ReviewJournal of the Endocrine Society2019
Nonthyroidal Illness Syndrome Across the Ages.
Review in Journal of the Endocrine Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Non-thyroidal illness syndrome and isolated low triiodothyronine as prognostic markers in acute illness: a systematic review and meta-analysis.Endocrine · 2026Pooled it
- Thyroid dysfunction risk in systemic lupus erythematosus: a systematic review of case-control studies.Frontiers in immunology · 2026Pooled it
- Effects of oral iodine supplementation in very low birth weight preterm infants for the prevention of thyroid function alterations during the neonatal period: results of a randomised assessor-blinded pilot trial and neurodevelopmental outcomes at 24 months.European journal of pediatrics · 2022Trial
- Early levothyroxine sodium administration and clinical outcomes in patients with sepsis: a MIMIC-IV database analysis.Scientific reports · 2026Article
- The Prognostic Significance of Low-Triiodothyronine Syndrome in Aneurysmal Subarachnoid Hemorrhage.Biomedicines · 2026Article
- Determinants of fatal outcome in septic shock patients with euthyroid sick syndrome.World journal of critical care medicine · 2026Article
- Hypothalamic-Pituitary-Thyroid and Adrenal Axis Modulation in Response to Fetal Porcine Reproductive and Respiratory Virus Infection.Comprehensive Physiology · 2026Article
- Thyroid function and risk of sepsis: a population-based prospective cohort study with traditional and genetic epidemiological analyses.Frontiers in endocrinology · 2026Article
- Non-thyroidal illness syndrome subtypes and mortality in sepsis: associations with thyroid autoantibodies.Frontiers in endocrinology · 2026Article
- Non-thyroidal illness (euthyroid sick) syndrome: Laboratory aspects and clinical significance in critically ill patients and other diseases - A narrative review.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026Review
- Predictors and Mortality Determinants of Non-Thyroidal Illness Syndrome Among Patients in the Medical Intensive Care Unit in Northeastern Tanzania.Clinical medicine insights. Endocrinology and diabetes · 2026Article
- The metabolic response to stress in critical illness: updated review on the pathophysiological mechanisms, consequences, and therapeutic implications.Annals of intensive care · 2025Review
- Critical illness-implications of non-thyroidal illness syndrome and thyroxine therapy.World journal of critical care medicine · 2025Review
- Euthyroid Sick Syndrome as an Index of Prognosis in Severe COVID-19 Disease.Medicina (Kaunas, Lithuania) · 2025Article
- Associations of Free and Reverse Triiodothyronine with Long-Term All-Cause Mortality After Acute Ischemic Stroke and Acute Myocardial Infarction.Journal of clinical medicine · 2025Article
- Developing a nomogram for risk prediction of the low T3 syndrome.Scientific reports · 2025Article
- Association between sensitivity to thyroid hormone and prognosis in septic patients: a retrospective cohort analysis.Frontiers in endocrinology · 2025Article
- Central Hypothyroidism with Cytomegalovirus Infection in an Extremely Preterm Infant: Correspondence.Indian journal of pediatrics · 2024Article
- Low T3World journal of critical care medicine · 2024Article
- Non-thyroidal Illness in Children with Congestive Heart FailureJournal of clinical research in pediatric endocrinology · 2024Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In conditions of acute illness, patients present with reduced plasma T3 concentrations without a concomitant rise in TSH. In contrast, plasma concentrations of the inactive hormone rT3 increase, whereas plasma concentrations of T4 remain low-normal. This constellation of changes, referred to as nonthyroidal illness syndrome (NTIS), is present across all ages, from preterm neonates and over-term critically ill infants and children to critically ill adults. Although the severity of illness strongly correlates with the severity of the NTIS phenotype, the causality of this association remains debated, and pathophysiological mechanisms remain incompletely understood. In the acute phase of illness, NTIS appears to be caused predominantly by an increased peripheral inactivation of thyroid hormones, in which reduced nutritional intake plays a role. Current evidence suggests that these acute peripheral changes are part of a beneficial adaptation of the body to reduce expenditure of energy and to activate the innate immune response, which is important for survival. In contrast, in more severely ill and prolonged critically ill patients, an additional central suppression of the thyroid hormone axis alters and further aggravates the NTIS phenotype. Recent studies suggest that this central suppression may not be adaptive. Whether treatment of this central component of NTIS in prolonged critically ill patients, with the use of hypothalamic releasing factors, improves outcome remains to be investigated in large randomized control trials.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.