《Treatment of Hypothyroidism-Leonard Wartofsky》经典培训课件.pptVIP

T4 Rx ALONE DOES NOT GUARANTEE EUTHYROIDISMGullo et al., PLoS one 6 (8):e22552; August 2011 Measured FT4, FT3 in 1811 athyreotic pts on LT4 with NL TSH vs. 3875 euthyroid controls Patients had higher FT4/lower FT3 (p = 0.001) Found ~ 20% of patients do not maintain FT4 and FT3 in reference range in spite of NL TSH Reflects inadequate peripheral T4 → T3 deiodination to compensate for missing T3 secretion ? Longterm effects /clinical consequences Athyreotic patients on LT4 with normal TSH Gullo et al., PLoS one 6 (8):e22552; August 2011 % with higher than Normal range FT4 % with lower than n