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Should I inform my oncologist my TSH that was 0.69 2 years ago is now 7.35?

I am 3 years in remission for Lymphoblastic large B-cell non-hodgkin lymphoma.  I am 64 years old very physically fit. 30 years ago I had total thyroidectomy followed by radioactive iodine for hoshimotos thyroiditis and graves disease. I have been stable since then. Currently my T3 is 2.6 and T4 is 1.5. They remain stable yet my tsh level continues to climb. I do have several cervical nodes slowly enlarging where the first cancer was but not of pathological size.I am slightly suspicious of a possible relapse brewing as I have also been having night sweats and random hives, poor appetite(food has no taste) and tire easily. I am scheduled to see my oncologist in 8 weeks but wonder if I should tell him about my TSH level now. I have read there is some connection with BCNHL and pituitary adenomas? I do not have any signs of being hypothyroid yet my GP wants to increase my daily synthroid from 137mcg to 150mcg. Normal t3 and high normal range t4 aren't triggering the pituitary to produce more TSH what could be?
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Avatar universal
I sure do understand why you would be so concerned, after your prior experience.  

A couple of things to clear up.  Synthroid is synthetic T4.  Synthroid is just a brand name, like Levoxyl and Levothyroxine.  The only difference among them is the filler/binders/dyes used to make the different tablets.  Also, when I mentioned revising your med/dosage, I did not mean increase the Synthroid.  In actuality you could slightly reduce your Synthroid dose and add some T3 to raise your Free T3 levels into the upper half of the range, and then adjust further to relieve hypo symptoms.  

Further, TSH levels mean very little when taking thyroid med.  In most cases, TSH becomes suppressed below range when taking adequate thyroid med.  Many doctors don't understand that and if it occurs they want to reduce meds based on interpreting a suppressed TSH as being hyperthyroidism.  In reality it is hyperthyroidism only if having accompanying hyperthyroid symptoms due to excessive levels of Free T4 and Free T3.  I mention this only to make you aware of it since increasing your Free T3 level may suppress your TSH.  You can read about this in Rec. 10 on page 14 of this link.  My own TSH has been suppressed well below range for for 30-35 years without ever having hyper symptoms.  

http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf

As for being within "normal" limits, that doesn't mean adequacy.  The ranges are far too broad due to the erroneous methodology used to establish ranges.  The all important objective for treatment with thyroid medication should be symptom relief, not just test results, and especially not TSH levels.  You can read about this in Item 4 on page 5 of the above link.  In addition, every one can have different levels at which they feel best, since there are many other processes and variables that affect tissue thyroid effects (symptoms)  See also Fig. 1 in the link.  
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Avatar universal
Can after a total thyroidectomy and radioactive iodine 35 years ago could it grow back or thyroid tissue? I just looked at CT scan from 09/14 that report says " minimal remnant thyroid tissue".  CT scan 12/16 report says "thyroid gland within normal limits".  Hmmm?  I have a history of treating my MS with interferon beta 1-A weekly for 15 years. Was very successful of keeping progression slow but subsequently I developed non Hodgkin lymphoma and can no longer do that.
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Avatar universal
Besides Synthroid there are many generics like Levoxyl, or Levothyroxine.  All are synthetic T4 hormone.  Then there are the desiccated (porcine) thyroid meds like Armour Thyroid, NatureThroid, and Westhroid, all of which contain both T4 and T3.  And then there are the synthetic T3 meds like Cytomel, and generics.
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3 Comments
35 years ago when I had hosimots type2 thyroiditis and graves disease and went into thyroid storm while an inpatient trying to be built up enough to tolerate surgery As the thyroid had grown into surrounding tissues and not responding to drug control a total thyroidectomy (very difficult) was followed by radioactive iodine treatments to kill any remaining cells. My drs told me to always use only natural synthroid no synthetic drugs. Since my t4 is really at an optimal level wouldn't it be better to just add a t3 supliment instead of more t4 in hopes that the higher t4 level will convert more to t3? Also another interesting thing I noticed reviewing my CT scan of neck and chest 12/16 report lists thyroid within normal limits?
You can understand why I may seem a bit neurotic about my thyroid after experiencing thyroid storm(remembering the parts of it that I was conscious through)! It was a real challenge to get through that and I was only given a 70% chance of surviving the surgery and a 50/50 chance of having a voice.
Correction to my survival percentage of surviving the surgery! 30% of making it through the surgery.  Lol big difference!
Avatar universal
Your Free T4 is at 70% of its range, while your Free T3 is only at 16% of its range.   This imbalance is indicative of poor conversion of T4 to T3, likely due to taking only T4 med, correct?  

Many of us have found it best for Free T4 to be at least mid-range, along with Free T3 to be in the upper half/upper third of its range, or as needed to relieve hypothyroid symptoms.TSH means very little when already taking thyroid med..  In fact, the majority of people have suppressed TSH when taking adequate thyroid med.  Note that would not mean hyperthyroidism, unless there were accompanying hyper symptoms due to excessive levels of Free T4 and Free T3.  A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as necessary to relieve hypo symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH results.  

So you need your med revised.  What med/dosage are you taking now?
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You refer to t3 med and t4 meds? I have always taken synthroid. What are the specific t3 or t4 drugs your referring to?
Avatar universal
T3 reference range = 2.3 - 4.2
T4 reference range = 0.8 - 1.8
TSH reference range= 0.40 - 4.50
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Avatar universal
You said you have no signs of being hypothyroid, yet you mentioned several:  night sweats, hives (could be related to the antibodies of Hashi's), and fatigue.  Along with a Free T3 of 2.6, I expect that your thyroid medication is inadequate.  What are the reference ranges shown on the lab report for the T4 and T3 results?
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I had hoshimotos 35 years ago
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