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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
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Experience:  MD
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I am 15 months post a total Thyroidectomy due to papillary

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Hello I am 15 months post a total Thyroidectomy due to papillary thyroid cancer with Folecular varian. Fortunately there was no distant metastatis and only in the nrck areas affecting all lymph nodes. I had a high RAI-131 of 150 degrees in May of 2014. Ever since my Thyroglobulin counts, my neck ultra sound ( done three months ago) have remained stable. My concern is mainly my Thyroglobulin antibodies. I have a slightly higher than normal thyroglobulin since my TT and esp RAI. I was told that one if the signs that the cancer is in the right direction is to have a gradual downward slide of my Tg antibodies which may take months or even years. My situation is different in that the Tg antibodies are fluctuation and I would even say they are slightly higher than a few months ago.( at 16 from 11) ..could this be a concern? I am scheduled to see my doctor in September for my six months revision. I will be doing another blood test and ultra sound. He mentioned that if my ultra sound comes out clean in SEPT with a stable Thyroglobulin plus if my antibodies have come down then we won't do another RAI-131 of 150. But if the antibodies are not down to a journal range of 6 then we will do another round. Any feedback from you will be greatly appreciate it
Submitted: 1 year ago.
Category: Medical
Expert:  Dr Basu replied 1 year ago.
Hi there,
This is Dr Basu, Experienced Specialist.
I am here to address your concerns and provide great service.
The Tg level of 16 or 11 are high compared to current guidelines.
The level should be below 1 or 2 to document clearance of the disease.
We also recommend TSH stimulated thyroglobulin level besides getting baseline level for better correlation.
If your TSH stimulated Tg level is low, then baseline level is not that important.
Given your level, you need a FDG PET scan also to look for the disease anywhere else in the body in addition to the ultrasound and RAI scan
You also should be on levothyroxine to keep the TSH level below 0.1 if not already on it.
Thank you for sharing your concerns with us today. If you have any additional questions or need further clarifications, please do not hesitate to ask. I am here to answer them. I wish you good health. Regards, ***** *****
Customer: replied 1 year ago.
Dear Dr Basu:
Thank you for your prompt reply!
Maybe I should clarify the following. My thyroglobulin count has been stable at 0.2. And my TSH due to my intake of Synthroid is at 0,01. What is fluctuating at the moment is my thyroglobulin Antibodies. They seem to be fluctuating. For example in January they were at 11 and now they are at 16. According to the doctors it is good news when the antibodies start decreasing with time and not the other way around and that's where my question arises: ' despite a stable .02 thyroglobulin does it mean there is something cancer related going on or could it be just inflammation etc
Once again, Thank you for your attention.
Expert:  Dr Basu replied 1 year ago.
Ok thanks for clarification.
Thyroglobulin antibodies level can fluctuate as long as your thyroglobulin level is low.
That fluctuation is not concerning --yes this can be due to the inflammation or body's better memories that immune system still able to produce antibodies.
So this is not conceerning in other words.
Thank you for sharing your concerns with us today. If you have any additional questions or need further clarifications, please do not hesitate to ask. I am here to answer them. I wish you good health. Regards, ***** *****

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