REFERENCES – REBUTTAL TO PRESCQIPP – BULLETIN 121 – LIOTHYRONINE

1. http://www.tpauk.com/main/article/greater-thyroid-system-table-ud/
2. Escobar-Morreale HF, del Rey FE, Obregon MJ, de Escobar GM. Only the combined treatment with thyroxine and triiodothyronine ensures euthyroidism in all tissues of the thyroidectomized rat. Endocrinology. 1996 Jun;137(6):2490-502
3. Joffe R, Blank DW, Post RM, Uhde TW. Decreased triiodothyronines in depression: A preliminary report. BIOLOGICAL PSYCHI 1985; 20: 922-925.
4. Cooke RG, Joffe RT, Levitt AJ. T3 augmentation of antidepressant treatment in T4-replaced thyroid patients. J CLIN PSYCHI 1992; 53, 1 (Jan): 16-18.
5. Gelenberg AJ. T3 + T4 = success. BIOLOGICAL THERAPIES IN PSYCHI NEWS-LTR 1992; 15, 4 (April): 14.
6. Dommisse J. T3 is at least as important as T4 in all hypothyroid patients.J Clin Psychiatry. 1993 Jul;54(7):277-9.
7. Whybrow PC (1994): The therapeutic use of triiodothyronine and high dose thyroxine in psychiatric disorder. Acta Medica Austriaca 21:47-5
8. CHOPRA IJ: Euthyroid sick syndrome: is it a misnomer? J Clin Endocrinol Metab 82: 329-334, 1997.
9. Sjöberg S, Eriksson M, Werner S, Bjellerup P, Nordin C. L-thyroxine treatment in primary hypothyroidism does not increase the content of free triiodothyronine in cerebrospinal fluid: a pilot study. Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. [email protected]. Scand J Clin Lab Invest. 2011 Feb;71(1):63-7.
10. Devlin WF, Watanabe H. Thyroxin-triiodothyronine concentrations in thryoid powders. J Pharm Sci. 1966 Apr;55(4):390-3
11. Alley RA, Danowski TS, Robbins T JL, Weir TF, Sabeh G, and Moses CL. Indices during administration of T4 and T3 to euthyroid adults. Metabolism. 1968;17(2):97-10
12. Escobar-Morreale HF, Obregon MJ, Escobar del Rey F, Morreale de Escobar G. Replacement therapy for hypothyroidism with thyroxine alone does not ensure euthyroidism in all tissues, as studied in thyroidectomized rats. J Clin Invest. 1995 Dec;96(6):2828-38
13. Asper SP Jr, Selenkow HA, and Plamondon CA. A comparaison of the metabolic activities of 3,5,3-triiodothyronine and l-thyroxine in myxedema. Bull John Hopkins Hosp. 1953; 93: 164
14. Blackburn CM, McConahey WM, Keating FR Jr, Albert A. Calorigenic effects of single intravenous doses of l-triiodothyronine and l-thyroxine in myxedematous persons. J Clin Invest. 1954 Jun;33(6):819-24
15. Gross J, Pitt-Rivers R. Physiological activity of 3:5:3′-L-triiodothyronine. Lancet. 1952 Mar 22;1(12):593-
16. Gross J, Pitt-Rivers R. 3:5:3′-triiodothyronine. 2. Physiological activity. Biochem J. 1953 Mar;53(4):652-7
17. Burroughs V, Shenkman L. Thyroid function in the elderly. Am J Med Sci. 1982, 283 (1): 8-17
18. Carter JN, Eastman CJ, Corcoran JM, and Lazarus L. Inhibition of conversion of thyroxine to triiodothyronine in patients with severe chronic illness. Clin Endocrinol. 1976; 5: 587-94
19. Tulp OL and McKee TD Sr. Triiodothyronine neogenesis in lean and obese LA/N-cp rats. Biochem Biophys Res Communications. 1986; 140 (1): 134-42
20. Katzeff HI, Selgrad C. Impaired peripheral thyroid hormone metabolism in genetic obesity. Endocrinology. 1993; 132 (3): 989-95
21. Croxson MS and Ibbertson HK. Low serum triiodothyronine (T3) and hypothyroidism in anorexia nervosa. J Clin Endocrinol Metab. 1977; 44: 167-73
22. Harns ARC, Fang SH, Vagenakis AG, and Braverman LE. Effect of starvation, nutriment replacement, and hypothyroidism on in vitro hepatic T4 to T3 conversion in the rat. Metabolism. 1978;27(11):1680-90
23. Opstad PK, Falch D, ktedalen O, Fonnum F, and Wergeland R. The thyroid function in young men during prolonged physical exercise and the effect of energy and sleep deprivation. Clin Endocrinol. 1984; 20: 657-6
24. Walfish PG.Triiodothyronine and thyroxine interrelationships in health and disease.Can Med Ass. J 1976, 115: 338-4
25. Feyes D, Hennemann G and Visser TJ. Inhibition of iodothyronine deiodinase by phenolphtalein dyes. Fed Eur Biomed Sci. 1982; 137(1):40-4
26. Bahn AK, Mills JL, Snyder PJ, Gann PH, Houten L, Bialik O, Hollmann L, and Utiger RD. Hypothyroidism in workers exposed to polybrominated biphenyls. N Engl J Med. 1980; 302: 31-
27. Ikeda T, Ito Y, Murakami I, Mokuda O, Tominaga M and Mashiba H. Conversion of T4 to T3 in perfused liver of rats with carbontetrachloride-induced liver injury. Acta Endocrinol. 1986;112: 89-92
28. Paier, B; Hagmller, K; Noli, MI; Gonzalez Pondal, M; Stiegler, C; Zaninovich, AA. Changes induced by cadmium administration on thyroxine deiodination and sulfhydryl groups in rat liver.J Endocrinol. 1993; 138(2):219-22
29. Barregrd L, Lindstedt G, Schtz A, Sllsten G. Endocrine function in mercury exposed chloralkali workers. Occup Envir Med. 1994; 51: 536-40
30. Burger AG, Lambert M, Cullen M. Interfrence de substances mdicamenteuses dans la conversion de T4 en T3 et rT3 chez lhomme. Ann Endocrinol (Paris). 1981,42:461-9
31. Grussendorf M, Hfner M. Induction of the thyroxine to triiodothyronine converting enzyme in rat liver by thyroid hormones and analogs. Clin Chim Acta. 1977;80:61-6
