Differences in Brain Glucose Metabolism During Preparation for 131I Ablation in Thyroid Cancer Patients: Thyroid Hormone Withdrawal Versus Recombinant Human Thyrotropin

Thyroid ◽  
2017 ◽  
Vol 27 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Hyeonseok S. Jeong ◽  
Eun Kyoung Choi ◽  
In-Uk Song ◽  
Yong-An Chung ◽  
Jong-Sik Park ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Glucose Metabolism ◽  
Cancer Patients ◽  
Brain Glucose ◽  
Brain Glucose Metabolism ◽  
Thyroid Hormone Withdrawal ◽  
131I Ablation ◽  
Recombinant Human Thyrotropin

scholarly journals Differences in Physicians' and Patients' Perception of Acute Hypothyroid Symptoms Induced by Thyroid Hormone Withdrawal in Thyroid Cancer Patients: A Multicenter Survey in Korea

2015 ◽  
Vol 4 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Dong Jun Lim ◽  
Won Bae Kim ◽  
Bo Hyun Kim ◽  
Tae Yong Kim ◽  
Young Suk Jo ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Cancer Patients ◽  
Social Life ◽  
Psychological Impact ◽  
Educational Background ◽  
Duration Of Symptoms ◽  
Thyroid Hormone Withdrawal ◽  
Multicenter Survey ◽  
Referral Hospitals

Background: Acute short-term hypothyroidism induced by thyroid hormone withdrawal (THW) for follow-up surveillance or therapeutic radioiodine causes patients with differentiated thyroid cancer to suffer from a myriad of deleterious symptoms. Objectives: To know how patient recognition of hypothyroid symptoms compares to physician perception of patient symptoms. Methods: The survey was performed in 10 referral hospitals throughout Korea from December 2010 to May 2011 and targeted patients with total thyroidectomy and remnant ablation. The survey consisted of questions regarding the effect of THW on patient symptoms, the duration of symptoms, impact on social life, and patient complaints. The physicians treating thyroid cancer patients also responded to the survey and provided their perceptions of patient symptoms and treatment decisions. Results: About 70% of the patients responded that they experienced a negative physical or psychological impact on their life and work due to hypothyroid symptoms. However, 76% of doctors thought hypothyroidism could negatively impact a patient's daily life but would be endurable. Two thirds of physicians do not routinely recommend recombinant human TSH (rhTSH) to their patients. Multivariate analysis showed patients with female sex, stronger educational background, emotionally negative experiences of hypothyroidism, and younger age were more willing to pay for therapy that could prevent hypothyroidism symptoms. Conclusions: There was a substantial gap in the perception of hypothyroid symptoms during THW between physicians and patients. Physicians who are aware of the seriousness of hypothyroidism in their patients were more likely to recommend the use of rhTSH for their patients.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: The role of rhTSH in the management of differentiated thyroid cancer: pros and cons

2019 ◽  
Vol 181 (4) ◽  
pp. R133-R145 ◽  
Author(s):  
Luca Giovanella ◽  
Leonidas H Duntas
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Differentiated Thyroid Cancer ◽  
Clinical Role ◽  
Serum Thyroglobulin ◽  
Thyroid Hormone Withdrawal ◽  
Clinical Sensitivity ◽  
Pros And Cons ◽  
Recombinant Human Thyrotropin

The use of recombinant human thyrotropin (rhTSH) testing in the diagnosis and therapy of differentiated thyroid cancer (DTC) has been adopted over the last two decades as an alternative to the classical thyroid hormone withdrawal avoiding the threat of hypothyroidism. Serum thyroglobulin (Tg) measurement is crucial for monitoring DTC patients over time. Until about a decade ago, optimal sensitivity of Tg assays for the detection of smaller disease foci required Tg measurement after thyrotropin (TSH) stimulation, carried out following thyroid hormone withdrawal or rhTSH administration. In very recent years, significant improvements in assay technology have resulted in highly sensitive Tg (hsTg) assays, sufficiently sensitive to obviate the need for rhTSH stimulation in most DTC patients. The aim of this paper is to review and discuss, via a ‘pros and cons’ approach, the current clinical role of rhTSH to stimulate radioiodine (RAI) uptake for treatment and/or imaging purposes and to increase the clinical sensitivity of Tg measurement for monitoring DTC patients when high-sensitive Tg assays are available.

scholarly journals Clinical use of recombinant human TSH in thyroid cancer patients

2000 ◽  
pp. 557-563 ◽  
Author(s):  
M Schlumberger ◽  
M Ricard ◽  
F Pacini
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Cancer Patients ◽  
Recurrent Disease ◽  
Clinical Use ◽  
Follicular Thyroid Cancer ◽  
Safe Alternative ◽  
Thyroid Hormone Withdrawal ◽  
Recombinant Human Tsh

Recombinant human TSH (rhTSH) is an effective and safe alternative to thyroid hormone withdrawal during the post-surgical follow-up of papillary and follicular thyroid cancer. Its clinical efficiency for the detection of persistent and recurrent disease is similar to that of thyroid hormone withdrawal. The main purpose for its use is to avoid hypothyroidism.

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