Keywords
nonthyroidal illnesses
thyroid hormones
thyroxine
cytokines
phagocytosis
How to Cite
Abstract
In press
Background. The thyroid system is a crucial regulator of homeostasis, influencing energy metabolism, immune responses, and adaptation processes. In clinical practice, the low triiodothyronine (T3) syndrome in non-thyroidal illnesses is often viewed as an adaptive response aimed at reducing energy expenditure. However, a one-sided interpretation of this phenomenon limits the understanding of its sanogenetic role in the immune response, as well as the rationale for using iodine and hormone replacement therapy when adaptive potential is depleted. Recent studies demonstrate that iodine performs not only a structural function in the synthesis of thyroid hormones but also exhibits independent antioxidant and immunomodulatory properties.
Aim. Based on source analysis, to substantiate the sanogenetic significance of the low T3 state during fasting and low T3 syndrome in non-thyroidal illnesses, and to evaluate the prospects for using iodine preparations and T3 replacement therapy as part of comprehensive rehabilitation medicine.
Materials and Methods. The methods of systematic analysis and a bibliosemantic approach were used. Publications from 2015–2025 indexed in PubMed, Scopus, ScienceDirect, EMBASE, Medline, Cochrane Library, and Google Scholar were analyzed. Selection was performed using the following keywords: rehabilitation medicine, non-thyroidal illnesses, thyroid hormones, thyroxine, cytokines, phagocytosis. Reviews, clinical and experimental studies in Ukrainian and English were included in the analysis.
Research Ethics. Preference was given to works adhering to bioethical principles and clinical standards, with a clear design and correct interpretation of results.
Results. Historically, iodine was used for the prevention of endemic goiter, and later in surgery and dermatology due to its antiseptic properties. Modern data confirm its antioxidant and immunomodulatory effects. Two variants of low T3 status have been described in patients: one with normal and one with elevated T3 clearance. The former is associated with fasting and liver damage, the latter with severe conditions such as trauma, infections, ischemia, and cancer pathology. Immune cells are capable of locally regulating thyroid hormone metabolism and iodine transport, which determines their role in adaptation mechanisms.
Conclusions. The low T3 syndrome can have both adaptive and maladaptive significance in non-thyroidal illnesses. Iodine is considered not only a component of thyroid hormones but also an immunomodulatory agent. This provides a basis for further research to determine the optimal strategy for iodine provision and thyroid hormone replacement therapy within modern rehabilitation medicine.
Keywords: rehabilitation medicine, nonthyroidal illnesses, thyroid hormones, thyroxine, cytokines, phagocytosis.
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