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  Vol. 291 No. 12, March 24/31, 2004 TABLE OF CONTENTS
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Synthetic Thyroxine vs Dessicated Thyroid—Reply

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Dr Lichten emphasizes the importance of considering costs when choosing between different medications with similar therapeutic efficacies. However, the objective of our study was to investigate the efficacy of levothyroxine plus liothyronine compared with levothyroxine monotherapy in primary hypothyroidism. We did not assess the efficacy of desiccated thyroid or the cost effectiveness of different thyroid hormone preparations.

If administered as in our study, liothyronine (Cytomel, King Pharmaceuticals, St Louis, Mo) 7.5 µg twice daily, along with levothyroxine, the cost of the liothyronine component alone would be over $100 for a 90-day supply.1 The brand of levothyroxine (Synthroid, Abbott Laboratories, Abbott Park, Ill) we used was simply the brand carried on our institution's pharmacy formulary. To provide thyroid hormone therapy in a similar manner to that used in our study, desiccated thyroid would need to be taken twice daily, since desiccated thyroid does not provide a slow-release form of . . . [Full Text of this Article]

Patrick W. Clyde, MD
pwclyde@mar.med.navy.mil
Naval Medical Center
Portsmouth, Va

Amir E. Harari, MD
Naval Medical Center San Diego
San Diego, Calif

K. M. Mohamed Shakir, MD
National Naval Medical Center
Bethesda, Md


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Synthetic Thyroxine vs Dessicated Thyroid
Edward M. Lichten
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Combined Levothyroxine Plus Liothyronine Compared With Levothyroxine Alone in Primary Hypothyroidism: A Randomized Controlled Trial
Patrick W. Clyde, Amir E. Harari, Eric J. Getka, and K. M. Mohamed Shakir
JAMA. 2003;290(22):2952-2958.
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