32. Erickson VJ, Cavalieri RR, Rosenberg LL. Thyroxine-5-diodinase of rat thyroid, but not that of liver, is dependent on thyrotropin. Endocrinology. 1982;111:434-40
33. Rezvani I, DiGeorge AM, Dowshen SA, Bourdony CJ. Action of human growth hormone on extrathyroidal conversion of thyroxine to triiodothyronine in children with hypopituitarism. Pediatr Res. 1981;15:6-9
34. Schrder-Van der elst JP, Van der heide D. Effects of streptozocin-induced diabetes and food restriction on quantities and source of T4 and T3 in rat tissues. Diabetes. 1992;41:147-52
35. Gavin LA, Mahon FA, Moeller M. The mechanism of impaired T3 production from T4 in diabetes. Diabetes. 1981;30:694-9
36. Hoover PA, Vaughan MK, Little JC, Reiter RJ. N-methyl-D-aspartate does not prevent effects of melatonin on the reproductive and thyroid axes of male Syrian hamsters. J Endocrinology. 1992;133:51-8
37. Chanoine J-P, Safran M, Farwell AP, Tranter P, Ekenbarger DM, Dubord S, Alex s, Arthur JR, Beckett GJ, Braverman LE, Leonard JL. Selenium deficiency and type II 5-deiodinase regulation in the euthyroid and hypothyroid rat: evidence of a direct effect of thyroxine. Endocrinology. 1992;130:479-84
38. Arthur JR, Nicol F, Beckett GJ. Selenium deficiency, thyroid hormone metabolism, and thyroid hormone deiodinases. Am J Clin Nutr Suppl. 1993; 57:236S-9S
39. Beard J, Tobin B, and Green W. Evidence for thyroid hormone deficiency in iron-deficient anemic rats. J Nutr. 1989;772-8
40. Fujimoto S, Indo Y, Higashi A, Matsuda I, Kashiwabara N, and Nakashima I. Conversion of thyroxine into triiodothyronine in zinc deficient rat liver. J Pediatr Gastroenterol Nutr. 1986;5:799-805
41. Olin KI, Walter RM, and Keen CL. Copper deficiency affects selenoglutathione peroxidase and selenodeiodinase activities and antioxidant defense in weanling rats. Am J Clin Nutr 1994;59:654-8
42. Westgren U, Ahren B, Burger A, Ingemansson S, Melander A. Effects of dexamethasone, desoxycorticosterone, and ACTH on serum concentrations ot thyroxine, 3,5,3-triiodothyronine and 3,3,5-triiodothyronine. Acta Med Scand. 1977;202 (1-2): 89-92
43. Heyma P, Larkins RG. Glucocorticoids decrease the conversion of thyroxine into 3,5,3-triiodothyronine by isolated rat renal tubules. Clin Science. 1982; 62: 215-20
44. Scammell JG, Shiverick KT, Fregly MJ. Effect of chronic treatment with estrogen and thyroxine, alone and combined, on the rate of deiodination of l-thyroxine to 3,5,3-triiodothyronine in vitro. Pharmacology. 1986;33: 52-7
45. Aizawa T, Yamada T. Effects of thyroid hormones, antithyroid drugs and iodide on in vitro conversion of thyroxine to triiodothyronine. Clin Exp Pharmacol Physiol. 1981; 8: 215-25
46. Voss C, Schrober HC, Hartmann N. Einfluss von Lithium auf die in vitro-Deioderung von l-Thyroxin in der Ratten leber. Acta Biol Med Germ. 1977; 36:1061-5
47. Hays MT. Absorption of oral thyroxine in man. J Clin Endocrinol Metab. 1968; 28 (6):749-56
48. Surks MI, Schodlow AR, Stock Jm, Oppenheimer JH. Determination of iodothyronine absorption and conversion of L-thyroxine using turnover rate techniques. J Clin Invest. 1973; 52:809-11
49. Hubbard WK. FDA notice regarding levothyroxine sodium. Federal register. 1997; 62(157): 1-10
50. Peran S, Garriga MJ, Morreale de Escobar G, Asuncion M, Peran M. Increase in plasma thyrotropin levels in hypothyroid patients during treatment due to a defect in the commercial preparation . J Clin Endocrinol Metab. 1997;82(10):3192-5
51. Selivonenko VG, Zaika IV. The function of the thyroid and thyrotropic function in patients with chronic ischemic heart disease and rhythm disorders. Lik Sprava. 1998 Jan-Feb;(1):81-3
52. Inama G, Furlanello F, Fiorentini F, Braito G, Vergara G, Casana P. Arrhythmogenic implications of non-iatrogenic thyroid dysfunction. G Ital Cardiol. 1989 Apr;19(4):303-10 (Hypothyroidism in patients with hyperkinetic ventricular arrhythmias (25%), atrial fibrillation (37.5%) and atrio-ventricular block (37.5%))
53. Vanin LN, Smetnev AS, Sokolov SF, Kotova GA, Masenko VP. Thyroid function in patients with ventricular arrhythmia. Kardiologiia. 1989 Feb;29(2):64-7 (Hyperthyroidism was diagnosed in 4.8% of 21 patients with persistent ventricular arrhythmias, and latent hypothyroidism was diagnosed in 38.1%)
54. Nesher G, Zion MM. Recurrent ventricular tachycardia in hypothyroidism==report of a case and review of the literature. Cardiology. 1988;75(4):301-6
55. Fredlund BO, Olsson SB. Long QT interval and ventricular tachycardia of “torsade de pointe” type in hypothyroidism. Acta Med Scand. 1983;213(3):231-5
56. Miura S, Iitaka M, Suzuki S, Fukasawa N, Kitahama S, Kawakami Y, Sakatsume Y, Yamanaka K, Kawasaki S, Kinoshita S, Katayama S, Shibosawa T, Ishii J. Decrease in serum levels of thyroid hormone in patients with coronary heart disease. Endocr J. 1996 Dec;43(6):657-6
57. Cerillo AG, Bevilacqua S, Storti S, Mariani M, Kallushi E, Ripoli A, Clerico A, Glauber M. Free triiodothyronine: a novel predictor of postoperative atrial fibrillation. Eur J Cardiothorac Surg. 2003 Oct;24(4):487-92
58. Telkova IL, Tepliakov AT. Changes of thyroid hormone levels in the progression of coronary artery disease. Arteriosclerosis. Klin Med (Mosk). 2004;82(4):29-34
