Euthyroid Sick Syndromes (Euthyroid Sick Syndrome)

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.

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Networked: 277 relevant articles (3 outcomes, 14 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Nephrotic Syndrome (Syndrome, Nephrotic)
2.	Myocardial Infarction
3.	Stroke (Strokes)
4.	Burns
5.	Brain Neoplasms (Brain Tumor)

Experts

1.	Hodzic, Emir: 3 articles (04/2015 - 01/2011)
2.	Iervasi, Giorgio: 3 articles (06/2014 - 02/2013)
3.	Kobayashi, I: 3 articles (07/2001 - 03/2000)
4.	Kotajima, N: 3 articles (07/2001 - 03/2000)
5.	Fukumura, Y: 3 articles (07/2001 - 03/2000)
6.	Kanda, T: 3 articles (07/2001 - 03/2000)
7.	Halilcevic, Alma: 2 articles (04/2015 - 01/2011)
8.	Lado-Abeal, Joaquin: 2 articles (01/2015 - 04/2013)
9.	Novitzky, Dimitri: 2 articles (10/2014 - 01/2009)
10.	Kallushi, Enkel: 2 articles (06/2014 - 01/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Euthyroid Sick Syndromes:

1.	Insulin (Novolin)FDA Link 09/01/1986 - "In conclusion, we may state that substituting porcine with human insulin has not brought about any significant metabolic improvement in our patients, as can be seen from the persistent tendency to the low T3 syndrome." 09/01/1986 - "The purpose of our study was to evaluate if the change to human insulin would result in better metabolic control and disappearance of the tendency to the low T3 syndrome that was evidenced in group A. " 02/01/2014 - "Glucose concentrations between 120-160 mg/dL can serve as a reasonable target for insulin infusion protocols.• There is no data to suggest that treatment of abnormal thyroid function tests in nonthyroidal illness syndrome/sick euthyroid leads to benefits in either mortality or morbidity. " 07/01/1990 - "Thus, in the rats with low T3 syndrome induced by streptozotocin-diabetes, a lowered iodothyronine 5'-deiodinase activity is not fully inhibited by insulin treatment, whereas the T3 content in the liver is re-established during an observation period of 8 days. " 12/01/1996 - "Serum norepinephrine and atrial natriuretic factor were significantly higher, and insulin significantly lower in the sick euthyroid syndrome group. "
2.	Thyroxine (Levothyroxine)FDA LinkGeneric 06/19/2015 - "Non-thyroidal illness syndrome (NTIS), characterized by low serum 3,5,3'-triiodothyronine (T3) with normal l-thyroxine (T4) levels, is associated with malignancy. " 04/01/2001 - "Five patients presented at diagnosis with euthyroid sick syndrome characterized by borderline low thyroxine circulating levels (T3 0.8-1.3 ng/mL, FT3 1.5-1.7 pg/mL) and mildly raised TSH (4.6-5 microU/mL). " 05/01/2000 - "The sick euthyroid syndrome and the National Health Service: thyroxine alone is not the cure." 10/08/1983 - "Euthyroid sick syndrome and free thyroxine assay." 08/13/1983 - "Euthyroid sick syndrome and free thyroxine assay."
3.	Triiodothyronine (Liothyronine)FDA LinkGeneric 10/01/2014 - "This has led to the hypotheses that D3 impacts injury tolerance by reducing local T3 signaling and contributes to the fall in serum triiodothyronine (T3) observed in up to 75% of sick patients (termed the low T3 syndrome). " 09/01/2011 - "Low T3 syndrome is a protective reaction of the organism and is associated with conversion of T4 into hormonally inactive triiodothyronine (rT3). " 05/01/2009 - "Sick euthyroid syndrome (SES) was defined as low total triiodothyronine (T(3)) with normal TSH levels. " 05/01/2002 - "Exercise training through a wide variety of mechanisms reverses sick euthyroid syndrome (normalization of free triiodothyronine levels) and improves the ability to exercise. " 03/01/2001 - "The "sick euthyroid syndrome" is also seen in association with significant illnesses and consists of decreased levels of circulating triiodothyronine (T3). "
4.	HormonesIBA 09/01/1998 - "Despite its complexity, euthyroid sick syndrome is a model for the study of thyroid hormone metabolism regulation. " 07/01/1993 - "Results from several studies indicate that total T3 (active thyroid hormone) concentrations are significantly reduced during and after CPB (ie, the euthyroid sick syndrome). " 01/01/2015 - "Changes in thyroid hormone levels, mostly as non-thyroidal illness syndrome (NTIS), have been described in many diseases. " 12/01/2011 - "Disorders in the secretory cycle of follicular thyrocytes and their correction with thyrotropic hormone in experimental non-thyroidal illness syndrome." 05/01/2011 - "During illness changes in thyroid hormone metabolism occur, collectively known as the non-thyroidal illness syndrome (NTIS). "
