The Rates of Utilization of Thyroxine and of Desiccated Thyroid in Man: The Relation Between the Iodine in Desiccated Thyroid and in Thyroxine

Thompson, Willard O.; McLellan, Lawrence L.; Thompson, Patricia J.; Dickie, Lois F. N.

doi:10.1172/jci100492

Cited by 21 publications

(3 citation statements)

References 9 publications

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“…Earlier studies reported that DTE and L-T 4 effectively increased patients' metabolic rates (13)(14)(15)(16)(17). In 1978, a study by Jackson and Cobb (18) evaluated the changes in serum thyroid hormone concentrations when switching from DTE to L-T 4 in 40 patients.…”

Section: Discussionmentioning

confidence: 99%

Desiccated Thyroid Extract Compared With Levothyroxine in the Treatment of Hypothyroidism: A Randomized, Double-Blind, Crossover Study

Hoang

Olsen

Vinh

et al. 2013

The Journal of Clinical Endocrinology &Amp; Metabolism

127

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Section: Discussionmentioning

confidence: 99%

Desiccated Thyroid Extract Compared With Levothyroxine in the Treatment of Hypothyroidism: A Randomized, Double-Blind, Crossover Study

Hoang

Olsen

Vinh

et al. 2013

The Journal of Clinical Endocrinology &Amp; Metabolism

127

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“…These were not designed as superiority trials, their therapeutic goals were the normalization of serum PBI or BMR, and doses were dramatically higher than used today. For example, desiccated thyroid and intravenous l -thyroxine monotherapy normalized BMR, pulse, and body weight in myxedema (29), l -triiodothyronine monotherapy was likewise effective (30), and the potency of l -triiodothyronine exceeded that of l -thyroxine (31). …”

Section: Evidence Of Overtreatment In Early Trialsmentioning

confidence: 99%

The History and Future of Treatment of Hypothyroidism

McAninch¹,

Bianco²

2016

Ann Intern Med

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Thyroid hormone replacement has been used for more than a century to treat hypothyroidism. Natural thyroid preparations (thyroid extract, desiccated thyroid, or thyroglobulin), which contain both thyroxine (T4) and triiodothyronine (T3), were the first pharmacologic treatments available and dominated the market for the better part of the 20th century. Dosages were adjusted to resolve symptoms and to normalize the basal metabolic rate and/or serum protein-bound iodine level, but thyrotoxic adverse effects were not uncommon. Two major developments in the 1970s led to a transition in clinical practice: 1) The development of the serum thyroid-stimulating hormone (TSH) radioimmunoassay led to the discovery that many patients were overtreated, resulting in a dramatic reduction in thyroid hormone replacement dosage, and 2) the identification of peripheral deiodinase-mediated T4-to-T3 conversion provided a physiologic means to justify l-thyroxine monotherapy, obviating concerns about inconsistencies with desiccated thyroid. Thereafter, l-thyroxine mono-therapy at doses to normalize the serum TSH became the standard of care. Since then, a subgroup of thyroid hormone–treated patients with residual symptoms of hypothyroidism despite normalization of the serum TSH has been identified. This has brought into question the inability of l-thyroxine monotherapy to universally normalize serum T3 levels. New research suggests mechanisms for the inadequacies of l-thyroxine monotherapy and highlights the possible role for personalized medicine based on deiodinase polymorphisms. Understanding the historical events that affected clinical practice trends provides invaluable insight into formulation of an approach to help all patients achieve clinical and biochemical euthyroidism.

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“…Means, Lerman and Salter (3), using preparations analyzed for thyroxine by the method of Harington and Randall (4), have concluded from work with myxedema patients that the activity of desiccated thyroid gland is proportional to its total iodine content. Working also with myxedema patients, Thompson, McClellan, Thompson and Dickie (5) reported similar results in their earlier work but more recently (6) have obtained figures that lead them to doubt their first conclusions and to consider that the question remains unanswered.…”

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confidence: 70%

Comparative Calorigenic Action of Normal and Patho-Logical Thyroid Glands Administered in Equi-Thyroxine Doses

Palmer

Leland²

1935

J. Clin. Invest.

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The Rates of Utilization of Thyroxine and of Desiccated Thyroid in Man: The Relation Between the Iodine in Desiccated Thyroid and in Thyroxine

Cited by 21 publications

References 9 publications

Desiccated Thyroid Extract Compared With Levothyroxine in the Treatment of Hypothyroidism: A Randomized, Double-Blind, Crossover Study

Desiccated Thyroid Extract Compared With Levothyroxine in the Treatment of Hypothyroidism: A Randomized, Double-Blind, Crossover Study

The History and Future of Treatment of Hypothyroidism

Comparative Calorigenic Action of Normal and Patho-Logical Thyroid Glands Administered in Equi-Thyroxine Doses

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