TY - JOUR T1 - Thyroxine monotherapy after thyroidectomy: Coming full circle AU - Cooper DS Y1 - 2008/02/20 N1 - 10.1001/jama.299.7.817 JO - JAMA SP - 817 EP - 819 VL - 299 IS - 7 N2 - The concept of hormone replacement therapy is commonly credited to Brown-Sequard, who in 1889 at age 72 years injected himself with an extract of dog testicles and noted enhanced vitality and mental acuity.2 The concept of “internal secretion” arose from these experiments, and soon thereafter Murray successfully treated myxedema with “juice” extracted from sheep thyroid glands.3 Replacement therapy with virtually all clinically relevant hormones has been possible since the middle of the 20th century. The challenge, however, is to administer these hormones in deficiency states in a way that precisely replicates the complex manner in which they are endogenously secreted. Insulin replacement in patients with type 1 diabetes is an obvious example of this difficulty. Even the most sophisticated patient using an external insulin pump and continuous glucose monitoring has difficulty mimicking normal insulin secretion without being subjected to potentially dangerous hypoglycemia. SN - 0098-7484 M3 - doi: 10.1001/jama.299.7.817 UR - http://dx.doi.org/10.1001/jama.299.7.817 ER -