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Thryglobulin test result

tmcinally
Posts: 1
Joined: Oct 2006

Just had a yearly blood test for follow up to papilary thyroid cancer I had three years ago. Had my entire thyroid removed June 2003 and went through one radiation treatment and scan. I have yearly blood test to assess the thyroid levels. The last two years, my levels have been low but this year, my test result came back at 4? Does anyone know what that means? My doctor sent me a note advising me of this and thinks I should have an ultrasound of my neck done by a specialist. I thought I was out of the cancer woods but now starting to think otherwise - does this mean that the cancer could be back?

lilmonkeyshine
Posts: 10
Joined: Oct 2006

the test is a marker in helping to determine if cancer has returned. I personally would request a full body scan. Hope this helps.

aykt36
Posts: 28
Joined: Jun 2010

thanks

FenwayS
Posts: 11
Joined: Jun 2005

Hi,

I hope I can help.

I had a totally thyroidectomy in July of '05 and radiation in Sept/Oct. I had blood tests every couple of months because my thyroglobulin level wasn't descending. Finally at one year I had my full body scan and it showed nothing, my doctor gave me a clean bill of health. A day later my thyroglobulin test came back at 18 or something like that (don't remember the exact number) so my doctor ordered an ultrasound to be done by the radiologist rather than a technician (I'd had an ultrasound prior to my scan that also yielded good results). The radiologist found two lymph nodes, one a 1.7cm and the other a 1.2cm and some other questionable areas that couldn't be confirmed on the ultrasound. Because of the finding, they did an ultrasound guided biopsy. Those results showed "atypical cells". I now have to undergo another biopsy and a PT/CT scan.

My whole point of this is to tell you that your thyroglobulin level should come back undectable. A level of 4 should be looked into. However, I would personally not reccommend a full body scan because they are not sensitive enough to always see cancers in the lymph nodes. In my experience, an ultrasound performed by the right individual was the most effective thing. I have yet to see what will happen with the PT/CT scan but it has been ordered because the two tests together are much more sensitive and one can pick up things the other cannot.

As a start, if I were you I would ask for an ultrasound and ask that it be performed by the radiologist or a technician with a LOT of experience. And go from there. OH! Forgot to say that my last thyroglobulin level was at 3, yet we know there is cancer present. Sorry to yammer on but I wanted to give you as much info as I could! Best of luck to you!

Fen

tcbuds
Posts: 4
Joined: Jul 2004

Hi tmcinally, I just logged on to see what discussions might be going on and found yours. As you are finding out, the Tg levels are tumor marker or thyroid tissue marker for us. Anything over 2 is a concer. I would recommend a thorough neck ultrsaound and FNA by a very capable Radiologist or Endocrinologist. May I ask what region you live? I had to have my neck lymph nodes removed this past Spring because of elevated Tg one year after TT and RAI. But, the fact that I had one of the best doctors in the world do my ultrasound and FNA's, he was able to map out my whole left side that was infected so that the surgeon could remove every lymph node that was cancerous. My Tg level was a climbing 16 before surgery and now it is <0.5 (which is undetectable) this September after my February surgery! Good news for me. We are as good as our surgeons and endocrinologist!
tcbuds@whidbey.com is my e-mail.

litman25
Posts: 7
Joined: Nov 2006

I just went through my 3rd scans. I was told that my Tg was test and went from a 2 to a 20. They then did a full body PT scan everything was good. My doctor things it is residual thyroid tissue that was not effected with the I131 radiation. He says that it may or may not be cancer again? I am confussed. The oncologist is suggesting surgary. The Endo thinks I should do radiation again. Do you have any suggestions?

BellsAngel69
Posts: 102
Joined: Dec 2009

My levels went from 0 to 2, then 4, then 9. They found a reocurrence in my hip bone. I had surgery to remove it. Subsequent tests, my levels still weren't down after the surgery, they were higher. Now my level went from 29 to 121 in six months, and I find myself having yet another PET and full body scan. The PET I had in May when my level was 29 showed nothing. I was relieved but not convinced.

I'm so frustrated that the PET's are showing nothing, yet my TSH is so high. I don't know what to think anymore.

