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SAM's many roles: SAM is the primary methyl donor, used in DNA/RNA methylation, protein modification, and synthesis of neurotransmitters and hormones

18 Patients were randomized to receive 100 mg IV furosemide twice daily, with or without 100 ml of compound hypertonic saline solution (2.8% NaCl with 0.2% KCl and 0.9% MgSO4)

Laboratory markers include suppressed free T3 with normal TSH (euthyroid sick syndrome), elevated cortisol, and in severe cases, low LH and FSH indicating hypothalamic suppression