How do you decide when to act upon TFT derangements in hospitalized patients (e.g. start/adjust thyroid replacement therapy) vs attribute to NTIS (formerly euthyroid sick syndrome) and advise repeat TFTs as an outpatient?

It is not always easy to discern, but typically in NTIS, T3, T4, and TSH are all low or normal (TSH may be slight elevated but not markedly elevated). True hypothyroid (requiring new medication or adjustments of existing medications) typically has a high TSH and low Free T4, and the patient may have...