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Last update 23 Jan 2025

Euthyroid Sick Syndromes

Last update 23 Jan 2025

Basic Info

Synonyms

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

+ [27]

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

NCT06242626

/ CompletedNot ApplicableIIT

Low T3 Versus Low T3T4 Syndrome in Septic Shock Patients- a Prospective Observational Cohort Study

This prospective observational cohort study included all septic shock patients with two groups of ESS and anylised in 28-day outcome, clinical biochemical parameters and hemodynamic monitoring.

Start Date01 Oct 2022

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

1,202

Literatures (Medical) associated with Euthyroid Sick Syndromes

01 Jan 2025·Endocrine, Metabolic & Immune Disorders - Drug Targets

Is Low-free Triiodothyronine (fT3) Associated with Increased Morbidity in Patients Admitted to Coronary Care Units?

Article

Author: Akkus, Oguz ; Akkus, Gamze ; Yasdıbas, Ramazan ; Huzmeli, Irem ; Sen, Fatih ; Otegen, Alper Tunga

Background:The effects of thyroid hormone on patients hospitalized in coronary intensive care units are still controversial. Objective: We retrospectively examined thyroidMethods:A total of 208 (Female/Male; 46.6%/53.4%) patients without any history of thyroid disease were enrolled and screened. Patients with specific heart disease and existing thyroid hormone parameters were included in the study. Low triiodothyronine syndrome is characterized by reduced serum total or free T3 (fT3) concentrations in normal free T4 (fT4) and TSH levels.Results:The common diagnosis of the patients in the coronary care unit is acute coronary syndrome (n = 59, 28.2 %) and heart failure (n = 46, 23.3%). Patients were divided into two groups according to left ventricular ejection fraction percentages (LVEF ≤39% vs LVEF ≥40%). Plasma fT3 levels were significantly correlated with low LVEF (≤39%) (p =0.002). fT3 (r = -0.183, p =0.013) and hospitalization etiology (r = -0.161, p =0.023) were also the most critical parameters affecting the length of hospitalizationConclusion:Low fT3 was associated with reduced ejection fraction and prolonged hospitalization, which may lead to potential morbidities in HF patients and may be useful in risk stratification and treatment strategies.

14 Oct 2024·Cureus

Long-Term Impacts of COVID-19 on Thyroid Health: Insights From Clinical Studies

Review

Author: Kunchala, Keerthi ; Yennam, Anil Kumar ; Ruma, Umme ; Metry, Sherien ; Syal, Ria ; Amatul-Raheem, Hajera ; Bojanki, Nagavenkata Lova Surya Vamsi Avinash ; Kapadia, Sagar D ; Suarez, Cristhian ; Siddiqui, Maheen ; Kaur, Jasmeet

BACKGROUNDCOVID-19 emerged in December 2019 and rapidly became a global pandemic. It has since been associated with the progression of various endocrine disorders, including thyroid disease. The long-term effects of this interplay have yet to be explored. This review explores the relationship between COVID-19 and thyroid diseases, emphasizing thyroid gland function and the clinical implications for managing thyroid disorders in infected individuals.OBJECTIVESThis narrative review intends to provide insight into the scope of research that future clinical studies may aim to address regarding the long-term effects of COVID-19 infection on thyroid health.METHODSKeywords including "thyroid disease", "COVID-19", and "long-term" were used to search PubMed and Google Scholar for updated and relevant clinical research.RESULTSCOVID-19 affects the thyroid gland multifacetedly and includes direct viral invasion, immune-mediated damage, and hypothalamic-pituitary-thyroid axis disruption. Approximately 15% of COVID-19 patients experience thyroid dysfunction, which can present as thyrotoxicosis, hypothyroidism, or non-thyroidal illness syndrome (NTI). Noteworthy findings include inflammatory thyroiditis. Long-term effects, including those observed in children, include persistent hypothyroidism and exacerbated pre-existing thyroid-autoimmune conditions. Management of thyroid disorders in COVID-19 patients requires consideration: anti-thyroid drug (ATD) therapy used to treat hyperthyroidism in COVID-19 patients may need adjustment to prevent immunosuppression. Radioactive iodine (ROI) alternatives and interleukin-6 (IL-6) receptor antagonists could offer potential benefits and should be further explored.CONCLUSIONLongitudinal follow-ups post-COVID-19 for patients with new and pre-existing thyroid disorders can improve disease outcomes. In addition, pathophysiological research on thyroid dysfunction in COVID-19 may help develop strategies to prevent and alleviate thyroid gland abnormalities post-COVID-19.

02 Sep 2024·Clinical Kidney Journal

The impact of severe nephrotic syndrome on thyroid function, nutrition and coagulation

Article

Author: Fendler, Wojciech ; Literacki, Sławomir ; Rozmysłowicz, Tomasz ; Kronbichler, Andreas ; Niemczyk, Stanisław ; Matyjek, Anna

ABSTRACTBackgroundNephrotic syndrome (NS) is characterized by urinary loss of proteins, including hormones and their carrier proteins, potentially resulting in endocrine disorders. This study aimed to assess thyroid dysfunction frequency and potential implications in NS.MethodsIn this case–control study, patients with severe NS (serum albumin ≤2.5 g/dl) and controls without proteinuria were evaluated for thyroid, haemostatic and nutritional parameters, including body composition.ResultsA total of 42 nephrotic and 40 non-proteinuric patients were enrolled. The NS group showed higher thyroid-stimulating hormone and lower free hormones, corresponding to a higher frequency of both euthyroid sick syndrome {ESS; 36% versus 5%; odds ratio [OR] 10.6 [95% confidence interval (CI) 2.2–50.0]} and hypothyroidism [31% versus 5%; OR 8.5 (95% CI 1.8–40.7)] compared with the control group. Levothyroxine supplementation was required for 11 NS patients (26% of the NS group). In addition, compared with control individuals, NS patients exhibited lower lean tissue mass and a trend towards hypercoagulability, which was evidenced by higher levels of most coagulation factors and fibrinolysis inhibitors, and reduced endogenous anticoagulants activities. Furthermore, NS patients with ESS presented with a 10.4 kg (95% CI −18.68 to −2.12) lower lean tissue mass. Those with hypothyroidism had significantly reduced activity of coagulation factor X [by −30% (95% CI −47 to −13)] and protein S [by −27% (95% CI −41 to −13)] compared with euthyroid NS individuals.ConclusionsThyroid dysfunction is common in severe NS, often necessitating levothyroxine supplementation, which supports routine thyroid workup. A potential link between thyroid, nutritional and coagulation disorders in NS requires further investigation.

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