Increasing the level of TSH in women. What diseases cause an increase in the level of TSH in the blood

Thyroid stimulating hormone (TSH) is produced by the pituitary gland, which is a gland small size located in the lower part of the central part of the brain. TSH stimulates the synthesis of thyroid hormones such as T3 (triiodothyronine) and T4 (thyroxine). These biologically active substances are involved in the metabolism of fats, carbohydrates and proteins, as well as in the work of almost all human organs. In addition, they regulate many mental functions. In our review, we will try to deal with the indicators of the concentration of this hormone in the blood.

TSH and its functions

The pituitary thyroid-stimulating hormone regulates the formation of thyroxine and triiodothyronine according to the principle feedback. That is, when the level of the latter rises, they suppress the production of TSH and vice versa. Therefore, with various dysfunctions of the body, these three substances must be checked together.

When the pituitary gland malfunctions, TSH levels may decrease or increase. In the first case, the patient develops hyperthyroidism (hyperthyroidism syndrome), and in the second - hypothyroidism (deficiency of thyroid hormones). The causes of the violation may be pathologies of the hypothalamus or thyroid gland. The unit of measure for TSH is the international unit per milliliter.

The norm of thyroid-stimulating hormone in the blood of women, men and children

The norm depends on the age group of the person, as well as on other factors. The highest concentration of this substance is observed in children under 2.5 months - 0.6–10 μIU / ml. By the age of 5, its level decreases to 0.4-6 μIU / ml, and in adolescents aged 5-14 years, the indicators are 0.4-5 μIU / ml. The norm for adults is 0.4–4.0 μIU / ml.

Thyroid-stimulating hormone during pregnancy changes in accordance with the term. So, in the first trimester, due to active restructuring female body it decreases somewhat due to hyperstimulation of the thyroid gland. Additional thyroxine is necessary for the normal formation of organs and tissues of the fetus. Therefore, until the 12th week of pregnancy, the content of TSH in the mother's blood is 0.2–2.0 μIU / ml. Then the content of TSH approaches the standard values, and in the third trimester it may even increase slightly.

The secretion of this substance can change during the day. So, at 2-4 o'clock in the morning it is maximum. High rates are also observed at 6-8 am. TSH drops to a minimum at 17-18 pm. The normal rhythm of its secretion is disturbed in persons who are awake at night. Some increase in its content can be observed in older people.

A blood test for thyroid-stimulating hormone is extremely important for determining the state of the thyroid gland, monitoring the effectiveness of treatment and diagnosing female infertility. Also, the study can be prescribed for:

  • an increase in the size of the thyroid gland;
  • symptoms of hyperthyroidism: anxiety, palpitations, insomnia, weakness, decreased visual acuity, photophobia, diarrhea, swelling around the eyes;
  • signs of hypothyroidism: constipation, dry skin and hair loss, edema, obesity, cold intolerance, menstrual irregularities.

A blood test can be ordered by an endocrinologist, gynecologist, neurologist, internist, pediatrician or surgeon.

Should know!
Because TSH levels fluctuate throughout the day, blood tests should be taken around the same time every day.

Thyroid-stimulating hormone is elevated: what does it mean?

This phenomenon can be observed if the function of the thyroid gland decreases. Often, such an increase is noted at the asymptomatic stages of the disease, when T3 and T4 do not yet exceed the norm. An increase in TSH is accompanied by weakness, a decrease in concentration, a slowdown in thought processes, irritability, sleep disturbances, pallor, edema, a decrease in body temperature, constipation, nausea, and the development of obesity, which is difficult to correct.

An increase in its concentration is observed with the following pathological conditions:

  • hypothyroidism of various types;
  • primary adrenal insufficiency at the stage of decompensation;
  • thyrotropinoma;
  • immunity of the body to thyroid hormones;
  • pituitary or lung tumors;
  • Hashimoto's thyroiditis;
  • mental disorders;
  • syndrome of unregulated production of TSH;
  • preeclampsia;
  • condition after removal of the gallbladder;
  • hemodialysis;
  • exposure to lead and certain medications: anticonvulsants, antipsychotics, calcitonin, iodides, prednisolone, etc.

High thyroid stimulating hormone can also be observed after intense physical exertion. In order to reduce the content of this substance in the blood, the doctor may prescribe synthetic thyroxine (T4) preparations to the patient. The desired effect is often achieved within a week after the start of therapy. Upon completion of treatment, the patient should be examined by an endocrinologist, ultrasound procedure thyroid gland and thyroid panel examination. Thereafter, inspections should be repeated once a year.

Note!
Treatment of any pathology associated with the endocrine system must be carried out under the strict supervision of a physician. Self-medication is fraught with serious hormonal disruptions.

Decreased levels of thyroid-stimulating hormone in the blood

Thyroid-stimulating hormone is lowered in toxic goiter, thyrotoxicosis, T3-toxicosis, hyperthyroidism in pregnancy, pituitary injury, inflammation or malignant tumor of the thyroid gland, psychological stress, starvation or overdose of hormonal drugs. A decrease in the concentration of TSH is facilitated by the use of steroids, thyroxine, drugs for the treatment of hyperprolactinemia and a number of other medications.

With a decrease in the content of this substance in the blood, the patient develops headaches, blood pressure and body temperature may increase, heart rate increases, appetite increases, tremors in the body may appear, and an upset in the digestive system often occurs.

The level of thyroid-stimulating hormone is considered underestimated if its value is 0.1 mIU / l or less. In such cases, it is necessary to check the work of the cardiovascular system and the level of T3 and T4. If nodular goiter became the cause of the imbalance, then the patient is prescribed radioiodine therapy, and in the most serious cases, surgery. Patients with Graves' disease are treated with B-blockers, which reduce the symptoms of the disease. In other cases, it is necessary to treat the underlying disease that caused the hormonal failure.

Thyroid stimulating hormone analysis reveals early stages diseases of the endocrine system, as well as pathologies of other organs. This substance is extremely important for energy metabolism in the body. To determine its concentration, the patient must donate venous blood on an empty stomach (abstinence from food should be 8-14 hours). Two days before the study, you should refuse to take steroid and thyroid drugs. During the day before visiting the clinic, emotional and physical stress should be avoided. Do not smoke three hours before testing.

Should be remembered
The current TSH level reflects the situation over the past 3-6 weeks. Accordingly, the control measurement of its content is recommended to be carried out no earlier than 8–10 weeks after the start of therapy or a change in the dosage of the drugs used.

Wednesday, 03/28/2018

Editorial opinion

Deviations from the normal concentration of the hormone TSH in the blood can occur for a variety of reasons, many of which are considered physiological. Therefore, it is so important to trust the opinion of specialists - endocrinologists, oncologists and other specialized doctors, and not engage in non-professional diagnostics and subsequent self-treatment.

The thyroid gland is so good at masking the symptoms of its disease that people often make mistakes and, mistaking its manifestations for signs of another disease, treat a non-existent disease or do not pay attention to the malaise at all. Therefore, doctors, after asking the patient about the symptoms of the disease and, suspecting problems with the thyroid gland, prescribe a blood test for hormones, among which a special place is taken by measuring the level of thyroid-stimulating hormone (TSH).

