TSH suppressive therapy: an overview of long-term clinical consequences.

An overview of long-term clinical consequences of TSH suppressive therapy provides evidence that serum TSH levels should be maintained at levels <0.1 mU/l in high-risk (stage III and IV) patients, whereas lower-risk patients should be allowed to have their TSH levels rise into the normal range after residual disease has been ruled out by imaging and/or stimulated thyroglobulin measurement. The proper management of patients with known residual thyroid cancer, who are also elderly or who have underlying serious comorbidities (e.g., osteoporosis, cardiovascular disease, diabetes), is uncertain and requires a high degree of clinical experience and judgment.