FINE ADJUSTMENT OF THYROXINE REPLACEMENT DOSAGE: COMPARISON OF THE THYROTROPHIN RELEASING HORMONE TEST USING A SENSITIVE THYROTROPHIN ASSAY WITH MEASUREMENT OF FREE THYROID HORMONES AND CLINICAL ASSESSMENT

CARR, D.; MCLEOD, D. T.; PARRY, G.; THORNES, H. M

doi:10.1111/j.1365-2265.1988.tb01219.x

Cited by 210Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryAdrenal Hormones and Disorders

FINE ADJUSTMENT OF THYROXINE REPLACEMENT DOSAGE: COMPARISON OF THE THYROTROPHIN RELEASING HORMONE TEST USING A SENSITIVE THYROTROPHIN ASSAY WITH MEASUREMENT OF FREE THYROID HORMONES AND CLINICAL ASSESSMENT

CARR, D., MCLEOD, D. T., PARRY, G., THORNES, H. M·1988·Clinical Endocrinology

DOI 10.1111/j.1365-2265.1988.tb01219.x

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Abstract

Thyroxine replacement therapy for 21 adult patients with primary hypothyroidism was adjusted to the dosage at which each patient had a normal thyrotrophin (TSH) response to thyrotrophin releasing hormone (TRH). Clinical assessment and measurement of TSH (by sensitive immunoradiometric assay), free thyroxine (FT4) and free tri-iodothyronine (FT3) were made at this dosage and at higher and lower doses of thyroxine. Clinical observations, FT3 and FT4 assays were relatively insensitive to small alterations of thyroxine dosage, in contrast to which basal TSH measurements correlated well with TRH responsiveness and were sensitive to fine adjustments of thyroxine dosage.

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The insufficient peripheral T3 production cannot be appropriately corrected by increasing L-T4 dose, because the inhibitory effect of elevated T4 on D2 will end up increasing the imbalance of serum free T4 to free T3 ratio.
“The in-sufficient peripheral T3 production cannot be appropriately corrected by increasing L-T4 dose, because the inhibitory effect of elevated T4 on D2 [28,30,69] will end up increasing the imbalance of serum free T4 to free T3 ratio [67] .”
From 2012 ETA Guidelines: The Use of L-T4 + L-T3 in the Treatment of Hypothyroidism (2012) · cites this paper as [28]

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Authors: CARR, D., MCLEOD, D. T., PARRY, G., & THORNES, H. M.
Affiliations: University Hospital of North Tees (GB)
Corresponding author: CARR, D.
Venue: Clinical Endocrinology
Publisher: Wiley
Published: 1988-03
Volume: 28
Issue: 3
Pages: 325-333
ISSN: 0300-0664 (ISSN-L)
1365-2265
DOI: 10.1111/j.1365-2265.1988.tb01219.x
OpenAlex: W2036844510
Cited by: 210
References: 1
Citations by year: 2026: 1 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 7 · 2020: 4 · 2019: 6 · 2018: 2 · 2017: 8 · 2016: 9 · 2015: 5 · 2014: 7 · 2013: 4 · 2012: 6
FWCI: 4.35
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 7321 d)
Locations: Clinical Endocrinology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords: thyroxine replacement, dose titration, primary hypothyroidism, free thyroxine, free triiodothyronine
MeSH terms: Adult, Aged, Female, Humans, Hypothyroidism, Male, Middle Aged, Thyroid Hormones, Thyrotropin, Thyrotropin-Releasing Hormone, Thyroxine

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FINE ADJUSTMENT OF THYROXINE REPLACEMENT DOSAGE: COMPARISON OF THE THYROTROPHIN RELEASING HORMONE TEST USING A SENSITIVE THYROTROPHIN ASSAY WITH MEASUREMENT OF FREE THYROID HORMONES AND CLINICAL ASSESSMENT

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