![]() for example, amiodarone and iodine-rich contrast substances can impair peripheral conversion of thyroxine (T4) to triiodothyronine (T3), whereas corticosteroids and dopamine can decrease the secretion of TSH, result fo this low level of TSH in the systemic circulation and that also hinder T4 release, which subsequently reduces T3 conversion 2,3,4. In chronic disease condition, multi-pharmacy also hinder the normal functioning of the thyroid gland. The contributory factors for Euthyroid Sick Syndrome are pro-inflammatory cytokines and other inflammatory mediators, which are responsible for certain changes in hormonal imbalance.Įxperts predict that cytokines or other mediators of inflammation may react with hypothalamus (present in brain where pituitary gland is located) and pituitary (master gland secretes TSH to control T4 and T3 level), the thyroid gland (secretes T4 and T3), and the hepatic deiodinase system (assists in conversion of T4 to T3), as well as on binding of thyroxine to thyroid binding globulin. ![]() But probably certain physiological alterations like peripherally decrease conversion from T4 to T3, reduction of clearance of rT3 synthesized from T4 and reduced binding of thyroid hormones to thyroxine-binding globulin (TBG). The exact pathophysiology is yet now not clear.
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