenous drug effects. The most common abnormality results in low T3 THYROID HORMONE with progressive decrease in THYROXINE; (T4) and TSH. Elevated T4 with normal T3 may be seen in diseases in which THYROXINE-BINDING GLOBULIN synthesis and release are increased.

Clinical Trials associated with Euthyroid Sick Syndromes

ChiCTR2400093391

/ SuspendedPhase 4IIT

A Randomized Controlled Trial of Thyroid Hormone Replacement Therapy in Children with Euthyroid Sick Syndrome Following Congenital Heart Disease Surgery with Cardiopulmonary Bypass

Start Date01 Jan 2025

Sponsor / Collaborator

Nanjing Children's Hospital Ltd.

NCT06660823

/ Not yet recruitingPhase 3IIT

Role of Levothyroxine Supplementation in Delayed Recovery Following Cardiac Surgery

Research indicates that hypothyroidism decreases heart contractility, reduces stroke volume and rate, affects the vascular endothelium, and increases the risk of atherosclerosis, systemic vascular resistance, hypertension, atherogenic lipid profile, and coagulation abnormality .
Hypothyroidism was reported to be strongly related to cardiovascular disease, respiratory complications, neurological complications, and a significant difference in ventilator weaning time.
Once subclinical hypothyroidism patients are treated with levothyroxine, their physical fitness measured by a 6-minute walk is significantly improved, also showed that levothyroxine treatment can optimize the treatment of heart failure with preserved functions (HFpEF) and heart failure with reduced functions (HFrEF) patients with systolic left ventricular dysfunction and sub clinical hypothyroidism (SCH).
The primary aim of this study is to investigate the effect of supplementation of oral levothyroxine in delayed recovery patients post cardiac surgery.

Start Date01 Nov 2024

Sponsor / Collaborator

Ain Shams University

ChiCTR2500100201

/ RecruitingNot ApplicableIIT

Correlation between low T3 syndrome and ICU acquired weakness in critically ill patients

Start Date08 Jun 2024

Sponsor / Collaborator-

100 Clinical Results associated with Euthyroid Sick Syndromes

100 Translational Medicine associated with Euthyroid Sick Syndromes

0 Patents (Medical) associated with Euthyroid Sick Syndromes

1,238

Literatures (Medical) associated with Euthyroid Sick Syndromes

01 Mar 2025·Journal of Infection and Public Health

Population-level impact of COVID-19 on thyroid function tests: Results from a repeated cross-sectional study

Article

Author: Guéant, Jean-Louis ; Le Collen, Lauriane ; Berkebile, Gabriel ; Klein, Marc ; Barbé, Françoise ; Oussalah, Abderrahim ; Malaplate, Catherine

PURPOSEReports have highlighted thyroid abnormalities, including subacute thyroiditis and thyrotoxicosis, in COVID-19 patients, with a potential link between thyroid dysfunction and disease severity. However, population-level studies on COVID-19's impact on thyroid hormone levels are limited. We aimed to assess the impact of the COVID-19 pandemic on thyroid function tests at the population level.METHODSWe conducted a repeated cross-sectional study on consecutive patients who underwent thyroid function tests between March 1 and April 15, 2020, during the first wave of COVID-19 in northeastern France, and compared the results with those from the same period in 2018 and 2019.RESULTSThe study analyzed 3968 tests, including 1534 in 2018, 1547 in 2019, and 887 in 2020. Patients tested in the first wave of COVID-19 had significantly lower TSH and FT3 levels and higher FT4 levels than those in reference periods. On ROC analysis, the optimal thresholds for FT3 and FT4 were ≤ 4.5 pmol/L and > 12 pmol/L, respectively. On multivariable analysis, FT3 ≤ 4.5 pmol/L and FT4 > 12 pmol/L were independently associated with the first wave of COVID-19. The proportion of subjects with concurrent changes in FT3 and FT4 levels was significantly higher in 2020 than in the reference periods, with an odds ratio of 3.62 (95 % CI, 2.77-4.73). A phenome-wide association study of 128 clinical and biological predictors identified an independent association between a low FT3/FT4 ratio and COVID-19, hypertension, or amiodarone therapy, suggesting the contribution of euthyroid sick syndrome to this presentation. This association remained significant after adjustment for potential confounders such as thyroid disease, steroids, and iodinated contrast injection.CONCLUSIONThese findings suggest that COVID-19 is associated with significant population-level variation in thyroid function tests, which may have implications for managing COVID-19 patients.