59. Pavlou HN, Kliridis PA, Panagiotopoulos AA, Goritsas CP, Vassilakos PJ. Euthyroid sick syndrome in acute ischemic syndromes. Angiology. 2002 Nov-Dec;53(6):699-707
60. Pimenov LT, Leshchinskii LA. Thyroid hormone changes (iodothyroninemia) in patients with acute myocardial infarction, and their clinical significance. Kardiologiia. 1984 Oct;24(10):74-7
61. Satar S, Seydaoglu G, Avci A, Sebe A, Karcioglu O, Topal M. Prognostic value of thyroid hormone levels in acute myocardial infarction: just an epiphenomenon? Am Heart Hosp J. 2005 Fall;3(4):227-33
62. Zoncu S, Pigliaru F, Putzu C, Pisano L, Vargiu S, Deidda M, Mariotti S, Mercuro G. Cardiac function in borderline hypothyroidism: a study by pulsed wave tissue Doppler imaging. Eur J Endocrinol. 2005 Apr;152(4):527-33 (namely impairment of systolic ejection, a delay in diastolic relaxation and a decrease in the compliance to the ventricular filling. Several significant correlations were found between the parameters and serum-free T(3) and T(4) and TSH concentrations. Data strongly support the concept of a continuum spectrum of a slight thyroid failure in autoimmune thyroiditis)
63. Khaleeli AA, Memon N. Factors affecting resolution of pericardial effusions in primary hypothyroidism: a clinical, biochemical and echocardiographic study. Postgrad Med J. 1982 Aug;58(682):473-6 =
64. Reza MJ, Abbasi AS. Congestive cardiomyopathy in hypothyroidism. West J Med. 1975 Sep;123(3):228-30
65. Rays J, Wajngarten M, Gebara OC, Nussbacher A, Telles RM, Pierri H, Rosano G, Serro-Azul JB. Long-term prognostic value of triiodothyronine concentration in elderly patients with heart failure. Am J Geriatr Cardiol. 2003 Sep-Oct;12(5):293-7 (Lower serum T3 in cardiac failure: the odds ratio for events was 9.8 (95% confidence interval,2.2-43, p=0.004) for patients in the lowest tertile of triiodothyronine, that is, lower than 80 ng/dL, compared with patients with levels above 80 ng/dL)
66. Pingitore A, Landi P, Taddei MC, Ripoli A, L’Abbate A, Iervasi G. Triiodothyronine levels for risk stratification of patients with chronic heart failure. Am J Med. 2005 Feb;118(2):132-6
67. Klein I, Ojama K. In: Werner & Ingbars The Thyroid, ed. Braverman LE & Utiger RD, Lippincott-Raven Publishers, Philadelphia, 1996, 62: 799-804
68. Hamilton MA, Stevenson LW, Luu M, Walden JA. Altered thyroid hormone metabolism in advanced heart failure. J Am Coll Cardiol. 1990 Jul;16(1):91-5
69. Kozdag G, Ural D, Vural A, Agacdiken A, Kahraman G, Sahin T, Ural E, Komsuoglu B. Relation between free triiodothyronine/free thyroxine ratio, echocardiographic parameters and mortality in dilated cardiomyopathy. Eur J Heart Fail. 2005 Jan;7(1):113-8
70. Wortsman J, Premachandra BN, Chopra IJ, Murphy JE. Hypothyroxinemia in cardiac arrest. Arch Intern Med. 1987 Feb;147(2):245-8
71. Iervasi G, Pingitore A, Landi P, Raciti M, Ripoli A, Scarlattini M, L’Abbate A, Donato L. Low-T3 syndrome: a strong prognostic predictor of death in patients with heart disease. Circulation. 2003 Feb 11;107(5):708-13
72. Corrective thyroid therapy is safe in hypothyroid patients with common benign cardiac arrhythmias at the condition that thyroid treatment is started at low doses and then gradually and prudently increased to the adequate dose. The treatment does not trigger an increase in arrhythmia frequency except in rare patients with baseline atrial premature beats. It is, however, associated with an increase in basal, average and maximal heart rates
73. Polikar R, Feld GK, Dittrich HC, Smith J, Nicod P. Effect of thyroid replacement therapy on the frequency of benign atrial and ventricular arrhythmias. J Am Coll Cardiol. 1989 Oct;14(4):999-1002
74. Yamauchi K, Takasu N, Ichikawa K, Yamada T, Aizawa T. Effects of long-term treatment with thyroxine on pituitary TSH secretion and heart action in patients with hypothyroidism. Acta Endocrinol (Copenh). 1984 Oct;107(2):218-24 (T4 doses should be adjusted to maintain normal ET/PEP (systolic time intervals) rather than normal serum TSH levels)
75. Barnes BO. Prophylaxis of ischaemic heart-disease by thyroid therapy. Lancet. 1959 Aug 22;2:149-52
76. Holland FW 2nd, Brown PS Jr, Clark RE. Acute severe postischemic myocardial depression reversed by triiodothyronine. Ann Thorac Surg. 1992 Aug;54(2):301-5
77. Israel M. An effective therapeutic approach to the control of atherosclerosis illustrating harmlessness of prolonged use of thyroid hormone in coronary disease. Am J Dig Dis. 1955 June;161-8
78. Yokoyama Y, Novitzky D, Deal MT, Snow TR. Facilitated recovery of cardiac performance by triiodothyronine following a transient ischemic insult. Cardiology. 1992;81(1):34-45
79. Perk M, ONeill BJ; The effect of thyroid therapy on angiographic artery disease progression. Can J Card. 1997;13(3):273-6
80. Zondek H. Myxedema Heart. Munch Med Wochenschr. 1918, 65: 1180-3Novitzky D, Fontanet H, Snyder M, Coblio N, Smith D, Parsonnet V. Impact of triiodothyronine on the survival of high-risk patients undergoing open heart surgery. Cardiology. 1996 Nov-Dec;87(6):509-15.