In case of thyroid disease, it is he who is the first to go beyond the norm and speaks of the presence of an ailment even when the thyroid hormones have not yet changed their indicators. If the test results showed that TSH is elevated, this is a reason to sound the alarm, as it signals serious malfunctions in the body.

The hormone TSH (thyrotropin) is one of the hormones that the pituitary gland produces - an endocrine gland located at the bottom of the brain in a bone pocket sphenoid bone skulls. The main purpose of thyroid-stimulating hormone is to monitor the proper functioning of the thyroid gland by acting on thyroid hormones, thyroxine and triiodothyronine. The hypothalamus controls the work of the pituitary gland, one of the parts of the brain, which, analyzing the situation, sends a signal to the pituitary gland on how to proceed.

If the thyroid gland for some reason began to produce too much thyroid hormone, the pituitary gland receives a signal to reduce their production. As a result, it begins to produce less TSH hormone, which leads to a decrease in the production of thyroxine and triioditronine. If the brain has fixed the opposite situation, when the thyroid gland has reduced the production of hormones, the hypothalamus orders the pituitary gland to increase the synthesis of thyrotropin, which, acting on the thyroid gland receptors, increases the production of thyroid hormones.

Scientists have not yet agreed on which TSH indicators show the most optimal amount of the hormone: its level in the blood is constantly changing, depending on the time of day, age, and in women during pregnancy.

It is generally accepted that the amount of the hormone is normal, if its indicators in women range from 0.3 to 4.2 μU / ml, in men these parameters are slightly higher and range from 0.4 to 4.9 μU / ml. In children, the level of TSH in the blood is higher than in adults, especially in infants: at the age of ten weeks, they range from 0.7 to 11 mcU / ml, then gradually begin to decline.

When planning a pregnancy, it must be borne in mind that the optimal indicators for women should be within 2 μU / ml: one of the reasons why a woman cannot become pregnant is a too high level of thyrotropin, even if it does not exceed the norm.

If the thyroid-stimulating hormone is in this range, this almost eliminates the presence of thyroid diseases that can harm the health of an unborn baby. After conception has occurred, in the first trimester the level of the hormone is very low and fluctuates between 0.1-0.4 mcU / ml, then gradually increases.

Why does the hormone rise?

Even a slight increase in thyroid-stimulating hormone in the blood makes the doctor alert and, before deciding on the treatment, he will prescribe additional examinations. This suggests that the thyroid gland, for some reason, reduced the synthesis of thyroxine and triioditronine, and signals about initial stage thyroid disease. Among the reasons why the amount of thyrotropin can be increased are:

  • hypothyroidism - the thyroid gland, for some reason, begins to produce iodine-containing hormones below normal;
  • thyroid tumor;
  • pituitary tumor;
  • heredity;
  • removal of the gallbladder;
  • an overdose of iodine;
  • adrenal insufficiency;
  • autoimmune disease - the body takes thyroid cells for foreign ones and produces antibodies to destroy them;
  • severe form of preeclampsia (toxicosis) during pregnancy.

The main symptoms that lead the doctor to suspect that the patient has elevated TSH and reduced production of thyroid hormones are the patient's complaints of weakness, apathy, lethargy, insomnia, poor concentration, and memory impairment. Also, the deterioration of the endocrine system is reflected in appearance: a high level of TSH is often accompanied by swelling, pallor, baldness, brittle nails.

Another striking symptom of the development of the disease are problems with the digestive tract: constipation, nausea, loss of appetite, a sharp decrease / increase in weight. Often, a disease of the endocrine system is accompanied by a feeling of chilliness and cold, low body temperature, menstrual irregularities.

Proper Therapy

If the test results showed a high TSH, other studies should be done to diagnose the disease, this is especially important if the level of other hormones has not changed. This signals that the disease is detected immediately and the likelihood of successful treatment is high.

After a person has done all the necessary examinations, the doctor, based on the tests, will determine the causes of the disease and prescribe treatment. Therapy with medications can be combined with folk remedies. But such treatment must be agreed with the doctor and in no case self-medicate, since the use of folk remedies without the consent of the doctor can seriously harm and cause death.

Among the folk remedies that can strengthen the body and reduce the high level of thyrotropin, herbal teas or decoctions of their herbs occupy a special place. You can assemble them yourself, you can buy a ready-made collection in a pharmacy or individual components to cook it yourself.

AT folk medicine there are so many recipes herbal preparations aimed at lowering the level of thyroid-stimulating hormone. Some funds are supposed to be mixed in the same parts:

  • celandine, birch leaf, wild rose, yarrow, coltsfoot, licorice and angelica roots;
  • fruits of mountain ash and cocklebur, birch buds, elecampane root, St. John's wort;
  • chamomile flowers, chicory, rose hips, yarrow, mordovnik root;
  • St. John's wort, chicory, celandine, dill, chamomile, rose hips and cocklebur, dandelion roots.

Herbal teas are prepared in the same way. Mix the herbs well, after which 2 tbsp. l. pour boiling water, cover, put on a small gas and boil for ten minutes. After that folk remedy without filtering, pour into a thermos along with herbs. Thirty minutes before meals, you need to drink half a glass of infusion. After three months of therapy, the collection must be replaced with another folk remedy.

What is thyroid stimulating hormone (TSH)

Thyroid stimulating hormone (TSH), also known as thyrotropin, is produced in the pituitary gland and secreted into the blood. The main task of TSH is to stimulate the thyroid gland to produce hormones such as T3 (triiodothyronine) and T4 (thyroxine).

The thyroid gland is located at the base of your neck, under the Adam's apple. It absorbs the trace element iodine from the blood to produce the hormones T3 and T4. The importance of the thyroid gland is very important, because the hormones T3 and T4 play a significant role in the functioning of almost all parts of our body, including the brain, heart and liver.

The work of the thyroid gland is under the control of the hypothalamus of the brain, which produces thyrotropin-releasing hormone (TRH) to stimulate the pituitary gland to start producing thyroid-stimulating hormone (TSH).

There is such a dependence: the more thyroid-stimulating hormone (TSH) is produced, the more T3 and T4 hormones are produced. But when sufficient or high values ​​​​of T3 and T4 are reached, there is a decrease in the production of the hormone TRH and, consequently, the level of the hormone TSH decreases. This process helps keep the levels of T3 and T4 hormones at the right levels for the body.


How does thyroid stimulating hormone (TSH) work?

Thyroid-stimulating (thyroid-stimulating) hormone (TSH) increases T3 and T4 levels in several different ways.

TSH stimulates the production of T3 and T4 by binding to TSH receptors (TSH-R) on thyroid cells, which helps thyroid gland produce more proteins that absorb iodine from the blood. And then the thyroid gland uses this iodine to produce the hormones T3 and T4.

Iodine can exist in the body in different forms and can only be used to form T3 or T4 hormones if it is in its active form (oxidized). For this reason, thyroid stimulating hormone (TSH) further stimulates T3 and T4 production by increasing the protein that converts iodine to its active form ( thyroid peroxidase).

TSH not only increases the production of T3 and T4, but also stimulates their release into the bloodstream. When T3 and T4 are produced, they are stored by binding to another protein ( thyroglobulin), which keeps them from entering the bloodstream. TSH promotes the breakdown of this protein (by increasing proteases) and allows T3 and T4 to be released and enter the bloodstream.


