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For reasons that I do not yet fully understand (probably a simple clerical error) a patient with simple mild hypothyroidism (tsh 25miu/L, total T4 78 nmol/L free T4 9.1 nmol/L0 had a thyroglobulin assay performed rather than a TBG (thyroid binding globulin ) as is always the case is this sort of situation the thyroglobulin is not normal patient value 155 micrograms/L (quoted normal less than 60). The patient does not have a goitre and the neck is normal on examination (in this 30something female). I have found reference to patients with simple goitre having thyroglobulin levels up to 200 micrograms/L but nothing about simple goitre. The patient is now on thyroxine and I do intend to repeat the thyroglobulin as it should fall in this situation. It is difficult to prove a negative (ie that this patient does not have thyroid cancer) and the clinician is anxious and I am vexed by my inability to give him authorative advice (we don't do thyroglobulin assays - we send them away and the people we send them to don't know either). i bet there is someone out there who can advise! thanks (as ever) in advance James Falconer Smith Leicester ps the neck is normal on examination means on simple clinical examination (no imaging yet) %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%