It was suggested I have my TSH levels checked. I logged onto my page at Johns Hopkins (why I didn't do it sooner....?) and found that my levels as of 6-7-13 were:

TSH 0.50-4.50 mcIU/mL 0.19

I also saw my red and white blood counts and hemoglobin were low as well.

RBC 4.50-5.90 M/cu mm 3.20
WBC 4.50-11.00 K/cu mm 3.14
Hemoglobin 13.9-16.3 g/dL 9.6

I've had a general lack of energy (fatigue), especially in the mornings and a feeling of cold even in the heat of the day. I have to wear a lined flannel shirt and sleep under extra blankets at night when my partner/caregiver is sweating.

I have blood work scheduled for August 9th and see my MO the about an hour afterwards. I'll address this as well as the pain med issues then as well as with my RO on August 6th.

From your experience, would this account for the side effects I'm describing?

"T"

I had my TSH and free T4 checked again 21 days post treatment. My main symptom was being cold all the time and was tired. I was later told it was probably too early to check for thyroid damage but I think they indulged me anyway.

It is important to know the TSH and T4 free levels in reference to your baseline, pre treatment. TSH is the hormone that stimulates production of T4 by the thyroid. A high level of TSH can indicate hypothyroidism and vice versa. A low level of free T4 can indicate hypothyroidism as well.

My free T4 went down (1.04 to 0.81) but so did my TSH (2.63 to 0.58), when comparing pre treatment to 21 days post treatment, which is inconclusive. I haven't been tested again yet.

Do you know the pre treatment levels?

As for the blood tests, I'd think the low hemoglobin (as well as slightly low RBC count would contribute to fatigue. I had hemoglobin and RBC counts right around where you were and had some issues with fatigue, which have improved as my counts have rebounded. They told me I had (mild) anemia, caused by the chemo. It will take some time for the counts to improve. As of my last blood test (2.5 months out of treatment), hemoglobin and RBC count were still below my pre-treatment baseline and the standard range, but had improved. I was told it takes some time for the bone marrow to recover and produce RBCs and WBCs back to baseline levels.

[quote=AndrewL]

Do you know the pre treatment levels?

[/quote]

No, but I'm sure they're on record at Johns Hopkins. I plan on asking when I go in August.

As of 6-7 my MO said my counts had improved so I would hope they're better now. However, I had/have an issue with gout which is due to my blood counts being messed up as per my MO. I'm still fairly early on in recovery so I'm sure some of these side effects I'm experiencing will improve.

Thanks for the response!

"T"

[quote]My main symptom was being cold all the time and was tired.[/quote]Did you get any satisfactory explanation for what caused this? From weeks 1-4 post, I was always freezing unless it was like 80 degrees+. Now, my body seems adjusted but I lost about 35 lbs and personally attributed to the loss of my permanent fat blanket. lol
don

Hey Foo,

The test results indicate I'd be more hyper than hypo concerning my thyroid. I'm definitely not hyper, that's for sure! I lost a total of 60 pounds from last Fall. I lost a lot of fat and muscle. That combined with neuropathy in my feet from the chemo and cardio vascular disease doesn't help.

I'll be running it by my team when I see them the 6th and 9th of August but I think that's what's going on from the responses I'm getting. Now where's my flannel shirt? Brrrr!

"T"

Usually Thyroid damage from the radiation takes a few months post Tx to show up but do keep on top of it. Mine showed up (crapped out) 4 months post and I take a single pill a day. Problem is the NORMAL range for TSH testing is extremely wide and while your levels may fall within this range it may not be what's normal for you and that's why we tell everyone coming to this site pre Tx to get and record their pre Tx TSH. Certainly none of us are Endocrinologists and we don't profess to know their job so IMO they are the ones you need to consult with.

The symptoms you describe, tiredness, being cold, can be from the anemia, low hemaglobin. I have chronic anemia, hemaglobin ranges from 7.5 to 10. I'm never over that. I wear long pants, shirt, socks all day, even to bed from being cold. It's from treatment, which destroys RBC faster then they can be replaced, plus the compromised bone marrow where they are produced, doesn't make enough. . RBC picks up oxygen, hamaglobin, in the lungs, but there are not enough being made to attach, and be distributed in the body. Same thing with WBC. RBC have a life cycle of 90-120 days, and are continuously replaced by the body. If my hemoglobin gets lower than 9, I could get a Lance Armstrong shot lol, epogen or procrit, but during treatment, with active cancer, it's not recommended or used by some institutions, and if given when hemgaglobin is high, it runs the risk of speeding up cancer, increasing the size of tumor. If it gets under 8 or 7, I've been down to 6, I would get a blood transfusion. You can really get a transfusion if its under 10, depending on symptoms, hospital policy, doctor, but they also have their own risks. One is an increase of cancer recurrences, and seen a journal article of an increased HNC recurrence risk from 30% with no transfusion to 71% with one. As such, my hemaglobin gets up to 10 from one of the therapies, and goes down every three months, and need a shot or blood transfusion, and the same cycle continues, but they do help with quality of life.

Check your creatinine levels too, which measure your kidney function. Compromised kidneys can also cause anemia, low hemaglobin, plus others ailments, conditions.

What a mess - Cancer sucks. The potential side effects from the toxicity and bombardment of gamma rays seems a continual learning process. We all make the brutal treatments with rare exception, then face this kaleidoscope of minor to major "ailments' post treatment.

I slid through the gauntlet of treatment rather unscathed yet during the 7 weeks post I have experienced all sorts of minor conditions varying from sensitive teeth (hot and cold), ulcers and sores, hard to swallow, cold all the time (the extremes of that seem now history), aches and pains in various places, very sensitive scalp and ears and upper body surface/skin, etc. Tongue is really sensitive to toothpaste and just about any seasonings.

Mind you, I'm surely not complaining at all; the alternative was far worse but just how harsh treatment is continues to offer new surprises. Many say I look so great but inside there are many body as Paul points out that are just messed up. have a good day, don