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All patients tolerated both treatments equally well. Earlier studies reported that DTE and l -T 4 effectively increased patients' metabolic rates 13 - In, a study by Jackson and Cobb 18 evaluated the changes in serum thyroid hormone concentrations when switching from DTE to l -T 4 in 40 patients. Six of 40 patients experienced hyperthyroid symptoms while on DTE, which disappeared completely in 3 and diminished in the other 3 patients after the change to l -T 4. The present method of manufacturing DTE has improved the standardization of these drugs. Furthermore, some believe that T 1 monoiodothyronine and T 2 diiodothyronine may have other beneficial effects This is the first prospective, randomized, double-blind, crossover study of DTE and l -T 4 therapy in hypothyroid patients. We chose to randomize the patients in 2 groups and then cross over to better evaluate for any practice effect or placebo effect.

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