TSH Down, Tg up?

[shannon828]

So, I had my regularly scheduled follow-up ultrasound and bloodwork for ThyCa and while my ultrasound didn't turn up anything of interest, it seems that my Tg has risen from .9 to 2.0 while my TSH has dropped to .39 from .51.  Anyone have any freaking idea what that means?  LOL.  I am scheduled for a Thyrogen stimulation in July to see if my Tg rises when they stimulate my TSH, which would determine any further testing/scanning/treatment.  Does anyone have experience with detectable Tg levels and suppressed TSH?

[nissah46]

That's why we are monitored for life Shannon.  The Tg testing gives the doctors a heads up if there is any thyca lurking.  I know the waiting is horrible, but just know that it is very slow growing.  
Trish

[shannon828]

Thank you for your responses, really appreciated.

nissah:  My TSH was less than .1 (.096) only immediately following my TT.  Since then it's gone from 4.1- .51- .73- .56 and now .39.  My dosage has changed a few times since my TT, but I've been on my current dosage of .175 since July of 2009.

utah:  My Tg has never been less than .8.  Immediately following my TT it was 1 and then went to .8- .9 and now to 2.0  Obviously, there is a trend here and the idea of waiting another 6 months to find out that I have to have another treatment dose is annoying.  I don't want to spend 6 months worrying and then another 3 months anticipating the dose, etc.  I was VERY sick when I got 75mci back in May so I really would be dreading it.

Blah.  Freaking ThyCa.  It's like you never feel like you're out of the woods!

[utahmomma]

Shannon,

Your TSH is okay but *should* be lower.  The tricky thing is, when you are this suppressed, raising the dosage of your T4 meds enough to get the TSH to .1 without throwing you into thyroid storm.  Many endos would just say "good enough".  However, your Tg is concerning.  Don't wait 6 months to get it retested - it should be checked every 3 months or so.  They need to establish a trend on it.   If it continues to rise while the TSH is below 1.0 then it's a sign of recurrence.

My Tg has gone from .2 to .7 and my endo wants to test every 2 months and we are planning on another treatment dose this summer if the trend continues.  :-/

The Tg is much more sensitive to a recurrence than an I-131 or I-123 uptake or an ultrasound.  Tg will show microcancers growing before they can ever be visualized on imaging studies.  If it stays above 2.0 you need another *treatment* dose (not just scan dose).

Sorry.  :-(


HUGS

Utah
(more radiated than I care to be)

[nissah46]

Shannon was your latest Tg test unstimulated?  I think anything <.3 is considered undetectable, so they will want to find out why yours has risen.  We also want our TSH suppressed to less than 0.1.  Did they increase your synthroid dose?  Some doctors are allowing the TSH to rise slightly after a clean scan and undetectalle Tg.  
Trish