TTG 17 what is happening. What diseases cause an increase in the level of TSH in the blood. The importance of having a blood test for thyroid stimulating hormone

Thyroid-stimulating hormone plays an important role in the human body, but this substance is especially important for the fairer sex. The work of not only the endocrine, but also the reproductive female system largely depends on the level of TSH. Increased TSH in women threatens with many different complications, so it is important to identify and eliminate this violation in time.

What causes elevated TSH in women

Thyrotropin belongs to the hormones that regulate the functioning of the thyroid gland, so the consequences of changes in the production of TSH primarily concern the endocrine organ. A high level of thyroid-stimulating hormone in a woman can lead to the development of hypothyroidism and related diseases. As a result, the nervous and cardiovascular systems also suffer, and hearing, vision, respiratory, and gastrointestinal disorders appear.

An increased concentration of thyrotropin in a woman's blood is also dangerous for the reproductive system, because it often causes deviations in the menstrual cycle, problems with conception and pregnancy. If the level of thyroid-stimulating hormone rises during the period of childbearing, this can lead to premature birth and fetal malformations.

Reasons for an increase in TSH

An increase in the level of thyrotropin in women may be due to the following reasons:

thyroid pathology (hypo- or hyperthyroidism, Hashimoto's thyroiditis);
neoplasms in the pituitary gland;
severe somatic diseases;
insufficient function of the adrenal glands;
cancer processes;
removal of the gallbladder;
gestosis (in pregnant women);
mental disorders;
lead poisoning.

Elevated TSH does not always mean the presence of any pathology. Thus, the concentration of thyroid-stimulating hormone may temporarily increase under the influence of certain drugs - neuroleptics, iodine-containing drugs, hormonal contraceptives, beta-blockers.

What tests for thyroid hormones should a woman take?

Symptoms

An increase in the level of thyrotropin causes deviations in the work of many systems of the female body, causing a variety of symptoms. A woman may notice a sharp increase or decrease in body weight, swelling of the face and limbs, menstrual irregularities, changes in appearance (skin becomes dry, brittle nails, hair falls out badly).

Elevated TSH causes constant drowsiness, apathy and irritability due to disorders in the functioning of the nervous system, anemia, jumps in blood pressure, shortness of breath, digestive disorders (loss of appetite, constipation).

All these symptoms are non-specific and may indicate the development of some other diseases, therefore, if one or more of the above symptoms occur, a woman should consult a doctor and get tested for thyrotropin levels.

Treatment

If a woman has a high concentration of thyroid-stimulating hormone, in most cases she is prescribed treatment with synthetic hormonal drugs (Eutyrox, Levothyroxine). The dosage and duration of medication is determined individually, the drugs are introduced and canceled gradually.

Throughout the course of treatment, a woman must strictly follow the recommendations of the doctor and adhere to a special diet.

How to lower TSH in women with folk remedies

You can lower the level of TSH with the help of the following folk remedies:

Mix in equal proportions buckthorn bark, juniper berries, yarrow grass. 2 tbsp. l. collection, brew 1 liter of boiling water, cover, wrap with a towel and leave for 1 hour. Then strain the remedy and take 100 ml 3 times a day before meals.
Mix 1 glass of freshly squeezed persimmon juice with 40 ml of alcohol, pour into a dark glass container and leave for 3 days. Ready medicine to use 1 tbsp. l. three times a day, after diluting it with a small amount of water.
Take the same amount of celandine, chicory herb, elecampane root and Rhodiola rosea, dill and cocklebur fruits. 2 tbsp. l. mixture pour 1 liter of boiling water, put in a water bath for 15 minutes, then cool and strain. Take a decoction of 50 ml 3 times a day before meals.

Alternative medicine should not be used as the main treatment for elevated thyrotropin levels. In addition, before starting to take folk remedies, a woman needs to consult a doctor and make sure that there are no contraindications.

You may be interested in:

What you need to know about the thyroid hormone TSH
Hormone balance: what does it mean if TSH is elevated?

Deviations from the norm of TSH in children: causes, symptoms, methods of correction

Thyroid-stimulating hormone(TSH or thyrotropin) is a hormone secreted by the anterior pituitary gland, a gland located on the lower surface of the brain. The main function of TSH is the regulation of the thyroid gland, the hormones of which control the work of all metabolic processes in the body. Under the influence of thyrotropin, the concentration of thyroid hormones - thyroxine (T4) and triiodothyronine (T3) - increases or decreases.

