Thyroidactomy and recourrnce

[Habib58]

HI..my wife is 42 yrs old . she carried out total thyroidoctomy before six months and she get an I131 isotope treatment after operation in 2 months , After that she used to get thyroxin dose 150 while taking this tablet some symptoms occurred like allergic according to that we reduced her dose to 100 .. after about 45 days and  while cheeking thyroid function it was found her TSH is not normal 6.4 and her T3 AND T4 is normal now her doctor ask her to take an iodine dose for diagnosis so we worry about any recurrence  is occur...... plz i want ur help  

[Habib58]

Thank u for ur attention. As I told u the exam is for monitoring her state as the doctor said. For doing this scan she must stopped her thyroxine doses and unable I-131 isotope to uptake any carcinomic places that found after these 6 months I-131 isotope treatment.
The glad
Habib Saedi

[goolarra]

I was just wondering why he ordered the scan, but from what you've just said, it seems to be a routine exam six months after RAI, correct?

As far as her labs are concerned, I think she was just undermedicated for a while.  Her doctor's increased her meds again, so that should resolve itself.  I don't think there's anything in what I've seen that indicates recurrence.  Do you see something, or are you just nervous?

[Habib58]

What are the test results that you need to know about?
He told me that the scan is necessary for monitoring her case after  treatment  with I-131 in 12 Jun 2013 as a routine exam.

[goolarra]

I can't second guess your doctor.  He's examined your wife and may have more test results that we don't know about.  Did he tell you what prompted him to order the scan?  It seems that he lowered her dose too much and she was undermedicated for a while.  Perhaps you could ask him to explain further.

[Habib58]

Yes,she have hypo symptoms and also had papillary thyroid cancer.
Her doctor raised her dose to 150  mcg/day from 15 days ago, and suggest to stop medication on Nov 1st to prepare her for the iodine diagnosis dose one Dec 1st..  

[goolarra]

Your wife's FT4 is a little on the low side.  It's at 23% of the reference range, and many of us still have hypo symptoms until FT4 is at about 50% of range.  Her TSH is a little high, also indicating that she is probably undermedicated.  Considering her FT4 level, her FT3 looks good.  It ould be a little higher, but an increase in her meds should raise that as well.

Does she have hypo symptoms?

Did she have thyroid cancer?

I think that when you wife's doctor lowered her dose from 150 mcg to 100 mcg, he lowered it too much.  Dosage changes are usually made in 12.5-25 mcg increments.  Perhaps her doctor would try raising her dose again, to something between 100 and 150 mcg, before doing the scan???

[Habib58]

Thank so much for your response.
T3     2.1     Normal value (1.0-3.3) n.mol/L
T4     82      Normal value (55-170) n.mol/L
TSH  6.2     Normal value (0.4-4.0) MIu/L

Regards

[goolarra]

Please post your wife's actual FT3 and FT4 results and include reference ranges.  Ranges vary lab to lab. so they have to come from her own lab report.

Please list her symptoms.

Was her TT due to thyroid cancer?