Abstract
To establish their role in monitoring patients receiving thyroxine replacement biochemical tests of thyroid function were performed in 148 hypothyroid patients studied prospectively. Measurements of serum concentrations of total thyroxine, analogue free thyroxine, total triiodothyronine, analogue free triiodothyronine, and thyroid stimulating hormone, made with a sensitive immunoradiometric assay, did not, except in patients with gross abnormalities, distinguish euthyroid patients from those who were receiving inadequate or excessive replacement. These measurements are therefore of little, if any, value in monitoring patients receiving thyroxine replacement. To stop doing thyroid function tests in these cases would result in considerable savings nationally in the cost of reagents in laboratories using commercial kits.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Allen K. R., Scott R. D., Hewitt J. V., Watson D. Clinical value of a sensitive immunoradiometric assay for TSH. Ann Clin Biochem. 1985 Sep;22(Pt 5):506–508. doi: 10.1177/000456328502200507. [DOI] [PubMed] [Google Scholar]
- Beckett G. J., Kellett H. A., Gow S. M., Hussey A. J., Hayes J. D., Toft A. D. Raised plasma glutathione S-transferase values in hyperthyroidism and in hypothyroid patients receiving thyroxine replacement: evidence for hepatic damage. Br Med J (Clin Res Ed) 1985 Aug 17;291(6493):427–431. doi: 10.1136/bmj.291.6493.427. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bell G. M., Sawers J. S., Forfar J. C., Doig A., Toft A. D. The effect of minor increments in plasma thyroxine on heart rate and urinary sodium excretion. Clin Endocrinol (Oxf) 1983 May;18(5):511–516. doi: 10.1111/j.1365-2265.1983.tb02881.x. [DOI] [PubMed] [Google Scholar]
- Evered D., Young E. T., Ormston B. J., Menzies R., Smith P. A., Hall R. Treatment of hypothyroidism: a reappraisal of thyroxine therapy. Br Med J. 1973 Jul 21;3(5872):131–134. doi: 10.1136/bmj.3.5872.131. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jennings P. E., O'Malley B. P., Griffin K. E., Northover B., Rosenthal F. D. Relevance of increased serum thyroxine concentrations associated with normal serum triiodothyronine values in hypothyroid patients receiving thyroxine: a case for "tissue thyrotoxicosis". Br Med J (Clin Res Ed) 1984 Dec 15;289(6459):1645–1647. doi: 10.1136/bmj.289.6459.1645. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Johansen K., Hansen J. M., Skovsted L. The relationship between levels of thyroid stimulating hormone and of thyroxine and triiodothyronine in blood of hypothyroid patients. Acta Endocrinol (Copenh) 1978 Aug;88(4):691–697. doi: 10.1530/acta.0.0880691. [DOI] [PubMed] [Google Scholar]
- Larsen P. R., Silva J. E., Kaplan M. M. Relationships between circulating and intracellular thyroid hormones: physiological and clinical implications. Endocr Rev. 1981 Winter;2(1):87–102. doi: 10.1210/edrv-2-1-87. [DOI] [PubMed] [Google Scholar]
- Oldfield S., Ramsden D. B., Stephens K. E., Barrington H., Hall R. A., Milles J. J. Conflict between classifications based on free thyroxine and thyroid stimulating hormone concentrations in thyroxine-treated patients. Clin Chim Acta. 1985 Feb 15;145(3):307–311. doi: 10.1016/0009-8981(85)90038-5. [DOI] [PubMed] [Google Scholar]
- Pearce C. J., Himsworth R. L. Total and free thyroid hormone concentrations in patients receiving maintenance replacement treatment with thyroxine. Br Med J (Clin Res Ed) 1984 Mar 3;288(6418):693–695. doi: 10.1136/bmj.288.6418.693. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rendell M., Salmon D. 'Chemical hyperthyroidism': the significance of elevated serum thyroxine levels in L-thyroxine treated individuals. Clin Endocrinol (Oxf) 1985 Jun;22(6):693–700. doi: 10.1111/j.1365-2265.1985.tb00159.x. [DOI] [PubMed] [Google Scholar]
- Stock J. M., Surks M. I., Oppenheimer J. H. Replacement dosage of L-thyroxine in hypothyroidism. A re-evaluation. N Engl J Med. 1974 Mar 7;290(10):529–533. doi: 10.1056/NEJM197403072901001. [DOI] [PubMed] [Google Scholar]
- Toft A. D. Thyroxine replacement treatment: clinical judgment or biochemical control? Br Med J (Clin Res Ed) 1985 Jul 27;291(6490):233–234. doi: 10.1136/bmj.291.6490.233. [DOI] [PMC free article] [PubMed] [Google Scholar]
- WAYNE E. J. Clinical and metabolic studies in thyroid disease. Br Med J. 1960 Jan 2;1(5165):1–11. doi: 10.1136/bmj.1.5165.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wehmann R. E., Nisula B. C. Radioimmunoassay of human thyrotropin: analytical and clinical developments. Crit Rev Clin Lab Sci. 1984;20(3):243–283. doi: 10.3109/10408368409165776. [DOI] [PubMed] [Google Scholar]