# Stimulated vs. Unstimulated Thryglobulin



## joplin1975 (Jul 21, 2011)

Asking just out of curiosity...

When your doctors run your thyroglobulin, are they ok looking at unstimulated/suppressed results or do they insist on stimulated (via thyrogen or withdrawal) results?

Asking because my annual ultrasound noted slightly enlarged lymph nodes (the largest only about 1.6cms, but previously they had all been under 1cm) but morphologically normal in appearance. There was no tissue, residual, scar, or otherwise noted in the thyroid bed. While I did have bilateral tumors, the largest and more troublesome were on the left side...the enlarged lymph nodes were on the right.

My endo, radiologist, and surgeon (I trust my surgeon's opinion over everyone else's) all feel the nodes are nothing much to be concerned about (I did have a cold the week before). However, when I met with my endo this morning, she said the three of them agreed that there was no reason to pull the panic button, but they were moving my next WBS up to September 2015 "just to be sure." The previous plan was to do the next scan in 2017.

I'm fine with that but then I asked her why she didn't order a Tg and TgAB test "just to be sure." She said that they don't put much weight in a result when a patient is suppressed. She said unless I had a "pretty large recurrence" the number would be low...and that they only pay attention to stimulated results.

I'm not TOO worried, but now that I've left the office and am thinking about it, it seems like lots of people look at unstimulated numbers fairly regularly. Is my impression correct?


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## KeepOnGoing (Jan 2, 2013)

Ouch! I do hate it when that happens - "it's nothing to worry about, but..." It always leaves that lingering element of doubt. Not helped by someone questioning what I thought was the best test for recurrence going.

If it's any help, I've never had a stimulated thyroglobulin test - nor has one ever been suggested. The oncologist just checks the numbers (with antibodies, which doesn't help) and looks for movement upwards over a period of time.

I'd be interested in what others are doing, too.


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## joplin1975 (Jul 21, 2011)

That is helpful, thanks!

I knew they all preferred a stimulated test, but I guess I didn't fully appreciate that they didn't give much credence to the unstimulated test. It seems I've read a lot about people getting regular Tg draws and not using thyrogen...but now I'm wondering if I totally misunderstood that too. Just when you think you've got a handle on things... 

I am ok with waiting, I really don't think its anything major. But, my free t4 (which has been stable at about 1.8 for two years) suddenly jumped to 2.7 (the upper limit of the reference range) and no one seems to have an explanation, except to say "maybe its because you lost weight?." I don't feel any different and was surprised at the result...so, we're not changing things up...it just makes me wonder!


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## Andros (Aug 26, 2009)

LHM!! Thankfully I've not had the experience. Just want you to know I read this and I care.........................a lot!


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## Whisperwindkat (Jul 31, 2014)

I have not had this experience except when doctors are messing with my meds. When my TSH goes up then so do my antibodies and when my TSH is suppressed antibodies are very low. So maybe that helps with your understanding. Blessings, Kat


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## emil (Apr 10, 2012)

My endocrinologist looked at both as follows:

On 9/20/2013 (un-stimulated) thyroglobulin value was 0.2

On 11/8/14 (thyrogen stimulated) thyroglobulin value was 0.4

On 5/27/14 (un-stimulated) thyroglobulin value was 0.1

I am up for another test in one year.

So I guess thyroglobulin data can provide some insight according to my doctor.


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## Octavia (Aug 1, 2011)

To the best of my knowledge/recollection, my thyroglobulin results have always been stimulated.


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