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Nonthyroidal illness syndrome or euthyroid sick syndrome?
1Department of Medicine, UCLA Center for Health Sciences, Los Angeles, CA 90024, USA.
Summary
Nonthyroidal illness syndrome (NTIS) involves thyroid function changes seen in severe illness. Treatment with triiodothyronine (T3) shows some benefits, but further research is needed.
Area of Science:
- Endocrinology
- Internal Medicine
- Biochemistry
Background:
- Nonthyroidal illness syndrome (NTIS) is a complex endocrine disorder.
- It is characterized by alterations in thyroid hormone levels during severe systemic illness.
- NTIS affects thyroid hormone metabolism and regulation.
Purpose of the Study:
- To characterize the nonthyroidal illness syndrome (NTIS).
- To explore the underlying biochemical mechanisms contributing to NTIS.
- To review current understanding of thyroid function abnormalities in critical illness.
Main Methods:
- Systematic review of pertinent medical literature.
- Summary of studies on thyroid function in systemic non-thyroidal illnesses.
- Analysis of biochemical pathways involved in NTIS.
Main Results:
- NTIS presents with four main thyroid function patterns: low T3, low T3/T4, high T4, and other abnormalities.
- Observed in severe illnesses, post-surgery, caloric deprivation, and with certain drugs.
- Potential mechanisms include altered T3 production, reduced T4 uptake, changes in thyrotropin, and altered binding proteins.
Conclusions:
- Triiodothyronine (T3) administration shows some therapeutic benefit in NTIS.
- Thyroxine (T4) treatment has yielded limited improvement.
- Further research is required to define optimal T3 treatment strategies, including patient selection and dosage.