December 8, 2022

Thyroid stimulating hormone (TSH) reflects the amount of thyroid hormone in your body. Setting an appropriate target for TSH after thyroid cancer treatment is a key step in keeping you healthy and disease free. How to set the right TSH target after your thyroid cancer surgery is discussed in this video tutorial.

Giving you the right amount of thyroid hormone after thyroid surgery is a key to keeping you healthy if you’ve had thyroid cancer it may also be important for keeping you disease-free if you’ve watched our tutorial about hypothyroidism and thyroid hormone replacement you’ll already know that thyroid stimulating hormone or tsh is secreted by a gland at the base of

The brain called the pituitary and even though we occasionally need to check other hormones like t4 and t3 tsh remains the most sensitive indicator of how much thyroid hormone is in your bloodstream if we’re treating hypothyroidism without a history of thyroid cancer your tsh needs to be normal but sometimes patients with thyroid cancer require a suppressed tsh

And that depends on your age the severity of your cancer and other medical problems that you may have as well as your long term follow-up status if you have low risk thyroid cancer after thyroidectomy the goal is to keep your tsh in the low to mid normal range just like any other hypothyroid patient you won’t benefit from a suppressed tsh but for patients with more

Aggressive thyroid cancer tsh suppression may be the right thing to do the reason is that thyroid stimulating hormone or tsh is also thyroid cancer stimulating hormone if there’s any suspicion that you have persistent thyroid cancer or if you’re at high risk for cancer recurrence suppressing tsh will improve your odds of living disease-free if we have to suppress

Your tsh we’ll give you a slightly higher than normal dose of thyroid hormone this causes very mild hyperthyroidism and that’s what keeps your tsh low this mild hyperthyroidism is almost never symptomatic and when done for the right reasons any associated risks are offset by the benefits of improved thyroid cancer control in some cases even though tsh suppression

May seem like a good idea there were reasons we just can’t do if you’re older have the history of your regular heartbeat like atrial fibrillation coronary artery disease or chest pain like angina or if you have severe osteoporosis or for any reason you can’t tolerate tsh suppression risks will outweigh benefits and in these cases the goal will be to keep tsh as

Low as possible without creating side effects and unmanageable symptoms if you’re pregnant or planning a pregnancy and you require thyroid hormone replacement for any reason discuss this with your doctor especially if tsh suppression has been recommended for thyroid cancer depending on your cancer history tsh suppression may still be safe during pregnancy but the

Tsh target may need to be changed also like every other hypothyroid patient during pregnancy you’ll almost always require a substantial increase in your thyroid hormone dose this can occur as early as week four of your pregnancy and your baby needs this extra thyroid hormone for normal development if you’re thinking about getting pregnant or if you’re already in

The family way you and your doctor need to discuss this so you and your baby can stay healthy during your pregnancy even if tsh suppression is initially necessary it may not need to be permanent if you have no evidence of cancer on long term follow-up tsh suppression can often be relaxed and your tsh can be allowed to rise closer to normal or even into the normal

Range to find out if that’s the right thing for you you have to ask your doctor if i read replacement and the right tsh goal are important cornerstones for good thyroid cancer follow-up care measurement of a tumor marker called thyroid globulin and follow-up imaging are also keys to your long-term success make sure you understand these important points so your

Follow-up care can be as successful as possible for thyroid parathyroid calm i’m dr. steven hoang you

Transcribed from video