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Thyroxine should be tried in clinically hypothyroid but biochemically euthyroid patients

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7096.1764 (Published 14 June 1997) Cite this as: BMJ 1997;314:1764
  1. Gordon R B Skinner, Clinical virologista,
  2. R Thomas, General practitionerb,
  3. M Taylor, General practitionerc,
  4. M Sellarajah, General practitionerd,
  5. S Bolt, General practitionere,
  6. S Krett, General practitionerf,
  7. A Wright, General practitionerg
  1. a Harborough Banks, Old Warwick Road, Lapworth, Warwickshire B94 6LD
  2. b Old Road Surgery, Llanelli, Carmarthenshire SA15 3HR
  3. c 9 East Street, Prittlewell, Southend on Sea, Essex SS2 6LQ
  4. d 115 Humberstone Road, Pype Hayes, Erdington B24 0PY
  5. e Westcotes Health Centre, Leicester LE3 0LP
  6. f 118 Station Road, Hendon, London NN4 3FN
  7. g 57 Chorley New Road, Bolton BL1 4QR

    Editor—We wish to question present medical practice, which considers abnormal serum concentrations of free thyroxine and thyroid stimulating hormone–those outside the 95% reference interval–to indicate hypothyroidism but incorrectly considers “normal” free thyroxine and thyroid stimulating hormone concentrations to negate this diagnosis.1 It is unusual for doctors to start thyroxine replacement in clinically hypothyroid but biochemically euthyroid patients. …

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