81. Novitzky D, Cooper DK, Chaffin JS, Greer AE, DeBault LE, Zuhdi N. Improved cardiac allograft function following triiodothyronine therapy to both donor and recipient. Transplantation. 1990 Feb;49(2):311-6
82. Yao J, Eghbali M. Decreased collagen mRNA and regression of cardiac fibrosis in the ventricular myocardium of the tight skin mouse following thyroid hormone treatment. Cardiovasc Res. 1992 Jun;26(6):603-7
83. Facktor MA, Mayor GH, Nachreiner RF, D’Alecy LG. Thyroid hormone loss and replacement during resuscitation from cardiac arrest in dogs. Resuscitation. 1993 Oct;26(2):141-6
84. Shigematsu H, Shatney CH. The effect of triiodothyronine (T3) and reverse triiodothyronine (rT3) on canine hemorrhagic shock. Nippon Geka Gakkai Zasshi. 1988 Oct;89(10):1587-93.
85. Leslie J. De Groot. Dangerous Dogmas in Medicine: The Nonthyroidal Illness Syndrome. The Journal of Clinical Endocrinology & Metabolism January 1, 1999 vol. 84 no. 1 151-164
86. Chester Ridgway et.al. The Colorado Thyroid Disease Prevalence Study. Arch Intern Med. 2000;160:526-534.
87. O‘Reilly DS. Thyroid function tests-time for a reassessment. BMJ. 2000;320:13324.
88. Gullo D, Latina A, Frasca F, Le Moli R, Pellegriti G, et al. (2011) Levothyroxine Monotherapy Cannot Guarantee Euthyroidism in All Athyreotic Patients. PLoS ONE 6(8): e22552. doi:10.1371/journal.pone.0022552
89. Turner S. ‘Too Close for Comfort’. Thyroid Patient Advocacy. http://www.tpauk.com/main/article/too-close-for-comfort/
90. The Royal College of Physicians – http://www.rcplondon.ac.uk/sites/default/files/the-diagnosis-and-management-of-primary-hypothyroidism-revised-statement-14-june-2011_2.pdf
91. British Thyroid Association Summer Newsletter

http://www.british-thyroid association.org/news/BTA_Newsletter_JULY_2015.pdf

92. Goodwin J.S. The Tomato Effect..Rejectyion of Highly Effecatious Therapies..JAMA 1984; 251-18.2837-
93. Drug-company influence on Medical Education USA ; Lancet 2000;356 (9232)
94. The SIGN Guide to the AGREE guideline appraisal instrument. http://www.sign.ac.uk/methodology/agreeguide/index.html.
95. Bolitho v City and Hackney Health Authority [1997] 4 All ER 771.
96. Popper KR, Conjectures and Refutations, 1963, pgs 33-39 excerpted on the internet atand reprinted Routledge Classics, 2003, pgs 43-51
97. US Food and Drug Administration. Center for Drug Evaluation and Research. Equivalence of Levothyroxine Sodium Products. Joint Public Meeting (Cosponsored with the American Thy­roid Association, and the American Association of Clinical Endocrinologists). Retrieved from: [http://www.fda.gov/downloads/Drugs/Drug­Safety/PostmarketDrugSafetyInformationforPa­tientsandProviders/UCM161288.doc].
98. Wilson, I.C., Prange, A.J. Jr., and Lara, P.P. L-triiodothyronine alone and with impramine in the treatment of depressed women. In The Thyroid Axis, Drugs, and Behavior. Edited by A.J. Prange. New York, Raven Press, 1974, pp.49-62.
99. Altshuler, L.L., Bauer, M., Frye, M.A., et al. Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature. J. Psychiatry, 2001; 158:1617-1622.
100. Joffe, R.T. and Singer, W. A comparison of triidothyronine and thyroxine in the potentiation of tricyclic antidepressants. Psychiatry Res., 1990, 32:241-251.
101. Stern, R.A., Nevels, C.T., Shelhorse, M.E., et al. Antidepressant and memory effects of combined thyroid hormone treatment and electroconvulsive therapy: preliminary findings. Psychiatry, 1991, 30:623-627.
102. Lowe, J.C. The Metabolic Treatment of Fibromyalgia. Boulder: McDowell Publishing Co., 2000.
103. Lowe, J.C. and Honeyman-Lowe, G. Fibromyalgia and thyroid disease. Paper presented in Grenoble, France, May 6 (conference of the French Fibromyalgia Association of Rgion Rhne-Alpes) and discussed in Toulon, France on May 11 (at the Centre Hospitalier Intercommunal), 2000.
