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Fasting in healthy, euthyroid people causes reduced T3 and elevated rT3, although TSH is usually unchanged. [3] [5] [10] Even moderate weight loss can lower T3. [2] This may be primarily via reduced levels of leptin (the satisfaction hormone). Low leptin levels can downregulate hypothalamic TRH neurons and cause a reduction in TSH.
Low-T3 syndrome and high-T3 syndrome: Consequences of step-up hypodeiodination, e.g. in critical illness as an example for type 1 allostasis, [20] or hyperdeiodination, as in type 2 allostasis, including posttraumatic stress disorder. [12] Resistance to thyroid hormone: Feedback loop interrupted on the level of pituitary thyroid hormone receptors.
Polar T 3 syndrome is a condition found in polar explorers, caused by a decrease in levels of the thyroid hormone T 3. [1] [2] Its effects include forgetfulness, cognitive impairment and mood disturbances.
Triiodothyronine can be measured as free triiodothyronine, which is an indicator of triiodothyronine activity in the body. It can also be measured as total triiodothyronine, which also depends on the triiodothyronine that is bound to thyroxine-binding globulin. [18]
Both excess and deficiency of thyroxine can cause disorders. Hyperthyroidism (an example is Graves' disease) is the clinical syndrome caused by an excess of circulating free thyroxine, free triiodothyronine, or both. It is a common disorder that affects approximately 2% of women and 0.2% of men.
Free T4 and total T3 can be measured when hyperthyroidism is of high suspicion as it will improve the accuracy of the diagnosis. Free T4, total T3 or both are elevated and serum TSH is below normal in hyperthyroidism. If the hyperthyroidism is mild, only serum T3 may be elevated and serum TSH can be low or may not be detected in the blood. [14]
As the free amount reflects the amount available to body tissues, the most treatment-relevant measures for thyroid disorders are Free T 3 and Free T 4. [68] Typically, Free T 4 is the preferred test for hypothyroidism, [ 69 ] as Free T 3 immunoassay tests are less reliable at detecting low levels of thyroid hormone, [ 70 ] and they are more ...
Early attempts at titrating therapy for hypothyroidism proved difficult. After hypothyroidism was found to cause a lower basal metabolic rate, this was used as a marker to guide adjustments in therapy in the early 20th century (around 1915). [82] However, a low basal metabolic rate was known to be non-specific, also present in malnutrition. [82]