Thyroid-stimulating hormone includes two components - α and β. The α-chain is the same as that of the gonadotropic hormones that regulate the functioning of the gonads - chorionic (hCG), follicle-stimulating (FSH), luteinizing (LH). The β-component affects only the tissue of the thyroid gland. TSH binds to thyroid cells, causing their active growth (hypertrophy) and reproduction. The second function of thyrotropin is to increase the synthesis of T3 and T4.

Thyroid-stimulating hormone regulates the production of thyroid hormones by feedback. With a decrease in T3 and T4, the pituitary gland secretes more TSH to stimulate the thyroid gland. On the contrary, at high concentrations of T3 and T4, the pituitary gland reduces the synthesis of TSH. This mechanism allows you to maintain a constant concentration of thyroid hormones and a stable metabolism. If the relationship between the hypothalamus, pituitary gland and thyroid gland is disturbed, the order in the work of these endocrine glands is disturbed and situations are possible when, at high T3 and T4, thyrotropin continues to grow.

Thyroid-stimulating hormone is characterized by a daily rhythm of secretion. The peak concentration of TSH occurs at 2-4 am. Gradually, the amount of the hormone decreases, and the lowest level is fixed at 18 hours. With the wrong daily routine or when working on the night shift, TSH synthesis is disrupted.

The material for determining TSH is venous blood. The level of the hormone is determined in the blood serum by the immunochemical method. The waiting time for the result of the analysis is 1 day.

The role of TSH in the body of a woman

Disorders associated with the synthesis of TSH occur in women 10 times more often than in men.
The endocrine system is a complex mechanism in which hormones constantly interact and mutually regulate each other's levels. Thyrotropin is interconnected not only with thyroid hormones, but also with sex and gonadotropic hormones, the effect of which on the female body is very great. Thus, a change in the level of TSH affects most organs and systems of the female body.

Effect on the thyroid gland

Thyrotropin regulates the hormonal activity of the thyroid gland and the division of its cells. A high level of thyroid hormones in the blood provokes the hypothalamus to produce thyreostatin. This substance causes the pituitary
reduce TSH synthesis. Sensitive to the level of thyrotropin, the thyroid gland also reduces the production of T3 and T4.
With a decrease in T3 and T4, the hypothalamus produces thyreoliberin, which causes the pituitary gland to produce more TSH. An increase in the level of thyrotropin stimulates the thyroid gland - increases the synthesis of hormones, the size and quantity thyrocytes(thyroid cells).

1. Persistent TSH deficiency occurs:

with diseases of the hypothalamus and pituitary gland. He calls secondary hypothyroidism, accompanied by a slowdown in all metabolic processes.
with thyrotoxicosis. In this case, TSH deficiency is the reaction of the pituitary gland to high concentrations of T3 and T4.

2. Chronic excess TSH

with a pituitary tumor and other pathologies, it provokes a diffuse enlargement of the thyroid gland, the formation of a nodular goiter and symptoms hyperthyroidism(thyrotoxicosis).
with a decrease in thyroid function - an attempt by the endocrine system to stimulate the production of T3 and T4.

Signs of these changes will be described below.

Regulation of menstruation

TSH determines the level of thyroid hormones, as well as the synthesis of gonadotropic and sex hormones, which directly affect a woman's gynecological health and her menstrual cycle.

1. In chronic TSH deficiency, associated with the pathology of the pituitary gland and hypothalamus, secondary hypothyroidism develops. Low levels of T3 and T4 cause a decrease testosterone-estrogen-binding globulin(TESG). This substance binds testosterone, making it inactive. A decrease in TESH leads to an increase in the concentration of testosterone in the female body. Among estrogens, estriol comes first, which is a less active fraction compared to estradiol. Gonadotropic hormones react poorly to it, which entails a number of disorders. Their manifestations:

lengthening of the menstrual cycle associated with slow growth and maturation of the follicle in the ovary;
meager discharge during menstruation, they are explained by insufficient development of the endometrium and a decrease in the amount of uterine mucus;
uneven bleeding- one day scanty, the next - plentiful;
uterine bleeding not associated with menstruation.

These effects can lead to a lack of periods (amenorrhea), a chronic absence of ovulation and, as a result, infertility.

