Abstract: Thyroid-stimulating hormone (TSH) suppression therapy is an important adjuvant treatment following surgery for differentiated thyroid cancer (DTC).However,with the continuous rise in DTC incidence and the accumulation of long-term follow-up evidence,the traditional treatment model of "continuous,fixed,and deep suppression" is facing challenges.The 2025 update to the American Thyroid Association (ATA) guidelines for adult DTC marks a fundamental shift in the management philosophy of postoperative TSH:transitioning from "continuous suppression" to "individualized and moderate reduction or cessation" based on dynamic therapeutic response assessments.The new guidelines remove fixed TSH target recommendations during the initial treatment phase,emphasize risk-stratified management based on treatment response,and explicitly advise avoiding long-term suppression in low- to intermediate-risk patients without evidence of recurrence.By reviewing key studies cited in the guidelines that both support and question the benefits of TSH suppression,it becomes evident that current evidence remains controversial in many aspects.This article further explores TSH management strategies for low-risk DTC patients,long-term disease-free survivors,patients undergoing active surveillance,and those after thermal ablation,pointing out that "reducing or discontinuing treatment" is a viable strategy for patients with favorable therapeutic outcomes.

Key words: differentiated thyroid carcinoma; thyroid-stimulating hormone suppression therapy; American Thyroid Association; guidelines