Goals of TSH suppression therapy

1. For high-risk patients, an initial TSH target value of <0.1 mU/L is recommended.
2. For intermediate-risk patients, an initial TSH target of 0.1 to 0.5 mU/L is recommended.
3. For low-risk patients with undetectable serum Tg, a TSH target of 0.5 to 2 mU/L is recommended, regardless of whether 131I thyroid clearance therapy has been administered.
4. for low-risk patients who have undergone 131I thyroid clearance therapy and have low levels of Tg, or for low-risk patients who have not undergone 131I thyroid clearance therapy and have slightly higher Tg levels, a TSH target of 0.1 to 0.5 mU/L is recommended.
For patients with lobectomy, a TSH target of 0.5 to 2 mU/L is recommended.
6. For patients with unsatisfactory efficacy on imaging assessment, TSH target is recommended <0.1 mU/L in the absence of specific contraindications.
7. For patients with unsatisfactory efficacy of serologic assessment, TSH target is recommended to be 0.1-0.5 mU/L based on initial ATA risk stratification, Tg level, trend of Tg change and adverse effects of TSH suppression therapy.
8. For patients initially rated as high risk but with a satisfactory treatment response (clinical or serologic disease-free status) or unclear efficacy, a TSH target of 0.1 to 0.5 mU/L for up to 5 years with subsequent reduction in TSH suppression is recommended.
9. For patients with satisfactory treatment response (clinical or serologic disease-free status) or unclear efficacy, especially those at low risk of recurrence, a TSH target of 0.5 to 2 mU/L is recommended.
10. For patients without 131I thyroid clearance or adjuvant therapy and with satisfactory or unclear efficacy, who meet the criteria of negative neck ultrasound, low or undetectable suppressive Tg, and no trend of increasing Tg or TgAb, a TSH target of 0.5 to 2 mU/L is recommended.