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Old 11-17-2010, 10:28 AM   #1
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question on rise in TSH

I had thyroid cancer in June of 2008. Nods and thyroid removed and iodine radiation and radiation treatments followed, ending October of 2008. I just went through my six month check up. I had the two shots to prevent me going off thyroid replacement med of 200 mg. and blood work. My reading jumped from 4 to 11. Is that a concern? Dr. gave three options: 1) do nothing and retest in six months, 2) go on no-salt diet, iodine radition treatment and scan or 3) do CT scan to see if any exists. He also believes that the change in reading is nothing to be concerned about. Chest ex-ray and all other blood work have been normal. Advise????

 
Old 11-26-2010, 08:09 PM   #2
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Re: question on rise in TSH

Are you sure you mean TSH and not Tg (thyroglobulin)? TSH is thyroid stimulating hormone. If you were given Thyrogen shots for the WBS scan, your TSH should have been higher than those numbers. Were you given a full body scan as part of that regimen? If so, did it show any uptake of iodine?

In the 6month/annual tests, Thyroglobulin levels are usually tested - in a thyroid cancer patient, the target is zero or very close to it. The presence of Tg indicates thyroid cells are present somewhere in the body, cancerous or not. The idea behind the surgery and RAI is to eradicate all thyroid cells.

An increase in Tg can indicate disease. Docs tend to look at trends with Tg though, not just the number itself. So, if you have a rise in Tg, that can be a concern.

Do you have Tg antibodies? If so, that can mess with the Tg readings and make them potentially of little use. I have Tg antibodies and, although I have Tg readings that generally hover around zero, we know I have disease because we can see it in CT scans (I have lung nodules that don't show up in xrays).

If they did not do a 'tracer' dose of RAI with scan that last visit, I'd think that would be the next step. If nothing shows up in the body scan, a CT would be next. That's how my docs handled my last check up when my Tg number increased slightly.

Don't mean to alarm you, just hoping to help by sharing my experience.
Best to you.

 
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Old 05-19-2011, 12:24 PM   #3
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Re: question on rise in TSH

I am in the EXACT situation, but I do not find comfort in the fact that the levels are elevated. I think a history of cancer will do that to a person. I just did radioiodine scan followed by CT scan, both of which show a clear thyroid bed, but those levels still make me nerveous.

 
Old 07-21-2011, 11:14 AM   #4
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Re: question on rise in TSH

Quote:
Originally Posted by JamesRo View Post
I had thyroid cancer in June of 2008. Nods and thyroid removed and iodine radiation and radiation treatments followed, ending October of 2008. I just went through my six month check up. I had the two shots to prevent me going off thyroid replacement med of 200 mg. and blood work. My reading jumped from 4 to 11. Is that a concern? Dr. gave three options: 1) do nothing and retest in six months, 2) go on no-salt diet, iodine radition treatment and scan or 3) do CT scan to see if any exists. He also believes that the change in reading is nothing to be concerned about. Chest ex-ray and all other blood work have been normal. Advise????

 
Old 07-21-2011, 11:22 AM   #5
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Re: question on rise in TSH

Thanks for the response. I had a follow up CT scan after the Radioiodine uptake scan that was clear as well. I have personally decided to monitor the trends in labwork TG levels every few months, and go from there. They can't really treat something they can't visualize.
It does make me a bit unsettled that "good" or "bad" cells could be microscopic or traveled elsewhere and are not able to be picked up yet, plus, when I think of traveling cells, I think of bad cells being more likely to travel as opposed to healthy ones. When I think of cancer metastisis, it just makes more sense that the bad cells would take up residence elsewhere.
I would say decide what you feel comfortable with, and discuss it further with your Dr. I know that taking a wait and see approach is a difficult task, but why expose yourself to more radiation with further imaging?
just my opinion...I was diagnosed last March with papillary.
thanks

 
Old 07-23-2011, 07:09 AM   #6
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Re: question on rise in TSH (TG)

Was the test done at the same lab? Also, the TG test done on thyrogen will have a higher reading than one done while you are hypo.

If you look at the guidelines that all Doctors use for treating thyroid cancer, you will read that roughtly 1/3 of us will have TG where the source cannot be found. It is microscopic. They do not do repeated RAI's as often as they once did, because generally the source is in the lymph nodes which are usually not affected by RAI. The most dangerous type of thyroid cancer ie undifferentiated doesn't produce TG.

 
Old 07-27-2011, 06:50 AM   #7
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Smile Re: question on rise in TSH

Thanks for the info. The level was done at the same lab, and it was drawn during the week I received the Thyrogen, as I did not do a withdrawal scan.
I was diagnosed with papillary. I hope and pray it just some kind of fluke, and not microscopic cells somewhere.
Again, thanks for the response

 
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