Tsh level 3 yrs following pap. Cancer with Follicular Variant

[Sbow]

Hi Dr Lupo,
I am 3 years following my diagnosis in Dec. 2009.  (2 nodules, 1 was 1cm and 1 was .9 cm, Pap. Cancer with Follicular Variant)  My tsh levels have been good, anywhere from .01 - .9.  But since this October I have had several viral infections (Sinusitis, Bronchitis, Tonsilitis) than developed Oral Thrush and have had it for 4 weeks and after 3 meds for it I think it is finally getting a little better.  So my ENT doctor ( who also performed my 2 thyroid surgeries) ordered some blood work, tsh, t4, mag., phos, and B12.  All came back ok except my tsh is now 10.23 and in June of this year it was .9.

   My question is should I be concerned since my tsh level raised that much in a matter of 5 months?  I have been very tired, wake up a lot at night to use restroom, have some occasional night sweats, and dry mouth along with the thrush symptoms I have had.   It also took me 6 weeks for my symptoms to improve from my viral infections.  Had steroids along with antibiotic treatment.

Any advice you can give me would be greatly appreciated.

[Sbow]

Thanks Dr. Lupo!  I have had my prescription changed from Synthroid 125mg to 150mg, hopefully that will help.  Do you recommend having a thyroglobulin test.  I'm scheduled for one in June and also my annual u/s.  Thanks for your comments!

[Mark Lupo, M.D.]

It sounds like you need a higher dose of thyroid hormone replacement.  The TSH of 10.2 is not predictive of recurrence of the thyroid cancer.  The most important part of thyroid cancer followup is thyroglobulin blood test and neck ultrasound.  These are usually done on annual basis for the first couple of years.