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Sheldon S. Stoffer, MD; Walter E. Szpunar, PhD
Oakland Internists Associates Southfield, Mich

JAMA. 1986;255(14):1881-1882.

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

To the Editor.—

We have reported in the past on variations in the potency of levothyroxine products. We initially reported that a brand name levothyroxine product (Synthroid) had only 78% of expected potency.¹ We later reported that as a result of improved monitoring and possible changes in product manufacture, this product was more potent and had 100% of expected potency.² Recently, we encountered difficulties in two patients who previously purchased Synthroid in bottles of 1,000 tablets.

Report of Cases.—

CASE 1.—A 13-year-old boy with primary hypothyroidism was taking 0.15-mg tablets of Synthroid daily. He was generally compliant but would occasionally forget to take his medication two to three times per month. His mother had bought a bottle of 1,000 tablets of Synthroid in 1983. When tested in March 1985, his serum free thyroxine index (FTI) was 1.5 (normal, 1.4 to 4.0) and the serum thyroid-stimulating hormone (TSH) value . . . [Full Text PDF of this Article]

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