Similar changes in T3 and Reverse T3 can be seen in starvation. In more severe or prolonged illness there may also be a drop in Total T4 levels. The Free T4 and TSH usually, but not always, remain normal. The Resin T3 is usually normal and does not reflect changes in binding globulins. There is not an adequate explanation for the changes in T4 levels at the present time.
All values return to normal after recovery from the illness.
Replacement with thyroid hormone does not affect the outcome. He has developed pneumonia and is on a respirator. He can not give a history. Exam does not reveal any evidence of hypothyroidism. There is no goiter.