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Combination of Thyroid Medicines Not Necessary
Date:2/19/2008

One medication can do the job of both after thyroid removal surgery, study finds,,,,

TUESDAY, Feb. 19 (HealthDay News) -- Two treatments aren't always better than one, suggests new research comparing thyroid hormone levels before and after thyroid removal surgery.

The study, published in the Feb. 20 issue of the Journal of the American Medical Association, found that when people are only given synthetic levothyroxine (T4) after thyroid removal surgery, their levels of another hormone, triiodothyronine (T3), stay about the same as they were before surgery, suggesting that treatment with additional T3 isn't necessary.

"Basically, each patient's T3 levels remained the same after surgery as it was before," said study author Dr. Jacqueline Jonklaas, an assistant professor of medicine in the division of endocrinology at Georgetown University Hospital in Washington, D.C.

As many as 27 million Americans have some type of thyroid disease, according to the American Association of Clinical Endocrinologists; about half of these people are undiagnosed.

Normally, the thyroid makes two hormones -- T3 and T4. As much as 20 percent of T3 in the blood is directly produced by the thyroid, but the rest is made in tissues outside of the thyroid that convert T4 into T3, according to Jonklaas. Most people who've had their thyroids removed or who have had thyroid tissue destroyed as a result of treatment with radioactive iodine take supplemental T4 produce adequate levels of both hormones and feel fine.

But, said Jonklaas, in a small group of people taking just T4, cognitive problems occur, and experts thought maybe it was because these people were missing the extra dose of T3 normally produced in the thyroid, rather than converted from T4.

To try to alleviate these symptoms, some physicians have prescribed combination therapy that included T4 and T3. Jonklaas said that many clinical studies have been
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