Thyrogen protocol and Synthroid dosage

[PaulVS]

I am having my Thyroid removed on April 17th because of Papilloma Cancer probably Stage 2.   I can use Thyrogen
for the cancer treatment 8 weeks after the surgery.   This means I can start Synthroid the day after surgery.
Whether it's wise to avoid the traditional weeks of hypothyroidism and go with an artificial TSH booster is probably a good question but that's not my real question.   The question is dosage... my Thyroid is coming out and in time leading up to the surgery it will be performing normally.   My T4 bioavailable numbers are 1.14 and my TSH is 2.3.
So when the gland comes out, I start with a full bank of T4 and a fair amount of T3 still circulating.   My doc is starting me on a 25 microgram dose of Synthroid, (actually wants me to get compound thyroid so this is the fallback if I can't find that in my rural area)... then probably double it in 2 weeks.    I'm worried he's being too conservative.
I want the cancer-suppressing effects to be strong, and I don't want to be unnecessarily hypo (88% of normal is ok)
I know eventually I'll probably take 137 mcg, as I will have no gland at all.   What's your feeling about this starting
dose... off the wall low or a good approximation?   Paul in upstate NY.

[stny22]

Please call your doctor to confirm his/her treatment plan.  Do not stop without consulting them.   I had my first of the two thryrogen shots this morning and my doctor had me maintain my synthoid the whole time.

[ojramos]

do i continue taking my synthroid if 'm about to have a thyrogen shot tomorrow and the next day?? anyone??

[nissah46]

I am also from a small town, in Nova Scotia, Canada. Before being diagosed I had not heard about thyroid cancer.  Since then, I have encountered many people with it. It is much more prevalent than 30 years ago. I thought Thyrogen was more commonly used in the U.S., and less so in Canada.  When I met my endo oncologist he was just starting to use it, and really encouraged me to do so. Although it is very expensive it is worth it not to have to go hypo.  Good luck in looking for a new endo.
Trish

[PaulVS]

Thank you Nissah46,

I called my hospital and they said they would give me a one-month's supply of Synthroid after the surgery so I can quickly get a different endocrinologist.   This one owns his own hormone company and is trying to push compound thyroid on me.  
The hospital said I would get 125 Micrograms to start (I weigh 145, 50 yrs old).
Why this endo wants me on 25 Mcg for 2 weeks before going to 50 for 2 more weeks...
But living in upstate NY, Thyrogen is rarely used.   And Thyroid Cancer is fairly rare
in a small town.    I see you waited 5 months for RAI... that is also fairly new information...that scans done 6 weeks after TT are too soon and waiting until later
isn't a bad idea.   Now I am trying to get a new endo, 3 days before surgery.
/Paul

[nissah46]

I had a TT May/06. I was started immediately on synthroid125, and I also had a full functioning thyroid leading up to surgery. I had Thyrogen and RAI 5 months later in Oct.Thyrogen again in April/07 and will again on April 21and 22. My concern at the time of the first treatment was controversy about getting a good scan.  My doctor assured me it was just as reliable as going off meds, so I put my trust in him. I had read a book by Sara Rosenthal that implied it was not reliable, but he said the book was dated.By the way the book is excellent to read in advance and I refer to it frequently. It is The Thyroid Cancer book. Second Edition, by M. Sara Rosenthal,Ph.D.  I found it was written in easy to understand language.

[redhed87]

After my tt for cancer last May, I was not on any thyriod meds for a month until my RAI.  I went extremely hypo (tsh in the 70's).  AFter RAI, my doctor start me on 75mcg to be conservative.  It took about 7 months to find the right dose for me.  I am on 250 mcg and my tsh is .011  Everyone is different and absorbs differently.  I am 5'10", but I am thin.  He is still blown away by my dose being so high.  You have to wait to see how your body reacts.  I thought they didn't use thyrogen until you have had one clean scan.  

[KelDC]

Welcome to the board, Paul!  I am also in upstate NY, and I just had my thyroid removed on Monday. Like Shannon, I was prescribed Cytomel (25/2 x day) for after the surgery. When we found out I could do Thyrogen for RAI, my endo gave me Synthroid instead. I've been started on 150. I honestly don't know much about the dosage, but I'm sure someone here will have plenty to offer on that.  

Best of luck and again, welcome!

[PaulVS]

Ok, good to know and glad to hear you got those lovely drugs working for you.
Yup, it's good to get that sickly gland outta there, I wish you all the best on a speedy
recovery and a nice rest, if you are able to get any!  /Paul

[shannon828]

Welcome to the group Paul!  I just had my TT yesterday and am at home resting comfortably (and enjoying the wonders of modern pharmaceuticals).  My Endo told me that my Synthroid dosage will likely start out at 125, but they prescribed 25 mg of Cytomel taken twice a day, which I started today.  Cytomel is more fast acting and leaves the system faster, which is why I think they prescribed it.  I am also having Thyrogen injections for my scans/RAI and all the research that I've done indicates that in combination with the LID it is equally effective as going Hypo.  I know there are others on the board who can help you with your dosage question, but I just wanted to say hello and wish you the best on your surgery!!!