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Thyroglobilin Counts
Sept 2013 I had a total thyroidectomy for papillary thyroid carcinoma. I was administered I-131 a few mo. following surgery. My Thyroglobulin Antibodies continue to be in the high range in Dec, 2013 at 145, in June 2014 at 79 and in Sept. 2014 at 75, is this normal or a sign of something I should be concerned with. My understanding is the range should be undetectable. My Dr. seems unconcerned
I would stress that you must make the distinction between thyroglobulin (TG) and thyroglobulin antibodies (TGab). Elevated TG can be a cancer marker, but elevated TGab isn't necessarily. What's more important than actual numbers is trend. If your cancer elevated your TG, it went down after surgery, then comes back up, it can be a sign of recurrence. However, note that is TG, not TGab. Antibodies can take a while to go into remission.
Excerpt from Thyroid Cancer Survivors' Association, Inc. - Follow-Up Testing...
"Thyroglobulin (Tg): Thyroglobulin is a protein produced by thyroid cells (both normal and cancerous cells). After removal of the thyroid gland, Thyroglobulin can be used as a "cancer marker." Its number should be as low as possible. Sometimes this is termed "undetectable.” After your surgery and RAI, it may take months or years for the Tg number to come down to zero or undetectable.
A positive Tg test indicates that thyroid cells, either normal or cancerous, are still present in your body. Depending on the level of Tg in your blood, your doctor may want to monitor you more closely with other tests or scans and/or prescribe additional treatment.
If you did not receive RAI, your Tg level will probably be detectable. This is because some remnant thyroid tissue nearly always remains in your neck after surgery. If you had a lobectomy rather than a thyroidectomy, your remaining lobe will almost certainly produce Tg. However, it is still helpful to follow your Tg levels over time. If Tg levels increase, your doctor may recommend further imaging studies to locate the source.
From time to time, your doctor may recommend what is called a “stimulated Tg” measurement. This means that your TSH is elevated, by withdrawal from thyroid hormone or by receiving injections of the drug Thyrogen, and then your Tg is measured. Thyroglobulin testing can be more accurate when your TSH level is elevated.
Anti-thyroglobulin anti-bodies (TgAb): Some people produce anti-thyrogloblin antibodies. These are not harmful. However, they mask the reliability of the Tg value. If you have TgAb, imaging studies may be used to monitor for persistent or recurrent disease. Sometimes the antibodies disappear over time, although not always."
"Thyroglobulin (Tg): Thyroglobulin is a protein produced by thyroid cells (both normal and cancerous cells). After removal of the thyroid gland, Thyroglobulin can be used as a "cancer marker." Its number should be as low as possible. Sometimes this is termed "undetectable.” After your surgery and RAI, it may take months or years for the Tg number to come down to zero or undetectable.
A positive Tg test indicates that thyroid cells, either normal or cancerous, are still present in your body. Depending on the level of Tg in your blood, your doctor may want to monitor you more closely with other tests or scans and/or prescribe additional treatment.
If you did not receive RAI, your Tg level will probably be detectable. This is because some remnant thyroid tissue nearly always remains in your neck after surgery. If you had a lobectomy rather than a thyroidectomy, your remaining lobe will almost certainly produce Tg. However, it is still helpful to follow your Tg levels over time. If Tg levels increase, your doctor may recommend further imaging studies to locate the source.
From time to time, your doctor may recommend what is called a “stimulated Tg” measurement. This means that your TSH is elevated, by withdrawal from thyroid hormone or by receiving injections of the drug Thyrogen, and then your Tg is measured. Thyroglobulin testing can be more accurate when your TSH level is elevated.
Anti-thyroglobulin anti-bodies (TgAb): Some people produce anti-thyrogloblin antibodies. These are not harmful. However, they mask the reliability of the Tg value. If you have TgAb, imaging studies may be used to monitor for persistent or recurrent disease. Sometimes the antibodies disappear over time, although not always."
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