Euthyroid sick syndrome: Hi I would be grateful... - Thyroid UK

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Euthyroid sick syndrome

Phronsias2 profile image
35 Replies

Hi

I would be grateful for any help.

How long does euthyroid sick syndrome recovery take?

All I can find is

" The recovery from this euthyroid sick syndrome is, at least in part, TSH-dependent, since the prolonged elevation of TSH values preceded and persisted during the normalization of T3 and the elevation of T4 levels. This biphasic pattern of induction of and recovery from the euthyroid sick syndrome may be a general feature of nonthyroidal disease. The euthyroid sick syndrome should be interpreted not only in relation to the presence of nonthyroidal diseases but also in relation to the recovery from these diseases."

Are we talking weeks or months?

Thanks in advance

Frank

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Phronsias2 profile image
Phronsias2
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greygoose profile image
greygoose

I'm not sure you'll find many people with Euthyroid Sick Syndrome on here because - in theory, anyway - it's only temporary.

Funny thing is, I was reading something about it earlier today, but now can't find it! But, it seemed to be saying that the time of recovery depended on why caused it, and when the under-lying illness goes, thyroid hormones with automatically return to normal - but, you have to get rid of the under-lying cause, whatever it is.

Maybe you'll find this thread helpful:

healthunlocked.com/thyroidu...

Phronsias2 profile image
Phronsias2 in reply togreygoose

ThanksMy last dose of 10 micro grams of T3 was Monday morning at 6am, I was on 60 micro grams for 4 or 5 years, 7 weeks ago I could not bring myself to take 3 x 20 micro grams daily, so reduced to 50 then 40 then 20 and finally 10 micro grams, I am having a blood test on Tuesday and results on Thursday.

Thanks again

Frank

greygoose profile image
greygoose in reply toPhronsias2

And, how do you feel now, without T3? Are you sure you actually had Euthyroid Sick Syndrome and not hypothyroidism? Because they all seem to say that treating with T3, under those circumstances, is not advisable.

Phronsias2 profile image
Phronsias2 in reply togreygoose

HiI was severely bullied at work, sacked for £1.60 fraud, won my unfair dismissal case but the bullying continued , I became very ill, I was diagnosed with hypothyroidism but need the job, last march I had a cold which went to my lungs and have been off work since then, A couple of weeks before Christmas I started to feel over medicated, I read chronic stress can cause the high production of cortisol and this interferes with T4 and T3 and reverse T3 can be high. I am no longer in my job and feel really well.

greygoose profile image
greygoose in reply toPhronsias2

So, if I've understood correctly, you have diagnosed yourself with Euthyroid Sick Syndrome. Is that correct?

Do you happen to have your lab results from when you were diagnosed hypothyroid? It would be very interesting to see exactly what was tested and what the results and ranges were.

High levels of cortisol can interfer with conversion of T4 to T3, but you'd already been diagnosed as hypo by that time. Did you actually have your cortisol tested? Forget the rT3, it's not that important.

Phronsias2 profile image
Phronsias2 in reply togreygoose

HiI spoke to my GP about ESS and I am going Tuesday for a blood test, I will look for my lab results

Phronsias2 profile image
Phronsias2 in reply toPhronsias2

My original account here was Phronsias, all my details are on that account,I had trouble accessing that account ,so I opened this account, I just tried to access Phronsias and cant do it,

greygoose profile image
greygoose in reply toPhronsias2

healthunlocked.com/user/phr...

Is that it?

Phronsias2 profile image
Phronsias2 in reply togreygoose

Thats me

greygoose profile image
greygoose in reply toPhronsias2

Well, there's nothing in there about Euthyroid Sick Syndrome. Nor could I find your labs from your diagnosis. So, unless you have some information you haven't given us, I think it was rather a risky thing to reduce and stop your T3 like that. I really do think you have been barking up the wrong tree.

Phronsias2 profile image
Phronsias2 in reply togreygoose

healthunlocked.com/thyroidu..., in this post I give lab results, No mention of ESS because I cant get access to that account, If I am barking up the wrong tree how can I feel well not taking my medication?

greygoose profile image
greygoose in reply toPhronsias2

My last lab test results are:

Free T3 level - 4.6 pmol/L (2.6-5.7)

Free T4 level - 8 pmol/L (9-19)

TSH level - 7.07 mu/L

OK, so when were those labs done? And what were you taking at the time?

