Objective: To study transforming growth factor-b1 (TGF-b1) plasma concentrations in elderly patients with nonthyroidal illnesses (NTI). Design: Case-control study. Methods: We measured plasma concentrations of tri-iodothyronine (T 3 ), reverse T 3 (rT 3 ), thyroxine (T 4 ), free T 3 (fT 3 ) and free T 4 (fT 4 ) estimates, TSH, and TGF-b1 in 48 elderly NTI patients consecutively admitted in our Division of Internal Medicine and Metabolic Diseases, and in 11 healthy age-and sexmatched controls. Results: The data on thyroid hormones enabled us to identify three groups: Group A, subjects (8 patients) with T 3 and fT 3 levels comparable to those in controls; Group B, subjects (30 patients) with T 3 and fT 3 levels lower than controls but rT 3 levels comparable to those of controls; Group C, subjects (10 patients) with T 3 and fT 3 levels lower than those of controls and higher rT 3 levels. The patients of Group C showed higher plasma levels of TGF-b1 compared with controls. Moreover, we found a positive correlation between TGF-b1 and rT 3 (r S ¼ 0.38, P < 0.01) in the whole group of NTI patients. Conclusions: Our data seem to confirm the hypothesis that TGF-b1 could play a role in the pathogenesis of some modifications of thyroid function observed in patients with nonthyroidal illnesses.