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ARTICLE | March 1979

T4-Thyrotoxicosis

Robert H. Caplan, MD; Anthony S. Pagliara, MD; Gary Wickus, PhD

Arch Intern Med. 1979;139(3):377. doi:10.1001/archinte.1979.03630400091035.

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To the Editor.— We read with interest the article, "T₄-Thyrotoxicosis," by Dorfman and Young in the Archives (138:1016-1017, 1978). In most hyperthyroid patients, the serum concentrations of both thyroxine (T₄) and triiodothyronine (T₃) are elevated. Hyperthyroidism owing to the hypersecretion of T₃ alone ("T₃-toxicosis") is a well-established entity and has been suggested to be a premonitory form of hyperthyroidism.¹ In addition, serum T₃ level is usually elevated to a greater degree, relative to T₄ value in conventional hyperthyroidism. For these reasons, some investigators suggest that the serum T₃ level is the best test for the diagnosis of hyperthyroidism, and several reviewers state that the serum T₃ level is invariably elevated in hyperthyroidism.Dorfman and Young, however, describe a 41-year-old man with well-documented Graves' disease in whom the serum T₃ level was persistently normal and the hyperthyroidism was due

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Caplan RH, Pagliara AS, Wickus G. T4-Thyrotoxicosis. Arch Intern Med. 1979;139(3):377. doi:10.1001/archinte.1979.03630400091035.

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