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In order to determine the frequency of thyroxine (T4) toxicosis and study the possibility of usefulness for differentiation between thyrotoxic Graves' disease and destructioninduced thyrotoxicosis, the serum concentrations of T4, triiodothyronine(T3), reverse T3 (rT3), and T4-binding globulin (TBG) and the values of T3-uptake and radioactive iodine uptake (RAIU) were measured, and free, T4 index (FT4I), free T3 index(FT3I) and serum ratios of T3 to T4 (T3 /T4 ratio) and T3 to rT3 (T3 /rT3 ratio) were calculated in 92 untreated patients with thyrotoxic Graves' diseas (16 with other systemic illnesses and 4 who were pregnant) and 14 patients with destruction-induced thyrotoxicosis (4 with subacute thyroiditis, 8 with postpartum transient thyrotoxicosis, 1 with silent thyroiditis and 1 with chronic thyroiditis with subacute aggravation). The serum concentrations of T4 and T3 and the values of FT4 I, FT3 I, T3/T4 ratio and T3 /rT3 ratio were significantly lower in Graves' patients complicated with other systemic illnesses than those in Graves' patients without any complication. The serum concentrations of T4 , T3 , rT3 and TBG and the values of FT4 I, FT3 I, T3 /T4 ratio, T3 /rT3 ratio and RAIU in elderly (over the age of 61 years) patients with Graves' disease without any complication were not significantly different from

Serum Ratios of Triiodothyronine to Thyroxine and Reverse-triiodothyronine in Graves' Disease and Destruction-induced Thyrotoxicosis