Differentiated thyroid cancer is the commonest form of thyroid cancer, and its prognosis is
favourable in the majority of cases. Suppression of thyroid stimulating hormone (TSH) by supra
-
physiological thyroid
hormone replacement has been the mainstay of long
-
term management for
over 60 years. However, evidence for a beneficial outcome of TSH suppression is conflicting and
intervention must be balanced against adverse effects, particularly affecting the cardiova
scular
system and skeleton. Here we discuss the role of TSH suppression in the long
-
term management of
differentiated thyroid cancer in the context of risk
-
stratification for disease recurrence and the latest
clinical guidelines.