Serum cortisol is often elevated in ESS, which can make it a distinguishing factor against hypothyroidism (which is usually low or low-normal in those patients) ( 1). This panel additionally includes hs-CRP, which is a great marker of inflammation in the body ( 1, 2). Given the association between ESS and cardiovascular conditions like myocardial infarction and congestive cardiac failure, assessing heart health may be indicated based on the patient’s history and clinical picture. If desired and depending on the underlying cause of the disease, practitioners can dive deeper with testing, such as a renal panel or a liver function panel ( 1, 2). It measures glucose, calcium, and electrolytes, hence giving indications about kidney and liver function, as well as electrolyte and fluid balance. A CMP is a blood test that gives doctors a big-picture look at the body's chemical balance and metabolism. Many of the conditions linked to ESS, such as starvation, anorexia nervosa, sepsis, diabetic ketoacidosis, and cirrhosis, are metabolic in nature. In addition, serum rT3 will be elevated, and T3 will be low ( 1, 2). In ESS, you would expect to see TSH <10 mlU/L (usually low to slightly elevated) but not high as is usual in primary hypothyroidism. This test provides insight into how the thyroid is producing and converting its hormones. Given that ESS is characterized by abnormal thyroid function in the context of a non-thyroidal illness, it's critical to assess the overall function of the thyroid. Thyroid Function PanelĪ Comprehensive Thyroid Function Panel will measure markers such as T3, T4, reverse T3 (rT3), TSH, and thyroid antibodies. Functional Medicine Labs to Test For The Root Cause Of Euthyroid Sick Syndromeįunctional medicine labs offer a variety of tests that can help tailor treatment to patients, allowing providers to optimize management strategies. Other disorders that might lead to abnormal thyroid function test results pointing towards this condition encompass chronic kidney disease, diabetic ketoacidosis, drug overdose, and severe fasting ( 1, 2). Recently, there's been an observed connection between this syndrome and Covid-19, especially with the discovery that low T3 levels in affected patients serve as an early indicator of poor prognosis. Additionally, medical interventions such as major surgeries can act as triggers ( 1, 2). Conditions like pneumonia, anorexia nervosa, sepsis, significant trauma including hip fractures, cardiopulmonary bypass, myocardial infarction, malignancies, burns, organ transplantations, congestive cardiac failure, hypothermia, and cirrhosis have been linked to its onset. Coma: A profound state of unconsciousness.Įuthyroid Sick Syndrome Underlying CausesĮuthyroid sick syndrome is associated with a myriad of critical illnesses.Lethargy: A state of fatigue or sluggishness.Hypoventilation: Decreased breathing rate.Hypothermia: A low body temperature that can be life-threatening.However, during the recovery phase, they might be slightly higher than normal. TSH Levels: These might be within the normal range or even on the lower side.Increased rT3 Levels: A prominent feature in ESS.Decreased T4 Levels: Observed in patients with more severe or prolonged illness. Decreased T3 Levels: This is the most common anomaly. The thyroid function test results of these patients might show abnormalities despite them having a functioning thyroid gland. Euthyroid Sick Syndrome Signs & SymptomsĮSS is observed in patients with a range of acute or chronic non-thyroid disorders ( 1). Significantly, despite the low levels of thyroid hormones, replacement with thyroid hormones is not warranted in these patients ( 1). The treatment focus is predominantly on managing the root illness. The unique feature of this syndrome is that, while thyroid hormone levels are decreased, the affected individual remains euthyroid, meaning their thyroid is operating in a normal capacity.ĭiagnosing ESS is primarily based on ruling out hypothyroidism. This occurs in patients suffering from systemic illnesses that are not related to the thyroid. What is Euthyroid Sick Syndrome?Įuthyroid sick syndrome (ESS), also known as non-thyroidal illness syndrome, is a state wherein the levels of thyroid hormones in the blood are unusually low, yet the thyroid gland is functioning normally. In this article, we will discuss what euthyroid sick syndrome is, what causes it, its clinical features, and how to treat it holistically based on the underlying disease state. What causes this? Turns out a lot of different things – from severe liver and kidney disease to anorexia.įor patients with this disorder, treating the underlying cause is the key to its resolution. Euthyroid sick syndrome is a condition where your thyroid functions normally, but your thyroid levels show up as abnormal.
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