The replacement solution such as albumin provides new binding sites for free thyroid hormones present in the circulation and thus leads to reduction of free thyroid hormone levels.35 Since thyroid surgery can be associated with significant perioperative mortality in uncontrolled thyrotoxicosis, plasmapheresis is an effective therapeutic procedure that helps achieve a euthyroid state before a definitive thyroidectomy. This evidence concerns the gene TG and thyrotoxicosis.