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World J Crit Care Med. Sep 9, 2025; 14(3): 102577
Published online Sep 9, 2025. doi: 10.5492/wjccm.v14.i3.102577
Critical illness-implications of non-thyroidal illness syndrome and thyroxine therapy
Christos Savvidis, Dimitra Ragia, Efthymia Kallistrou, Eleni Kouroglou, Vasiliki Tsiama, Stella Proikaki, Konstantinos Belis, Ioannis Ilias
Christos Savvidis, Dimitra Ragia, Efthymia Kallistrou, Eleni Kouroglou, Vasiliki Tsiama, Stella Proikaki, Konstantinos Belis, Ioannis Ilias, Department of Endocrinology, Hippocration General Hospital, Athens GR-11527, Greece
Co-first authors: Christos Savvidis and Dimitra Ragia.
Author contributions: Savvidis C, Ragia D, and Ilias I designed the research study; Savvidis C, Ragia D, Kallistrou E, Kouroglou E, Tsiama V, Proikaki S, Belis K and Ilias I performed the research; Savvidis C, Ragia D, Kallistrou E, Kouroglou E, Tsiama V, Proikaki S, Belis K and Ilias I wrote the manuscript.
Conflict-of-interest statement: All the Authors declare that they have no conflict of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ioannis Ilias, MD, PhD, Department of Endocrinology, Hippocration General Hospital, 63 Evrou Street, Athens GR-11527, Greece. iiliasmd@yahoo.com
Received: October 23, 2024
Revised: March 17, 2025
Accepted: March 27, 2025
Published online: September 9, 2025
Processing time: 269 Days and 6.8 Hours
Core Tip

Core Tip: Nonthyroidal illness syndrome, common in critically ill patients, disrupts thyroid function through cytokine-driven mechanisms. While thyroid hormone replacement therapy shows potential in certain subgroups, such as in patients with septic shock, evidence on its benefits remains inconclusive. Future research should focus on individualized treatment approaches to improve outcomes.