The sick euthyroid syndrome: changes in thyroid hormone serum parameters and hormone metabolism
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While serum T3 levels may decline by 30% and remain within the normal range, tissue T3 may decline by 70-80%, resulting in profound cellular hypothyroidism with normal serum TSH, FT4, and FT3 levels.
“While serum T3 levels may decline by 30%, which is significant, but still within the so-called “normal range”, tissue T3 may decline by 70–80%, resulting in profound cellular hypothyroidism with normal serum TSH, FT4, and FT3 levels”
From Diagnosis and management of treatment-refractory hypothyroidism: an expert consensus report (2017) · cites this paper as [31]
TSH may be a poor indicator of peripheral thyroid levels in conditions such as chronic stress, chronic illness, diabetes, insulin resistance, obesity, leptin resistance, depression, chronic fatigue syndrome, fibromyalgia, premenstrual syndrome, and dieting or weight gain.
“As a result, TSH may be a poor indicator of peripheral thyroid levels in the presence of such conditions.”
From Diagnosis and management of treatment-refractory hypothyroidism: an expert consensus report (2017) · cites this paper as [31]
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- Authors
- Docter, R., Krenning, E. P., de Jong, M., & Hennemann, G.
- Affiliations
- Erasmus MC (NL)
- Corresponding author
- Docter, R.
- ORCID
- Krenning, E. P.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 1993-11
- Volume
- 39
- Issue
- 5
- Pages
- 499-518
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2121588417
- Cited by
- 345
- References
- 242
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 7 · 2022: 12 · 2021: 6 · 2020: 8 · 2019: 12 · 2018: 6 · 2017: 6 · 2016: 10 · 2015: 10 · 2014: 9 · 2013: 12 · 2012: 10
- FWCI
- 3.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- low T3 syndrome, thyroid hormones, serum thyroid hormones, thyroid hormone metabolism
- MeSH terms
- Euthyroid Sick Syndromes, Humans, Thyroid Hormones, Thyrotropin, Thyroxine, Triiodothyronine
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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