104. Lowe, J. Thyroid disease and fibromyalgia syndrome. Lyon Mditerrane Mdical: Mdecine du Sud-Est., 2000, 36(1):15-17, (Janvier, Fvrier, Mars) 2000.
105. Goichot, B. and Schlienger, J.L. “Les indications extrathyroVdiennes des traitements par hormones thyroVdiennes.” Md. Interne, 1998, 19:720-725
106. Dyke, C.M., Yeh, T., Jr., Lehman, J.D., et al. “Triiodothyronine-enhanced left ventricular function after ischemic injury.” Thorac. Surg., 1991, 52:14-19.
107. Klemperer, J.D., Zelano, J., and Helm, R.E. “Triiodothyronine improves left ventricular function without oxygen wasting effects after global hypothermic ischemia.” Thorac. Cardiovasc., 1995, Surg., 109:457-465.
108. Vavouranakis, I., Sanoudos, G., Manios, A., et al. “Triiodothyronine administration in coronary artery bypass surgery: Effect on hemodynamics.” Cardiovasc. Surg. (Torino), 35(5):383-389, Oct., 1994.
109. Wechsler, A.S., Kadletz, M., Ding, M., et al. “Effects of triiodothyronine on stunned myocardium.” Card. Surg., March 1993, 8 (Suppl.2): 338-341.
110. Salter, D.R. “Acute severe post-ischemic myocardial depression reversed by triiodothyronine.” Thorac. Surg., August 1992, 54(2):301-305.
111. Hamilton, M.A., Stevenson, L.W., Fonarow, G.C., et al. “Safety and hemodynamic effects of intravenous trio othyronine in advanced congestive heart failure.” Cardiol., 1998, 81(4):443-447
112. Pearch, C.J. and Himsworth, R.L. “Total and free thyroid hormone concentration in patient receiving maintenance replacement treatment with thyroxine.” Med. J., 1984, 288: 693-695.
113. Burman, K.D. and Wartofsky, L. “Thyroid function in the intensive care unit setting.” Care Clin., Jan 2001; 17(1):43-57.
114. Weetman A.P. Whose thyroid hormone is it anyway? Clinical Endocrinology, March 2006.Volume 64: pp 231-233 (3).
115. Lowe, J.C., Garrison, R., Reichman, A., Yellin, J., Thompson, M., and Kaufman, D. “Effectiveness and safety of T3 therapy for euthyroid fibromyalgia: a double-blind, placebo controlled response-driven crossover study.” Bull. Myofascial Ther., 1997, 2(2/3):31-57
116. Lowe, J.C., Garrison, R., Reichman, A., and Yellin, J. Triiodothyronine (T3) treatment of euthyroid fibromyalgia: a small-n replication of a double-blind placebo-controlled crossover study. Bull. Myofascial Ther., 1997, 2(4):71-88.
117. Lowe, J.C., Reichman, A., and Yellin, J. The process of change with T3 therapy for euthyroid fibromyalgia: a double-blind placebo-controlled crossover study. Bull. Myofascial The1997, 2(2/3):91-124.
118. Bunevicius, R. and Prange, A.J. Mental improvement after replacement therapy with thyroxine plus triiodothyronine: Relationship to cause of hypothyroidism. J. Neuropsychopharmacol., June 2000, 3(2):167-174.
119. Saravanan, P., Chau, W.F., Roberts, N., et al. Psychological well-being in patients on adequate doses of L-thyroxine: Results of a large, controlled community-based questionnaire study. Endocrinol. (Oxf.), 2002, 57(5):577-585.
120. Kaplan M.M., Swartz S.L., Larsen P.R. Partial peripheral resistance to thyroid hormones. J. Med., 1981, 70: 1115-1121.
121. Lowe, J.C., Reichman, A., Yellin, J. A case-control study of metabolic therapy for fibromyalgia: long-term follow-up comparison of treated and untreated patients (abstract). Bull. Myofascial Ther., 1998, 3(1):23-24.
122. P Saravanan, C M Dayan. ‘Understanding Thyroid Hormone Action and the Effects of Thyroid Hormone Replacement – Just the Beginning Not the End’., Integrative Neuroscience and Endocrinology, University of Bristol: http://www.hotthyroidology.com/editorial_135.html
123. Wallace M: UK guidelines for the use of thyroid function tests. British Thyroid Association, British Thyroid Foundation, Assoc Clin Biochem, 2006. Retrieved from: [http://www.british-thyroid-association.org/info-for-patients/Docs/TFT_guide­line_final_version_July_2006.pdf].
124. British Thyroid Association. Hypothyroidism – clinical features and treatment. Retrieved from: [http://www.british-thyroid-association.org/info-for-patients/Docs/bta_patient_hypothyroidism.pdf].
125. Vanderpump MPJ, Ahlquist JAO, Franklyn JA, et al: Consensus statement for good practice and au­dit measures in the management of hypothyroid­ism and hyperthyroidism. BMJ, 1996; 313(7056): 539-544.
126. Jonklaas J, Bianco AC, Bauer AJ, et al: Guidelines for the treatment of hypothyroidism. American Thyroid Association Task Force on Thyroid Hor­mone Replacement. Thyroid, 2014; 24: 1670-1751. Retrieved from: [http://online.liebertpub.com/doi/pdf/10.1089/thy.2014.0028].
127. Garber JR, Cobin RH, Gharib H, et al: Clinical practice guidelines for hypothyroidism in adults. (Co-sponsored by the American Association of Clinical Endocrinologists and the American Thy­roid Association, published jointly in Thyroid and Endocrine Practice). Endocr Pract, 2012; 11: 1-207.
128. Baskin HJ: Medical guidelines for clinical practice for the evaluation and treatment of hyperthyroid­ism and hypothyroidism. Am Assoc Clin Endo­crinol, 2002; 2006 Amended Version. Retrieved from: [www.aace.com/files/hypo_hyper.pdf].
