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The main reason might be that only few studies have examined TSH, T3, and T4 values concurrently [3].

However, there is some evidence indicating that deficiencies in T4 and TSH are related to functional outcome as well [3, 5, 10].

The long-term dynamics of endocrine alterations after severe brain injury has not been sufficiently investigated yet.

Thus, the present study examines the prognostic value of different thyroid hormones concurrently (T3, T4, and TSH) in a sample of postacute patients undergoing neurological and neurosurgical early rehabilitation (NNER).

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The present study confirms the influence of these general factors.

In addition, an association between thyroid hormones and functional outcome was demonstrated for NNER patients.

The clinic offers treatment in all phases of neurological rehabilitation, ranging from acute patient care (phase A) to medical-occupational rehabilitation (phase E).

Some of the drugs used in acute care or rehabilitation facilities such as glucocorticoids, iodinated contrast agents, propranolol, barbiturates, dopamine, opiates, furosemide, and sulfonamides disrupt the thyroid gland at different levels and may trigger an iatrogenic inhibition of thyroid function [7].

Data regarding the relationship between free T4 or TSH and outcome are not as clear.

There is limited evidence that serum levels of thyroid-related hormones might influence functional outcome in the acute phase of brain damage.

However, the relationship is complex, and the relevance for functional outcome and the question of therapeutic interventions remain the subject of an ongoing debate [1].

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