Thyroid Stimulating Hormone (TSH) Elevated: Health Risks

Elevated thyroid stimulating hormone (TSH) linked to poor heart health

A study of over 30,000 people found that people with higher TSH levels tend to also have higher blood pressure.

A meta-analysis of data from multiple studies involving more than 55,000 patients showed that people with very high TSH values ​​demonstrate a significantly greater likelihood of developing(and death) ischemic heart disease.

Another study, which included 314 patients at risk for developing various heart diseases, found that high levels of TSH were associated with more serious disorders in.

Findings have also been demonstrated regarding the relationship between increased thyroid stimulating hormone (TSH) and increased blood pressure in children, especially those who are overweight.

High thyroid stimulating hormone (TSH) indicates elevated levels of cholesterol and triglycerides

Two studies have shown that increasing TSH levels occur with a simultaneous increase in "bad" cholesterol(low density lipoprotein - LDL) in blood.

Another study of almost 21,000 people showed similar results and also found that high levels of thyroid-stimulating hormone (TSH) correlate with lower levels of “good” cholesterol(high-density lipoproteins - HDL).

High Thyroid Stimulating Hormone (TSH) Levels Linked to Obesity

Two separate studies showed that women Overweight or obese people have higher TSH levels than normal weight people. This relationship also includes people with a simple higher body weight and body mass index (BMI), a larger waist size, and a higher percentage of body fat.

Another study showed that, compared with women with low TSH levels, healthy young women with high TSH levels were twice as likely to develop metabolic syndrome(a condition that includes obesity, high blood pressure, and high levels of glucose, fat, and cholesterol in the blood).

The link between thyroid stimulating hormone (TSH) and obesity is not just for women. Two separate studies have shown that elevated TSH is associated with higher body mass index (BMI) in both men and women.

Thyroid-stimulating hormone (TSH) is also involved in the formation of weight in children. Baby obesity and overweight are associated with higher TSH levels, and these elevated values ​​are associated with increased levels of cholesterol, fat, and growth blood pressure.


Raisethyrotropic hormone (TSH) is harmful during pregnancy

Level TSH was significantly higher in women who could not conceive after 1 year of trying (so-called unexplained infertility) compared to women with normal TSH.

The drug Levothyroxine is used to treat cases of thyroid problems and is often given during pregnancy. One study looked at 1,013 pregnant women receiving levothyroxine and found that many of them had elevated TSH, which was associated with an increased risk of miscarriage.

In another study of more than 184,000 women, mothers who had high TSH levels in the 6 months before conception found an increased chance of spontaneous miscarriage before 20 weeks, stillbirth, preterm birth, and other pregnancy problems.

High Thyroid Stimulating Hormone (TSH) Values ​​Are Linked to General Inflammation

During an experiment involving 24 women who received 0.9 mg of thyroid-stimulating hormone (TSH), on the second day of taking the drug, a violation of the functions of blood vessels was found, which was most likely associated with an increase in general inflammation and oxidative stress.

In two animal studies an increase in TSH values ​​was accompanied by an increase in the main indicators of inflammation– tumor necrosis factor (TNF) and interleukin-6 (IL-6).

Elevated thyroid stimulating hormone (TSH) is a risk factor for thyroid cancer

Various studies, including meta-analysis, have shown that elevated TSH is a risk factor for thyroid cancer.

Another study in 126 patients with a specific type of thyroid cancer (papillary thyroid microcarcinoma) showed an association between increased levels of thyroid stimulating hormone (TSH) and faster cancer progression.

An increase in thyroid-stimulating hormone (TSH) values ​​indicates an increase in the stress hormone

In a study of 54 healthy adults, higher TSH values ​​were found along with increased levels of the stress hormone cortisol. Scientists have concluded that thyroid-stimulating hormone (TSH) makes the body more sensitive to the effects of stress.


Thyroid Stimulating Hormone (TSH) Low: Health Risks

Low levelthyrotropic hormone (TSH) linked to poorer mental health

Low TSH levels may contribute to lower mental health levels among the elderly. In a study involving 293 people over 65 years of age, a relationship was found between a decrease in TSH levels and deterioration in brain function.

In a study involving 1,843 people aged 55 years and older, it was shown that low TSH was associated with a 3-fold increase in the risk of developing dementia or developing.

A study of 1,503 older adults found that low levels of thyroid stimulating hormone (TSH) increase the likelihood of developing depressive symptoms and further development.

Low Thyroid Stimulating Hormone (TSH) Indicates Decreased Bone Density

Having higher levels of TSH in the blood contributes to better health bones in the elderly. Decreased TSH was associated with reduced bone mineral density in a study of 674 older women.

In another study of 686 older women, low thyroid-stimulating hormone (TSH) levels increased the risk of pelvic or spinal fractures.

A study of more than 14,000 patients showed that in older women (but not in women over 70), lower TSH levels were associated with an increased likelihood of hip and femoral neck fractures.

Thyroid stimulating hormone (TSH) and the elderly

Many studies show that TSH levels naturally increase as we age.

However, while elevated TSH is generally associated with negative health outcomes in adults and children, this an increase in thyroid-stimulating hormone (TSH) values ​​does not harm the elderly. Many studies show an inverse relationship - the lower the level of TSH in the elderly, the more health problems, while higher TSH values ​​\u200b\u200bmay protect the body.

Thyroid stimulating hormone (TSH) and longevity

Several studies suggest that elevated TSH may be beneficial for longer life. For example, in a study of very elderly people (median age was 98 years), higher levels of TSH were found compared to people in the control group, whose average age was about 72 years.

A study of 2,290 older adults aged 70-79 showed that slightly elevated TSH levels led to easier walking, faster walking, and better physical fitness than those with normal thyroid stimulating hormone (TSH).

Another study in 558 adults aged 85 to 89 found that elevated TSH was associated with the lowest risk of death.

Thyroid stimulating hormone (TSH) test

Because TSH controls the body's production of the hormones T3 and T4, knowing your TSH levels through a blood test can be helpful in determining if your thyroid is functioning properly and adequately.

This may seem counterintuitive, but high levels of thyroid-stimulating hormone (TSH) may indicate an underactive thyroid gland, while low TSH levels may demonstrate an overactive thyroid gland. This dependence is due to the fact that when you have a decrease in the production of T3 and T4, the body responds by increasing the level of TSH in order to stimulate the production of T3 and T4. In the case of an overactive thyroid gland (T3 and T4 increase), the opposite occurs.

The timing of the TSH test can make a difference in results as our TSH levels naturally change throughout the day according to . Studies show that TSH values ​​are higher at night and decrease during the day.

If you take an analysis for TSH without taking into account the values ​​of other thyroid hormones, this can lead to an incorrect and incomplete diagnosis. The panel of tests for determining the functioning of the thyroid gland, in addition to TSH, also includes tests for T4 (free T4) and T3 (free or total T3).


Thyroid stimulating hormone (TSH) interaction

thyrotropic hormone (TSH) and neurotransmitters

Studies and scientific reports show that the hormone dopamine(and other similar compounds) lowers thyroid stimulating hormone (TSH) levels.

One study in 20 healthy adults found that blocking dopamine receptors led to an increase in TSH levels, indicating a role for dopamine to suppress TSH production.

In another mouse study, dopamine, epinephrine, and norepinephrine were found to counteract the effects of TSH and block the release of the T4 hormone into the blood. And in a study with rats, it was shown that the administration of norepinephrine leads to an increase in TSH levels.

