["Low triiodothyronine (T3) syndrome": "thyroxine (T4) euthyroidism" evidence (author's transl)].Nouv Presse Med. 1979 Feb 03; 8(6):415-9.NP
As first described in serious systemic illnesses isolated decreased T3 plasma concentration was related to impaired peripheral conversion of T4, to T3 with preferential production of reverse T3 (rT3). A "low T3 syndrome" was seen in 47 out of 109 patients with extra-thyroidal diseases. Metabolic state, TSH and TSH responses to TRH were normal despite of low T3 concentration. Euthyroidism seems mainly due to T4 itself in these patients.