{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:14:57Z","timestamp":1761513297051},"reference-count":29,"publisher":"Akademiai Kiado Zrt.","issue":"19","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orvosi Hetilap"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:p> Introduction: L-thyroxine replacement therapy is the treatment of choice for hypothyroidism. Recently, several studies suggested to complete it with l-triiodothyronine in acquired hypothyroidism. Aim: To study the role of combined l-thyroxine and l-triiodothyronine therapy in special cases with congenital hypothyroidism. Method: Data of 16 patients (age: 11.9\u00b16.3 years; mean\u00b1SD) are presented who had high serum free thyroxine values or even above the upper limit of reference range (21.16\u00b12.5 pmol\/l) together with nonsuppressed TSH levels (15.7\u00b15.7 mIU\/l), and therefore received l-triiodothyronine in completion (0.18\u00b10.09 \u03bcg\/kg) once a day. Results: The combined replacement therapy resulted in a rapid improvement of the hormone parameters (TSH: 4.2\u00b13.15 mIU\/l; free thyroxine: 16.55\u00b12.4 and free triiodothyronine: 7.4\u00b11.8 pmol\/l). The efficiency of this combined therapy proved to be more evident (TSH: 4.33\u00b13.2 mIU\/l; free thyroxine: 16.85\u00b13.1 and free triiodothyronine: 6.4\u00b10.85 pmol\/l) in 10 patients treated for a longer period of time (duration of treatment: 2.9\u00b12.0 years). The dose of thyroxine substitution decreased from 2.6\u00b10.9 to 2.18\u00b10.6 \u03bcg\/kg\/day), the ratio of these hormones was between 5:1 and 19:1 and the quotient of free fractions was normalized (3.8\u00b10.4\u21922.6\u00b10.3) during the replacement therapy. Conclusions: According to the observation of the authors a serious disturbance of feed-back mechanism may develop in some (&gt;5%) children with congenital hypothyroidism (increased TSH release despite elevated free thyroxine level) after normal function of the feed-back system for years. Hormone parameters of these patients improve, then become normal on combined therapy supporting the rationale for this treatment method. Orv. 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