Another study in rats showed that the hormone serotonin can lead to an increase in thyroid-stimulating hormone (TSH) values.

Thyroid stimulating hormone (TSH) and antidepressants

Drugs for depression (antidepressants) can have different effects on TSH production, depending on the type of drug.

One study in 62 depressed patients showed that repeated use of a norepinephrine reuptake inhibitor (NRI) reboxetine - lowered TSH levels. However, the selective serotonin reuptake inhibitor (SSRI) drug sertraline increased TSH.

Thyroid-stimulating hormone (TSH) and other hormones

Research has shown that glucocorticoids(steroid hormones such as cortisol and dexamethasone) reduce thyroid-stimulating hormone (TSH) levels in patients with hypothyroidism and in healthy people, possibly by inhibiting the production of the hormone TRH.

Studies in rats have shown that the hormone testosterone may have an effect on the increase in the level of thyrotropic hormone (TSH).

Other thyroid stimulating hormone (TSH) interactions

Rexinoids (a type of retinol - vitamin A) may lower thyroid-stimulating hormone (TSH) levels in rodents, healthy humans and cancer patients (possibly by suppressing TSH secretion and gene expression). However, one study in 10 patients showed that one type of rexinoids (bexarotene) did not affect TSH levels.

A meta-analysis of 7 different studies showed a decrease in TSH values ​​​​in people with hypothyroidism taking the drug metformin. But this decline did not occur in people with normal thyroid function.

Many studies show that interferon-alpha (commonly used to treat hepatitis C) leads to an increase in thyroid disorders.

Various opioids lead to an increase in the rate of development of thyroid insufficiency.

In one study of 38 cancer patients, it was observed that after chemotherapy with Docetaxel, the TSH level increased significantly.

Another study of 70 school-age children found that those children who lived in areas with excess fluorine in water had higher levels of TSH.

It was also found that smokers have lower blood TSH values than non-smokers.

Thyroid Stimulating Hormone (TSH) for Hypothyroidism and Hyperthyroidism

hyperthyroidism is a condition in which the thyroid gland is overactive and produces excess thyroid hormones T3 and T4. Due to the fact that these hormones are involved in many processes in the body, such a malfunction of the thyroid gland can lead to the development of a wide variety of symptoms.

Causes of hyperthyroidism

The most common cause of hyperthyroidism is Graves' disease, as well as an autoimmune lesion of the gland, when antibodies begin to act like the effects of TSH, which leads to an overproduction of thyroid hormones.

Other common causes of hyperthyroidism are toxic nodular goiter(enlargement of the thyroid gland, also known as Plummer's disease) and painless ("silent") thyroiditis(state when the immune system attacks the thyroid gland, causing it to become inflamed).

It very rarely happens that pituitary tumors (adenomas) can lead to excessive secretion of thyroid-stimulating hormone (TSH). This can lead to overactive thyroid or symptoms of hyperthyroidism.


Symptoms of hyperthyroidism

The most common symptoms of hyperthyroidism can be:

  • Nervousness
  • Increased sweating(sweating)
  • big thirst
  • Hyperactive reflexes
  • Poor tolerance for temperature changes

Less common symptoms of hyperthyroidism include:

  • Fatigue
  • Weight loss
  • Hypersensitivity of the eyes, leading to watery eyes, or painful sensitivity to sunlight (photophobia)
  • Increase heart rate(tachycardia)
  • Tissue swelling (peripheral edema)
  • Eyelid movement delay
  • Excessive stool production (more than 3 times a day)

Hyperthyroidism can also cause psychological symptoms such as apathy although this symptom is more common in elderly patients (>70 years).

Hyperthyroidism can also cause a range of symptoms that affect the physiology of the mouth, jaw and pharynx. These symptoms include a burning sensation in the mouth, osteoporosis of the jaw bones, an increase in thyroid tissue (goiter), and an increased risk of caries and periodontal disease.

Hyperthyroidism is also known to reduce (by increasing the activity of osteoclasts, cells that break down bone tissue) that can lead to osteoporosis.

Hyperthyroidism is associated with an increase in oxidative stress due to an increase in the number of reactive oxygen species and a decrease in the effectiveness of antioxidants.

Causes of hypothyroidism

Hypothyroidism– the opposite of hyperthyroidism, when the thyroid gland does not produce enough T3 and T4 hormones. Due to the prevalence of these hormones throughout the body, their decline can cause many different symptoms.

Worldwide, the most common cause of hypothyroidism is iodine deficiency.

Another relatively common cause of hypothyroidism is Hashimoto's thyroiditis (an autoimmune disease) where the body's immune system attacks and gradually destroys the thyroid gland.

Procedures that kill or surgically remove thyroid cells, such as iodine ablation or removal of the thyroid gland can also cause hypothyroidism.

Many studies have shown that lithium therapy leads to an increased likelihood and incidence of hypothyroidism and goiter.

Symptoms of hypothyroidism

Hypothyroidism causes various physical and psychological symptoms.

The most common symptoms of hypothyroidism

  • Fatigue
  • Constipation
  • Weight gain
  • carpal tunnel syndrome
  • Depression
  • Anxiety
  • Memory problems
  • Attention problems

Hypothyroidism can also cause a range of symptoms that affect the oral cavity eg: mouth breathing, thick lips, small lower jaw (micrognathia), thin tooth enamel (enamel hypoplasia), tongue swelling or inflammation, salivary gland enlargement, taste distortion (taste perversion).

With long-term hypothyroidism, it can lead to a delay in body growth and a delay in bone formation. Hypothyroidism is also associated with increased oxidative stress by increasing reactive oxygen species and reducing the action of antioxidants.

Other symptoms of hypothyroidism may include:

  • slow pulse
  • Sweating reduction
  • Dyspnea
  • Loss (loss) of hair
  • Dry skin (especially on the elbows) or its yellow color
  • Hoarse voice
  • Body edema
  • Hearing loss
  • Muscle pain
  • slow reflexes
  • Decline in childbearing
  • erectile disfunction

Causes and Factors of High and Low Thyroid Stimulating Hormone (TSH) Levels

Stress

There are many different ways stress affects T3 and T4 levels. For example, many studies have shown that experiencing negative and stressful life events increases the likelihood of developing Graves' disease, a common cause of thyrotoxicosis (persistent elevation of thyroid hormone levels, thyroid hormone toxicity).

However, this conclusion is not so clear-cut, as several other studies have concluded that stress is not involved in Graves' disease and related conditions.

However, several animal studies support the idea that stress is a contributing factor to thyroid dysfunction. For example, several studies in rats have shown that stress impairs thyroid function, albeit in different ways.

The stress caused by the impact of electrical current on the rat tails led to a decrease in the levels of the hormones T3, T4 and thyroid stimulating hormone (TSH).

In rats that have been exposed social stress, developed hypothyroidism. Various stressors (including cold water or food deprivation, cold temperature, flashing lights, etc.) led to an increase in the production of hormones T3 and T4.

Nutrition (diet)

The idea of ​​switching to a ketogenic diet (a diet high in fat and low in carbohydrates) is popular with many people, and is even a common treatment for people with epilepsy. However, may interfere with thyroid function. For example, a study of 120 epileptic patients found that 17% of the subjects developed hypothyroidism as a result of this diet.

