What is the role of starvation in the development of euthyroid sick syndrome?

Updated: Aug 28, 2020
  • Author: Serhat Aytug, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Total T4 usually remains unchanged, but thyroidal secretion might be diminished. Free T4 may remain unchanged, or it may elevate due to decreased binding of T4 secondary to an increase in free fatty acids, which elevate during starvation. Serum total T3 and free T3 levels decrease dramatically. rT3 generally is elevated, and basal TSH secretion is diminished. TSH response to TRH also is diminished.

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