Thyroid cancer and thyroiditis

TSH suppression in well-differentiated thyroid cancer and thyroid nodules -The target level for TSH suppression in these conditions has not been established in controlled studies. In addition, the efficacy of TSH suppression for benign nodular disease is controversial. Therefore, individualize the dose of levothyroxine used for TSH suppression based on the specific disease and the patient being treated. 

Cancer Risks The increased risk of thyroid cancer after thyroid irradiation in childhood has been recognized for nearly 50 years (Dolphin, 1968). Thus, a major concern of therapy relates to the risk of thyroid cancer. Detractors of therapy point to the increased rates of thyroid cancer and thyroid nodules observed in young children exposed to radiation from nuclear fallout at Hiroshima or after the Chernobyl nuclear reactor explosion. 

In addition to age, the radiation dose plays a major role in causing cancer (Dolphin, 1968 Ron et al., 1995 Boice, 2005, 2006). The risk of thyroid cancer and thyroid nodules is highest with exposure to low or moderate levels of external radiation (0.1-25 Gy), and not with the considerably higher doses used internally to treat Graves disease (>150Gy) (Dolphin, 1968 Ron etal., 1995 Boice, 2005, 2006 Sigurdson et al., 2005). 

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