please I need an answer

[charleymac7236]

I have had no energy with lots of agitation and anxiety for 2 months now. My Doc. did a TSH 3rd gen. test on me, it was 0.173. Please tell me what that means? tks

[tito55]

YOU DR. are the ONLY Thyrroid Specalist that I could find on this very helpfull medical sight  and I am very sorry for all the continued questions but my wife,s endo rushs us out of the office before I can ask other questios PLEASE HELP .I am very sorry but I forgot to mention this. Well the endo is waitng for a room at the hospital for her RAI. I asked if it was absolutely necessay and he replied yes. So a asked if there was any cancer left and he was not sure but was not happy with the Tg level of 8.1 and felt very confident that to play it safe he would recommend RAI so she is trying to  get her mind and body ready for it. I asked when should she start her low iodine diet and he relied that it was not necessay because her TSH level was on 04/07/10, 70.1 and by the time the RAI would be given it would be much lower. What do you think about all this? Thank you so much. Dr. Lupo

[tito55]

I was tring to remember the report by memory, and  I am very sorry for the confusion. I have a copy of the Pathology report in front of me and I will type it exactly the same for you to read and if you can give me your opinion on the need of RAI. The endo is waiting for a room in the Hospital to become available, for the RAI on my wife . Thank you for all your help, consideration, patience and time.

                                  
                                                            Diagnosis
1. Benign Parathyroid tissue.
2. "     "     "     "            "
3.Total thyroidectomy showing:
-      Foci of Thyroid papillary carcinoma, bilateral, up to 2.5 cm. in size.
-      The main tumor nodule located at the left mid and lower lobe of thyroid
parenchyma with partial involvemfent of left side of isthmus.
-      Capsular fibrosis, foci of calcifications and a few giant cells present.
-       Inked resection margin negative for malignancy.
4.Nodular benign thyroid tissue, no definite lymph node seen.

                                                     Comments
Tumor summary:
1. Type of tumor-     Papillary carcinoma.
2. Size of tumor-      0.4 and 2.5 cm. in size.
3. Grade of tumor-    Well to moderately differentiated.
4. Invasion beyond the thyroid capsule- Not idenified.
5. Lymphovascular invasion- Identified.
6. Number of tumor nodules - two.
7. Non-tumor thyroid tissue - Unremarkable.
8. Lymph nodes -    Not identified.
9. AJCC Pathology Stage  -  T2, NX, MX, Stage II.    

  Last questions  what do mumber 5 and 9 mean?   iMuchas Gracias!                            

[Mark Lupo, M.D.]

Usually this is not significant - monitoring alone is recommended in most cases w/ repeat thyroid labs in 6-8 weeks to see if this is a slight transient abnormality or not.  If persistently slightly low TSH and with persistent symptoms w/o other cause, we sometimes (but not always) use a low dose of methimazole to completely correct the TSH to see if it helps.