129. Singer PA, Cooper DS, Levy EG, et al: Treatment guidelines for patients with hyperthyroidism and hypothyroidism. (Standards of Care Committee, American Thyroid Association.) JAMA, 1995; 273: 808-812.
130. Kaplan MM: Clinical perspectives in the diagnosis of thyroid disease. Clin Chem, 1999; 45: 1377-1383.

Joint Committee on Higher Medical Training, Higher Medical Training Curriculum for Endocrinology and Diabetes Mellitus,2003

131. Pritchard EK: Reducing the Scope of guidelines and policy statements in hypothyroidism. J Orthomol Med, 2013; 28(2): 75-86.
132. Turner S. Thyroid Patient Advocacy. TPA Hypothyroid Patient Survey http://www.tpauk.com/main/article/publication-of-tpa-hypothyroid-patient-survey/
133. AL, Kendall MJ. Causality assessment of adverse effects: when is re-challenge ethically acceptable? Drug Saf. 2001;24(11):793-9
134. Pritchard, EK, MSc.Metis Research, Inc., ‘Survey Finds Thousands of Patient Counterexamples Disputing the Enforced Proscription of All Triiodothyronine Containing Therapies’. JOM.Volume 30, Number 1, 201
135. Onyebuchi Okosieme, Jackie Gilbert, Prakash Abraham, Kristien Boelaert, Colin Dayan, Mark Gurnell,Graham Leese, Christopher McCabe, Petros Perros, Vicki Smith, Graham Williams and Mark Vanderpump: Management of Primary Hypothyroidism: statement by the British Thyroid Association Executive Committee. Clinical Endocrinology (2015)
136. Goldberg M, The Case For Euthyroid Hypometabolism, Am J Med Sc October, 1960 pgs 479-493
137. Goldberg M, Diagnosis of Euthyroid Hypometabolism, Am J Obst & Gynec, 81(5): 1053-1058, 1961
138. Baisier, WV, Hertoghe, J., B, Eekhaut, W., Thyroid Insufficiency? Is Thyroxine the Only Valuable Drug?, Journal of Nutritional and Environmental Medicine, Vol. 11, No. 3, September 2001, pages 159-166
139. Braverman LE, Ingbar SH, Keinwem S, Conversion of Thyroxine (T4) to Triiodothyronine (T3) in Athyreotic Human Subjects, The J Clin Invest, 1970
140. BRUCE H. COHEN, MD, DEBORAH R. GOLD, MD. What we know so far.Cleveland Clinic Journal of Medicine Volume 68.No 7; July 2001
141. Dillman E, Gale C, Green W, et al. Hypothermia in iron deficiency due to altered triiodithyroidine metabolism. Regulatory, Integrative and Comparative Physiology 1980;239(5):377-R381.
142. Smith SM, Johnson PE, Lukaski HC. In vitro hepatic thyroid hormone deiodination in iron-deficient rats: effect of dietary fat. Life Sci 1993;53(8):603-9.
143. Zimmermann MB, Köhrle J. The Impact of Iron and Selenium Deficiencies on Iodine and Thyroid Metabolism: Biochemistry and Relevance to Public Health. Thyroid 2002;12(10): 867-78.
144. Jabbar A, Yawar A, Waseem S, Islam N, Ul Haque N, Zuberi L, Khan A, Akhter J. Vitamin B12 deficiency common in primary hypothyroidism. Department of Medicine, Aga Khan University, Karachi, Pakistan. 2008 May;58(5):258-61.
145. Julia Bársony, P. Lakatos, J. Földes and T. Fehér. Effect of vitamin D3 loading and thyroid hormone replacement therapy on the decreased serum 25-hydroxyvitamin D level in patients with hypothyroidism: Acta Endocrinol November 1, 1986 113 329-334
146. CATARGI, F. PARROT-ROULAUD, C. COCHET, D. DUCASSOU, P. ROGER, and A. TABARIN. Thyroid. December 1999, 9(12): 1163-1166. doi:10.1089/thy.1999.9.1163. Published in Volume: 9 Issue 12: January 30, 2009
147. Bjørn G. Nedrebø, Ottar Nygård, Per M. Ueland, and Ernst A. Lien; Plasma Total Homocysteine in Hyper- and Hypothyroid Patients before and during 12 Months of Treatment. Clinical Chemistry September 2001 vol. 47 no. 9 1738-1741
148. JOHN E. JONESt PAUL C. DESPER, STANLEY R. SHANE, AND EDMUND B. FLINK .Magnesium Metabolism in Hyperthyroidism and Hypothyroidism: Journal of Clinical Investigation. Vol. 45, No. 6, 1966
149. Lawrence Wilson, MD .COPPER TOXICITY SYNDROME Revised, July 2011, The Center For Development. http://www.drlwilson.com/articles/copper_toxicity_syndrome.htm
150. Vivek R Joshi, Ayaz K Mallick, Manjunatha Goud B K, Ravindra Maradi, Maheshwar G Reddy, Raghavendra Tey, Gaurav Shorey. Effect of serum copper concentration and ceruloplasmin on lipid parameters leading to increased propensity to cardiovascular risk. Department of Biochemistry, Melaka Manipal Medical College, Manipal University. ISSN: 0975-8585
151. Iham Amir Al-Juboori , Rafi Al-Rawi, Hussein Kadhem A-Hakeim. Estimation of Serum Copper, Manganese, Selenium, and Zinc in Hypothyroidism Patients. IUFS Journal of Biology Short Communication 121 IUFS J Biol 2009, 68(2): 121-126
152. Rajagopal KR, Abbrecht PH, Derderian SS, Pickett C, Hofeldt F, Tellis CJ, Zwillich CW. Obstructive sleep apnea syndrome and hypothyroidism (a report of three cases)].Ann Intern Med. 1984 Oct; 101(4):491-4.
