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Dear Tanya, Thanks for your reply. Indeed, I have come across these reviews. However, these seem to focus on direct effects of TKI’s on thyroid function with secundary TSH increase. In patients with DTC there is no thyroid gland anymore. Bart Van: Hart, Tanya [mailto:[log in to unmask]] Verzonden: maandag 11 juli 2016 13:33 Aan: Ballieux, B.E.P.B. (KCL) Onderwerp: RE: rising TSH in DCT patients on TKI's I'm not familiar with TKI use in thyroid cancer, but we commonly see significant TSH increases in other patients taking these drugs, often despite apparently normal fT4 and sometimes on thyroxine. Rarely we see thyroiditis/hyperthyroidism. There are quite a few interesting reviews out there. Tanya Dr Tanya Hart FRCPath Clinical Scientist Department of Clinical Biochemistry Poole and Royal Bournemouth Hospitals From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Bart Ballieux Sent: 11 July 2016 12:10 To: [log in to unmask]<mailto:[log in to unmask]> Subject: rising TSH in DCT patients on TKI's Dear colleagues, Has anyone come across marked TSH rises in iodine refractory patients with differentiated thyroid carcinoma? This is under stable thyroxine replacement conditions. Do TKI’s influence deiodinase activity? Do TKI’s influence TRH-receptor signalling Or do TKI’s possibly influence pituitary TSH-receptor signalling? Best regards, Bart B.E.P.B. Ballieux PhD, Clinical Biochemist Endocrinology, Department KCL, E2-P. Leiden University Medical Centre, P.O.box 9600, 2300RC Leiden Tel: +3171-5262165/62278 Fax: +3171-5266753 email: [log in to unmask]<mailto:[log in to unmask]> P Please consider the environment before printing this e-mail ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ DISCLAIMER: This email and any files transmitted with it are confidential and intended solely for the use of the individual, individuals or entity to whom they are addressed. Any views or opinions expressed are those of the author and do not necessarily represent the views of Poole Hospital NHS Foundation Trust unless otherwise explicitly stated. This email may contain confidential and/or privileged materials. In the case of confidential and/or privileged materials, any review, retransmission, dissemination or other use of these materials by individuals or entities other than the intended recipient may be the subject of legal action. If you receive an email in error from Poole Hospital NHS Foundation Trust, please contact the sender and delete the material from your computer. ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/