Another study showed that high-fat or low-carb diets can also reduce T3 levels. A diet high in fat, protein, and low in carbohydrates can lower thyroid-stimulating hormone (TSH) levels.

Overeating (gluttony) - another frequent cause of thyroid dysfunction. The study showed that chronic overeating led to an increase in the level of the hormone T3 over a short and long time (from 3 weeks to 7 months).

In experiments on rats, high fat diet, led to the suppression of the thyroid gland: the amount of the hormone T4 decreased and the level of TSH increased.

radiation exposure

Exposure of the thyroid to radiation is a major risk factor for the development of thyroid cancer, especially in children.

One of standard methods cancer treatment is radiation therapy. Unfortunately, radiation therapy puts patients at greater risk of developing thyroid cancer as shown in several studies involving children.

Radiation exposure also increases the risk of thyrotoxicosis and hypothyroidism.

Soy sauce

Soy products contain substances that can mimic or interfere with the activity of certain hormones (such as estrogen). Because of this, soy foods can also interfere with proper thyroid function.

One study of 189 children found that those children who fed with soy milk demonstrated in the future more likely to develop autoimmune thyroid disorders(for example, Hashimoto's disease). [AND]

Three months of increased soy intake led to an increase in goiter, drowsiness, and constipation in a study of 37 previously healthy adults. However, these symptoms disappeared after the elimination of soy in the diet.

In a study of 78 patients (children with hypothyroidism) who were fed soy products, higher levels of the hormone TSH were found in these children compared to those who did not receive soy.

Iodine

Thyroid hormones are made with the trace element iodine, which people need to get from food. If there is a lack of iodine in the diet, then such a diet can lead to hypothyroidism and can cause goiter (a significant swelling of the thyroid gland that is secreted in the neck).

However, slight iodine deficiency, can actually lead to overactive thyroid(because the thyroid gland is overstimulated to compensate for mild iodine deficiency).

Many studies also show that Excessive iodine intake can lead to hyperthyroidism. For example, children living in an area with abnormally high concentrations of iodine in drinking water show more significant disorders in the thyroid gland (increased levels of TSH and thyroid antibodies).

Animal studies and test-tube studies show that excess iodine can be toxic to the thyroid, leading to cell death in the thyroid.

vitamins

Many studies show that vitamin D deficiency associated with thyroiditis, an autoimmune disorder of the thyroid gland. And one study of 60 people showed that vitamin D deficiency was also associated with hypothyroidism.

Vitamin B12 deficiency can lead to the development of hypothyroidism, as was found in a study of 116 patients.


What increases the risk of thyroid-stimulating hormone (TSH) disorders

Diabetes and thyroid dysfunction

Other studies have reported that up to 30% of patients diabetes may exhibit some type of abnormal thyroid function.

Many studies show that metformin, medicinal product used to treat diabetes, reduces the level of thyroid-stimulating hormone (TSH), which further increases the risk of hypothyroidism in people with diabetes.

Pregnancy and thyroid stimulating hormone (TSH)

Due to hormonal changes and thyroid stimulation that occur during pregnancy, thyroid disorders are more common in pregnant women. Near 2.1-3.4% of pregnant women experience either hypothyroidism or hyperthyroidism.

One study of 482 pregnant women with thyroid disorders showed that if these problems were corrected, there was no risk to their children. However, these mothers still have an increased chance of developing high blood pressure and damage to the liver and kidneys(preeclampsia).

However, pregnancy-related thyroid problems can cause developmental problems in children if left untreated. The children of 62 women who had hypothyroidism showed a decline in IQ (text on IQ), deterioration in speech, attention and reading skills along with overall school performance.

Many other studies have also found a variety adverse effects on children of women with hyperthyroidism. These include: low birth weight during pregnancy (intrauterine growth retardation), premature birth, and low birth weight.

polycystic ovary syndrome

Women with PCOS are more likely to get thyroid disorders and signs of hypothyroidism For example, autoimmune thyroiditis, high levels of thyroid-stimulating hormone (TSH) and the development of a goiter. Hypothyroidism is often diagnosed with ovarian cysts, but most likely it is not the cause of this disease.

Thyroid treatment options

natural methods

One study in 36 healthy patients showed that eating kelp, which contains large amount of iodine, leads to an increase in the level of thyroid-stimulating hormone (TSH).

If you have thyroid disorders, then you should limit the intake of large amounts coffee. Studies show that coffee blocks the body's absorption of the T4 hormone.

if you have lactose intolerance limiting lactose intake may help the thyroid function. In a study of 83 patients with Hashimoto's thyroiditis, a lactose-free diet was shown to reduce TSH levels in people with lactose intolerance.

Physical exercise help naturally increase TSH and T4 levels. In a study of 60 men, moderate to vigorous exercise was shown to increase these hormones. The best results in changing hormone levels could be obtained with anaerobic(power) load with 70% heart rate load, but with a further increase in the load to 90% CC, the level of hormones T3, T4 and TSH began to fall.

Indian medicine plant ashwagandha may also help to increase levels of the hormones TSH, T3 and T4 in people with mild hypothyroidism.

Selenium is important for thyroid health, as this trace element helps convert hormones from T4 to T3. Numerous studies have shown that selenium is able to reduce levels of T4 hormone production. In addition, in areas with high rates of goiter in the population and selenium deficiency, there is a decrease in the levels of the antioxidant glutathione. But taking supplements with selenium contributed to the normalization of this level.

Methods for the treatment of hyperthyroidism

The most common treatment for hyperthyroidism in the US is radioactive iodine ablation which is generally safe. Radioactive iodine destroys thyroid cells, and the gland begins to produce fewer hormones.

Other treatments for thyrotoxicosis include thyroidectomy(surgical removal of the thyroid gland), and receiving “ antithyroid drugs such as Tapazole ( methimazole) and propylthiouracil (which stop the synthesis of thyroid hormones) or cholestyramine (which helps to eliminate excess thyroid hormones from the body).

In addition, drugs such as beta blockers(propranolol, atenolol, and nadolol) may also be used to relieve symptoms of hyperthyroidism.

Hypothyroidism Treatment Methods

One of the best treatment options for hypothyroidism is levothyroxine therapy. This drug increases the level of thyroid hormones in the body.

Another procedure that also increases thyroid hormone levels is taking dried thyroid extract(thyroid tissue taken from animals and prepared for medical use) and taking Liothyronine .

Side effects of thyroid medication

Main a side effect of radioactive iodine ablation is hypothyroidism including acute thyroiditis.

One study in 449 patients with Basedow's disease found that side effects of antithyroid medications included skin rashes, liver damage (hepatotoxicity), and low white blood cell counts (agranulocytosis/neutropenia).

Others side effects antithyroid drugs are joint pain, swelling, nausea and vomiting.

Common complications after thyroidectomy (surgical removal of the gland) are hypothyroidism, low calcium levels, and paralysis of the vocal cords.

One study of 30 patients with hypothyroidism showed that levothyroxine can lead to impaired heart diastolic function (filling with blood), a decrease in the physical capacity of the heart, and an increase in the thickness of the walls of arterial vessels.

Additional Information

Many of the studies in this article talk about links between high or low TSH levels and certain health conditions. These studies are relevant, but it is important to note that such a relationship does not imply causation. Just because not quite normal levels of thyroid-stimulating hormone (TSH) in certain health conditions does not mean that TSH is the cause of changes in health.

