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Stephen R. Smith, MD
El Paso, Tex

Arch Intern Med. 1980;140(9):1251-1252.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In response to Dr Wiener's letter, we have reexamined our data by calculating a "free T₃ index," T₃ level divided by unsaturated thyroid hormone binding capacity index. From the 32 normal subjects, a range of 77 to 165 ng/dL was determined. From the seven patients with elevated T₃ and normal T₄ levels, a range of 209 to 348 ng/dL was found. Thus, in this particular group, calculation of a free T₃ index did not alter the impression that notable T₃ elevation was present, despite the fact that some of the patients failed to show the suppressed levels of TSH that we find associated with hyperthyroidism. Our conclusion remains unchanged, namely, that among individuals with high T₃ levels and normal T₄ levels, only certain of them merit the diagnosis of "T₃ toxicosis."

Our data are at variance with Dr Wiener's implied suggestion that TSH secretion is controlled largely by free T3. . . . [Full Text PDF of this Article]

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