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"Uremia can cause endocrine dysfunction including decreased tissue conversion of T4 to T3. This can cause a hypothyroid state"

This is from uworld. Is there a particular mechanism to how uremia does this?
 

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Uremia must interfere with the deiodinase somehow. Who knows? Selenium deficiency (the deiodinase is selenium-dependent) can also inhibit peripheral T4 -> T3 conversion...
 
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