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rhTSH avoids the consequences of prolonged withdrawal, including:

1. The usual signs or symptoms of hypothy-roidism, and its consequences for organ function in particular on the brain, heart, liver, and kidney; it avoids the worsening of any associated disease, and also the hazards of any drug therapy induced by a decreased renal or hepatic function; finally, modification of physiology induced by hypothyroidism is avoided and thus any vital function is conserved and any associated impairment be avoided.

2. Moderate to severe impairment of the ability to work and difficulties in operating a motor vehicle; these consequences are usually underscored by the patients themselves, and are significant because these patients are typically young or middle aged. The number of days of work missed by the patient was reduced by about 14 days when rhTSH was used instead of withdrawal.

3. As a consequence, quality of life was maintained and was much better during rhTSH than during hypothyroidism. Patient preference for rhTSH over withdrawal is universal. Side effects were minimal, being observed in less than 10% of patients, and consisted mainly of mild and transient nausea and headache, and no patient developed detectable anti-rhTSH antibodies.

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