Value of T3 for Thyroid Cancer Patients Waiting for RAI

Researchers looked at the value of using T3 as a temporary treatment for thyroid cancer patients who are preparing for radioactive iodine (RAI) therapy. In research reported on in the Journal of Clinical Endocrinology and Metabolism , two groups of patients requiring RAI therapy were investigated. One group included patients studied immediately after thyroidectomy, whereas the other included those withdrawn from suppressive levothyroxine (i.e., Synthroid, Levoxyl) therapy that followed thyroidectomy and postoperative RAI treatment. The TSH levels were measured two to three times each week until they reached more than 30 mU/liter, at which point the patients received RAI. What researchers found was that the TSH concentrations reached levels above 30 within 18 days for 95% of patients after thyroidectomy, and 22 days for 95% of patients after the withdrawal of levothyroxine treatment. According to researchers, minimal symptoms of hypothyroidism were noted in either group when RAI was administered, and the TSH levels rose rapidly without T3 treatment.

According to the researchers: "To minimize symptoms of hypothyroidism, serum TSH levels should be measured twice weekly, starting 10 days after thyroidectomy or T(4) withdrawal. The data cast doubt about the value and benefits from using T(3) in preparing patients for RAI therapy."

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Source: Serhal DI, et. al. "Rapid rise in serum thyrotropin concentrations after thyroidectomy or withdrawal of suppressive thyroxine therapy in preparation for radioactive iodine administration to patients with differentiated thyroid cancer." J Clin Endocrinol Metab. 2004 Jul;89(7):3285-9.