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Your suggestion regarding medical suppression rather than ablative therapy for recurrent episodes of this disorder was discussed with my patients in the mid-1970s. As you point out, it would be necessary for patients receiving suppressive doses of thyroid hormone to maintain this therapy after initiating it during the recovery phase from the thyroiditis. I explained this alternative to my patients at that time with recurrent episodes and advised them they would require thyroid hormone indefinitely, since I could predict neither the timing nor the recurrence of the thyroiditis nor could I predict with absolute certainty that this form of therapy would prevent further episodes. One of my initial patients, an internist who had four recurrent episodes, responded with the logic that if he had to take thyroid hormone indefinitely, he might as well have the gland destroyed. Subsequent patients with recurrent episodes were treated with radioactive iodine, since I was
Duick DS. Thyrotoxicosis-Reply. Arch Intern Med. 1981;141(6):819. doi:10.1001/archinte.1981.00340060127041