Euthyroid Hyperthyroxinemia

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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Age / Sex of Euthyroid Hyperthyroxinemia

Older men who are weak or delicate may manifest higher free thyroxine levels.

Causes of Euthyroid Hyperthyroxinemia

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

Sign and symptoms

Thyroid hormone resistance signs include following:
• Goiter
• Nystagmus
• Tachycardia
• Increased metabolic rate
• Deafness
• Liver disease signs include the following:
• Icterus
• Hepatomegaly

Investigations for Euthyroid Hyperthyroxinemia

• Obtain a detailed clinical evaluation
• Measurement of TSH by a third generation assay
• Measurement of free T4


The tumors, such as glucagonoma, islet cell tumors, or estrogen-secreting tumors, may be resectable.


• Most of the conditions are self-limiting.

Differential diagnosis

• Hyperthyroidism

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