153. Rack SK, Makela EH. Hypothyroidism and depression: a therapeutic challenge Department of Behavioural Medicine and Psychiatry. Ann Pharmacother 2000 Oct; 34(10):1142-5
154. Jonathan Stephen Murray, Rubaraj Jayarajasingh, Petros Perros. Deterioration of symptoms after start of thyroid hormone replacementBMJ.2001 August 11; 323(7308):332-333
155. Annane D, Sébille V, Charpentier C, Bollaert PE, François B, Korach JM, Capellier G, Cohen Y, Azoulay E, Troché G, Chaumet-Riffaud P, Bellissant E.Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA. 2002 Aug 21;288(7):862-71.
156. Orian Truss, M.D. Restoration of Immunologic Competence to Candida Albicans [http://orthomolecular.org/library/jom/1980/pdf/1980-v09n04-p287.pdf]
157. Diabetes Care January 2011 vol. 34 no. Supplement 1 S11-S61
158. McDermott JH, Coss A, Walsh CH. Celiac disease presenting as resistant hypothyroidism. Thyroid. 2005 Apr;15(4):386-8.
159. John Saunders. The practice of clinical medicine as an art and as a science. Med Humanities 2000;26:18-22 doi:10.1136/mh.26.1.18
160. Wilson James L. Adrenal Fatigue, The 21st Century Stress Syndrome. Smart Publications. ISBN 1-890572-15-2
161. Robert H. Seller, MD and Andrew B. Symons, MD, MS ‗Differential Diagnosis of Common Complaints‘, 6th Edition. ISBN: 9781455707720
162. Differential Diagnosis (DDX) Definition: ―The distinguishing of a disease or condition from others presenting with similar signs and symptoms,‖ Merriam-Webster
163. Differential Diagnosis (DDX) ‖is a systematic method used to identify unknowns. This method, essentially a process of elimination, is used by taxonomists to identify living organisms, and by physicians and other qualified professionals to diagnose the specific disease in a patient. Not all medical diagnoses are differential ones: some diagnoses merely name a set of signs and symptoms that may have more than one possible cause, and some diagnoses are based on intuition or estimations of likelihood.‖ Wikipedia: http://en.wikipedia.org/wiki/Differential_diagnosis
164. Differential Diagnosis is a medical adaption of the process of elimination. These processes are based upon the logic of disjunctive syllogism, which is known from antiquity as modus tollendo poner
165. Turner S. Thyroid Patient Advocacy. http://www.tpauk.com/main/article/a-response-from-the-mhra-regarding-ndt/
166. https://en.wikipedia.org/wiki/Biological_half-life
167. http://www.ncbi.nlm.nih.gov/pubmed/20447070 (peer-reviewed clinical research
168. Simona Grozinsky-Glasberg, Abigail Fraser, Ethan Nahshoni, Abraham Weizman and Leonard Leibovici. Thyroxine-Triiodothyronine Combination Therapy Versus Thyroxine Monotherapy for Clinical Hypothyroidism: Meta-Analysis of Randomized Controlled Trial. The Journal of Clinical Endocrinology & Metabolism July 1, 2006 vol. 91 no. 7 2592-2599
169. Celi FS, Zemskova M, Linderman JD, et al., The pharmacodynamic equivalence of levothyroxine and liothyronine. A randomized, double-blind, cross-over study in thyroidectomized patients., Clin Endocrinol, 2010 May; 72(5) 709-715, doi: 10.1111/j.1365-2265.2009.03700.x.
170. Robinson P. Recovering with T3: My Journey from Hypothyroidism to Good Health Using the T3 Thyroid Hormone. Elephant in the Room Books; 2011.
171. Wiersinga W, M, Duntas L, Fadeyev V, Nygaard B, Vanderpump M, P, J, 2012 ETA Guidelines: The Use of L-T4 + L-T3 in the Treatment of Hypothyroidism. Eur Thyroid J 2012;1:55-71
172. Rudolf Hoermann, John E.M. Midgley, Adrienne Giacobino, Walter A. Eckl, Hans G€unther Wahl, Johannes W. Dietrich and Rolf Larisch.Homeostatic equilibria between free thyroid hormones and pituitary thyrotropin are modulated by various influences including age, body mass index and treatment. Clinical Endocrinology (2014)
173. Rudolf Hoermann, John E. M. Midgley, Rolf Larisch and Johannes W. Dietrich.Homeostatic Control of the Thyroid–Pituitary Axis:Perspectives for Diagnosis and Treatment. Endocrinoly .20 November 2015
174. Vijay Panicker, Ponnusamy Saravanan, Bijay Vaidya, Jonathan Evans, Andrew T. Hattersley,Timothy M. Frayling, and Colin M. Dayan. Common Variation in the DIO2 Gene Predicts Baseline Psychological Well-Being and Response to Combination Thyroxine Plus Triiodothyronine Therapy in Hypothyroid Patients
175. Gross, J. et al.THE IDENTIFICATION OF 3:5:3′-L-TRIIODOTHYRONINE IN HUMAN PLASMA.The Lancet , Volume 259 , Issue 6705 , 439 – 441
176. Honeyman-Lowe, G. and Lowe, J.C. Your Guide to Metabolic Health. Boulder: McDowell Health Science Books, 2003.
177. http://patient.info/medicine/liothyronine-tablets
178. Dussault, J.H. Congenital hypothyroidism. Werner and Ingbar, The Thyroid: A Fundamental and Clinical Text, 6th edition. Edited by L.E. Braverman and R.D. Utiger, New York: J.B. Lippincott Co., 1991, pp.1225.
179. Azukizawa M., Pekary A.E., Hershman J.M., Parker D.C. Plasma thyrotropin, thyroxine, and triiodothyronine relationships in man. Clin. Endocrinol. Metab. Sep 1976; 43(3):533-42.
