Summary of Euthyroid sick syndrome
Transcript for Euthyroid sick syndrome
Content Reviewers:Rishi Desai, MD, MPH, Yifan Xiao, MD, Tanner Marshall, MS, Evan Debevec-McKenney, Miguel Quintana, MD
Euthyroid sick syndrome
The term euthyroid sick syndrome, also known as nonthyroidal illness syndrome, can be broken down. Eu- refers to good and -thyroid refers to the thyroid gland which produces thyroid hormones.
So, euthyroid sick syndrome is a state where the thyroid gland is functioning normally, but the thyroid hormones are at abnormal levels.
Normally, the hypothalamus, which is located at the base of the brain, secretes thyrotropin-releasing hormone, known as ΤRH, into the hypophyseal portal system - which is a network of capillaries linking the hypothalamus to the anterior pituitary.
The anterior pituitary then releases a hormone of its own, called thyroid-stimulating hormone, thyrotropin or simply TSH.
TSH stimulates the thyroid gland which is a gland located in the neck that looks like two thumbs hooked together in the shape of a “V”.
If we zoom into the thyroid gland, we’ll find thousands of follicles, which are small hollow spheres whose walls are lined with follicular cells, and are separated by a small amount of connective tissue.
Follicular cells convert thyroglobulin, a protein found in follicles, into two iodine-containing hormones, triiodothyronine or T3, and thyroxine or T4.
Once released from the thyroid gland, these hormones enter the blood and bind to circulating plasma proteins.
Only a small amount of T3 and T4 will travel unbound in the blood, and these two hormones get picked up by nearly every cell in the body.
Once inside the cell T4 is mostly converted into T3, and it can exert its effect. T3 speeds up the basal metabolic rate.
T3 increases cardiac output, stimulates bone resorption - thinning out the bones, and activates the sympathetic nervous system, the part of the nervous system responsible for our ‘fight-or-flight’ response.
Thyroid hormone is important - and the occasional increase can be really useful when you need a boost to get through the final rounds of a sporting competition or to stay warm during a snowstorm!
Meanwhile, thyroid hormones are involved in a number of other things, such as normal function of sebaceous and sweat glands, growth of hair follicles and regulation of the synthesis of proteins and mucopolysaccharides by skin fibroblasts.
In euthyroid sick syndrome, even though the thyroid gland is functioning normally, there is still a deficiency of thyroid hormones in the bloodstream, particularly T3.