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measured as being thyrotoxic on Levoxine by suppressed TSH levels.  Conversely, 2 of 21 who were considered euthyroid on Levoxine were found to have suppressed TSH levels and therefore were considered thyrotoxic while on the Synthroid.  Overall, 26 percent of these people underwent a change in their basal TSH classification, which at least would have stimulated their clinician to change their thyroid hormone dose in order to achieve a euthyroid state.

The final study that I would like to show you is the study from Dr. Dong and colleagues which was done in a more sophisticated manner than Dr. Escalante's study or even ours.  Patients were recruited into this study to be euthyroid on stable doses of thyroxine at either 100 or 150 micrograms daily for at least 6 weeks prior to their randomization.  Following recruitment, the patients began their assigned L-thyroxine treatment from the study drugs and after 6 weeks equilibrium, they were admitted for thyroid function testing, whereby a fasting sample prior to the last dose of the study drug was obtained and then frequent sampling was obtained over the next 24 hours.  These are the four medications that were utilized.

Dr. Dong reported that the area under the

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