How the availability of recombinant human TSH has changed the management of patients who have thyroid cancer.

Recombinant human TSH (rhTSH) is used in patients who have had surgery for thyroid cancer but are at low risk of recurrence. The rhTSH is used for the preparation of postoperative administration of 3.7 GBq (100 mCi) of radioiodine for thyroid-remnant ablation and for the determination of serum thyroglobulin levels during follow-up. In these two conditions, the efficiencies of levothyroxine withdrawal and rhTSH administration are similar; however, rhTSH can be administered during levothyroxine treatment, and its use avoids the hypothyroid period induced by levothyroxine withdrawal, reduces whole body exposure after radioiodine administration, avoids potential morbidity and maintains a better quality of life compared with hormone withdrawal.