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In the Clinic |


Michael T. McDermott, MD
Ann Intern Med. 2012;157(1):ITC1-1. doi:10.7326/0003-4819-157-1-201207030-01001
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Hyperthyroidism is a clinical state characterized by excessive serum concentrations of thyroxine (T4), triiodothyronine (T3), or both with suppression of serum thyroid-stimulating hormone (TSH) levels. Some observers prefer the term thyrotoxicosis for this condition and restrict the term hyperthyroidism to the types of thyrotoxicosis that are caused when the thyroid gland synthesizes and secretes too much thyroid hormone. To avoid confusion, however, we will consider hyperthyroidism and thyrotoxicosis to be the same and will use only the term hyperthyroidism.

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Table 1 Frequencies of Symptoms and Signs
Posted on July 8, 2012
Howard Homler
Private Practice
Conflict of Interest: None Declared
Table 1 was referenced as from a paper published in 1946... I suspect with our current laboratory testing methods that patients are seen earlier in the disease course. I'm skeptical that the frequencies of symptoms and signs fits current clinical experience. Are there not more recent data?
Endocrinology by the Numbers
Posted on August 31, 2013
Mark Antony LaPorta MD FACP
Private Practice and Locum Tenens
Conflict of Interest: None Declared
As a well-educated and diligent general internist, it is my observation that endocrinologists --"thyroidologists" in particular -- would have us become accountants. This article reinforces that observation. I am dedicated to the concept that my patient is more than numbers, even number representing state and molecules, and I encourage my academic (have you looked up the etymology and definition of that word lately?) colleagues to bear that in mind when treating the body in the seat. To wit: I remain thoroughly unconvinced about "subclinical hypothyroidism" and I maintain that thyrotoxicosis is a clinical and physiological state, not entirely congruent with your numerical measurements.
While we're at it, remember the carpenter's dictum: "measure twice, cut once."
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