Thyroid cancer recurrence

[Gracevd70]

Hi everyone
I've been dealing this crazy thyroid levels and even crazier ultrasounds that finally the sent me to have radiation iodine whole body scan done that shows I have Thyroid Cancer again that has spread to my lymph nodes could my issues with crazy lab numbers since thyroidectomy in 2016 be because of this cancer coming back?

[gimel]

I think the guideline changed in 2015.

[gimel]

I really don't know about the effect of the immunosuppressive drug.  I do know that more recent studies showed that suppressing TSH did not work as they thought for so any years.  In fact the protocol has been changed and no longer requires TSH suppression.  

[Gracevd70]

Oh that might explain my recent Endo wanting to bring my TSH levels up how long ago did they change this? I've always been told I'm low risk and did not require neck ultra sounds If I didn't fight to have first US I might not know I have recurring cancer...I often felt like the throw away thyroid cancer patient since I never according to military endos I'm low risk no need for check ups.

[gimel]

Fluctuating numbers doesn't hurt you unless it affects symptoms.  Hang in there.

[Gracevd70]

Another question for you.  I have always been told my low TSH would prevent a cancer recurrence if/is true wouldn't my low TSH have kept me disease free or is it possible that the thyroid labs are incorrect ?  What's the chance if any my current immunosuppressive drug could actually create a false low lab reading and for these past 3 yrs Ive actually had a higher TSH then lab results say.... I'm just curious as NO Doctor really understands these biologic drugs.

[gimel]

So I don't know of any reason for some of the test results fluctuating.  Some of it is of course due to med dosage changes.  If you are feeling good at present dosage, then stick with it.    If you should start to   have any hypo symptoms then I would suggest that you consider going back to the 88 and increase T3 up to 20.   Also you need a new thyroid doctor.  And make sure they always test for both FT4 and FT3.  If not tested for Vitamin D, B12 and ferritin you should do so and then supplement as needed to optimize.  D should be at least 50 ng/mL, B12 in the upper part of its range, and ferritin should be at least 100.

[Gracevd70]

The fluctuation of my Labs is crazy and it fluctuates even on same dosage and obviously with the med change.   I've developed Psoriatic Arthritis after I lost my thyroid for some reason and I inject monthly with immunosuppressive drug and I'm positive this messes with my number but no solid proof.

[gimel]

So I don't know of any reason for some of the test results fluctuating.  Some of it is of course due to med dosage changes.  If you are feeling good at present dosage, then stick with it.    If you should start to   have any hypo symptoms then I would suggest that you consider going back to the 88 and increase T3 up to 20.   Also you need a new thyroid doctor.  And make sure they always test for both FT4 and FT3.  If not tested for Vitamin D, B12 and ferritin you should do so and then supplement as needed to optimize.  D should be at least 50 ng/mL, B12 in the upper part of its range, and ferritin should be at least 100.

[Gracevd70]

I was wrong I did have 2 things happens between Jan 2019 to now besides med changes I was on Cymbalta for the chronic pain for 2 months which caused abnormal bleeding that lead to mild anemia.    Cymbalta I believe is the reason for the <.14 TSH and I've been to 7 different endos and with cancer recurrence I certainly can not pay out of pocket , so I'm stuck with the TSH,FT3,T3

[gimel]

Sorry to keep asking questions, but each answer seems to bring up more questions.    Was there anything else happening during the first 8 months of this year that might have had an impact on you.  Stress, etc.  

The 2 grains of Armour is equivalent to about 130 mcg of T4.   When you switched to 88 mcg and 10 mcg of T3, that is equivalent to only about 118 mcg of T4, so it was a reduction.   The switch to 100 + 10 is equivalent to 130 mcg of T4, same as with 2 grains of Armour, but your FT4 was considerably higher than on the Armour and I expect that your FT3 was lower.  So a key question is how were you feeling on the 88 + 10 compared to the 100 + 10 doses?

Also, at the time of your 2/19 tests how long had you been on the 2 grains of Armour?

[Gracevd70]

As far as life and health everything has been the same and on 88mcg and 100mcg I feel exactly the same only thing I noticed between 88mcg was my Cholestrol levels that went 20 points higher from Armour to the 88mcg.....when I do thyroid and cholesterol levels again in December I'm hoping it will drop .....my Endo says cholesterol (LDL) has nothing to do with thyroid, literatures say different.

[Gracevd70]

I've been on Armour since Aug of 2018 so 5 months by Jan

[gimel]

Grace, not sure if it will help with an explanation or not, but when were the tests done after the switch to 88 mcg of T plus 10 mcg of T3?

[Gracevd70]

The test were done 8 weeks after the switch I didn't eat or have coffee and do test early morning and take my thyroid meds after test.

[gimel]

Very sorry to hear that you are not yet free of the cancer.  Since you had a thyroidectomy and are on replacement thyroid med I cannot imagine how your lab numbers would be affected; however, please tell us your actual lab results that you described as "crazy".

[Gracevd70]

Hi Gimel
Here is my last thyroid test on (2 grain Armour Thyroid and Synthyroid/Cytomel)

Jan 2019 test results: (Felt fine)
Armour Thyroid 2grains
TSH: 0.186  (0.27-4.20)
T4 : Test was not ran because tsh was not below or above TSH lab range!
T3 : 102.9 (80-200)
FT3: 2.86 (2.0-4.4)
FT4:0.97  (.093-1.7)

Aug 2, 2019 Armour Thyroid Results (I requested the switch to synthyroid/Cytomel) I had horrible shakes I couldn't hold a cup without spilling it was bad.
Tsh: <0.014 (0.27-4.20)
Ft4: 1.10 (0.93-1.7)
Ft3: 3.380 (2.0-4.4)
T3: 1.21 (80-200)

Switched to 88mcg synthyroid/ 10mg cytomel (Requested increase to 100mcg because FT4 was so low)
Tsh:  1.46 (0.27-4.20)
Ft4: 0.92 (below range) (0.93-1.7)
Ft3: NOT Tested (2.0-4.4)
T3: 90.5 (80-200)

Switched to 100mcg synthyroid/ 10mg Cytomel
Nov 18,2019 (Prior to Thyrogren inj for WBS) 100mcg synthyroid and 10mcg cytomel
TSH - 0.669 (0.27-4.2)
T3 - 116.7 (80-200)
FT4- 1.35 (0.93-1.7)

Endo that prescribed Synthyroid/Cytomel refuses to test FT3.  It just seems my results are never consistent they are all over the place and Im a huge stickler with following same schedule for taking my thyroid meds and just wonder if these numbers changing could in fact be residual thyroid tissue(Cancer)still making hormones which is causing these low thyroid numbers (Thyroid cancer has also spread to nodes both sides of neck) 1st cancer diagnoises I only had it in thyroid NO SPREAD...if this keeps up I feel I could be thyroidless without medication these endos keep trying to reduce my meds below the 88mcg synthyroid (I refused to go lower then 88mcg).   Still waiting to hear from Endo on recurrence plan.

I use to SPLIT my armour doses during the day and I still split my 100mcg synthyroid and 10mcg cytomel.