DOI: 10.32322/jhsm.1989734 ISSN: 2636-8579

From a favorable laboratory profile to RAI-related outcomes: extending the evidence for LT3-assisted withdrawal

Alev Çınar
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Levotriiodothyronine (LT3)-assisted withdrawal may improve short-term tolerability during hypothyroidism induction in patients with differentiated thyroid carcinoma undergoing preparation for radioactive iodine therapy. Recent findings suggest a more favorable laboratory profile while maintaining adequate thyroid-stimulating hormone stimulation. However, adequate TSH elevation remains a surrogate marker and does not directly establish therapeutic effectiveness. Future comparative studies should therefore determine whether the biochemical advantages of LT3-assisted withdrawal are accompanied by preserved radioactive iodine–related outcomes. Relevant endpoints may include post-therapy imaging findings, longitudinal thyroglobulin and anti-thyroglobulin antibody measurements, structural and biochemical response categories, and predefined ablation or follow-up outcomes. Integrating laboratory tolerability with clinically meaningful radioactive iodine endpoints would clarify whether LT3-assisted withdrawal represents not only a more tolerable but also an oncologically sound preparation strategy for patients with differentiated thyroid carcinoma.

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