180. Weeke J., Gundersen H.J. Circadian and 30 minutes variations in serum TSH and thyroid hormones in normal subjects. Acta Endocrinol (Copenh), Dec 1978; 89(4):659-72.
181. Nicolau G.Y., Haus E., Plinga L., Dumitriu L., Lakatua D., Popescu M., Ungureanu E., Sackett-Lundeen L., Petrescu E. Chronobiology of pituitary-thyroid functions. Rom J Endocrinol, 1992; 30(3-4):125-48. C. I. Parhon, Institute of Endocrinology, Bucharest, Romania
182. Nimalasuriya A., Spencer C.A., Lin S.C., Tse J.K., Nicoloff J.T. Studies on the diurnal pattern of serum 3, 5, 3′-triiodothyronine. J Clin Endocrinol Metab, Jan 1986; 62(1):153-8
183. Behall K.M., Scholfield D.J., Hallfrisch J.G., Kelsay J.L, Reiser S. Seasonal variation in plasma glucose and hormone levels in adult men and women. Am J Clin Nutr. Dec 1984; 40(6 Suppl):1352-6
184. Fukuda H., Greer M.A., Roberts L., Allen C.F., Critchlow V., Wilson M. Nyctohemeral and sex-related variations in plasma thyrotropin, thyroxine and triiodothyronine. Endocrinology, December 1975, December 97(6):1424-31
185. Chan V., Jones A., Liendo-Ch P., McNeilly A., Landon J., Besser G.M. The relationship between circadian variations in circulating thyrotrophin, thyroid hormones and prolactin. Clin Endocrinol (Oxf), October 1978, 9(4):337-49
186. Rodriguez T., Lavis V.R., Meininger J.C., Kapadia A.S., Stafford L.F. Substitution of liothyronine at a 1:5 ratio for a portion of levothyroxine: Effect on fatigue, symptoms of depression, and working memory versus treatment with levothyroxine alone. Endocr Pract, Jul-Aug 2005; 11(4):223-33.
187. Sawka A. M., Gerstein H.C., Marriott M.J., MacQueen G.M., Joffe R.T. Does a combination regimen of thyroxine (T4) and 3, 5, 3′-triiodothyronine improve depressive symptoms better than T4 alone in patients with hypothyroidism? Results of a double-blind, randomized, controlled trial. J Clin Endocrinol Metab 88:45514555, 2003.
188. Clyde, P.W., Harari, A.E., Getka, E.J., and Shakir, K.M.M. Combined levothyroxine plus liothyronine compared with levothyroxine alone in primary hypothyroidism: a randomized controlled trial. JAMA, 2003, 290:2952-2958.
189. Cassio, A., Cacciari, E., Cicgnani, A., et al. Treatment of congenital hypothyroidism: thyroxine alone or thyroxine plus triiodothyronine? Pediatrics, 2003, 111(5):1055-1060
190. Tobin MJ: Counterpoint: Evidence-based medicine lacks a sound scientific base. Retrieved from: CHEST, 2008; 133: 1071-1074
191. Refetoff S, Dewind LT, DeGroot LJ: Familial Syndrome combining deaf-mutism, stippled epiphyses, goiter and abnormally high PBI:
192. http://drmyhill.co.uk/drmyhill/images/2/24/Prescribing_guidelines_for_thyroid_hormones_BSEM.pdf
193. Introduction to Tort: 2/14/2008 http://www.oup.com/uk/orc/bin/9780199292240/strong_ch01.pdf
194. Kirk E, Kvorning SA, Acta Med. Scandinav., Suppl. 184. pp 3-83. 1947
195. Means JH, Lectures on Thyroid, Cambridge, Harvard University Press, pgs 48-49,
196. Refetoff S, Weiss RE, Usala SJ, The Syndromes of Resistance to Thyroid Hormone, Endocr Rev, 1993, 14(3):348-399
197. Gossel, TA, Endocrinology Continuing Education accredited by the Accreditation Council for Continuing Medical Education (ACCME), 2005
198. Baskin, HJ, MD, Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Hyperthyroidism and Hypothyroidism, Am Assoc Clin Endocrinol, 2002, Rev 2006
199. Levy EG, Ridgway EC, Wartofsky L, Algorithms for Diagnosis and Management of Thyroid Disorders, www.thyroidtoday.com 2004.
200. Patients with Hyperthyroidism and Hypothyroidism, and ―Guidelines for Detection of Thyroid Dysfunction.The American Thyroid Association provides links to several hypothyroidism related guidelines www.thyroid.org
201. Garber JR, Hennessey JV, Lieberman JA, Morris CM, Talbert RI, Managing the Challenges of Hypothyroidism, Supplement to J of Fam Pract, 2006, www.jponline.com
202. Kaplan MM, Clinical Perspectives in the Diagnosis of Thyroid Disease, Clin Chem, 1999, 45:8(B) 1377-1383
203. Wrutniak-Cabello C, Casas F, Cabello G: Thyroid hormone action in mitochondria. J Molec Endocrinol, 2001; 26: 67-77.
204. Salway JG, Granner DK: Metabolism at a Glance. 3rd ed. Malden, MA. Blackwell Publishing. 2004.
205. http://www.bmj.com/content/351/bmj.h5114
206. https://www.gov.uk/guidance/contact-mhra
207. http://www.britishgenerics.co.uk/about-generics
208. Sackett, DL, Straus, SE, Richardson, WS, et al: Evidence-Based Medicine: How to Practice and Teach EBM. 2nd ed. Edinburgh, UK. Churchill Livingstone. 2000; 108. Page 30 and 108
209. Pritchard EK, ―The Linguistic Etiologies of Thyroxine-Resistant Hypothyroidism,‖ Thyroid Science www.thyroidscience.com – click on ―debate.
210. Duty of Care: http://www.medicalprotection.org/uk/advice-booklets/mps-guide-to-ethics—a-map-for-the-moral-maze/chapter-4—duty-of-care