Often, changes in TSH levels are the influence of a disease or some factor on the abnormal production of TSH. Without further deeper research, it is impossible to accurately understand the cause of the change in TSH readings.

Publication author

The information on this site has not been evaluated by any medical organization. We do not seek to diagnose and treat any disease. The information on the site is provided for educational purposes only. You should consult your physician before acting on information from this site, especially if you are pregnant, breastfeeding, taking medication, or have any medical condition.

An analysis for TSH is prescribed to determine the pathologies of the thyroid gland, including if hypothyroidism is suspected.

Indications for the analysis of the concentration of thyroid hormones

An imbalance of active substances synthesized by the thyroid gland negatively affects the functioning of the entire organ system, since these hormones support cellular respiration.

The manifestation of signs of hypothyroidism is purely individual: in some people their absence is observed (even with a high rate of hormone deficiency), in others the disease makes itself felt with pronounced signs.

Violation of the synthesis of active substances of the thyroid gland leads to the failure of many organs, so the symptoms are quite diverse.

Symptoms that signal a possible disruption of the thyroid gland, including hypothyroidism:

  • physical weakness;
  • decreased activity, slowness;
  • mood swings;
  • apathy;
  • fast fatigue and drowsiness;
  • memory impairment (often forgotten events that happened recently);
  • hair loss, eyebrows and brittle nails;
  • the skin becomes dry;
  • swelling of the limbs;
  • disorders of the stomach (constipation);
  • chilliness (cold extremities even if the person is warm);
  • noticeable coarsening of the voice;
  • weight gain without increasing portions of food intake;
  • disruption of the reproductive system.

In some women with hypothyroidism, infertility and the absence of menstruation were noted.

These symptoms are typical not only for hypothyroidism, so you can find out their cause only after diagnosis. These signs are a bell that signals the need to contact an endocrinologist.

Also, studies on thyroid-stimulating hormone are carried out in such cases:

  • if a person's relatives suffered from thyroid diseases, diabetes mellitus, adrenal insufficiency;
  • if the patient has had thyroid disease, surgery on this organ;
  • man took medicines containing lithium carbonate, iodine, amiodarone;
  • if the patient has an elevated cholesterol level, anemia, high prolactin levels, an increased concentration of CPK, LDH enzymes;
  • if the person has been exposed to radiation;
  • with pituitary and hypothalamic diseases;
  • if a person complains of violations of the cardiovascular system;
  • with congenital pathologies;
  • if the child has a delay in mental or physical development.

Features of the analysis for TSH

TSH in hypothyroidism rises due to the following chain of processes:

  • The thyroid gland produces insufficient amounts of T3 and T4.
  • The pituitary gland secretes more thyroid-stimulating hormone to stimulate the thyroid gland and increase the concentration of T3 and T4.
  • There is an increase in TSH levels.

Changes in the concentration of TSH, T3 and T4 are interdependent, so an adequate diagnosis can only be made after measuring the level of all three hormones.

TSH analysis is the only way to diagnose subclinical hypothyroidism. It is carried out in the morning (from 8 to 12 hours), since it is at this time of day that the highest concentration of TSH in the body is.

For further research, blood is taken from the patient from a vein and determine how many units of thyroid-stimulating hormone it contains. For an accurate diagnosis, one analysis is not enough, since an increased rate does not always indicate thyroid diseases, it can be a one-time failure of the hormonal balance due to any negative factors. In addition, a series of analyzes makes it possible to evaluate the work of various organs and systems.

In the form of laboratory test results, there should be indicators of the level of such substances:

  • free triiodothyronine;
  • thyrotropin;
  • free thyroxine;
  • antibodies to thyroglobulin (allows you to identify autoimmune diseases).

Thyroid hormones can be examined not only with a blood test, but also with the help of a laboratory assessment of saliva, some doctors consider the results of the second more reliable.

In the treatment of hypothyroidism, a laboratory assessment of the concentration of hormones should be carried out at least once a year.

Preparatory stage for analysis on the level of TSH

Before submitting material for TSH research, the following rules should be followed:

  • it is forbidden to eat at least 3 hours before meals (material for research is taken in the morning on an empty stomach), it is allowed to drink water without gas;
  • a few days before the study, you can not eat spicy and fatty foods;
  • exclude in two days physical exercise;
  • before the procedure, you should give up cigarettes and alcohol;
  • if the analysis has to be taken several times (if it is necessary to monitor the level of TSH over a certain period of time), it should be carried out at the same time;
  • stressful situations should be avoided;
  • if a person takes hormonal drugs, such treatment should be stopped 14 days before laboratory diagnosis;
  • you need to abandon vitamins and drugs, which include iodine, as it affects the functioning of the thyroid gland;
  • If you are taking any medications, it is important to tell your doctor about it.

The results of the study do not depend on the menstrual cycle.

If a person takes thyroxine, it is forbidden to stop treatment, but you need to drink the drug after donating blood or saliva.

The results of a laboratory study are of interest to all patients, but it is impossible to understand the numbers stated in them without prompts.

The TSH rate depends on the age of the patient:

  • The level of TSH in the blood of newborns should be in the range of 0.6-10 units. per liter of blood.
  • At the age of 2.5 months to 2 years, the norm of thyroid-stimulating hormone is 4-7 units. per liter of blood.
  • For children 2-5 years old, the normal value is 4-6 units.
  • The normal concentration of TSH for children over 14 years of age and for adults is 0.4-4 units.

Depending on gender, the norms are as follows:

  • in men - 0.4 - 4.9 units,
  • in women - 4.2 units.

For pregnant women, the concentration is within the range of 0.2-3.5 units, the level of the hormone depends on the duration of pregnancy.

The indicator may slightly decrease or increase for this position, this is normal, but if the deviations are large, you need to pay attention to the state of your health and the development of the fetus.

For most people, 0.4 to 2.5 mU/L is normal (95% of the population). Significantly fewer individuals have a TSH level of up to 4 mU/l. It is believed that an indicator above 2.5 mU / l requires regular monitoring (1 time per year), in modern medicine there is a question about the appointment of people with such an indicator of treatment.

The result of the study may indicate deviations from the specified norm up or down, which, accordingly, indicates an increased or decreased level of TSH in the blood.

In hypothyroidism, the level of serum thyroid-stimulating hormone is increased by 10-12 times, slightly lower values ​​are recorded less often.

Test results and types of hypothyroidism

After receiving the results of the analyzes, first of all, pay attention to the concentration of T3 and T4. Hypothyroidism is ruled out if T3 is between 3 and 8 and T4 is between 4 and 11 (data from saliva analysis).

Values ​​below 3 (for T3) and below 4 (for T4) indicate hypothyroidism.

To determine the degree of hypothyroidism, TSH and T3, T4 data are needed:

  • Primary hypothyroidism (subclinical or mild form). The level of TSH is increased (5-10 mU / l), and the hormones T3 and T4 initially remain normal, then gradually decrease.
  • secondary hypothyroidism. The concentration of thyrotropic, and T3 and T4 is lowered. At this degree, thyroid dysfunction is pronounced.
  • Hypothyroidism. The level of TSH is very low, sometimes even to zero, and the content of T3 and T4 is increased, such indicators are due to the fact that TSH is synthesized only when T3 and T4 are reduced.

