{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T08:45:21Z","timestamp":1782722721931,"version":"3.54.5"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Endocrinol Diabetes"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>Euthyroid sick syndrome (ESS) is characterized by abnormal thyroid function tests, most notably a low triiodothyronine (T3) level, occurring in the absence of intrinsic thyroid disease. A 54-year-old woman presented to the endocrinology clinic with a 4-month history of progressive fatigue, lethargy, and new-onset cold intolerance after initiation of semaglutide for weight management. The dose was titrated monthly over 4\u2009months, during which she experienced significant weight loss of 22\u2009kg. Laboratory evaluation revealed a thyroid function profile classic for ESS, with low free T3, low-normal free T4, and a normal thyroid-stimulating hormone (TSH) level that was inappropriately low relative to the reduced T3. After exclusion of primary thyroid and pituitary disorders, a diagnosis of ESS secondary to the catabolic state induced by rapid weight loss was made. The patient was counseled that this represented a physiological adaptation rather than intrinsic thyroid disease. Semaglutide was continued given its metabolic benefits, and nutritional optimization with adequate caloric and protein intake was advised.<\/jats:p>","DOI":"10.1177\/11795514261443862","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T05:27:57Z","timestamp":1776922077000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Euthyroid Sick Syndrome Precipitated By Rapid Weight Loss Following Semaglutide Initiation: A Case Report"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2369-7494","authenticated-orcid":false,"given":"Ziad W.","family":"Elmezayen","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Kafr Elsheikh University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6849-8421","authenticated-orcid":false,"given":"Farah","family":"Qrareya","sequence":"additional","affiliation":[{"name":"Department of Medicine, An-najah National University Faculty of Medicine and Health Sciences, Nablus, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3266-541X","authenticated-orcid":false,"given":"Abdallah","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Department of Medicine, An-najah National University Faculty of Medicine and Health Sciences, Nablus, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5346-9973","authenticated-orcid":false,"given":"Hossam","family":"Salameh","sequence":"additional","affiliation":[{"name":"Department of Medicine, An-najah National University Faculty of Medicine and Health Sciences, Nablus, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1191-9985","authenticated-orcid":false,"given":"Waheed","family":"Qaisi","sequence":"additional","affiliation":[{"name":"Department of Medicine, An-najah National University Faculty of Medicine and Health Sciences, Nablus, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Ganesan K Anastasopoulou C Wadud K. 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