Rising Thyroglobulin

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Hi all, I had a TT in Nov 2019 for papillary thyroid cancer. No RAI. since then my TSH has always been well suppressed and Thyroglobulin has always been undetectable <0.1.

bloods a couple of weeks ago show TSH of 46 and thyroglobulin of 6. Antibodies remain 0. 

I have not changed levothyroxine dose-100mcg and am vigilant about taking 1hr before food/caffeine etc and 4hrs before calcium. 

plan is to increase levo to 125mcg 4xweek and 100mcg 3x week and repeat bloods in another 2 weeks with follow up appt to see if anything has changed again. 

just looking for some advice really, concerned about the Tg changing and can’t understand why the TSH has risen so high with no lifestyle changes. Am I right to be concerned?

has anyone had a Tg of 6ish and had recurrence? 

  • Hi. After being well suppressed with very low thyroglobulin your high TSH is surprising. It is good to see you are being retested to check if there was an error in the test. Hope it all works out well for you. 

  • The Tg of 6 should not be a cause for concern because it's - effectively - a 'stimulated' level. By your TSH being so high, your Tg is increased - in the same way it would be if you had a thyrogen injection or went off your medication for a few weeks.

    To compare stimulated and unstimulated is not effective.

    My concern for you is how you've got your TSH that high.

    You clearly know how to take the tablets so I would suggest:

    * check the expiry date on your tablets. Could they have been out of date or stored incorrectly? 

    * did the brand of tablets change in the months before you had your blood test? It shouldn't have such a big impact, but some people may have issues

    * did you put on a ton of weight between blood tests that might have needed you to increase your dose?

    * have you started taking any other kinds of medication that could be interfering - even if you take them at a different time of day? Some drugs and supplements need to be taken at least 4 hours after you thyroxine.

    Best wishes

    Barbara

    “Scars are tattoos with better stories.” – Anonymous

  • Hi thanks for this, I am concerned that it’s detectable though. Surely if the whole thyroid was removed then even the stimulated Tg should be undetectable? 

    I’ve checked all the interactions and the expiry dates and all is fine. The brand has changed though. I’ve put a little weight on but not enough to make this much of a difference.