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Inicio Endocrinología y Nutrición (English Edition) Potential risks of the adverse effects of thyrotropin suppression in differentia...
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Vol. 58. Issue 2.
Pages 75-83 (February 2011)
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Vol. 58. Issue 2.
Pages 75-83 (February 2011)
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Potential risks of the adverse effects of thyrotropin suppression in differentiated thyroid carcinoma
Posibles efectos adversos del tratamiento supresor de la TSH en el carcinoma diferenciado de tiroides
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Jordi L. Reverter
Corresponding author
, Eulàlia Colomé
Servei d’Endocrinologia i Nutrició, Departament de Medicina, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
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Jordi L. Reverter, Eulalia Colomé
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Abstract

In patients with differentiated thyroid cancer, long-term inhibition of TSH secretion by levothyroxine administration is required when there is evidence of persistent or recurrent disease. In such cases, levothyroxine doses should be monitored to achieve the goals of TSH inhibition and avoidance of clinical hyperthyroidism. The possibility that TSH-suppressive therapy may cause adverse effects continues to be controversial, especially for elderly patients. Many studies on the potential harmful effects of suppressive treatment on various organs or systems have been conducted with discordant results. There is however no scientific evidence to suggest that the clinical impact of these effects is significant.

Keywords:
Differentiated thyroid carcinoma
Levothyroxine suppressive treatment
Resumen

En pacientes afectos de cáncer diferenciado de tiroides, la inhibición a largo plazo de la secreción de TSH, mediante la administración de levotiroxina, es necesaria cuando hay evidencias de enfermedad persistente o recurrente. En estos casos las dosis de levotiroxina deben ser monitorizadas para conseguir los objetivos de inhibición de la TSH evitando el hipertiroidismo clínico. La posibilidad de que el tratamiento supresor de la TSH pueda producir efectos adversos es aún motivo de controversia, principalmente en pacientes ancianos. Existen multitud de estudios sobre los posibles efectos perjudiciales del tratamiento supresor sobre diversos órganos o sistemas con resultados discordantes aunque no existen evidencias científicas de que su impacto clínico sea significativo.

Palabras clave:
Cacinoma diferenciado de tiroides
Tratamiento supresor levotiroxina
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