What is recombinant TSH?

Patients undergoing radioactive iodine scans require preparation to ensure that the images obtained are of high quality. This preparation is directed towards increasing the level of TSH in the body in an effort to drive more 131-Iodine into cells. This can be accomplished through a process of thyroid hormone withdrawal similar to the one used to prepare for radioactive iodine treatment. While this process is effective, it may be difficult for patients who develop pronounced symptoms of hypothyroidism (including fatigue, lethargy, impaired concentration, and intolerance of cold temperatures) whenever they stop taking thyroid hormone for any length of time. As an alternative, radioactive iodine scans can be performed with the use of recombinant TSH.

Recombinant TSH is a pharmacologic preparation of a hormone called thyrotropin alfa that is produced through recombinant DNA technology. This hormone is identical to the TSH that is normally produced by the human pituitary gland. When it is mixed in solution and injected into the body, it enters the bloodstream and raises the level of TSH. Patients who receive recombinant TSH as preparation for radioactive iodine scans can continue to take their thyroid hormone without interruption. Thus far studies involving the use of recombinant TSH have been limited to adults with thyroid cancer. Further studies will need to be performed to see if it can be safely used in children with thyroid cancer.

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