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. 2021 Feb 27;13(5):995. doi: 10.3390/cancers13050995

Table 4.

Main benefits and disadvantages in the use of TH deprivation vs. stimulation with recombinant human TSH before RAI therapy.

Benefit Disadvantages
TH deprivation for 2–4 weeks
  • -

    Chronic synthesis of thyroid proteins (TG, NIS, TPO, and Duox2)

  • -

    High levels of TG protein within the colloid

  • -

    Higher amount of TG-131I in the remnant after RAI
  • -

    Increased tumor cell proliferation

  • -

    Cold iodine organified TG accumulated within the colloid

  • -

    Colloid-accumulated TG downregulation of NIS expression

  • -

    TG or TG-131I, before or after RAI treatment, present in the bloodstream

  • -

    131I organification in TG less efficient

  • -

    Lower half-life of organified 131I within remnant tissue

  • -

    Hypothyroidism induced by chronic TSH after 3–4 weeks of TH deprivation

  • -

    Longer hospitalization time
Recombinant human TSH
  • -

    De novo NIS and TG protein synthesis

  • -

    High efficiency in the organification of radioiodine in the nascent TG

  • -

    Longer radioiodine half-life in the remnant

  • -

    Less radioiodine biodistribution in other organs

  • -

    Lower amount of TG in the bloodstream

  • -

    Less proliferation of tumor cells

  • -

    Better quality of life for the patient

  • -

    Shorter patient admission time
  • -

    Lower amount of 131I organification.

  • -

    Recombinant hTSH cost