Thryglobulin test result

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 said:

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.</p>

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?

litman25 said:

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?

Elevated TSH usually means cancer
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.

tonesgurl said:

tmcinally,
I had TT in July
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

tonesgurl
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.

Just wanted to point out
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.

alapah said:

Just wanted to point out
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.

alapah,
I know the
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 said:

tonesgurl,
really sorry your
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.

alapah,
No offense taken. I
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.