28 Feb 2025·Endocrine Connections

Induction of type 2 and 3 deiodinase in the blood cells of critically ill patients

Article

Author: Vidart, Josi ; Braun, André Cardoso ; Oliveira, Thaliane Carvalho ; Abib, Julia Brum ; Dutra, Rachel Pinto Dornelles ; Marchesan Moreira Breit, Mariana ; Alves Correa, Maria Paula ; Wajner, Simone Magagnin ; Argenti, Gustavo ; Thomazini, Ludmilla C D ; Almeida, Giovanna

Altered type 2 and 3 deiodinase (D2 and D3) can disrupt thyroid hormone metabolism and contribute to non-thyroidal illness syndrome (NTIS). The impact of the colocalization of D2 and D3, and their expression in immune cells isolated from critically ill patients, are still not fully understood. Our objective was to assess the D2 and D3 in the neutrophils and monocytes of patients admitted to the intensive care unit (ICU) for any cause. Blood samples were collected from 96 ICU patients at admission and on day 7. We employed different cell gradients and flow cytometry to separate and purify cells from whole blood. Parameters indicating redox balance were measured, including total carbonyls, sulfhydryl content and glutathione (GSH) levels. The expression and colocalization of DIO2 and DIO3 were evaluated through RNAscope, real-time PCR (polymerase chain reaction) and immunofluorescence. The formation of carbonyls, a marker for oxidative damage to proteins, was elevated in all patients, while sulfhydryl and GSH levels were found to be reduced. The expression of DIO2 and DIO3 in neutrophils and monocytes from both surviving and deceased patients demonstrated significant variations in localization. Notably, elevated levels of D3 protein showed distinct distribution patterns between the groups. Levels of T3 in each cell type varied and were correlated with patient outcomes. The specific distribution of these enzymes has also been associated with prognosis. The set of these findings enhances our understanding of the pathophysiology of NTIS and may provide valuable information for prognostic assessments.

01 Feb 2025·European review for medical and pharmacological sciences

Euthyroid Sick Syndrome (ESS) in proximal femoral fractures: a proof-of-concept evaluation of postoperative outcomes in elderly patients.

Article

Author: Pesare, E ; Ginestra, W ; Vicenti, G ; Maccagnano, G ; Moretti, B ; Coviello, M ; Di Gioia, L ; Giorgino, F ; Gallo, C ; D'Aprile, M ; Caruso, I

OBJECTIVEThe diagnosis of euthyroid sick syndrome (ESS) in several diseases has been associated with poor outcomes, and proximal femur fractures are among the most common injuries in elderly patients, representing a leading cause of disability and mortality. There are no studies evaluating the mortality rate in patients with proximal femur fractures and ESS. The aim of our study was to evaluate a potential higher mortality rate in geriatric patients with proximal femur fracture and affected by ESS.MATERIALS AND METHODSIn this proof-of-concept study, all patients older than 65 years with a diagnosis of proximal femur fracture were included. They were all treated surgically. The main exclusion criteria were acute cardio-pulmonary events, neoplastic diseases, and any thyroid or endocrine pathology.RESULTSThirty-six patients who met our criteria were enrolled: 20 of them had a diagnosis of ESS (Group A), while 16 had a normal thyroid function as control (Group B). The mortality rate was evaluated at one month, three months, six, and twelve months after surgery. The survival analysis of enrolled patients showed a higher mortality rate in patients with ESS (p = 0.049) regardless of baseline comorbidities.CONCLUSIONSThe ESS could be included among the predictive factors of all-cause mortality in geriatric patients with proximal femur fracture.

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