Simpson
Posts: 3
Joined: Mar 2010

I suggest you to consult to the specialists soon. Don't stay confused it will make the situation much worser. Visit as many specialists as you can and get through it. I wish you all the best for your health progress.
MNUI

MLG
Posts: 52
Joined: Mar 2010

I had papillary thyroid cancer and had a TT in August 2008,with 6 lymph nodes taken out of my neck, 4 of them being cancerous. RAI 6 weeks after.
My thyroglobulin level has always been 0.2 (virtually nondetectible),and I've gone every 4 months to have that done since my surgery.
Just found out the thyroglobulin is now at 14. I am having the two thyrogen injections next week, low dose of RAI then two days later a whole body scan.
The doctor who always checks my bloodwork and neck is still my surgeon (an ENT surgeon) who is highly recommended (even by most nurses)and he has been highly recommended as far as the thyroid cancer surgeon.
I've read where some people are going to an oncologist. Do most areas have one who specializes in thyroid cancer?
After reading posts, I pretty much know there is either thyroid tissue regrowth or cancer cells, both of which should be removed, but I am afraid that if the body scan doesn't show anything then my doctor won't do anything. I always thought an ultrasound was done first and then the body scan.
If it doesn't show anything should I request an ultrasound? But wouldn't they only be doing the ultrasound around my neck and what if it is someplace else, the ultrasound wouldn't show it.
I know I wouldn't be able to stand the thought of my thyroglobulin levels being higher, and if the scan doesn't show anything then just sitting around for another 3-6 months until he would want to do another scan.
Plus, this surgeon doesn't feel the need to be put on a low iodine diet, either for the scan plus he told me that I didn't need to do it before my ablation, 1 1/2 years ago.
Should I be seeing an oncologist instead of a highly experienced ENT surgeon?
I live in central Illinois and in my city there is an facility called Cancer Center of Peoria, my surgeon is the head doctor of the thyroid cancer part of that facility.
Thanks for any insight on thyroglobulin and body scans.

Michelle

miladyx
Posts: 85
Joined: May 2009

while you are on your thyroid meds??? if so, did the tg go up from 0.2 to 14 in just 4 months? This is quite a jump. Do you know if the same lab was used to measure your blood work results? IF the WBS does not show anything i would definitely request an ultrasound and/or a PET/CT.

... and yes, in my humble opinion you do need an endocrinologist as that is the type of doctor that specializes in thyroid cancer treatment. Most people do not see their surgeons much after their operation...

MLG
Posts: 52
Joined: Mar 2010

For 1 1/2 years my thyroglobulin has been 0.2 while on Synthroid.
I had my bloodwork done last Nov. 2009, still 0.2

Now, in March it is 14.

How does someone find a good endocrinologist who specializes in thyroid cancer?

miladyx
Posts: 85
Joined: May 2009

... yahoo group (thyca) for thyroid cancer patients... here is the link: http://health.groups.yahoo.com/group/Thyca/messages?o=1

You will have to subscribe to become a member but it has many many members and gets heavy traffic. if you post a question in that group asking for endocrinologists in the Chicago area, i would think you have a very good chance of getting recommendations...

By the way do you mind if i ask how old were you when diagnosed?

MLG
Posts: 52
Joined: Mar 2010

I found out 3 days after my 40th birthday and I am not even 42 yet.

I was supposed to start nursing school and had to have a school physical and that is how they found it.
Put nursing school off a year and started school this past August.

Looks like I might have to put it aside again.

Thanks a lot for your tips.

Michelle

miladyx
Posts: 85
Joined: May 2009

http://www.thyca.org/

it has a ton of vital information.

butterfly123
Posts: 52
Joined: Feb 2010

Hi Michelle-
I had the same thing. I was diagnosed 5 years ago with papillary TC and my Tg shot up a year ago. Before my Tg was always less than 1 while on thyroid meds and even with Tg stimulated. My tg jumped to 6 while on thyroid meds.

