TY  - JOUR
T1  - THyroid replacement therapy-reply
AU  - Bunner DL
Y1  - 1979/04/01
N1  - 10.1001/archinte.1979.03630410093032
JO  - Archives of Internal Medicine
SP  - 489
EP  - 489
VL  - 139
IS  - 4
N2  - In Reply.— 
    In Dr Klinefelter's letter two questions are raised; first, that clinical response is adequate as a guide in assessing dosage, and second, that cost control is needed and laboratory testing as suggested would raise the costs.I clearly agree that testing does raise the cost initially but I ask the cost of chronic underreplacement or overreplacement in terms of patient survival and in actual dollars. The study on absorption of thyroxine by Hays1 helps to explain why one dosage schedule based on body weight or surface area is not satisfactory. I also note that the findings used in following up patients I tested who were receiving thyroid replacement were, in order, historical and physical findings, then laboratory data. Given the frequency of complaints compatible with mild underreplacement, such as fatigue, coldness, and depression, objective guidelines such as thyroxine and thyroid-stimulating hormone levels are of great help in
SN  - 0003-9926
M3  - doi: 10.1001/archinte.1979.03630410093032
UR  - http://dx.doi.org/10.1001/archinte.1979.03630410093032
ER  -