iyhderuto skic oymsnerd si emtmeossi ealcdl low" T3 rmdn"eys.o Aosl oyu nowk htta the ptaient si iuyhtedro bueasce hre T4 and SHT ear thnwii hte ncreereef e.gran heS si kic.s

I am rof eosm enrosa erinalgn utaob tsih orf teh rsfti eimt so lIl' rwiet a tib abuto oietuhdyr iskc msyenodr ni eacs ti hepls oemnoes.

tIs' a esdsiae fo oeicxslnu - eth driytho omrneosh aer awkch tbu eth diryoht danlg istlef msees to be tlotyla en.fi cflapyiiS,lce T3 eelvls are l,wo 3rT is hhgi eh(t cviytati of eifftnrde ednsaisoide rae ff,o os r3T is mdea mero nda rddedega e,lss hghtuo ti dn'seot emes ikle teh 3rT lveel sha nay ohetr icinallc a.icos)mnitpli As eht other smcemont hvea oeeinnm,dt TSH nad T4 are tyacplily mnoa,rl thogaluh yteh cna be dcreedase as ellw in eserev .cssae

Ertuydhoi iksc myodsner si ptylyacli due ot na unegryndli calctiri isenlls ro asvtitnrao - the dbyo pstos gnakim the enmsohor sa na rtxeeme ramseeu ot seav yregen dna .osuerresc heT eeatnttmr si ot atrte the rneungyidl i;lelssn rhitoyd mohoenr yrathep is ont emrmendocde as its tesivecfenfse si usicilnvneo.c

In itsh eqiutnos ,emts eth tnpetia hsa na yrninlegud .lslisne erH rodityh dnlag orskw infe dseo(rpsn paaeprpyoltir ot S)T.H sClsica sace fo dtiroueyh scki ynd.oesmr

eGnvi htat ehr 4T vlesle rea loam,nr ew nac elur uot B, ,D dna E. 'Im a udumdm and ptu C aceesbu I dha on eiad wtah ehduiotry skci odeynrms s.aw Btu nivge taht reh HTS elevl si saol nao,lrm sit' nto na usesi thiw the phmtlysuahoa ro yurtptiia ndagl.

oScsu:e(r kiiw apge and this elrctai)

rohdiyEtu ksic nyomserd = lseelv fo T3 draon/ T4 rea ombarlan, tub het ordtyhi ndgla oeds otn paprae to eb itfouynscdln.a The clisclasa opyptnhee of ihts tdnicioon si enoft esne in asortn,avit ciicatrl sleil,sn or ttenpsia ni eht ieintvnes crae nu.it heT tsom nmcomo eoonhrm tnpetar si lwo ottal dan eefr ,T3 ldteeaev T3,r dna olnmra 4T nad TSH e.slvle

In rhyudeoit kisc e,msnyodr rhtee lwli be ramlno ,rT3 owl 3T, dna mnrlao →HST htis is seauecb ni claicrit llesins etrhe is asreedced taicvyti of 21/DD oen5s-denoidmoai yivttaci oyrman(ll 4T → T3, and 3rT → ),T2 dna edrsaicne cttviaiy fo 3D 5' oeaiseodnimdno yaro(lmnl T4 → r)T3

tiaPstne thwi reevse uoythdiEr Skic onyeSdmr may have lwo fere 4T, lwo attlo ,4T DAN wol SHT lseelv

roEyihtud ciks ydnmreos

uDe t:o vseeer iecssmty snillse peisss()

haP:t sockeiytn -LI(,1 NF,aT L-6I) -tg&;- descrdeae rrihpepale desdae5n'oii- *

:Lasb rmnalo S,HT anolmr ,T4 owl ,T3 hghi rT3 e(llcar thta T4 nca be eotrncdev to eeirht 3T ro r3.T)

*ether rae aynm nehcassmim htta dael to sit;h ve,weohr ihts is the smot yaiclilncl nrtevela fro slba