Myxedema and Corticosteroids

Abstract

To the Editor:— I would like to take belated but nevertheless emphatic exception to a consultant's response in theQUESTIONS AND ANSWERScolumn ( 202 :1157, 1967). The first question asked: Should patients with uncomplicated primary myxedema be treated with corticosteroids along with thyroid hormone and how much should be used? The response indicated that cortisone acetate should be employed in this specific situation in a declining fashion. A formidable precedent has been established and confirmed by most physicians who have met this situation. That the exhibition of corticosteroids would ever be appropriate strikes me as being superfluous and possibly of potential harm. No one discounts the relevance of steroids in the hypothyroid patient that might be at the time of discovery encountering stress, ie, surgery, acute infection, or other challenging illness. Otherwise, it just seems unnecessary to concern oneself with the incredible statistical improbability of Schmidt's syndrome, much less with