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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Elevated Thyroglobulin
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.
Elevated Thyroglobulin
by MNC, Aug 09, 2006 12:00AM
In March 2006, I was diagnosed with papillary and follicular carc. I had 2 surgeries (three weeks apart) to remove all nodules and thyroid tissue. I was put on 125mcg of Levothyroxine (Synthroid). My TSH (.60) was higher than he wanted it to be, so he upped my synthroid to 137mcg. I had RAI treatment in May 2006. My Oncologist ordered a thyroglobulin test a couple of weeks ago. The results were that the thyroglobulin levels were 60. My Oncologist has scheduled higher dose RAI treatment for next month. What does it mean when thyroglobulin levels are high? Is another treatment necessary?
Doctor's Answer
by Mark Lupo, M.D., Aug 09, 2006 12:00AM
, Aug 09, 2006 12:00AM
The high Tg level means there is still thyroid tissue present -- the question is whether this is normal thyroid or cancer.
Please make sure the thyroglobulin antibodies are being tested with the Tg levels -- if the antibodies are positive then the Tg is NOT interpretable.
You are only 3 months post I-131 -- I usually do not repeat the dose for 5-6 months. What was the initial dose? Were you off synthroid or did they do it with Thyrogen? What did the post-treatment scan show?
I am concerned about simply giving more I-131 -- I would do a thorough neck ultrasound (tough to find someone who can really do this) -- looking for lymph nodes or thyroid "bed" masses.
Give some follow-up on this -- let me know where you are as I think you need to see a thyroid specialist to make sure more I-131 is the next right step.
Please make sure the thyroglobulin antibodies are being tested with the Tg levels -- if the antibodies are positive then the Tg is NOT interpretable.
You are only 3 months post I-131 -- I usually do not repeat the dose for 5-6 months. What was the initial dose? Were you off synthroid or did they do it with Thyrogen? What did the post-treatment scan show?
I am concerned about simply giving more I-131 -- I would do a thorough neck ultrasound (tough to find someone who can really do this) -- looking for lymph nodes or thyroid "bed" masses.
Give some follow-up on this -- let me know where you are as I think you need to see a thyroid specialist to make sure more I-131 is the next right step.
I was put on a low iodine diet for 10 days, taken off Synthroid for 7 days, & received Thyrogen injections as well.
The post treatment scan showed that the entire neck area was lit up, and my Oncologist said that was normal after treatment.
My post treatment blood work revealed a thyroglobulin level of 1300. So, he repeated my blood work a couple of weeks ago, and the levels were down to 60. He seemed a little concerned that the levels were still elevated, told me there may be some very small cancer cells present, and scheduled me an appt. to receive a higher dose of RAI next month.
I will make sure the thyroglobulin antibodies are being tested with the Tg levels.
I may very well get a second opinion with a thyroid specialist.
Thank you for the info.