What are the symptoms when a Recurrence

I am new to this group or to ANY group for that matter. In March 2011 I was having some heart issues and was hospitalized and through all the tests, that's how they found that I had 2 small nodules in my thyroid. The 1st Dr. I saw dismissed it and said that it must have been the angle the sonogram was taken that gave a false report and thought it was no big deal. But I kept having a sore throat and a cough, so I went for a 2nd opinion and 3 months later I had a half pound tumor removed along with my thyroid. I was diagnosed with both papillary and follicular cancer. 2 months after my surgery I had RAI. Since then I have gained so much weight, I am constantly tiered, annoying cough, my bones hurt and I have real bad short term memory loss. My levels have never been normal and they have me on 350mg of synthroid. It's been very hard, because since everyone sees me going to work and doing my normal activities, they assume that I am ok and therefore all my symptoms must be in my mind. I was doing fine for a little while, but lately my voice has gotten hoarse and my throat feels the way it did before the surgery. I was wondering if anyone has had any of these symptoms and if these are signs of recurrence. Any information I get would be so appreciated. Thanks

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It sounds to me like your medication is likely giving you fits. I had a recurrence but no real symptoms, other than my raging antibodies. It seems like it has been about 2 years since your surgery (just guessing). What is your Thyroglobulin? If you haven't had a recent Thyroglobulin test and an ultra sound of your throat, that would be in order as an annual test.

350mcg of Synthroid is a lot. You must not be converting your T4 to T3, which is the active form of the hormone that our body uses and needs. In your case, yours is probably being converted to reverse T4 more than T3. If your doctor won't test you for free T3 and consider adding Cytomel to your medications, then you might want to consider a second opinion to find someone who will. In the meantime, you could add 200mcg of Selenium (selenomethionine) to try to get some help going with your conversion to T3.

Also, you could have absorption issues in your upper intestine, where the medication is absorbed. Are you taking it an hour before eating or drinking anything other than water? Are you making sure you don't take any supplements with calcium or iron for at least 4 hours (more might be better for you)?

Do you know what your risk factor is? What is your TSH and your free T4 level? What has your doctor been doing for follow-up monitoring (testing)? I really hope you get some help and feel better soon.

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My daughter had a recurrence recently and the only way she new was her Tg went from 0 to 11 and then a US showing 2 nodules in her thyroid bed.

I totally agree with everything Cabro said. Please go see a Dr. and get to the bottom of this. You shouldn't have to feel this awful for this long.

Hang in there.

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I totally agree with the previous two posters. You need to see a doc asap. Since you are in Orlando is it possible for you to go to the Mayo Clinic in Jacksonville. If possible request to see Dr Burnett there.

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Thank you guys for the replies. I have to admit that I never thought of asking the doctor for the copy of the lab report. I guess I just trusted them with my health. They did add 5mcg of Liothyronine to the 350mg of Synthroid and now wait 2 weeks for more labs. Also, back when I was looking for a doctor on my 2nd opinion, I had went to a cancer specialist and was totally embarrassed when I was told that although I did have cancer it "WAS NOT THE SERIOUS ONE", at that point I felt that what I had was really no big deal. And although I have gone through so much in the last 2 years, I still feel uncomfortable to be looked at as if I am making a bigger deal of something not so serious. But after joining this group, I realize that I have gone through this the wrong way. Thanks again!!!!

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Don't let that one doctor dininish you! Stay strong and fight this. Cancer specialists only treat anaplastic thyroid cancer and some medullary. Endos treat this and are the experts for papillary and follicular thyroid cancer. It changes lives and needs to be taken seriously.

Also, there are some medications like birth control pills and others that interfere with T4. Go over your meds with a fine-toothed comb with your endo to make sure you don't have any conflicts there.

I'm gkad you have added Cytomel and hope it helps. Wishing you success with all of this and answers.

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350 is really a lot

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What brand is a good quality of Selenomethionine and where online can you buy it? The only health food store where I live does not have it. They have Selenium and Methionine separately. Do they work if you buy them separately? If yes, how many milligrams of each one?
Thank you!

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rosiekw: I use Solaray and bought it locally. Amazon has it, but you can shop around for it. http://www.amazon.com/s/ref=nb_sb_ss_i_1_15?url=search-alias%3Daps&field-ke ywords=solaray%20selenium%20200%20mcg&sprefix=Solaray+seleniu%2Caps%2C230

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Cabro I click on the link and shows Selenium. Is Selenium the same as Selenomethionine or they are 2 different supplements?
Thank you!
Rosie

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@rosie Selenomethionine is a good form of selenium. Just make sure you never take "sodium selenite" or "selenium selenate " which are unacceptable cheap junk used in bargain vitamin brands to save money and get selenium listed on labels.

