Format

Send to

Choose Destination
Head Neck. 2017 Dec;39(12):2567-2572. doi: 10.1002/hed.24926. Epub 2017 Sep 27.

Thyroid-stimulating hormone suppression therapy for differentiated thyroid cancer: The role for a combined T3/T4 approach.

Author information

1
Department of Otolaryngology, The Shrewsbury and Telford NHS Trust, Telford, UK.
2
Department of Clinical Oncology, The Deansley Centre, Royal Wolverhampton Hospital, Wolverhampton, UK.
3
Department of Clinical Oncology, The Shrewsbury and Telford NHS Trust, Telford, UK.

Abstract

BACKGROUND:

In the management of differentiated thyroid carcinoma, surgery with or without postoperative radioiodine, and thyroid-stimulating hormone (TSH) suppression is the standard of care in most patients. Levothyroxine is recommended for long-term TSH suppression. For some patients, this may be difficult to tolerate due to adverse effects, such as impaired cognitive function.

METHODS:

This article reviews the evidence for the role of combination treatment with triiodothyronine (T3) and levothyroxine (T4) in these patients.

RESULTS:

The evidence for combination T3 and T4 treatment comes mainly from studies on hypothyroidism, and research into its use for TSH suppression is limited.

CONCLUSION:

Although the evidence base is not strong, there is a small group of patients who may benefit from combination T3 and T4 treatment due to difficulty tolerating thyroxine. Until further evidence is available, a case-by-case approach is recommended.

KEYWORDS:

thyroid neoplasms; thyrotropin; thyroxine; triiodothyronine

PMID:
28960722
DOI:
10.1002/hed.24926
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center