Author Affiliation: Division of Endocrinology, Sinai Hospital of Baltimore and the Johns Hopkins University School of Medicine, Baltimore, Md. Dr Cooper is Contributing Editor, JAMA.
Hormone replacement therapy" was originally reported by Murray, who
in 1891 described the successful treatment of myxedema with injections of
sheep thyroid extract.1 By 1898, therapy for
this chronic, severely debilitating condition was hailed as "unparalleled
by anything in the whole range of curative measures" by Osler.2 Seven
decades later, desiccated thyroid was characterized by the standard thyroid
textbook of the day as ". . . as perfect a form of therapy as any known to
medicine. . . ."3 With the subsequent identification
of thyroxine (T4) and triiodothyronine (T3) as the 2
major thyroid hormones, it was assumed that replacement therapies containing
both compounds were more physiological than treatment with either alone. Thus,
despite the availability of synthetic T4 in the early 1960s, the
prescription of desiccated animal thyroid or synthetic combinations of T4 and T3 continued well into the 1970s.
Cooper DS. Combined T4 and T3 Therapy—Back to the Drawing Board. JAMA. 2003;290(22):3002-3004. doi:10.1001/jama.290.22.3002