I do not want to scare you but I was told that a detection of tg (in the absense of antibodies) and post-RAI treamtent is a clear indicator of residual disease/recurent thyroid cancer. I hope you are able to find a good doctor or endo. I am so fortunate to have a doctor that would not give up trying to find the cancer. BTW, my thyrogen Tg is 50 and my hypo Tg is 150. My ultrasounds are always clean. I have had a lot of tests to find the Tg source including Ultrasounds, RAI tracer dose, Cts, MRIs and Pet/CT. Do not give up looking for the Tg source...although with your history of thyroid cancer in the lymph nodes then it is probably another lymph node that is affected. All my diagnostic tests were negative except the PET. If your doctor does not do anything then you should find another doctor that will.

Wishing you the best and make sure you find a doctor willing to help you. I have had a bad endo in the past and if I was still under that drs care I would really have problems. Good luck and let us know how you make out.

MLG
Posts: 52
Joined: Mar 2010

You said that yours came back and the PET found it. Did you have to go through another ablation and was your Tg a 6 when you had that done?
I might have spoken ahead of what I should but my dr is very, very good at what he does. I was only looking at the "what ifs", what if the scan shows nothing and he does nothing...

That might not be the case.

I wonder, if it is in more lymph nodes if ablation usually takes care of that or if that would be something that they would want to remove with surgery and then do ablation.

Here I go again...I just need to wait until I have the scan and then go from there.

It is really hard though to concentrate. I am in school and haven't been able to really concentrate on studying. I'm sure I'll flunk my test that I have next Wed. considering that is the time I have my thyrogen shots and RAI pill.
Thanks!
Michelle

butterfly123
Posts: 52
Joined: Feb 2010

Sorry i did not mean to day that your doctor was not good. I wanted to stress the point that an elevated Tg is something that needs to be dealth with. I read all kinds of posts about endos that want to watch and wait. What are they watching? And what are they waiting for?

My Tg of 6 was while I was thyroid meds so it definetly meant that it would be higher with thyrogen or while hypo. My Tg was not stimulated for my PET exam. Tg was 50 with thyrogen and then Tg was 150 while hypo.

When I was going through all the diagnostic testing I did have a tracer dose of RAI (with thyrogen shots). Some times the tracer is not enough to make things "light up" or a tumor/lymph node could be RAI-resistant. Also, when thyroid cancer lights up on a PET it usually does not take up on the RAI WBS...it's a flip flop effect. I actually had both things occur..... When we found the thyroid cancer tumor, I was then treated with a full dose of RAI in the hopes that it would take up RAI (eventhough it lit up on the PET). The tumor is RAI resistent but I also had other areas that did take up the RAI. I have more than one area of concern.

Insurance, at least my insurance, will only cover a PET if RAI tracer dose scan is negative and stimulated Tg is above 10. So depending....you may be able to have a PET done. But hopefully the RAI tracer dose will reveal the source. A PET also means that the tumor is more hungry since it took up the sugar and therefore considered more "agressive."

My lymph nodes were never invloved with my thyroid cancer. I believe the most patients, if they have a recurrent thyroid cancer lymph node, sugery is preferred then RAI.

I know how hard it is to deal with cancer and the unknown. It took about 5 months to find my Tg source and I still have thryoid cancer in my body (18 months later). I hope to start treatment in the next months then take things from there.

Let me know if I can help. I would be interested to know your Tg result after you have the thyrogen injections.

Do you have pure papillary thyroid cancer or a variant of papillary?

Good luck on your exams. I know it's hard and wishing you the best.

ima_survivor
Posts: 6
Joined: Jan 2010

Good doctors are hard to come by. i had to fight with my insurance forever to get the care I needed. The team of docs I have now have been really good to me, they even have a whole entire panel of extremely capable doctors look at and examine my individual case. If you are in California try for a UCLA referral for an endocrinologist through your primary care provider. If you have PPO it shouldn't be a problem, but with HMO you can make it work also!

elke
Posts: 1
Joined: Apr 2006

I am not sure what my levels have been. have been told in the past but cannot remember but will be sure to check. i had my thyroid removed in sept. 03 and they called me the next day to say they found folicular and papillary cancer and that this was the best cancer to have. that was the thyroid surgeon who told me this. since then have had the i131 body scan every spring. have been in the hospital 4 times to take the radiation iodine pill. my dr. told me a few weeks ago when i asked why i have to go all the time that i would have to have a clean bill of health for 2 years and then would only have to have the radiation iodine every five years. he has told me that the cancer is not necessarily back but that my thyroid tissue grows back and there may be cancer cells. Does all this sound right to anyone?? my dr. is very good and i trust his opinion. any comments???