2. Chronic excess TSH with pituitary adenoma, it can cause opposite changes characteristic of hyperthyroidism:

shortening the interval between periods, irregular menstrual cycle in violation of the secretion of female sex hormones;
amenorrhea- the absence of menstruation against the background of violations of the synthesis of gonadotropic hormones;
meager discharge accompanied by soreness and weakness on critical days;
infertility, caused by a violation of the secretion of gonadotropic hormones.

Formation of secondary sex organs

The release of female sex and gonadotropic hormones depends on the level of TSH.

1. With a decrease in TSH instead of active estradiol, the inactive form comes first - estriol. It does not sufficiently stimulate the production of follicle-stimulating gonadotropic hormones (FSH) and luteinizing hormones (LH).
Insufficient production of these hormones in girls causes:

delayed puberty;
late onset of menstruation;
sexual infantilism - lack of interest in sex;
mammary glands are reduced;
the labia and clitoris are reduced.

2. With a prolonged increase in TSH girls younger than 8 years old may show signs of precocious puberty. A high level of TSH provokes an increase in estrogen, FSH and LH. This condition is accompanied by the accelerated development of secondary sexual characteristics:

enlargement of the mammary glands;
pilosis of the pubis and armpits;
early onset of menses.

Why is a TSH test prescribed?

A blood test for thyrotropin is considered the most important test for hormones. In most cases, it is prescribed in conjunction with the thyroid hormones T3 and T4.

Indications for the appointment

Reproductive dysfunction:

anovulatory cycles;
lack of menstruation;
infertility.

Diagnosis of thyroid diseases:

enlargement of the thyroid gland;
nodular or diffuse goiter;
symptoms of hypothyroidism;
thyrotoxicosis symptoms.

Newborns and children with signs of thyroid dysfunction:

poor weight gain
delayed mental and physical development.

Pathologies associated with:

violation of the heart rhythm;
baldness;
decreased sexual desire and impotence;
premature sexual development.

Monitoring the treatment of infertility and thyroid diseases.

Pregnant women in the first trimester, if they have latent hypothyroidism.

Signs of elevated TSH

Elevated thyrotropin is often detected with hypothyroidism. In this regard, the signs of elevated TSH coincide with the symptoms of hypothyroidism.

Weight gain. The slowdown of metabolic processes leads to the deposition of nutrients in the subcutaneous fat layer.
Edema eyelids, lips, tongue, limbs. Puffiness occurs due to water retention in the tissues. The greatest amount of fluid is retained in the spaces between the cells of the connective tissue.
chilliness and chills are associated with a slowdown in metabolic processes and the release of an insufficient amount of energy.
Muscle weakness. Accompanied by a feeling of numbness, "goosebumps" and tingling. Such effects are caused by circulatory disorders.
Disorders in the work of the nervous system: lethargy, apathy, depression, night insomnia and daytime sleepiness, memory impairment.
Bradycardia- slowing the heart rate below 55 beats per minute.
Skin changes. Hair loss, dry skin, brittle nails, reduced skin sensitivity are caused by a deterioration in peripheral circulation.
Deterioration of the digestive system. Manifestations: decreased appetite, enlarged liver, constipation, delayed gastric emptying, accompanied by a feeling of fullness, heaviness. Changes occur with a deterioration in the motor activity of the intestine, slowing down the processes of digestion and absorption.
Menstrual irregularities- scanty painful menstruation, amenorrhea, absence of menstruation, uterine bleeding not associated with menstruation. A decrease in the level of sex hormones is accompanied by a loss of sexual desire. Often there is mastopathy - a benign growth of breast tissue.

These symptoms rarely appear all together, this occurs only with prolonged hypothyroidism. In most cases, a moderate increase in TSH does not manifest itself in any way. For example, in a situation where TSH is elevated, and thyroxine (T4) remains normal, which happens with subclinical hypothyroidism, symptoms may be completely absent.

With an increase in TSH due to pituitary adenoma, the following may occur:

headaches, more often in the temporal region;
visual impairment:
loss of color sensitivity in the temporal region;
deterioration of lateral vision;
the appearance of transparent or dark spots in the field of view.

