NORMAL LOW T3 LOW T3-T4 LOW T3 NORMAL TSH rT3 Normal Range TT4 T3 WELL ILLNESS RECOVERY WELL Severity Early Late

High rT3 Low T3 Low T4 CYTOKINES NUTRITION Local Tissue Thyroid Hormone Metabolism High rT3 Low T3 Low T4 rT3 T2 T4 T3 Inhibitor T3 T3S WBC T3 T3AC X

HEALTHY/OUTPATIENT HOSPITALIZED/NTI 1000 1000 100 r = - 0.84 r = 0.22 100 10 10 TSH TSH 1 1 0.1 0.1 0 2 4 6 8 10 12 14 16 0 2 4 6 8 10 12 14 16 FREE T4 FREE T4

WELL ILLNESS RECOVERY WELL NORMAL LOW T3 LOW T3/T4 LOW T3 NORMAL NORMAL RANGE WELL ILLNESS RECOVERY WELL SEVERITY EARLY LATE

TSH < 0.4 mU/L 7.5% TSH < 0.1 TSH < 0.01 6.9% 0.6% 6.9% 0.6% ILLNESS THYROID GLUCOCORTICOID

TSH > 4.5 mU/L 7.5% TSH 4.5 - 20 TSH > 20 5.8% 1.7% 5.8% 1.7% ILLNESS THYROID