LBelle
Posts: 42
Joined: Oct 2009

I just recently learned that my Tg level is 3.8. Is this alarming?

Corinne_M
Posts: 2
Joined: Nov 2009

I just received my Tg result today, and it was at .031. According to my endo, that is a good number it should be undetectable. But I have read on the many research that I have done, that as long as your Tg level is below 5, it is considered a safe level. However, it's always best to talk to your doctor about your results. I wish you all the best!

tonesgurl
Posts: 42
Joined: Dec 2009

tmcinally,

I had TT in July '09, 160millicuries of RAI in November '09 along with a bodyscan. My Endo says that it was clear except for the thyroid bed showed alot of uptake(?). I asked if it had gone into the lymphnodes he wasn't sure. I just recently had my thyroglobulin tested for the first time in this month and it is 6.8 he says I may need at least 1 more dose of RAI possibly 2. So at this point I am lost!!!!!!!!!! No other tests have been ordered like another ultrasound or anything. What to do next is what I need to know?????????
PLEASE HELP ANYONE

BellsAngel69
Posts: 102
Joined: Dec 2009

You should have a PET scan with elevated TSH level, but a lot of insurances won't do it unless your level is over 10. If the RAI whole body scan showed uptake, then it was probably residual thyroid tissue left over after your thyroidectomy. A follow-up RAI is what is usually ordered, and hopefully will kill off the remaining cells. That's the usual course of action.

If it went into the lymph nodes, chances are they would show uptake also, so I think it's safe to say it hasn't gone there.

tonesgurl
Posts: 42
Joined: Dec 2009

My TSH is 32.9 and my Endo hasn't said anything about me having or even needing a PET scan. I post here so that I can get other's knowledge and experience or even what questions I should be asking. I always make sure to have a list ready for my appointments but I often think matbe I am not asking the right questions?! Anyways......... thank you. I don't know of anything on the lymph nodes so I know that's a good thing. I often think that my doctor doesn't tell me everything (like trying to spareme or something, my opinion is tell me straight up so I know the full extent of whatever the situation is).

alapah's picture
alapah
Posts: 260
Joined: Oct 2009

Just wanted to point out that TSH and Thyroglobulin are two different things. It seems like everyone responding here, even if they say "TSH" really is speaking of thyroglobulin. Thyroglobulin is a tumor indicator but it also may merely indicate the presence of non-cancerous thyroid cells within the body. RAI ablation is intended to kill of all thyroid cells, cancerous or otherwise. Sometimes patients require more than one round of RAI to do this. The aim is to have a very low Tg number, as others have stated. If you have thyroglobulin antibodies (as i do) thyroglobulin is a less effective indicator.

TSH, on the other hand, is thyroid stimulating hormone. In thyroid cancer patients, Synthroid/levothyroxine are dosed at a level high enough to suppress cancer as well as supply the body with the needed hormone. You're basically made to be slightly hyperthroid.

tonesgurl
Posts: 42
Joined: Dec 2009

alapah,

I know the difference between the TSH and Thyroglobulin, I was asking questions about both. My Endo seems to be evasive with me when I ask alot of questions and being that I am kind of stuck with him due to my insurance, I post on here and ask questions to get other's experience and/or opinions.

I don't know alot of the throid cancer information and it has helped me alot to share and read other's knowledge on the topic.

alapah's picture
alapah
Posts: 260
Joined: Oct 2009

tonesgurl,
really sorry your endo is not helpful - having cancer is hard enough without docs who can't provide info and thoughfully answer questions. forums are definitely helpful in filling in those gaps. i had one doc i really disliked for that reason - he seemed so offended that i'd even ask a question at all, as though i was questioning his skills. anyway, i hope my post didn't offend - I actually just was confused in reading the post above yours.

tonesgurl
Posts: 42
Joined: Dec 2009

alapah,

No offense taken. I just get so frustrated with the whole situation, ya know?
My fam just expects me to be 'normal' as if nothing is going on and right now that's not happening! It's good to have people to listen and who can relate to what I am going through.