In primary hypothyroidism, 3 stages are distinguished, the indicators of which are the following levels of hormones:

  • TSH is more than 0.4 mU / l, T4 and TK are both elevated or one of them is manifest hypothyroidism;
  • TSH is more than 0.4 mU / l, T4 and T3 are normal - subclinical hyperthyroidism;
  • TSH is less than 0.4 mU / l, T4 is reduced - overt hypothyroidism;
  • TSH is less than 0.4 mU / l, T4 is normal - subclinical hyperthyroidism.

In the study of venous blood, it is possible to determine not only the content of hormones, but also changes in the plasma:

  • an increase in cholesterol indicates a decrease in hormone synthesis;
  • myoglobin is increased, and T3 and T4 are lowered - evidence of advanced hypothyroidism;
  • the concentration of creatine kinase is 10 times higher than the norm, the LDH titer is more than normal, indicating the development of myopathy in hypothyroidism;
  • an increase in calcium, serum carotene, a decrease in alkaline phosphatase, iron levels and its ability to interact with proteins are also indicators of changes in hormonal balance.

At the subclinical stage, hypothyroidism can be cured without harm to health, but it develops rapidly, so it is important to diagnose this pathology in time.

If deviations from the norm are detected, the specialist prescribes additional procedures to differentiate the disease.

TSH levels in congenital hypothyroidism

Congenital hypothyroidism is diagnosed in 1 out of 5000 newborns, such statistics indicate the prevalence of this pathology.

The causes of this disease are:

  • iodine deficiency or thyroid disease in the mother of the child during pregnancy;
  • pathologies of formation and development (dysplasia) of the tissues of the thyroid gland of the child;
  • aplasia (absence) of thyroid tissue;
  • resistance to thyroid hormones;
  • congenital tumor formations in the brain;
  • developmental disorders of the pituitary or hypothalamus.

To determine hypothyroidism in a newborn, blood is taken from the heel for 3-4 days. Depending on the results of the analysis, a diagnosis is made:

  • the level of thyroid-stimulating hormone above 50 microunits per 1 liter of blood is an indicator of congenital hypothyroidism;
  • an indicator in the range of 20-50 microunits per 1 liter indicates the need for diagnosis of transient hypothyroidism.

If congenital hypothyroidism is detected, treatment is started immediately (at the subclinical stage), before the manifestation characteristic symptoms. In the case of this disease, lifelong hormone therapy is required.

Methods for normalizing the level of TSH

With hypothyroidism, TSH is normalized with the help of drugs, depending on the stage of the disease:

  • At the subclinical stage, L-thyroxine is used, the dosage is determined by the specialist individually.
  • Manifest hypothyroidism is treated with Levothyroxine. Its dosage depends on the age of the patient (persons under 60 are prescribed a dose of at least 1.6-1.8 mcg / kg of body weight, after 60 years the drug should be taken at 12.5-25 mcg per day, increasing by 25 mcg every 60 days before normalization of TSH).
  • Advanced stages of hypothyroidism are treated with L-thyroxine, individually selecting the dosage. In no case should you increase the dose on your own, this should only be done by an endocrinologist based on these tests.

L-thyroxine is also used to treat congenital and transient hypothyroidism. The dosage depends on the age and weight of the babies. For premature babies, there are some peculiarities of taking the drug.

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Treatment of thyroxine imbalance

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Thyroid hormones: violations and norm

Diseases of the thyroid gland affect all functions of the body. Complaints of patients with hypothyroidism and thyrotoxicosis may be non-specific or absent altogether. For accurate diagnosis and control of the treatment of thyroid tissue diseases, laboratory tests are performed - tests for hormones and antibodies.

Basic research in diseases of the thyroid gland:

  • thyrotropin;
  • thyroxine (free);
  • thyroxine (general);
  • triiodothyronine (free);
  • triiodothyronine (total);
  • thyroglobulin;
  • antibodies to thyroglobulin, thyroperoxidase, TSH receptors;
  • calcitonin.

In different laboratories, the norms (reference values) for these indicators may differ slightly depending on the method of determination and reagents.

Thyrotropin (TSH)

The norm of TSH is from 0.4 to 4 mIU / l in adults and children over 7 years old. In newborns, thyrotropin should be from 1.1 to 17 mIU / l, in infants up to a year - from 0.6 to 10 mIU / l, one-year-old babies - from 0.6 to 7 mIU / l.

The norm of TSH in pregnant women is from 0.4 to 2.5 mIU / l in the first and second trimester, from 0.4 to 3 mIU / l - in the third trimester.

Thyrotropin is the main marker of thyroid function. In many cases it is used for screening.

TSH is produced in the pituitary gland. This tropic hormone regulates the functioning of thyroid gland cells. Thyrotropin stimulates the release of thyroid hormones (T3 and T4), hypertrophy and hyperplasia of thyrocytes.

If TSH is higher than normal during thyroid disease, then the patient is diagnosed with primary hypothyroidism - a lack of thyroid hormones.

This condition develops

  • after treatment (extirpation of thyroid tissue or radioisotope therapy);
  • with chronic autoimmune thyroiditis;
  • with endemic goiter;
  • with congenital disorders;
  • with an overdose of thyreostatics.

If TSH is below normal, then they talk about primary hyperthyroidism (thyrotoxicosis) - an excess of the main thyroid hormones.

This condition can be caused by:

  • diffuse toxic goiter;
  • toxic adenoma of the thyroid gland;
  • nodular toxic goiter;
  • subacute thyroiditis and autoimmune thyroiditis in the initial stages;
  • overdose of tablets in hormone replacement therapy.

Pathology of the pituitary gland provokes a change in TSH. In such cases, low TSH is a sign of secondary hypothyroidism. This disease may result from surgery, radiation therapy, malignancy or benign tumor brain.

High TSH in the pathology of the pituitary gland is a sign of secondary thyrotoxicosis. This rare condition occurs in some neoplasms of the brain (pituitary adenoma).

Free thyroxine (free T4)

The normal level is 0.8 to 1.8 pg/mL (10 to 23 pmol/L). Produced by thyrocytes using molecular iodine. Its synthesis is increased by TSH. Free T4 has a relatively low functional activity. On the periphery and in the thyroid tissue, it turns into active T3.

Action of free T4:

  • increases heat production;
  • increases the metabolic rate;
  • increases the sensitivity of the myocardium to catecholamines;
  • raises blood sugar levels.

Low free T4 is a sign of hypothyroidism.

Reason for this condition:

  • destruction of thyroid tissue (during radical treatment or during an autoimmune process);
  • prolonged iodine deficiency;
  • pituitary damage.

High free T4 is a sign of thyrotoxicosis.

Etiology of the condition:

  • diffuse toxic goiter;
  • toxic goiter (nodular or multinodular);
  • toxic autonomous thyroid adenoma, etc.

Total thyroxine (total T4)

The norm of total T4 is from 5.5 to 11 ng / ml or (according to other units of measurement) from 77 to 142 nmol / l. This analysis is less informative than free T4. The study also evaluates thyroxine levels. The accuracy is affected by the concentration of blood proteins, concomitant diseases, the state of the liver.

Total thyroxine is used only as an additional study.