Signs of low TSH

Reduced TSH often occurs with hyperthyroidism (thyrotoxicosis), when thyroid hormones suppress the synthesis of thyrotropin. In this case, the symptoms of TSH deficiency coincide with the signs of thyrotoxicosis.

weight loss with a good appetite and normal physical activity associated with increased metabolism.
Goiter - a bulge on the anterior surface of the neck in the region of the thyroid gland.
Elevated temperature up to 37.5 degrees, feeling hot, sweating in the absence of infectious and inflammatory diseases.
Increased appetite and frequent stools. Patients eat a lot, but at the same time lose weight. The rapid emptying of the bowels, without diarrhea, is caused by the acceleration of peristalsis.
Violation of the heart. Tachycardia is a rapid heartbeat that does not disappear during sleep. Accompanied by an increase in blood pressure. With a long course, heart failure develops;
Bone fragility. People suffer from bone pain, frequent fractures and multiple tooth decay associated with mineral imbalance and calcium loss.
Neurasthenic mental changes. Increased excitability of the nervous system is accompanied by trembling in the body, fussiness, irritability, rapid mood swings, decreased concentration, obsessive fears, panic attacks, fits of anger.
muscle weakness fatigue, muscle atrophy. Attacks of weakness of individual muscle groups of the trunk or limbs.
Eye symptoms. The eyes are wide open, a rare blinking and a feeling of "sand in the eyes" are characteristic.
The skin is thinning. It is moist to the touch, has a yellowish tint, which is associated with impaired peripheral circulation. Characterized by fragility of hair and nails, their slow growth.

How to Prepare for a TSH Test

Blood from a vein for TSH is taken in the morning from 8 to 11. To exclude hormone fluctuations, it is necessary:

do not eat for 6-8 hours before taking the test;
do not smoke 3 hours before the study;
exclude the use of drugs that affect the functioning of the pituitary gland (the list is given below);
for a day to eliminate stress and emotional stress;
a day to refrain from excessive physical exertion.

On what day of the menstrual cycle is blood taken for analysis?

There is no dependence of the level of TSH on the phases of the menstrual cycle. In this regard, blood sampling for TSH is performed on any day.

Normal TSH values in women by age

In different laboratories, the limits of the norm may differ, therefore, the endocrinologist should deal with the interpretation of the results.

What pathologies cause elevated TSH levels?

An increase and decrease in TSH may be associated with disorders in the "hypothalamus-pituitary-thyroid gland" system or solely with thyroid problems. In most cases, an increase in TSH occurs in response to a decrease in thyroid hormone levels.

List of diseases

1. Pathology of the thyroid gland, accompanied by a decrease in T3 and T4, cause an increase in TSH through feedback.

Conditions after removal of the thyroid gland and treatment of the thyroid gland with radioactive iodine.
Autoimmune thyroiditis. An autoimmune disease in which the immune system attacks the cells of the thyroid gland, resulting in a decrease in the production of thyroid hormones.
Thyroiditis. Inflammation of the thyroid gland, which is accompanied by a decrease in its hormonal function.
Thyroid injury- as a result of tissue damage and swelling, the production of hormones worsens.
Severe iodine deficiency. Its absence causes a decrease in the production of T3 and T4, which entails an increase in TSH.
Malignant tumors thyroid gland.

2 . Diseases of other organs accompanied by increased production of TSH

Hyperprolactinemia. The hormone prolactin, like TSH, is produced by the anterior pituitary gland. It is not uncommon for the synthesis of these two hormones to increase simultaneously.
Congenital adrenal insufficiency. In this case, the increase in TSH is associated with low levels of cortisol.
Hyperfunction of the hypothalamus- it produces an excess of thyreoliberin, which leads to excessive synthesis of the pituitary gland.
thyrotropinoma- a benign tumor of the pituitary gland that produces TSH.
Insensitivity of the pituitary gland to the hormones T3 and T4. A genetic disease that manifests itself as symptoms of thyrotoxicosis. The pituitary gland increases the synthesis of TSH with a good functioning of the thyroid gland and a normal titer of thyroid hormones.
Insensitivity of body tissues to thyroid hormones. A genetic disease that manifests itself as a delay in mental and physical development.

Conditions that can lead to an increase in TSH levels:

severe colds and infectious diseases;
heavy physical work;
strong emotional experiences;
neonatal period;
old age;

Medications that can lead to an increase in TSH:

anticonvulsants - phenytoin, valproic acid, benserazide;
antiemetics - metoclopramide, motilium;
hormonal - prednisone, calcitonin, clomiphene, methimazole;
cardiovascular - amiodarone, lovastatin;
diuretics - furosemide;
antibiotics - rifampicin;
beta-blockers - metoprolol, atenolol, propranolol;
neuroleptics - butyrylperazine, perazine, clopentixol, aminoglutethimide;
narcotic painkillers - morphine;
recombinant TSH preparations.

