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Previous Volume 346:67-68 January 3, 2002 Number 1 Next

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To the Editor: In his Clinical Practice article on subclinical hyperthyroidism (Aug. 16 issue),¹ Toft states that "the choice should be made between a trial of antithyroid drugs and close clinical follow-up." The well-accepted and benign use of beta-blockade pending definitive treatment is not mentioned. In addition, the high failure rates of both propylthiouracil and methimazole² and their potential toxic effects (including potentially fatal agranulocytosis³ and hepatotoxic effects⁴) are not discussed. The use of radioiodine, which is widely recognized as safe and definitive therapy, is mentioned only briefly as an option for secondary treatment.

Lawrence Parker, M.D.
Veterans Affairs . . . [Full Text of this Article]

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