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What causes high thyroglobulin?

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Posted on Thu, 27 Feb 2014
Question: I am interested in getting an opinion about my thyroid issues. I was recently diagnosed with hypothyroidism and am taking 50 mcg of Synthroid. I have only been on meds for 3 weeks. The doctors switched my meds 3 times in those 3 weeks. First 125 mcg of Synthoroid which I had a bad reaction too, then 60 mg of Armour, and now 50 mcg of Synthroid. I am concerned because I don't understand what my labs mean. I am 36 years old. Have 2 kids (4 years old and 1 year old) and was always considered a healthy person overall. Exercise, eat ok, etc. was diagnosed because I was feeling tired, heavy chest, and having heart palpitations. But nothing was really that bad. Initially my TSH was 9.90 T4 .90 TPO AB 25 and what i just received is what is scary to me and I don't understand. Thyroglobulin was 43.9 Thryoglobulin antibodes was 20 When I was first diagnosed my thyroid was enlarged because of the hypothyroidism, but I have no nodules or any thing like that. What does such a high Thryoglobulin mean? I must clarify-- I do not know what my thyroglobulin AB are-- I saw on the test results page (which you have a copy of) Thyroglobulin and then it was followed by thryoglob TGRIA (which i assumed were antibodies but I do not know for sure.)
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Answered by Dr. Shehzad Topiwala (1 hour later)
Brief Answer: Thyroid Detailed Answer: Thyroid management can be fairly complex and typically an endocrinologist is best trained to deal with these conditions. Based on your reports and symptoms, it is possible you may have experienced a condition called thyroiditis. This is a temporary bruising of the thyroid gland that initially causes excess thyroid hormone to be released in the circulation. This is often associated with high TG (Thyro globulin) levels in the blood as is the case with your lab reports. Gradually this process heals by itself, however during the natural course of recovery the blood levels go through phases of normalcy and hypothyroidism, before the thyroid finally settles into a steady state of either normal or permanent hypothyroidism. It is not uncommon for non-thyroid expert doctors to misconstrue this as permanent hypothyroidism even while the thyroid is yet to recover fully. And patients are left with an incorrect lifelong hypothyroidism diagnosis. Sometimes, if symptoms during the hypothyroid phase of thyroiditis are compelling then it is not wrong to start treatment with synthroid for a few weeks. But the best way to approach this is to wean synthroid slowly (take half the pill daily) and check TSH and free T4 after 6 weeks to see if the numbers change. If they are not significantly different then synthroid can be completely stopped and TSH/Free T4 should be checked again in 6 weeks. Your antibodies are negative suggesting that the likelihood of you having permanent hypothyroidism is low. Do not worry about the high thyroglobulin levels. They are only a marker of thyroiditis.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shehzad Topiwala (6 minutes later)
Thank you so much Dr. Topiwala! I do very much appreciate you taking the time to look at my case. Can you tell me - based on my lab reports-- were my thyroglobulin AB tested?? What is the first Thryoglobulin on the reports? Versus the second one listed as Thryoglobulin TGRIA? Also-- are there any natural supplements I can take to further support my thyroid since it has already had these problems?
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Answered by Dr. Shehzad Topiwala (7 hours later)
Brief Answer: Follow up Detailed Answer: There are no natural supplements that one needs to support the thyroid. I am aware of many such products that have proliferated the over-the-counter market. Even the FDA has deemed many of these unsafe. The only such item one might perhaps need is iodine. However, since the implementation of universal salt iodization (meaning the salt that we consume is fortified with iodine), it is rare to be deficient in iodine unless you are strictly on a no salt diet. Iodine is required for the manufacturing of thyroid hormone by the thyroid gland. Regarding, your lab tests, the thyroglobulin was tested and was high. But as I said do not read too much into that. At some stage of thyroiditis it is expected to be elevated and often normalizes in due course. There is no need to test it further. Your thyroglobulin antibodies have been tested too and they are negative
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Shehzad Topiwala

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Practicing since :2001

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What causes high thyroglobulin?

Brief Answer: Thyroid Detailed Answer: Thyroid management can be fairly complex and typically an endocrinologist is best trained to deal with these conditions. Based on your reports and symptoms, it is possible you may have experienced a condition called thyroiditis. This is a temporary bruising of the thyroid gland that initially causes excess thyroid hormone to be released in the circulation. This is often associated with high TG (Thyro globulin) levels in the blood as is the case with your lab reports. Gradually this process heals by itself, however during the natural course of recovery the blood levels go through phases of normalcy and hypothyroidism, before the thyroid finally settles into a steady state of either normal or permanent hypothyroidism. It is not uncommon for non-thyroid expert doctors to misconstrue this as permanent hypothyroidism even while the thyroid is yet to recover fully. And patients are left with an incorrect lifelong hypothyroidism diagnosis. Sometimes, if symptoms during the hypothyroid phase of thyroiditis are compelling then it is not wrong to start treatment with synthroid for a few weeks. But the best way to approach this is to wean synthroid slowly (take half the pill daily) and check TSH and free T4 after 6 weeks to see if the numbers change. If they are not significantly different then synthroid can be completely stopped and TSH/Free T4 should be checked again in 6 weeks. Your antibodies are negative suggesting that the likelihood of you having permanent hypothyroidism is low. Do not worry about the high thyroglobulin levels. They are only a marker of thyroiditis.