Euthyroid Sick Syndrome
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Euthyroid sick syndrome is not very well understood.

It is a condition where TSH and T3/T4 levels are low, but there is no underlying pathology of the thyroid. These test results are the same as those found in secondary hypothyroidism (i.e. usually caused by a pituitary problem), and as a result, differentiation is difficult.
It is associated with stress, and thus if serum cortisol levels are raised, it is likely that euthyroid sick syndrome is present as opposed to a pituitary problem.
If serum cortisol and gonadotropin levels are low, then secondary hypothyroidism should be suspected.
It often presents in association with an acute illness, and as a result it may be useful to delay diagnosis until the acute episode has passed, as this acute episode could affect thyroid function test results.

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Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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