# TgAb questions



## cgoeschel (Aug 24, 2010)

I had total thyroidectomy back in June of 2010 with RAI ablation on October 4th 2010. Two months after RAI ablation, my TgAb levels were over 1,500 (endo says that it was most likely because of the destruction of any remaining thyroid cells that caused a spike in the level of TgAb). March of 2011 my TgAb level was 847 so it had gone down substantially. June of 2011 they were 654, again going down but not as much as the first drop.  I just had my labs done again in December and now the TgAb level is down to 181. So I am thinking this is great news as it continues to go down and I thought I read somewhere that it can take years to completely go away (if ever) but I overheard my Endo and his assistant saying that they thought there still might be some disease present (papillary carcinoma is what i had). I only got to see the assistant and I told her to look at my charts and see that my values continue to decline and she said that they should be lower than they are by now. I said that I read that i could take years for them to completely go away and she said no, that they should be lower by now. I think they're wrong (not in denial) but I still think its good that the values continue to decline. Until the TgAb is gone the normal TG test is unreliable. My TSH is 
<0.01, and Im on 212 Mcg of Synthroid. Your thoughts, experiences?


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## Andros (Aug 26, 2009)

cgoeschel said:


> I had total thyroidectomy back in June of 2010 with RAI ablation on October 4th 2010. Two months after RAI ablation, my TgAb levels were over 1,500 (endo says that it was most likely because of the destruction of any remaining thyroid cells that caused a spike in the level of TgAb). March of 2011 my TgAb level was 847 so it had gone down substantially. June of 2011 they were 654, again going down but not as much as the first drop. I just had my labs done again in December and now the TgAb level is down to 181. So I am thinking this is great news as it continues to go down and I thought I read somewhere that it can take years to completely go away (if ever) but I overheard my Endo and his assistant saying that they thought there still might be some disease present (papillary carcinoma is what i had). I only got to see the assistant and I told her to look at my charts and see that my values continue to decline and she said that they should be lower than they are by now. I said that I read that i could take years for them to completely go away and she said no, that they should be lower by now. I think they're wrong (not in denial) but I still think its good that the values continue to decline. Until the TgAb is gone the normal TG test is unreliable. My TSH is
> <0.01, and Im on 212 Mcg of Synthroid. Your thoughts, experiences?


It would appear that you are correct (maybe.)

If thyroglobulin antibodies are present when the doctor is monitoring thyroglobulin levels, they will interfere with the test results. This may mean that the doctor will not be able to use thyroglobulin as a tumor marker for thyroid cancer. If thyroglobulins antibodies are being used as a monitoring tool and have stayed high or dropped low initially but are increasing over time, then it is likely that the treatment has not been effective and the condition is continuing or recurring. If levels are falling and/or have fallen to low or undetectable levels, then it is more likely that the therapy has been effective.

http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

Has your doctor run the thyroglobulin as well? It is true that the presence of thyroglobulin Ab will skew the thyroglobulin but I still think this would be a valuable test in that the healthy person should have "some" thyroglobulin but not high titers. High titers would also suggest cancer. So, because you still have some thyroglobulin Ab after all this time, I would err on the side of caution and listen to your doctor. As you know, you should not have any thyroglobulin Ab.

There is no way I would dismiss what the doctor is saying. And what has the doctor suggested as the next step?

You might be interested to know that thyroid tissue can and does travel to other bodily organs similar to the way endometriosis does.

Hope I have been helpful. Of course the above is only opinion.


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## cgoeschel (Aug 24, 2010)

It should also be noted that I have/had Hashimotos thyroiditis which also causes elevated TgAb antibodies. The thyroglobulin number was <0.2


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## Andros (Aug 26, 2009)

cgoeschel said:


> It should also be noted that I have/had Hashimotos thyroiditis which also causes elevated TgAb antibodies. The thyroglobulin number was <0.2


As you know, the presence of the antibodies skew the result for the thyroglobulin. But, that number sure looks good. I wonder what the average amount of thyroglobulin should be under normal circumstances though.

See, that's the key right there. Did your lab give you a range for that result?

It is a real diagnostic problem for as you say, TgAb are present in many who have Hashi's.

You can only make the decision that you think is right for you based on the information you are able to find combined w/your doctor's input and expertise.


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## cgoeschel (Aug 24, 2010)

I'm getting thyrogen shots and a whole body scan next month to be sure I'm clear.


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## Andros (Aug 26, 2009)

cgoeschel said:


> I'm getting thyrogen shots and a whole body scan next month to be sure I'm clear.


Very excellent. I am truly glad to hear this.

And by the way; many w/Hashi's and Graves' do have cancer. So it's hard to know what came first; "The cart or the horse!"


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