triiodothyronine--reverse and Kidney-Diseases

Modern day evaluation of thyroid disorders requires a combination of accurate clinical judgement and reliable, sensitive, and specific thyroid functions tests. Principle among the latter are thyroxine (T4) 3, 5, 3'-triiodothyronine (T3), and thyroid-stimulating hormone (TSH). Also playing an important role in special situations are free thyroxine, an assessment of bound and unbound thyroid-binding globulin, TRH stimulation, long-acting thyroid stimulator (LATS), antibodies to thyroid hormone and to thyroid receptors. Basic to interpretation of these tests in the clinical setting is a comprehension of the relationship of the hypothalamus, the pituitary, and the thyroid gland as well as a knowledge of the peripheral metabolism of thyroxine and triiodothyronine. The role of each of these laboratory tests in the evaluation of hyper- and hypometabolic states, their alteration in nonthyroid and other endocrine disorders, and the effects of environmental and physiological factors on these tests are reviewed.

Topics: Adult; Aged; Autoantibodies; Calcitonin; Choriocarcinoma; Female; Fetus; Hepatitis; Humans; Hyperthyroidism; Hypothalamo-Hypophyseal System; Hypothyroidism; Infant, Newborn; Kidney Diseases; Male; Mental Disorders; Middle Aged; Pregnancy; Stress, Physiological; Thyroglobulin; Thyroid Diseases; Thyroid Function Tests; Thyroid Gland; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Topics: Acute Kidney Injury; Humans; Kidney Diseases; Nephrotic Syndrome; Thyroid Hormones; Thyroxine; Thyroxine-Binding Proteins; Triiodothyronine; Triiodothyronine, Reverse

Topics: Female; Humans; Kidney Diseases; Labor, Obstetric; Liver Diseases; Pregnancy; Thyroid Diseases; Triiodothyronine, Reverse

As first described in serious systemic illnesses isolated decreased T3 plasma concentration was related to impaired peripheral conversion of T4, to T3 with preferential production of reverse T3 (rT3). A "low T3 syndrome" was seen in 47 out of 109 patients with extra-thyroidal diseases. Metabolic state, TSH and TSH responses to TRH were normal despite of low T3 concentration. Euthyroidism seems mainly due to T4 itself in these patients.

Topics: Aged; Anorexia Nervosa; Diet, Reducing; Humans; Hypothyroidism; Kidney Diseases; Liver Cirrhosis; Neoplasms; Obesity; Thyroid Function Tests; Thyrotropin; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse