Some Aspects of the Diagnosis and Treatment of Hypothyroidism

Abstract

The danger of relying on the B.M.R. for diagnosis of hypothyroidism is emphasized. Determination of the serum PBI level is the single most reliable screening test. When this is invalid because of artifactitious iodine contamination, in vitro tests which measure the uptake of radioactive liothyronine by erythrocytes in whole blood or by a resin combined with serum are useful. In treatment, the advantages of sodium l-thyroxin over thyroid extract are described. Individualization of dosage is essential. Failure to initiate therapy with a low dosage may result in acute psychosis, adrenocortical insufficiency or, most commonly, myocardial ischemia.