Vascular invasion? What does it mean.

[SassyMH]

I have just been copied in to a letter to my GP and don't understand it all. I knew I had a total thyroidectomy (2 ops) due to cancer but it says, " 3.5cm papillary thyroid cancer with vascular invasion" does anyone know what vascular invasion means ? Also the letter gives my blood results, most of which I understand except "thyroglobulin and anti-thyroglobulin antibodies undetectable" what does this mean and also what effects can this have on my health. I am currently feeling better than I have for years, but the Doctor is saying my T4/T3 need to be reduced to avoid osteoporosis so I am being referred to Endo. I would like to know what the contents of the letter means so any help/advice would be appreciated. Thank you.

[SassyMH]

Thank you so much for your advice. Best wishes. X

[Nanaedake in reply to SassyMH]

Yes, I agree with JaneyJaney. It's your oncologist that should be determining your TSH level. I would not reduce meds without their advice. If the doctor is concerned about osteoporosis, they could refer you for a bone scan called a DEXA scan now to get a baseline and repeat in a couple years time. Doing the right resistance and weightbearing exercise is best way to prevent osteoporosis.

You need to feel well to exercise so if you're feeling good then I would be reluctant to change anything if it were me. Keep a check on vitamin D levels and treat yourself to sunshine holidays to store vitamin D. Best wishes.

[SassyMH in reply to Nanaedake]

Thank you for the above advice. I do regular exercise and take Vit D; but think I will try and get a bone scan just to check. I see the consultant who performed my surgery in August so I wont be doing any drug changes without his approval as he has been most supportive throughout. Thanks again for your help. Best wishes.

[SlowDragon Administrator]

Do NOT accept dose reduction unless Ft3 is over range and/or feel over treated

Usually after TT the aim is to keep TSH at zero

For full Thyroid evaluation you need TSH, FT4 and FT3 plus tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common,

Ask GP to test vitamin levels

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

Suggest you make new post with recent results, exactly what dose replacement you are on and what vitamin supplements you are currently taking

[SassyMH in reply to SlowDragon]

Thank you for the above. My last bloods T4/T3 were both at the high end of normal. I will go see the Endo when the appointment comes through, thank you for the advice NOT to reduce meds, its reassuring to have your advice. Many thanks.

[SassyMH]

Thank you for the above information. My cancer and radioactive iodine was 6 years ago. It was during my 6 monthly check at the hospital that the Doctor (one I haven't seen before) said that they had only allowed my TSH to stay so low for so low because I felt so awful. Now I am taking T3 (self funding) and feel much better she wants to reduce the medication to raise my TSH. I will go to the Endo appointment when it comes through but feel I want as much info as possible. This is the first time vascular invasion has been mentioned so I am hoping she has got it wrong. I am going to phone my usual Doctors secretary next week and ask the question. Thanks again for your comments. Best wishes.

[Wetsuiter in reply to SassyMH]

so you resort to self funding in otder to feel well and the Dr decides that your improvemt means she can reduce the meds you do get. That s terrible!

[SassyMH in reply to Wetsuiter]

I know, its like a double insult!