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T-4 to T-3 Thyroid Hormone Conversion
There is a problem that can occur in a small percent of hypothyroid patients, being treated with T-4 hormone therapy, referred to as "inadequate conversion of T-4 to T-3". This can mean they need a hormone replacement medication containing both T-4 and T-3 thyroid hormone.

http://www.bellaonline.com/articles/art55731.asp

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