In Reply.—Dr Rosler mistakenly assumes that this article was a comparison of radioactive iodine therapy with exogenous thyroid hormone treatment. Instead, its purpose was to evaluate these two adjunctive methods of treatment, each on its own merits and not in competition.
I disagree with Dr Rosler's assertion that benefit from thyroid hormone treatment has not been demonstrated. I refer him to the exhaustive review of De Keyser and Van Herle,1 as well as to an animal study performed by Doniach,2 both of which were referenced in my original article. As to the "intense thyrotropin stimulation," it may not exist once the patient has become hyperthyroid, but it certainly can and does exist before that time, particularly if the patient has undergone a total thyroidectomy. Many examples of this have been published, <br/>some referenced in my article. With little or no thyroid tissue remaining after surgery, there will