Thyroid function tests and hypothyroidism: Restoring serum TSH to reference range should be goal of replacement

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7398.1086-b (Published 15 May 2003) Cite this as: BMJ 2003;326:1086
  1. Mark P Vanderpump (mark.vanderpump@royalfree.nhs.uk), consultant physician,
  2. Jayne A Franklyn, professor of medicine
  1. Royal Free Hospital Trust, London NW3 2QG
  2. Division of Medical Sciences, University of Birmingham, Queen Elizabeth Hospital, Birmingham B15 2TH, UK

    EDITOR—The article from Meier et al concludes that judicious initiation of thyroxine treatment in overt hypothyroidism should be guided by clinical and metabolic presentation and thyroid hormone concentrations and not by serum thyroid stimulating hormone concentrations.1 This conclusion seems to contradict overwhelming evidence that serum thyroid stimulating hormone represents the most sensitive …

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