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Euthyroid Sick Syndrome: The Basics

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A patient may be diagnosed with euthyroid sick syndrome if he has low levels of thyroid hormones and abnormal thyroid function test results but his thyroid gland is in normal working order.

The challenge is that the diagnosis of euthyroid sick syndrome can only be determined if it is confirmed that the person does not have hypothyroidism.

What causes it?

Other underlying illnesses cause the syndrome, such as:

• Chronic renal failure and other chronic illnesses

• Sepsis
• Diabetic ketoacidosis
• Thermal injuries
• Other major trauma injuries
• Surgery
• Cancer
• Heart attack
• Inflammatory conditions
• Lack of protein
• Fasting or eating disorders such as anorexia nervosa


It may be difficult for the doctor to know whether the patient has hypothyroidism or euthyroid sick syndrome. Blood tests to look at thyroid stimulating hormone (TSH) will help determine this as levels of TSH are either low, normal or slightly elevated.

In hypothyroidism they are normally high. Blood cortisol levels are elevated, whereas in hypothyroidism they are lowered.

Patients who are severely ill and receiving intensive care may not be given a thyroid function test at first unless the doctor believes they have a thyroid disorder. Some medications given may interfere with the results of thyroid function tests, such as iodine washes or contrast agents.


The usual treatment of hormone replacement therapy for hypothyroidism will not correct euthyroid sick syndrome. Instead, treatment to correct the underlying disorder is given and the problem usually corrects itself once that has been given.


Euthyroid Sick Syndrome, The Merck Manual. Web. 30 January 2012. http://www.merckmanuals.com/professional/endocrine_and_metabolic_disorders/thyroid_disorders/euthyroid_sick_syndrome.html?qt=&sc=&alt=

Euthyroid Sick Syndrome, Medscape Reference. Web. 30 January 2012. http://emedicine.medscape.com/article/118651-overview

Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting.

Reviewed January 30, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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