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Elevated Thyroglobulin Levels
I am normally a very energetic out-going and lively person who, over the last year, experienced MAJOR stressors in my life. I am an Emergency Room Nurse Practitioner by trade, and I am not one to complain, since I see, on a daily basis, so many things that make me feel grateful for what I have...BUT...
I found a nodule on my thyroid three months ago and finally went to one of NYC's best Endocrinologists last week for a work-up, since I have so many symptoms of hypothyroidism...fatigue, loss of eyebrow hair, hair thinning, irregular menses, emotional liability, dry skin, weight gain, etc. My thyroid scan showed a few small nodules, and I also have some cervical lymphadenopathy. My TSH is normal (2.62), and all my other thyroid function tests are within normal limits.
My Doc did not do a biopsy during my first visit; he chose to wait for the results of my blood tests. Everything was normal, except that I have elevated levels of thyroglobulin.
Do I need a biopsy?
Thanks, in advance, for any info you can offer to help me feel better.
I found a nodule on my thyroid three months ago and finally went to one of NYC's best Endocrinologists last week for a work-up, since I have so many symptoms of hypothyroidism...fatigue, loss of eyebrow hair, hair thinning, irregular menses, emotional liability, dry skin, weight gain, etc. My thyroid scan showed a few small nodules, and I also have some cervical lymphadenopathy. My TSH is normal (2.62), and all my other thyroid function tests are within normal limits.
My Doc did not do a biopsy during my first visit; he chose to wait for the results of my blood tests. Everything was normal, except that I have elevated levels of thyroglobulin.
Do I need a biopsy?
Thanks, in advance, for any info you can offer to help me feel better.
Hi..I suspect I might have a thyroid problem and am researching doctors..I live in Manhattan. Would you please share the name of the Endocrinologist that treated you?
Thanks so much!
Thanks so much!
My thyroglobulin was checked three times and was 3803, 5700, and 2840. My lab said that <56 was normal. I had my thyroid removed and it was benign. Tg means nothing unless you have ThyCa and then it's (Tg) used to measure growth/recurrance.
Tg can be elevated by hashimotos, by any sort of trauma like a biopsy, or by certain antibodies in your blood like heterophile antibodies.
Tg can be elevated by hashimotos, by any sort of trauma like a biopsy, or by certain antibodies in your blood like heterophile antibodies.
GravesLady-
Thank you so much for taking the time to answer my question and being so informative!
My nodules are very small--2mm--so I guess the course is careful monitoring.
You mentioned that a number of benign thyroid conditions may be associated with elevated thyroglobulin levels, and I am curious/eager to learn what they may be. I would like to figure out what caused my thyroglobulin to become elevated.
Calcitonin levels were not done. My only abnormal values were:
Thyroglobulin: 38.2 (high)
PTH, intact: 9.6 (low), but my calcium was normal (9.8), so this was not significant
MCH: 34.1 (high)
DHEA: 222 (high)
17-OH-Pregnenolone serum and dihydrotestosterone are pending.
FYI, my TFT results were normal:
TSH: 2.62
T4, total: 10.4
T3 uptake: 27.7
T4, free, calculated: 2.88
Thanks, in advance, for your kind assistance. I appreciate the information and am grateful to have learned so much in the last few hours!
Alison
Thank you so much for taking the time to answer my question and being so informative!
My nodules are very small--2mm--so I guess the course is careful monitoring.
You mentioned that a number of benign thyroid conditions may be associated with elevated thyroglobulin levels, and I am curious/eager to learn what they may be. I would like to figure out what caused my thyroglobulin to become elevated.
Calcitonin levels were not done. My only abnormal values were:
Thyroglobulin: 38.2 (high)
PTH, intact: 9.6 (low), but my calcium was normal (9.8), so this was not significant
MCH: 34.1 (high)
DHEA: 222 (high)
17-OH-Pregnenolone serum and dihydrotestosterone are pending.
FYI, my TFT results were normal:
TSH: 2.62
T4, total: 10.4
T3 uptake: 27.7
T4, free, calculated: 2.88
Thanks, in advance, for your kind assistance. I appreciate the information and am grateful to have learned so much in the last few hours!
Alison
Nodular thyroid disease is extremely common: a 5 to 10% lifetime risk exists for developing a thyroid nodule which can be felt. Some of these are cancerous. Only certain kinds, about 20% of nodules develop into cancer.
Over 12,000 cases of thyroid cancer are diagnosed annually in the United States (0.004% of the population), but thyroid cancer-related deaths are rare.
It is always better to be safe by having nodules checked out, then to be sorry later.
Thyroglobulin is the protein precursor of thyroid hormone and is made by normal well differentiated benign thyroid cells or thyroid cancer cells. Although thyroglobulin levels may be elevated in thyroid cancer, a large number of benign thyroid conditions may also be associated with elevated levels of thyroglobulin, therefore, an increased thyroglobulin alone in a patient not known to have thyroid cancer is not a sensitive or specific test for the diagnosis of thyroid cancer.
If nodules are large enough fine-needle biopsy is recommended. Biopsy of nodules greater than 1 cm to 1.5 cm in size advocate biopsy of nodules.
2mm are cause for careful monitoring. With 11mm and 13mm
Suggested the following test:
PET/CT scan
Radioactive iodine uptake (RAIU) - Determine whether thyroid cancer has spread beyond the thyroid gland.