No mention of ESS because I cant get access to that account,

How many accounts do you have? You now have access to 'Phronsias' and 'Phronsias2'. Is there another one?

If I am barking up the wrong tree how can I feel well not taking my medication?

Because that's what happens. You take thyroid hormone replacement for a while, you stop taking it - for whatever reason - and you feel so wonderfully well that you become convinced you were misdiagnosed! But it doesn't last. Sooner or later - and I once went for six months feeling well without my THR! - the symptoms come creeping back in. And, those results above say that you were very hypo at that time. So, I don't think those look like the results of someone with ESS.

Another thing, have you had your antibodies tested? It could be that you have Autoimmune Thyroiditis, where levels fluctuate.

Phronsias2 profile image
Phronsias2 in reply togreygoose

HiThanks for taking the time to help me, I ESS question only came to light a few weeks ago,I have not had access to my original account for over a year so you will not find any mention of ESS on that account, I have two accounts on this forum but only have access to this account, as I said information on ESS is difficult to find on the web and outpatients who develop ESS is even harder to find,( for me anyway it is), I do not have the test results to hand you asked for, As long as I feel good and symptom free, I will not take any medication. Thanks again, ps rT3 play a big role in ESS, I can give you a link to a couple of video's I found on youtube but information on ESS is hard to find.

greygoose profile image
greygoose in reply toPhronsias2

You now have access to both your accounts, because I sent you the link.

rT3 doesn't play a big role in anything. rT3 will be high in ESS, certainly, but that doesn't mean it plays any sort of a role. It is inert and is the result of using up excess T4 - which is the body's way of protecting itself. But the rT3 itself doesn't do anything. If you're interested in the latest findings on rT3, have a look at this thread:

healthunlocked.com/thyroidu...

Phronsias2 profile image
Phronsias2 in reply togreygoose

Thanks,I will post my lab results on Thursday when my GP rings me

greygoose profile image
greygoose in reply toPhronsias2

OK Don't forget the ranges! Results without ranges are meaningless because they vary from lab to lab. :)

tattybogle profile image
tattybogle

Basically it's day's/ weeks , rather than weeks/ months... as it's usually to do with critical illness/ injury.

You might find some of the graphs half way down this article of help in understanding Euthyroid Sick Syndrome (NTIS Non Thyroidal Illness Syndrome)

thyroidpatients.ca/2020/02/...

Or, i seem to remember there was a better piece somewhere in Thyroid Patients Canada archives, but i can't find it now

thyroidpatients.ca/home/sit...

Phronsias2 profile image
Phronsias2 in reply totattybogle

Thanks for your reply.

Sweetpeaflower profile image
Sweetpeaflower

Hi,

I am no expert, and here to learn about my own thyroid issues, but I do have a profession where I meet a lot of patients who have been critically ill.

Euthyroid Sick Syndrome (or NTIS as we sometimes say), can manifest itself in such situations, and sometimes also after other kinds of temporary disease/starvation/stress, e g major surgery.

It can be caused by many different things, even selenium deficiency and medications.

The patients I see, that have this, usually recover within a couple of mounths. If they have been very ill, that puts a lot of strain on the whole endocrine system, and as their overall health improves, their nutrition improves, so does their thyroid.

However, if the thyroid symtoms don't get better and/or if blood tests show low levels of free T3, T4 and elevated TSH after 3-6 months, they have to start thyroid medication and then it is usually not "just" NTIS. At least that is how it is dealt with where I work.

Sometimes disease or severe stress is the very starting point for autoimmune disease and the thyroid getting hypo/hyper.

I really hope you will feel better soon!

(Sorry if my English is a little bit unclear, I live in Sweden :-).)

Phronsias2 profile image
Phronsias2 in reply toSweetpeaflower

Thanks,Your English is superb!!!

I am no expert myself, from what I have read, one of the major recovery prerequisites is removal from the stressful environment and it is common for the person like myself to be able to pinpoint a period of time when the illness began, I can not find research on outpatient ESS but chronic stress is a known cause.Also how can I feel well not taking my medication at all for 6 days and 6 weeks on a substantially lower dose eg 20 micro for 4 weeks before.

