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Very high post-surgical Tg

Posts: 6
Joined: Jul 2010

Hi all: I'm new and looking for anyone who has had a high post-surgical Tg.

My synopsis:

Early May: Dx -- papillary carcinoma
5-17-10: TT w/7 of 14 lymph nodes positive for cancer
6-29-10: RAI scan dose shows 1 additional lymph node, uptake in neck only
6-29-10: RAI dose 178 mci based on post-surgical Tg of 221
7-7-10: Post-treatment scan scheduled

One question I have is whether my high number can be attributed to thyroiditis-like symptoms at diagnosis (tender thyroid, quick enlargement, mixture of hypo and hyper symptoms).

Could the remaining tissue be high in Tg because of thyroiditis and not necessarily cancer?

Haven't asked my doc this question yet.

Nuke doc says he's "very concerned" and we'll likely do a CT scan in 4 months to look for tumors. After that, another RAI around January. Haven't talked to Endo yet.


Posts: 52
Joined: Feb 2010

I did not have a high Tg post-surgery. But I thought that it can take a couple of months for the Tg to get out of your body. Because it circulates in the blood, the time frame will vary from person to person. You are not even 2 months post TT so I would expect that your Tg will be lower. Although the Tg level of 221 is still high. The most important Tg level will be after your RAI treatment (and RAI can take awhile to work, even up to 1-year until you see the true Tg level).

The RAI absorbs thyroid cells only and tg is only made from thyroid cells or thyroid cancer. So there is a very good possibility that your have additional lymph nodes that could be thyroid cancer or other tumors. Also, it sounds like you have only had the tracer dose of RAI.....the full dose (178 mci) may show additional areas. Sometimes the tracer is not enough and additional sites will show up only after you have had the full RAI dose.

I have recurrent thyroid cancer (follicular variant of papillary). My Tg went up to 150 while hypo approx 4 yrs post TT. I was told by every endo that any detectable Tg post TT and post RAI treatment is residual thyrid cells/tissue or recurrent cancer.

Sounds like you have good doctors. If you still have detectable Tg after everything, make sure your doctors keep looking for the tg source. It may take awhile and the waiting is very stressful.
Best of luck and health to you!!!

Posts: 1
Joined: Oct 2017
I am a 69 years old, male. Because of a substernal goiter that was pressing my trachea I had a total THYROIDECTOMY on august,15. There was no pain at all or any kind of symptom. The substernal goiter was diagnosed incidentally by a chest Rx and CT, prior to my partial prostatectomy, to remove a benign hyperplasia.
The after surgery biopsy found a 0.4 cm pappilary microcarcinoma stage pt1a. The surgeon told me that it was restricted to the thyroid left lobe, there was any metastases or neck lynph nodes invasion. He told me there was NO need to do I131 ablation and sent me to an endocrinologist..
On october,17, aproximately 60 days after surgery, I did a neck ultrasound and the results were "clean". According to my endo, nothing to be concerned. 
On the same day, aproximately, I did a blood job. The more important results are:
TSH = 16.67 mcUI/mL - Very high indeed. My daily medication is levothyroxine sodium 100. In the first week after surgery I had levothyroxine sodium 50, then next week levothyroxine sodium 75. The blood job was done when I had 40 day having levothyroxine sodium 100.
Previous exam done on june,9, before surgery, resulted in TSH = 2.62 mcUI/mL
Free T4 = 1.0 ng/dL - The same value I had before the surgery on a blood job done on june,9.
TgAb = 10.0 U/mL - The same value I had before the surgery on a blood job done on june,9.
Tg = 2,6 ng/mL - In the previous blood job, my doctor did not asked it. It should be below 2.0 ng/mL. I have read that this level can drop after some months, even years. I hope it is caused by benign remaining thyroid tissue after TT. I will ask my endo to go on thyroxine to suppress TSH and avoid remaning tissue to grow. Only levothyroxine will be not enough!
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