# timeline?



## LauryH (Feb 15, 2013)

My 1/21/13 FNA came back as "suspicious" for both nodules. I have a TT scheduled for next Tuesday, 2/26. The surgeon has said that he has never seen a "suspicious" come back as benign, so I'm expecting that I will have a malignancy and need to have RAI.

My endo has said I will not be on hormone replacement until after the path results are back (a week), and then if they're what I expect, I will continue in withdrawal to prepare for RAI. She has told me it generally takes 2-3 weeks to get to the TSH level needed.

My question is: when does the LID start? Would it be concurrent with the last 2 weeks of withdrawal or do I need to wait till the TSH level is reach & then go on LID? My concern is that would then be 4-5 weeks in withdrawal and I'm very anxious about hypo side effects.


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## Octavia (Aug 1, 2011)

The LID would be concurrent with the last 2 weeks of withdrawal. Once your TSH is where it needs to be (likely 30 or higher), you should get the RAI pretty soon after that (within a few days).


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## joplin1975 (Jul 21, 2011)

Yes, two weeks of LID. You need your TSH to be 30-40ish, minimally. Mine was 70something two weeks after surgery, so it can go up quickly depending how active


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## Octavia (Aug 1, 2011)

Yes...it can go up rather quickly. Mine went up to 104 and 105 the two times I've withdrawn my meds. But honestly, it wasn't that bad because it was temporary. If it had lasted longer, I probably would have felt pretty bad.


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## joplin1975 (Jul 21, 2011)

You can also ask about thyrogen. Some doctors don't like to use it for initial RAI treatment (only follow up scans) and some insurance companies don't pay for it, but...it's a possibility.


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## LauryH (Feb 15, 2013)

Thank you for the replies!

My doctor has said that withdrawal is better than Thyrogen (it's on my question list to ask her why she believes this), but she has offered it if the symptoms get bad.


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## Octavia (Aug 1, 2011)

You'll be sluggish, but really, it's not too bad. I'm surprised insurance companies are willing to pay the exorbitant price of Thyrogen when there's a free alternative that really isn't that bad.


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## joplin1975 (Jul 21, 2011)

Agreed. I've read some articles that thryogen is a good option for follow up, but for your first therapy levels dose, going hypo is the way to go.


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