Elevated TSH – Hypothyroidism
Euthyroid sick syndrome
Early diagnosis and treatment of infantile hypothyroidism with thyroid hormone prevents irreversible mental retardation and growth impairment.
Commonly Encountered Situations
Hashimoto thyroiditis accounts for about 90% of all hypothyroidism cases.
Suggested Additional Lab Testing
T4 is normal and then becomes low preceding a decline in T3.
Antithyroid peroxidase and antithyroglobulin tests are positive.
Ablative hypothyroidism: T4 and T3 are low following a procedure that ablates the thyroid gland.
Infantile hypothyroidism: T4 and T3 are low in a newborn or infant.
Euthyroid sick syndrome
In moderately ill patients, T4 is normal with a low T3, a reverse T3 is elevated, and TSH is normal.
In severely ill patients, T4 is low with a low T3, an elevated reverse T3, and a low TSH.
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