BellsAngel69
Posts: 102
Joined: Dec 2009

I keep typing TSH when I mean TG. Elevated Thyroglobulin indicates a reocurrence. Unfortunately, sometimes even a pet scan won't show anything with elevated TG, that's what happened to me. Mine TG was 29 but the PET was clean, so they thought. Six months later my TG was 130, and a subsequent PET showed a reocurrence in my liver, very, very rare. Lucky me. I just had a liver resection and am waiting for post TG level checks, which won't be done until May.

loispol1
Posts: 84
Joined: Feb 2010

I had my surgery from April 9 postponed because of a blood clot. My GP/internist ordered a complete thyroid panel for comparison for tests after my surgery. I just got the results and it says my thyroglobulin is 43.6 (H) and the normal range is 1.3-31.8. Of course I still have the thyroid. My doc said the elevation could be coming from the hurthle cell tumor (whether or not it is malignant?). I have hasimotos, FNA hurthle cell neoplasm, multinodular goiter since 1993. Hurthle cell neoplasm was still on small side in February, I think .7x.7x.7 cm. I have over 8 nodules -some are 1.5 cm others smaller. The two other nodules (1.5 cm and another) FNA biopsied came back benign. I read that having this test before is very helpful for post-surgery comparison as it indicated thyroglobulin levels can be relied on to gauge any returning of cancer? My thyroglobulin ab was <.9 range 0,0-4.0 IU/mL. This test done previously in 2007 by the same lab came back as < 3.0 with a lab range of 0.0-14.4 IU/mL? Did the lab range change? My TPO thyroid peroxidase was 41.0 which indicate antibodies, previously it was 40.0 in 2007. Now the lab range is 0-60 u/mL but my two different doctors told me this range is not accurate and I looked up this test online and saw two other labs showed ranges as normal being <20 IU/mL & the another said a positive result was >9.0 IU/mL. My FT3 & FT4 were right in the middle range and my doctor said they were perfect. My TSH has always been very low and on thyroid medication it has remained around .002 or so with no negative side effects. It did suppress my goiter and nodules; perhaps it has been keeping things at bay? I also had a reverse T3 result of 442 (H) normal ranges 90-350. My doctor told me there is still controversy concerning this test, and that having my thyroid out will change everything so we are just going to keep things the way they are for now. Anyone know anything about all this?

JESSCLARK30
Posts: 5
Joined: May 2010

I NEED SOME GOOD INFO , I WAS DIAGNOSED W PAPILLARY W FOLLICULAR VARIANCES(WHATEVER THAT MEANS) IN JULY 09 AT 31YR. I HAVE HAD TOTAL THYROIDECTOMY IN JULY 09,ABLATION IN AUG AND GOOD SCANS IN SEPT, ANOTHER I131 SCAN IN FEB W GOOD REPORT 2, AND RECENTLY STARTED SEEING ENDO AND SHE DID THYROGLOBULIN W ANTIBODY LABS AND THEY CAME BACK HIGH ON FRI, TG-4.6 AND TGAB-5.6, BUT TG TUMOR MARKER WAS 0.1 , I GO SEE HER ON TUES BUT I'M REALLY CONFUSED AND CONCERND!!! MY MD CALLED ME 4X ON FRI W CONCERN, PLEASE HELP

miladyx
Posts: 85
Joined: May 2009

In your message you said that your tg is 4.6 and then a little later you said your tg tumor marker is 0.1 - which is it - 4.6 or 0.1? if it is 0.1 there isnt much of a problem... or was it 0.1 and now it went up to 4.6?? If that is the case has the bloodwork been done at the same lab both times?

butterfly123
Posts: 52
Joined: Feb 2010

Hi Jess-
Hopefully by now you have spoken to your doctor.

If you have tg antibodies, then your Tg can measure falsly high or low. I am not sure what the Tg tumor marker means? Tg is the blood test used for testing reoccurnce post RAI therapy. I too have follicular variant of papillay and had reoccurence about 2 years ago. Your doctor will probably have you get a stimulated Tg test and Ultrasound.

Good luck and please let us know what you found out.

aykt36
Posts: 28
Joined: Jun 2010

thanks you

aykt36
Posts: 28
Joined: Jun 2010

thanks

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