thyroid cancer

[jiggyjog]

I had surgical removal of my left thyroid lobe for a mixed papillary/follicular cancer in 1980.I was put on a high dosage of eltroxin to suppress production of TSH. My T4 was elevated but the only symptom of hyperthyroidism I had were palpitations.I have now been told my T4 should be normal with onlyy slight suppresion Of TSH. My Tsh is now .743 with a normal value of !.0. I've read that the TSH  should be <0.1. Should I be concerned.I do not want a reoccurrence of my cancer.

[jiggyjog]

No I didn't have RAI after surgery. I had a cold nodule and was told the only treatment required was suppression of TSH. My TSH was suppressed to <0.01 for over 20 years and it was only after I moved away and changed doctors that my dosage of eltroxin was changed. I really do feel much better on the lower dose and I have never had any reoccurrence. I am glad I found this site as it is nice to talk to people who have been through a similar experience especially when it was cancer.

[utahmomma]

Did you have RAI after your surgery?  My TSH was suppressed to around 1. for years then I had a recurrence and needed RAI.  Now my target level is .1.

There are lots of us who have been through thyroid cancer on the thyroid disorder forum if you need to discuss with other patients.

Utahmomma
papillary carcinoma '03
RAI '06

[jiggyjog]

I think my cancer must have been stage 1 or 2 as there was no malignancy found outside the gland itself and no distant metastacies.The lower limit of the TSH range is 1.0. Thank you for your speady reply.

[Fernando Roque, MD]

Hi. The NCCN guidelines for TSH suppression using thyroid hormone specifies that the correct dose of thyroid hormone is the dose that "decreases the serum concentration to just below the lower limit of the normal range for the assay being used".  Excessive suppression of TSH to thyrotoxic levels (levels where you start having hyperthyroid symptoms) is not recommended for lower risk (Stage I - II) patients.  So my question is: are you stage I-II? And what's the lower limit of  the normal range for your TSH assay (you can look for this in the written official results from the lab.)? If you're stage I - II, your target TSH should just be slightly below that lower limit of normal.  If your present TSH value of 0.743 is above the lower limit, you may need to increase the dose of your eltroxin.