Free triiodothyronine (free T3)

The rate of free triiodothyronine is from 3.5 to 8.0 pg / ml (from 5.4 to 12.3 pmol / l). This active thyroid hormone is 10% produced by thyrocytes and 90% is formed in peripheral tissues from thyroxin.

Action of free T3:

  • activation of the central nervous system;
  • increase in calorie consumption;
  • increased metabolism;
  • an increase in the number of heartbeats per minute;
  • increased blood pressure, etc.

Increased free T3 occurs with thyrotoxicosis of various etiologies, reduced - with hypothyroidism.

Most often, disturbances in free T3 are observed in old age and with prolonged iodine deficiency.

Total triiodothyronine (total T3)

The norm of total triiodothyronine is from 0.9 to 1.8 ng / ml. Or on a different scale of measurements - from 1.4 to 2.8 nmol / l. This analysis is optional. It estimates blood triiodothyronine levels with less accuracy than free T3.

The accuracy of the analysis is influenced by many factors: concomitant somatic and mental illnesses, the concentration of blood proteins, diet.

thyroglobulin

The analysis for thyroid hormones is supplemented by the study of thyroglobulin. Normally, the concentration of this protein in the blood is from 0 to 50 ng / ml. After radical surgery on the thyroid gland (extirpation), this figure should be less than 1–2 ng/ml.

Thyroglobulin is a specific colloid protein of thyroid gland cells.

A high level of the substance indicates the destruction of thyrocytes. For example, with chronic autoimmune thyroiditis, subacute thyroiditis, etc.

The appearance of thyroglobulin in the blood after radical treatment indicates a relapse of the disease (thyroid cancer).

Antibodies to thyroglobulin (AT-TG)

Normally, antibodies to thyroglobulin are not detected or detected in low concentrations (up to 100 mU/l).

AT-TG are immunoglobulins directed against thyrocyte colloid protein.

An increase in the concentration of antibodies to thyroglobulin occurs in all autoimmune diseases of the thyroid gland.

The reason for the high rate of AT-TG may be:

  • Graves' disease;
  • chronic autoimmune thyroiditis;
  • postpartum thyroiditis, etc.

Thyroid hormones change later in autoimmune processes than antibodies appear. Thus, these indicators can be considered an early marker of diseases.

Antibodies to thyroperoxidase (AT-TPO)

Normally, antibodies to thyroperoxidase should be in a low titer (up to 30–100 mU/l) or absent.

This type of antibody is directed against the thyroid enzyme involved in the synthesis of thyroxine and triiodothyronine.

A high level of AT-TPO occurs in any autoimmune disease of the thyroid tissue. In addition, in 25% of cases this indicator is increased in people without thyroid pathology.

Thyroid hormones at high values ​​of AT-TPO may correspond to hypothyroidism (with chronic autoimmune thyroiditis) or thyrotoxicosis (with diffuse toxic goiter).

Antibodies to TSH receptors

This specific indicator is used to detect Graves' disease.

In children and adults, antibodies to TSH receptors (AT-rTTH) are normally found in low titer - up to 4 U / l. For diagnosis and control of treatment, the interpretation of AT-rTTH indicators is used: from 4 to 9 U/l - a doubtful result, more than 9 U/l - an active autoimmune process.

AT-rTTG - are immunoglobulins that compete for receptors on the cell of the thyroid gland with pituitary thyrotropin.

Antibodies to TSH receptors have a thyroid-stimulating effect.

A high level of AT-rTTH is a marker of Graves' disease. In a certain amount, these antibodies are also found in other autoimmune diseases of the thyroid gland.

Calcitonin

The norm of this hormone is from 5.5 to 28 nmol / l. It does not belong to the main biological active substances thyroid gland. Calcitonin is secreted by the C-cells of the thyroid tissue.

The hormone is a parathyroid hormone antagonist.

Calcitonin:

  • reduces the concentration of total and ionized blood calcium;
  • inhibits the absorption of calcium in the gastrointestinal tract;
  • increases urinary calcium excretion;
  • deposits calcium in bone tissue (increases mineralization).

A high level of the hormone is observed in medullary thyroid cancer, with relapse of this type of cancer, with oncology of other organs (colon, stomach, pancreas, breast).

Elevated TSH levels: causes, symptoms, diagnosis and treatment

Elevated levels of TSH indicate the occurrence of disorders in the thyroid gland or the pituitary system. The symptom appears in women and men due to changes in the level of hormones T3 and T4.

A high level of TSH (thyrotropin) determines the course of the following pathologies:

  • Primary (problems with the thyroid gland).
  • Secondary (failures in the work of the hypothalamus and pituitary gland).
  • Source of the problem
  • We identify the disease

Source of the problem

In the first case, the causes of elevated TSH are the pathology of the thyroid gland:

  1. after surgery or undergoing autoimmune hypothyroidism;
  2. development of thyroiditis after 1-3 months after childbirth;
  3. taking a separate group of medicines (amiodarone, eglonil, cerucal, estrogen);
  4. treatment with iodine 131 (radiiodine therapy);
  5. adrenal insufficiency;
  6. increase in prolactin levels.

Acute stresses, increased loads, lack of sleep and advanced age have a great influence.

The causes of functional disorders of the hypothalamus (secondary series) lie in the pituitary adenoma, insensitivity of the pituitary gland to thyroid hormones and the lack of perception of triiodothyronine. In women, the consequences of hormonal disorders are more acute - statistics determine the ratio of 10 representatives of the fair sex to one man. Among the main diseases, autoimmune thyroiditis is the leader, during which the thyroid-stimulating hormone and the level of antibodies to TPO (anti-TPO) are higher than normal.

Malfunctions of the pituitary and hypothalamus are found in equal proportions in both sexes.

We identify the disease

What to do if, as a result of laboratory tests, the level of thyroid-stimulating hormone is slightly higher than normal? It is necessary to determine the severity of the pathology and the degree of deficiency of thyroid hormones.

With a slight overestimation of the indicators, there may not be any signs. When TSH is strongly elevated, this indicates high insufficiency T3 and T4.

The severity of primary hypothyroidism is classified based on the signs:

  • Subclinical - elevated TSH levels at T4 are normal.
  • Manifest - TSH is greatly elevated, and T4 is below normal.
  • Complicated - the formation of cretinism, heart failure, secondary pituitary adenoma.

In the first case, it is very difficult to identify the symptoms. Manifest hypothyroidism is the main cause of a number of changes:

  • According to external signs (formation of edema, weight gain, the appearance of dryness and pallor of the skin, brittle nails and hair).
  • According to mental and emotional indicators (feeling of depression and the appearance of depression, irritability).
  • According to cardiovascular manifestations (slow pulse, low or high blood pressure).
  • On the work of the digestive system (poor appetite, constipation).

At increased amount thyroid-stimulating hormone in the blood, there is a feeling of exhaustion, weakness and drowsiness. It can also cause anemia.

Since with the development of pathology in the body, TSH reacts more slowly than thyroid hormones, it will take 1-2 months to assess its response to changes in the concentration of T3 and T4. The use of modern diagnostic techniques makes it possible to carry out tests of the third generation of TSH with a sensitivity limit of 0.002 μIU / ml (the TSH norm is 0.4 - 4 μIU / ml). If there are deviations from the norm, a re-analysis should be carried out. If the results are confirmed, do not rush to search folk methods treatment. They are fruitless.