Thanks again

Frank

Sweetpeaflower profile image
Sweetpeaflower in reply toPhronsias2

Hi,

I really don't know and I can understand that this is confusing for you.

I think some of the more experienced members here can guide you, or try to find a doctor with special interest in endocrinology.

I'm afraid I can only contribute with some overall information on this matter. Wishing you the best of luck.

Batty1 profile image
Batty1

I have found lots of articles talking about Euthyroid Sick Syndrome.

Phronsias2 profile image
Phronsias2 in reply toBatty1

I would be grateful for any links to these articles, preferably outpatients with ESS please

Batty1 profile image
Batty1 in reply toPhronsias2

I have a heck of a time getting links on here 🤷‍♀️ If you copy Euthyroid Sick Syndrome and click the search button you will go right to them Merck Medical has a nice article about it.

merckmanuals.com/profession...

I hope this worked.

Phronsias2 profile image
Phronsias2 in reply toBatty1

Thanks

I have read this already, outpatients with ESS research is like hens teeth.and research on ESS caused by chronic stress is my what I want, 99.9% of what I found on the web is about people already in hospitals with serious illness who develop ESS in Hospital.

Batty1 profile image
Batty1 in reply toPhronsias2

This is the only thing I read about ESS and Stress.

Euthyroid Sick Syndrome is not a disease, but a condition arises due to some underlying disorder that increases physiological stress and responsible for decrease level of Both T3 and T4 level. Therefore, identification and treatment of underlying cause consequently elevate the thyroid hormones level and reduce the risk of related complications.

Direct treatment to elevate the thyroid level by thyroid hormone replacement therapy is not recommended for Euthyroid Sick Syndrome, as some research result showed that this therapy worsens the cardiovascular condition2,3.

Phronsias2 profile image
Phronsias2 in reply toBatty1

Thanks for your help!!!

in reply toPhronsias2

With all due respect, it sounds like you're trying to find research to back up your theory that you have ESS, but given that you've been hypothyroid for a decade, I'd suggest that it is not ESS.

Hypothyroidism can be brought to the fore by stress as well.

I do hope you find a way to keep well.

Phronsias2 profile image
Phronsias2 in reply to

ThanksI just going to have a blood test now, GP should have the results Thursday

Phronsias2 profile image
Phronsias2 in reply to

HiI am open minded at the moment, I have never been able to reduce my T3 successfully in the past, even by 10 micro grams, my life was not worth living for a long time due to a group of people at work and the last time I was in work was March last year, I was offered ill health retirement December and I decided to take it, thats when I started to feel over medicated.

Thanks for trying to help me.

Thenightowl profile image
Thenightowl in reply toPhronsias2

This video was very interesting to me, it is about chronic thyroid issues due to nutritional deficiencies etc becoming more common. I will be interested to see what the pituitary specialist thinks. Best of luck and I hope you find some answers.

m.youtube.com/watch?v=kNvy3...

Phronsias2 profile image
Phronsias2 in reply toThenightowl

HiThanks for the link, I got the bulk of my information from Dr Childs (I think) videos, I also will be interested in what my GP says on Thursday, I did leave a message with my Endo 3 weeks ago but no reply as yet

Thenightowl profile image
Thenightowl

I'm wondering whether this is what I had last year. Seeing a pituitary specialist next week and will then have more private testing. My general health is very variable, with many issues- malabsorption being a major issue due to hypochloridria, etc. Last summer I was poorly, TSH and ft4 were low, but most recent test was ok, they've both increased, and pituitary hormones normal, although testosterone right at bottom of range.

Phronsias2 profile image
Phronsias2

HiA quick update, I just got off the phone with my GP, he wants to see me Monday, my TSH is 17 (range 2.4- 6 ) my T4 is unreadable ().12 ) he is concerned about my kidney filtration and to try and take 10 micro per day and he will see me Monday,

Thanks for all the help!!!!

Frank

Phronsias2 profile image
Phronsias2

HiI would be grateful for any help, I had a blood test last Tuesday, I got a phone call this morning, telling me my GP wants to talk to me by phone next Tuesday, I have been taking 30 micro grams of liothyronine for the past two weeks (I was on 60 ) I asked what my T3 and TSH was, T3 is 8 ( 2.43-6.01) and TSH was 9.99 (0.35-4.94)

I still feel unwell.

Thanks in advance

Frank

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