Can Thyroid Dysfunction Cause Hormonal Imbalance?

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When to suspect that thyroid dysfunction is responsible for a hormonal imbalance, and how to determine whether it is the cause.

Assistant Professor, Department of Medicine, Division of Endocrinology, Mayo Clinic, Jacksonville, FloridaWhen patients present with nonspecific symptoms like fatigue, brain fog, mood changes, weight gain , dry skin, thinning hair, or with just a general complaint of"not feeling well," often they are already concerned about suffering from a"hormonal imbalance.

Second, TSH levels can be abnormal in the context of present or recent acute illness or hospitalization, called sick euthyroid syndrome or nonthyroidal illness syndrome. These levels will normalize spontaneously over a few weeks following the acute illness. For this reason, endocrinologists generally advise against measuring thyroid hormone levels during an acute illness, unless there is a strong clinical suspicion of a thyroid dysfunction.

Following the TSH trend is especially useful when suspecting a diagnosis of subacute thyroiditis. This is the result of a transient, self-limited thyroid inflammatory process, often triggered by an acute illness. In the initial, usually brief, phase, the"leakage" of preformed thyroxine stored in the thyroid parenchyma leads to higher-than-normal blood levels with resultant TSH suppression.

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