title: Changes within the thyroid axis during critical illness.
abstract: Pronounced alterations in plasma thyroid stimulating hormone and thyroid hormone levels occur during critical illness without any evidence for thyroid disease. Plasma T3 decreases and plasma rT3 increases within a few hours after the onset of disease, and the magnitude of these changes is related to the severity and the duration of the disease. This article reviews the mechanisms behind the observed changes, and focuses on the regulation of thyroid hormone deiodination and transport, as well as the potential positive or negative effects for both the acute and the chronic phase of critical illness.
authors.affiliation: Department of Internal Medicine, Room Ee 502, Erasmus University Medical Center, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands. robin.peeters@gmail.com
authors.forename: Robin P
authors.initials: RP
authors.lastname: Peeters
authors.forename: Yves
authors.initials: Y
authors.lastname: Debaveye
authors.forename: Eric
authors.initials: E
authors.lastname: Fliers
authors.forename: Theo J
authors.initials: TJ
authors.lastname: Visser
mesh_terms: D000208:Acute Disease; D001692:Biological Transport; D002908:Chronic Disease; D016638:Critical Illness; D004734:Energy Metabolism / Q000502:physiology; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D009490:Neurosecretory Systems / Q000503:physiopathology*; D013312:Stress, Physiological / Q000188:drug therapy / Q000503:physiopathology*; D013963:Thyroid Hormones / Q000502:physiology*
chemical_list: D013963:Thyroid Hormones