@all4mykids Not only is 350 mcg of T4 so super high but 5 mcg of the poorly absorbed Liothyronine is almost nothing as far as T3 goes. I would probably have your T4 at half that value, and probably aim for 25 mcg of T3. As an alternative I suggest asking your doctor to switch to natural thyroid such as nature-throid. Many doctors are not familiar with T3 dosing and simply switching to natural is the perhaps easiest way to go there, albeit perhaps not at optimal ratios as some might need more T3 and some might need less T3. As you are on such a super sized dose of T4 it suggests not only a major conversion disorder but perhaps other issues. Some reading for you to consider:

T4 to T3 really good summary:
http://www.naturalendocrinesolutions.com/articles/do-you-have-a-t4-to-t3-co nversion-problem/

Easy graphic - from MtDenali on this list:
http://www.thehealthyhomeeconomist.com/thyroid-disease-as-a-psychiatric-pre tender/

Dr Mercola on using Free t’s instead of TSH as primary labs (he is not addressing thyroid cancer patients but lays out case for Free t's):
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

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Thanks BiomedEE - I've added those links to my Thyroid file to peruse when I have a minute!!

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Me too BiomedEE. Thanks & Hugs.
Best,
Rosie

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rosie: Sorry I didn't tell you that the labeling on the bottle says L-selenomethionine for the Solaray.

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To those who has been ignored by their Endos when requesting Free T3 testing, I found and enclose a 2001 medical article about SENSITIVE THRYTROPIN ASSAYS AND FREE THYROID HORMONE MEASUREMENTS. I emailed to my Endo and asked him if he has a more recent article that rebuts this one to send it to me.

http://keck.usc.edu/en/Education/Academic_Department_and_Divisions/Departme nt_of_Medicine/Education_and_Training/Internal_Medicine_Residency/Resources /Articles/~/media/Docs/Departments/Medicine/Chief%20Resident/Articles/Endoc rinology/TFTs.pdf

Rosie

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I have a friend that only takes LEVO for Thyroid, (also takes other medications for other conditions), and had the following test results: Normal (low end) TSH, Normal TT4, Normal FT4, Normal TT3 and HIGH FT3. Very rare but it happens. It could be another underlying illness or condition, or an interaction with another medication or it could be just a side effect of another medication. For example, Amiodarone a heart medication, just by itself, no interactions, could cause Thyrotoxicosis regardless if the person takes Thyroid medication of any kind or any other medication. I also read that HIGH FT3 is an early form of T3 toxicosis whatever the cause is. My friend high Free T3 results triggered more tests to find out the cause. If that would be me, it would go unnoticed because my Endo do not test FT3 only TSH, TT4, FT4 & TT3. Another good reason to test FT3 whether you only take T4 medication for Thyroid or T4 plus T3 medication. Incidental test is how many of us were diagnosed with thyroid cancer in the first place. Thyroid medication is very sensitive to fluctuations due to unknown causes, and close monitoring of all the Ts and all the FTs besides the TSH is very important.

Enclose is the article:

http://www.academicjournals.org/jde/PDF/pdf2012/February/Kazanavicius%20et% 20al.pdf

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Good info to have, Rosie. Thanks. I wonder if T3 can rise with Graves, perhaps as a precursor of some kind. Like you say, so many doctors don't test T3, so I wonder if there is even any data on that. Yes, high T3 under those normal conditions is rare. At least it is in my experience. The thyrotoxicosis explanation wouldn't fly with a patient after TT and RAI. Does your friend still have her thyroid? Has she found the cause?

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Yes, Cabro, my friend has the thyroid. The strange thing is that the TSH, T4, FT4 normal, even T3 was normal, only the FT3 was high. Normal T3 and High FT3?

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One thing rosie is the ranges on FT3 are not very stable and some places have ranges that are not really based on anything substantial because they didn't really get many runs till perhaps recently. Thus they have a poor range not based on good lab practices or so on. Do you know what the FT3 was on your friend?

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BiomeedEE: She is out of town now. This is what I recall. FT3 was 4.25 or 425. TSH was 0.40. I don't recall the other numbers for the TT4, TT3, FT4, but I remember that they were not borderline, in fact they were not to far from the middle.
Thank you.
Rosie

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A FT3 of 4.25 is acceptable in many labs, not considered high. A typical range: 2.4- 4.4 pg/mL. A not updated range might be 2 - 3.5, but those kind of ranges are at places that didn't run FT3 much or something.

Post TT I think the range should be higher 3.0 to 5.0, the pituitary makes its own supply of T3 from T4 and does not know if remote places in body have adequate T3 or not. In a person with a thyroid the thyroid makes 20% of the T3, after TT that is lost but the pituitary gets all the T4 it could ever need but the rest of the body lost 20% of the T3.

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