Euthyroid hyperthyroxinemia is defined as a condition in which the total serum or free thyroxine T4 concentration is abnormal without evidence of clinical thyroid disease.

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[expand title=” Age / Sex of Euthyroid Hyperthyroxinemia ” expanded=”true”]

Older men who are weak or delicate may manifest higher free thyroxine levels.
[/expand][expand title=”Causes of Euthyroid Hyperthyroxinemia ” expanded=”true”]

Physiological causes: Pregnancy, Delayed puberty, Estrogen intake
Hereditary causes
Drugs: Heroin, methadone, perphenazine, Heparin, propranolol etc.
Thyroid  hormone resistance syndrome
Hyperthyroxinemia of systemic illness like liver disease, acute psychosis, islet cell carcinoma, HIV
Miscellaneous
[/expand][expand title=” Sign and symptoms” expanded=”true”]

Thyroid hormone resistance signs include following:
• Goiter
• Nystagmus
• Tachycardia
• Increased metabolic rate
• Deafness
• Liver disease signs include the following:
• Icterus
• Hepatomegaly
[/expand][expand title=” Investigations for Euthyroid Hyperthyroxinemia “]

• Obtain a detailed clinical evaluation
• Measurement of TSH by a third generation assay
• Measurement of free T4
[/expand][expand title=”Treatment “]

The tumors, such as glucagonoma, islet cell tumors, or estrogen-secreting tumors, may be resectable.
[/expand][expand title=”Prognosis “]

• Most of the conditions are self-limiting.
[/expand][expand title=”Differential diagnosis”]

• Hyperthyroidism
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