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October 4, 1995

Treatment Guidelines for Hyperthyroidism and Hypothyroidism-Reply

Author Affiliations

University of Southern California Los Angeles
The John Hopkins University School of Medicine Baltimore, Md

JAMA. 1995;274(13):1011-1012. doi:10.1001/jama.1995.03530130017010

In Reply.  —Dr Ahmad correctly points out that amiodarone affects thyroid function in certain individuals. However, it was the intent of our article to mention only agents that either alter absorption or metabolism of levothyroxine, a property that amiodarone does not possess. We did not have space to review the clinical presentation, diagnosis, and treatment of all forms of hyperthyroidism, only the most common.In response to Dr Brakke, while our guidelines may not depart in any "radical fashion from current practice," we do emphasize the serum TSH measurement as the best test for screening for thyroid disease, in contrast to some previous recommendations.1 We have no firm data that our guidelines will lead to cost savings since there are no formal economic analyses that examine the diagnosis and management of thyroid disorders. Yet it was the belief of the practicing clinicians on our committee that such savings would

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