Review on the occasion of a decade of recombinant human TSH: Prospects and novel uses

Leonidas H. Duntas, David S. Cooper

Research output: Contribution to journalReview articlepeer-review

Abstract

The introduction of recombinant human thyroid-stimulating hormone (rhTSH) almost a decade ago represents a remarkable achievement in the history of clinical thyroidology. rhTSH now contributes substantially to the diagnostic approach to thyroid cancer, offering a reliable and safe alternative to thyroid hormone withdrawal by avoiding the morbidity of hypothyroidism. Several recent studies have also demonstrated the efficacy of radioiodine ablation of thyroid remnants after preparation with rhTSH. Moreover, the use of rhTSH in this context is associated with a lower whole body exposure to radiation compared to thyroid hormone withdrawal. Although not approved officially, rhTSH-assisted treatment of locoregional or distant metastatic disease may be the treatment of choice for patients in whom hypothyroidism may be relatively contraindicated, such as the very young and the aged, although additional efficacy studies are necessary. The compound has also been shown to be useful in the treatment of nontoxic multinodular goiter, especially when the radioiodine uptake is low. Finally, rhTSH may prove to be useful in studying the functional reserve of thyroid in the aging process, as well as the putative role of the TSH receptor in extrathyroidal tissue, such as lymphocytes, osteocytes, and adipocytes.

Original languageEnglish (US)
Pages (from-to)509-516
Number of pages8
JournalThyroid
Volume18
Issue number5
DOIs
StatePublished - May 1 2008

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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