The Blood work is back and it’s Not Good!


I just heard from my doctor’s office, and my most recent TG (Thyroglobulin) level is back. It’s 148 — up from the test they did in June (130) and up from the test last September (81), which was one of the lowest levels I have received since they started testing me.

Thyroglobulin in the blood is an important laboratory test for checking whether a patient still has some thyroid present. The value of a serum Tg measurement lies in the fact that Tg can only be made by the thyroid gland — either the remaining normal part or the tumorous part.

Normally, after a thyroidectomy, the TG level goes down to zero. In the five years since mine, the TG level has never gotten anywhere near zero. So we knew that somewhere in my body there were still some thyroid cells left behind. This is despite the fact that I have had three rounds of radioactive iodine, but we could not find those cells on any of the imaging studies they have done. As long as the TG level was going down, the doctors felt we could leave things as they were. Now that the number has turned around, we need to be more aggressive in my treatment.

The doctor would like to move the imaging studies up (that were supposed to happen at the end of September) to see if we can find the cancer. But the main study that needs to be done is the Whole Body Scan (for radioactive iodine uptake). Normally, to do this test, they have to give me two shots of Thyrogen — a synthetic form of the Thyroid Stimulating Hormone (TSH). This causes any thyroid cells in my body to become active and absorb more iodine. But currently, there is a nationwide shortage of this and I cannot get any. The only other way to do this study is to take me off my thyroid medication for a month (each time they have done this to me in the past, I have gained 40 lbs).

The other study they want to do is called a PET scan. In this they give me radioactive sugar and then scan me to see how quickly the cells in my body are absorbing it. Since most cancer cells burn sugar faster than any other cells in the body, they can use this test to find the cancer — but only if my thyroid cells have started burning sugar instead of iodine. Two years ago, we found the recurrence I was having this way. But if the cancer has started burning sugar, that also means that it will be much more aggressive and much harder to treat.

My doctor is going to order a PET scan as soon as it can be done.

So as usual, there are no answers, and I am waiting for a new test.

I will write about the neurological problems I am having — and that are getting worse — later.

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