5.	Thyroid HormonesIBA 12/01/1990 - "During the 10.5-h study TNF produced the characteristic changes in circulating thyroid hormones and TSH observed in the sick euthyroid syndrome. " 01/01/2009 - "In dogs with Cushing's disease, many cases have low serum thyroid hormones concentrations due to euthyroid sick syndrome. " 12/01/2005 - "[Thyroid hormones disturbances in critical ill patients--low T3 syndrome]." 10/01/2000 - "Despite significant intraoperative and postoperative decreases in levels of thyroid hormones, low T3 syndrome was rare in this patient population. " 10/01/1996 - "2) Blood thyroid hormones show the similarity with low T3 syndrome. "
6.	Interleukin-6 (Interleukin 6)IBA 12/01/1996 - "The aim of the present study was to evaluate the role of IL-6 in the development of the sick euthyroid syndrome in IL-6 knock-out (IL-6(-/-)) mice compared to that in wild-type mice (IL-6(+/+)). " 03/01/2000 - "We conclude that euthyroid sick syndrome occurs in patients with AMI and euthyroid sick syndrome may regulated by IL-6 through suppressed of thyroid function." 12/01/1996 - "These findings suggest, but do not prove, a causal role for IL-6 in the development of the low T3 syndrome. " 11/01/1996 - "Interleukin-6 (IL-6), a pleiotropic cytokine, is postulated to be involved in the pathogenesis of sick euthyroid syndrome, although the direct in vitro effects of IL-6 on human thyroid function are controversial. " 12/01/1993 - "We conclude that the low T3 syndrome in nonthyroidial illness is associated with high serum IL-6 levels. "
7.	Thyrotropin (Thyroid-Stimulating Hormone)FDA Link 01/01/2002 - "Baseline thyroid function studies, including T3, reverse T3 (rT3), and thyroid stimulating hormone (TSH) levels, were similar between the two groups and typical of 'euthyroid-sick syndrome'. " 12/01/2011 - "Treatment with thyroid-stimulating hormone normalizing the secretory processes in the follicular thyrocytes is a pathogenetically justified method for correction of non-thyroidal illness syndrome in acute endotoxicosis." 12/08/2000 - "The syndrome of nonthyroidal illness, also known as the sick euthyroid syndrome, is characterized by a low plasma T3 and an "inappropriately normal" plasma thyrotropin in the absence of intrinsic disease of the hypothalamic-pituitary-thyroid axis. " 01/01/2000 - "Baseline thyroid functions, including T3, T4, rT3, and thyroid stimulating hormone (TSH) levels, were equal between the two groups and typical of patients with euthyroid sick syndrome. " 02/01/1998 - "In severe systemic illness and after major surgical procedures changes in thyroid function can occur, leading to the "euthyroid sick syndrome." Patients will have normal or decreased levels of T4, decreased free and total T3, and usually normal levels of thyroid stimulating hormone. "
8.	Thyrotropin-Releasing Hormone (Protirelin)FDA Link 01/01/2004 - "Feedback regulation of thyrotropin-releasing hormone (TRH): mechanisms for the non-thyroidal illness syndrome." 01/01/2006 - "The results of the study suggest that the use of thyroliberin in an acute stage of ischemic stroke prevents development of "low T3 syndrome" that promotes more rapid and essential regress of neurological disturbances." 06/01/1987 - "[Transient impaired thyrotropin response to thyrotropin-releasing hormone in a patient with low T3 syndrome]."
9.	Dopamine (Intropin)FDA LinkGeneric 12/01/1994 - "As a consequence, the sick euthyroid syndrome of severely ill patients receiving dopamine may be not an adaptive mechanism, but a condition of iatrogenic hypothyroidism." 12/01/1994 - "Dopamine infusion appears to induce or aggravate the sick euthyroid syndrome in critical illness. " 12/01/1994 - "We explored the effect of dopamine infusion (5 micrograms/kg/min) on the sick euthyroid syndrome of critically ill patients. " 12/01/1994 - "Dopamine and the sick euthyroid syndrome in critical illness." 11/01/1994 - "The data indicate that dopamine infusion induces or aggravates partial hypopituitarism and the euthyroid sick syndrome in critically ill infants and children."
10.	Epinephrine (Adrenaline)FDA LinkGeneric 06/01/1980 - "The present study suggests that increased tissue exposure to adrenaline might contribute to the hormonal changes seen in at least some case of the 'low T3 syndrome'."

