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June 15, 1957


JAMA. 1957;164(7):797. doi:10.1001/jama.1957.02980070079020

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To the Editor:—  The discovery of the efficiency of sodium liothyronine ( L-triiodothyronine ) as a metabolic stimulant has been followed by the concept of metabolic insufficiency, which is presumed to be related to failure of peripheral response to thyroxin (L-tetraiodothyronine ). This concept is a useful one on which to base further fundamental studies, but has, in our opinion, been used prematurely as a basis for therapy.The preliminary report entitled "Treatment of Metabolic Insufficiency and Hypothyroidism with Sodium Liothyronine," by Elmore M. Fields, M.D. (J. A. M. A.163:817-821 [March 9] 1957) illustrates an application of this concept to clinical therapeutics. We believe the following comments are worthy of consideration:1. The presence or absence of hypothyroidism could have been better documented. Unless delayed bone age is also behind height age (Talbot, N.B., and others: Functioning Endocrinology from Birth Through Adolescence, Cambridge, Mass., Harvard University Press, 1927, p. 13), it

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