Evaluating for thyroid disease requires measuring thyroid-stimulating hormone (TSH), free thyroxine (T4), and free triiodothyronine (T3). Looking at just the TSH will not give you the whole story. Normal TSH and free T4 combined with elevated free T3 may indicate hyperthyroidism or thyrotoxicosis.—PATRICIA SCHROEDER, APRN, FNP-C, Abilene, Tex. (183-8)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.

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