Thyroid imaging with radioactive iodine - will determine how your thyroid nodule is functioning.
Thyroid ultrasound cannot determine if thyroid nodules are cancerous or non-cancerous, but it can be a helpful diagnostic tool for identifying and measuring thyroid nodules as well as determining their structure.
Fine needle aspiration biopsy is the most important and definitive test to determine whether a thyroid nodule is cancerous is the fine needle aspiration biopsy. Most studies have shown that the greater number of separate needle aspirations done at the time of the biopsy, the greater yield and ultimate accuracy of the biopsy procedure. Hence it is common practice for several attempts to be made in the course of the biopsy procedure, or for the needle to be inserted into a few different locations within the thyroid nodule. A biopsy may not always give 100% accurate results, however, good centers will end up with informative and accurate results about 80-90% of the time a biopsy is done, certain types of nodules showing lots of follicular cells or Hurthle cells result in an inability to make an accurate preoperative diagnosis. With the limitations of the test, it will not be uncommon for you to have more than one biopsy in the first year of assessment, depending on the size of the nodule, the clinical appearance of the nodule, and the judgment of your doctor.
Open thyroid biopsy is another way if FNA can not be done for whatever reason. The biopsy can be done in approx 15 minutes, while you are still under and open. If it is cancerous they can operate right then and there. No waiting to come back for another incision/operation.
Calcitonin is available as a sensitive and specific tumor marker in the diagnosis of medullary thyroid carcinoma. Elevation of calcitonin almost always indicates the presence of medullary thyroid carcinoma, except for slightly elevated levels that are found in other neuroendocrine tumors, such as carcinoid, lung cancer or in pheochromocytoma and in patients with renal failure. The sensitivity of calcitonin measurement is improved by stimulation with pentagastrin. As for thyroglobulin assays, a high dose “hook” effect may occur at very high concentrations of calcitonin.
Some doctors, with certain type of nodules, will take the wait and see approach. That is, to see if it grows and at what rate.
You should talk this over with your doctor. He knows best, your particular situation. Hope this is not more than you wanted to know. I get carried away with info. ;)
Gook luck and think positive.
Over 12,000 cases of thyroid cancer are diagnosed annually in the United States (0.004% of the population), but thyroid cancer-related deaths are rare.
It is always better to be safe by having nodules checked out, then to be sorry later.
Thyroglobulin is the protein precursor of thyroid hormone and is made by normal well differentiated benign thyroid cells or thyroid cancer cells. Although thyroglobulin levels may be elevated in thyroid cancer, a large number of benign thyroid conditions may also be associated with elevated levels of thyroglobulin, therefore, an increased thyroglobulin alone in a patient not known to have thyroid cancer is not a sensitive or specific test for the diagnosis of thyroid cancer.
If nodules are large enough fine-needle biopsy is recommended. Biopsy of nodules greater than 1 cm to 1.5 cm in size advocate biopsy of nodules.
2mm are cause for careful monitoring. With 11mm and 13mm
Suggested the following test:
PET/CT scan
Radioactive iodine uptake (RAIU) - Determine whether thyroid cancer has spread beyond the thyroid gland.
Thyroid imaging with radioactive iodine - will determine how your thyroid nodule is functioning.
Thyroid ultrasound cannot determine if thyroid nodules are cancerous or non-cancerous, but it can be a helpful diagnostic tool for identifying and measuring thyroid nodules as well as determining their structure.
Fine needle aspiration biopsy is the most important and definitive test to determine whether a thyroid nodule is cancerous is the fine needle aspiration biopsy. Most studies have shown that the greater number of separate needle aspirations done at the time of the biopsy, the greater yield and ultimate accuracy of the biopsy procedure. Hence it is common practice for several attempts to be made in the course of the biopsy procedure, or for the needle to be inserted into a few different locations within the thyroid nodule. A biopsy may not always give 100% accurate results, however, good centers will end up with informative and accurate results about 80-90% of the time a biopsy is done, certain types of nodules showing lots of follicular cells or Hurthle cells result in an inability to make an accurate preoperative diagnosis. With the limitations of the test, it will not be uncommon for you to have more than one biopsy in the first year of assessment, depending on the size of the nodule, the clinical appearance of the nodule, and the judgment of your doctor.
Open thyroid biopsy is another way if FNA can not be done for whatever reason. The biopsy can be done in approx 15 minutes, while you are still under and open. If it is cancerous they can operate right then and there. No waiting to come back for another incision/operation.
Calcitonin is available as a sensitive and specific tumor marker in the diagnosis of medullary thyroid carcinoma. Elevation of calcitonin almost always indicates the presence of medullary thyroid carcinoma, except for slightly elevated levels that are found in other neuroendocrine tumors, such as carcinoid, lung cancer or in pheochromocytoma and in patients with renal failure. The sensitivity of calcitonin measurement is improved by stimulation with pentagastrin. As for thyroglobulin assays, a high dose “hook” effect may occur at very high concentrations of calcitonin.
Some doctors, with certain type of nodules, will take the wait and see approach. That is, to see if it grows and at what rate.
You should talk this over with your doctor. He knows best, your particular situation. Hope this is not more than you wanted to know. I get carried away with info. ;)
Gook luck and think positive.
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