Therapies and Procedures

1.	Hormone Replacement Therapy (Therapy, Hormone Replacement) 10/01/2014 - "To assess the efficacy of thyroid hormone replacement therapy for nephrotic syndrome (NS) patients associated with euthyroid sick syndrome (ESS). " 08/01/2005 - "The presence of a 'low T3 syndrome' in the setting of nonthyroidal illness has long been recognized as the 'euthyroid sick syndrome', with the recommendation to observe and not treat with thyroid hormone replacement therapy. "
2.	Thrombolytic Therapy 11/01/2002 - "The purposes of this study were to assess the occurrence of euthyroid sick syndrome in patients with acute myocardial infarction (AMI) or unstable angina (UA), and the relationship with beta-blocker or thrombolytic therapy. "
3.	Enteral Nutrition (Feeding, Tube) 01/01/2013 - "The aim of this study was to determine if early initiation of oral/enteral nutrition in burn patients minimizes the drop in fT3 levels, reduces the potential for euthyroid sick syndrome (ESS), and shortens the length of hospital stay (LHS). " 01/01/2013 - "The potential association of later initiation of oral/enteral nutrition on euthyroid sick syndrome in burn patients."
4.	Cardiopulmonary Bypass (Heart-Lung Bypass) 01/01/1997 - "The postoperative period after cardiac surgery with cardiopulmonary bypass (CPB) is associated with a low T3 syndrome, i.e. " 12/01/1995 - "Cardiopulmonary bypass temperature does not affect postoperative euthyroid sick syndrome?" 07/01/1991 - "Cardiopulmonary bypass and thyroid function: a "euthyroid sick syndrome"." 01/01/2014 - "Non-thyroidal illness syndrome and cardiopulmonary bypass in children with congenital heart disease." 10/01/1995 - "We concluded that this animal model is a useful model of myocardial injury simulating "euthyroid sick syndrome" as seen in patients with cardiopulmonary bypass, and T3 supplementation after reperfusion significantly enhanced postischemic left ventricular functional recovery but did not affect myocardial oxygen consumption and myocardial infarct size."
5.	Renal Dialysis (Hemodialysis) 07/06/2015 - "Low T3 syndrome and long-term mortality in chronic hemodialysis patients." 06/01/2014 - "Furthermore, euthyroid sick syndrome is associated strongly with mortality in hemodialysis patients. " 07/01/2011 - "Euthyroid sick syndrome and nutritional status are correlated with hyposelenemia in hemodialysis patients." 04/01/2015 - "There is statistically significant difference in the relative representation (percentage) between respondents to 72 months and respondents over 72 months duration of hemodialysis, namely: low T3 syndrome, which is a higher percentage was recorded in patients up to 72 months duration of dialysis (19.23%), then subclinical hypothyroidism where a greater percentage recorded in subjects over 72 months duration of dialysis (35.71%) before transplantation. " 01/01/2011 - "The relationship between T3 and HSCRP suggests that inflammation might be involved in the low T3 syndrome in hemodialysis patients, but we did not find a significant correlation between T3 and HSCRP levels in patients on peritoneal dialysis."