What Does This Thyroid Profile Test Result Post Thyroidectomy Indicate?

Posted on Sat, 20 Dec 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 20 Dec 2014 Answered on

Fri, 16 Jan 2015 Last reviewed on

Question : I had TT in nov 2012 and XXXXXXX in December 2012 for papilary carcinoma thyroid. I got my latest Thyroid profile test done today and results are
T3 0.6
T4 2.3
TSH 37.1
THESE RESULTS ARE AFTER 3 WEEKS OF OFF MEDICINE.

I use to take 200mcg of thyronorm and I am 30 year old female. My weiht is constant around 73kg (height 5'2") since my surgery.

Is my number suggesting towards hypothyroidism provided I am off medicine for past 3 weeks?

Answered by Dr. Ajish TP (11 hours later)

Brief Answer:
Thyroid function tests is showing hypothyroidism

Detailed Answer:
Hi XXXXXXX

Welcome to HCM. I have gone through your question and understand your concerns.

I will explain in detail to clear your doubts.

After total thyroidectomy and radio iodine treatment, there won't be any thyroid tissue left in the body if treatment was successful. So you will be hypothyroid after that if thyroxine ( thyronorm) is stopped. The TSH will be high and T3 and T4 will be low.

After the surgery and radio iodine treatment , to look for reappearance of cancer, we check some tests every 6 months. This include, ultrasound neck, some blood tests, and if needed iodine whole body scan.

The blood tests include serum thyroglobulin and anti thyroglobulin antibody. For this tests the doctor will usually stop the thyroxine for 3-4 weeks to have a stimulated value of thyroglobulin. This time your thyroid function tests will be showing hypothyroidism as your blood tests now.

Hope I have answered your questions. If you have any further queries I will be happy to help you.

Regards,

Dr Ajish TP [MD,DM]
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ajish TP (19 minutes later)

Sir, thanks for your answer. But my doubt is whether this hypothyroid symptems are due to stopping the medicine or it is due to something else. As hypothyroidism is not a welcome sign in these type of cases, do I need to worry?
Do I need to go for further tests?
Were results been the same if medicines were continue?

Answered by Dr. Ajish TP (13 minutes later)

Brief Answer:
The symptoms are due to hypothyroidism

Detailed Answer:
Hi XXXXXXX

Welcome back.

I hope you were of medications for blood tests or whole body scan as suggested by your doctor?

Once TSH is above 30, you can do the thyroglobulin levels / iodine scan if suggested, and can be restarted on thyroxine. Please consult your treating doctor to clarify the treatment plans.

Hypothyroidism is not a welcome sign, but for accurate estimation of thyroglobulin and for iodine scan TSH has to be above 30 miu/ml. So in practice we will stop the thyroxine for 3 weeks.

In my practice what I will do for thyroid cancer after TT and radio iodine treatment is:
1. Start on thyroxine 200-300 mcg after treatment
2. After 6 months - stop thyroxine for 3 weeks and do thyroglobulin and anti thyroglobulin antibodies.
3. If reports are normal restart on thyroxine and do Thyroglobulin and thyroglobulin antibodies every 6 months without stopping thyroxine. After 2 years, again I will stop thyroxine for 3 weeks and repeat the blood tests
4. At any point if thyroglobulin or antibodies are elevated I will do a whole body scan.

Once restarted on medications your symptoms will improve and thyroid function will return to normal.

Hope I have answered your questions. If you have any further queries I will be happy to help you.

Regards,

Dr Ajish TP [MD,DM]
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ajish TP (11 hours later)

Hi
Her serum thyroglobin result is 0.2
So things should be fine, I guess.

One final question is there any difference between thyronorm and eltroxin.

Answered by Dr. Ajish TP (18 minutes later)

Brief Answer:
That is fine. Both medicines are same.

Detailed Answer:
Hi XXXXXXX

Welcome back,

Her thyroglobulin values are normal. Now she can be started on thyroxine after consulting a doctor. Now the follow up will be every 6 months with serum thyroglobulin and thyroglobulin antibody.

After 2 years of surgery, if the investigation are normal, as in your case, the repeat testing can be done without stopping thyroxin.

Thyronorm and Eltroxin how are both thyroxine manufactured by two different companies. Just like calpol and Dolo for paracetamol.

Hope i have answered your question. If you have any further questions i'll be happy to help

Regards
Dr Ajish TP
Consultant endocrinologist

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj