Regulation of the thyroid axis during critical illness: a study of the peripheral changes during the low T3 syndrome - exploring safe reactivation strategies.

The aim of the current study is 1) to broaden our knowledge of the pathophysiology of the low T3 syndrome and 2) to study the effect of specific metabolic interventions on the low T3 syndrome in this context. The following interventions will be studied: 1. Impact of hypothalamic releasing factors, 2. Impact of glycemic control and 3. Impact of feeding. We will study the impact of proposed metabolic interventions on thyroid hormone metabolism in vital organ systems and we will do this in clinical studies as well as in our in-vivo animal model. In each interventional study, molecular changes in thyroid hormone signaling pathway will be studied by measuring the expression of specific thyroid hormone transporters, deiodinases, nuclear thyroid hormone receptors and important thyroid hormone regulated genes.

Keywords:Endocrinology, Thyroid axis, Critical illness

Disciplines:Anaesthesiology, Intensive care and emergency medicine, Endocrinology and metabolic diseases