Monday, April 9, 2012

Neck Ultrasound results are in along with the doctor's game plan

The doctor sent me an e-mail on Friday saying she would call me today and she did.  She reviewed my blood work (see prior posting) as well as my ultrasound results.
Ultrasound:  Stable from last year.  Small nodules are still present that we must check every year, but given that they are stable this is good.  It is likely scar tissue.  So the usual ultrasound will take place in a year's time.  :-)
Thyroglobulin (Tg):  It has gone up slightly year over year since 2010.  But, the assay changed in 2009.  Prior to that time my results were always < 0.1 or undetectable.  Then in 2010 they went up to 0.3...now up to 0.5.  The doctor said that Tg will move around slightly and so long as it is below 1.0 and everything else looks good - she is pleased.  I'm OK with this so long as we keep checking it every six months.
TSH:  Middle of normal range.  The doctor is fine with this and does not want me on more Synthroid.  It's a bit high for a thyroid cancer patient, but I do prefer how I feel when above 1.0 so I'm not complaining.  I did ask if I should add some T3 into the mix (add Cytomel to Synthroid) as many of my Inspire friends do this.  She is opposed since T3 acts immediately and can cause heart palpitations - which I already have and use a beta blocker to manage that.  So, no T3 for me.  I still want to improve my T4 to T3 conversion so I'll eat a few Brazil nuts now and then (great source of Selenium).
Parathyroid hormone and Vitamin D:  My parathyroid hormone went up.  My vitamin D went down.  The doctor is thinking that these two things are happening in conjunction, so she asked me to increase my daily intake of Vitamin D from 2000 IU to 3000 IU and retest in six months.  She said that unless I have osteoporosis or kidney stones, there is no reason to do more testing other than this.  I asked about osteopenia - I have that (precursor to osteoporosis).  For this she said "I don't know what to recommend."  So I'm going to increase my Vitamin D and see what happens in six months.  This is the only area where I'm not sure I agree with the doctor but I'm willing to test the theory.  I like data and increasing the Vitamin D and retesting the Vitamin D, Parathyroid hormone and Calcium levels in six months will provide data.  So for now, we just go forward one step at a time and thank the good Lord that I'm still here to worry about these issues!