In what pathologies are TSH values reduced?

A decrease in TSH is much less common than an increase in the level of this hormone. Predominantly thyrotropin below normal is a sign of an increase in thyroid hormones of the thyroid gland, which occurs with hyperthyroidism and thyrotoxicosis.

1. Diseases of the thyroid gland, accompanied by hyperthyroidism(thyrotoxicosis), in which a high level of T3 and T4 inhibits the synthesis of TSH.

diffuse toxic goiter (Basedow-Graves disease);
multinodular toxic goiter;
the initial phase of thyroiditis - inflammation caused by infection or immune attack;
thyrotoxicosis during pregnancy;
thyroid tumors producing thyroid hormones;
benign tumors of the thyroid gland.

2. Diseases of other organs accompanied by TSH deficiency.

Disruption of the hypothalamus. It produces an excess of thyreostatin, which blocks the synthesis of TSH.
bubble skid(violation of the development of pregnancy) and chorioncarcinoma (malignant tumor of the placenta). A decrease in thyroid-stimulating hormone is caused by a significant increase in the level of hCG (chorionic gonadohormone).
Hypophysitis- a disease that occurs when the immune system attacks the cells of the pituitary gland. Violates the hormone-forming function of the gland.
Inflammation and brain injury, surgery, radiation therapy. These factors cause edema, impaired innervation and blood supply to various parts of the brain. The result can be a malfunction of the cells that produce TSH.
Tumors of the hypothalamus and pituitary gland in which the tumor tissue does not synthesize TSH.
brain tumors, squeezing the pituitary gland and disrupting the production of hormones.
Cancer metastases in the pituitary gland is a rare complication in cancer patients.

Conditions that can lead to low TSH levels:

stress;
injuries and diseases accompanied by bouts of acute pain;

Medications that can lead to a decrease in TSH:

beta-agonists - dobutamine, dopexamine;
hormonal - anabolic steroids, corticosteroids, somatostatin, octreotide, dopamine;
drugs for the treatment of hyperprolactinemia - metergoline, bromocriptine, piribedil;
anticonvulsants - carbamazepine;
hypotensive - nifedipine.

Often, TSH deficiency is associated with taking analogues of thyroid hormones - L-thyroxine, liothyronine, triiodothyronine. These drugs are prescribed for the treatment of hypothyroidism. Incorrect dosage can inhibit the synthesis of thyroid-stimulating hormone.

Thyroid stimulating hormone (TSH) is produced by the pituitary gland, which is a small gland located in the lower part of the central region 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 thyroid-stimulating hormone of the pituitary gland regulates the formation of thyroxine and triiodothyronine according to the feedback principle. 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 the active restructuring of the 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 noted in 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 undergo an examination by an endocrinologist, ultrasound examination of the thyroid gland and examination of the thyroid panel. 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.

An analysis for thyroid-stimulating hormone allows you to identify diseases of the endocrine system in the early stages, 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.

Thyroid-stimulating hormone (TSH) is responsible for a number of important processes in the human body, including the functioning of the thyroid gland. However, it may turn out that TSH is elevated. What does this mean and should we be afraid of this phenomenon? We will talk about this later, focusing on the symptoms and treatment.

What is the norm of TSH, and what does it affect?

The norm of TSH in the blood is 0.4-4.0 mcU / l. This concentration of the hormone is enough to stabilize the thyroid gland.

There is a close relationship between TSH, as well as the hormones T3 (triiodothyronine) and T4 (thyroxine). When you change one of the indicators, the other two change. The norm of these indicators is important for the whole organism: the activity of the cardiovascular, endocrine and reproductive systems, as well as the gastrointestinal tract, depend on them.

Therefore, when TSH is elevated, the work of the body is difficult and requires external intervention.

It should be remembered that, on average, the norm for men and women, people of different ages, physique and height is different. Only a doctor can correctly interpret the results of the analysis in accordance with individual characteristics.

Rules for taking an analysis for TSH

Elevated TSH in women, as in other patients, is checked by donating blood from a vein. At the same time, in order to obtain accurate results of the analysis for TSH, t4 and t3, it is worth adhering to the following rules:

2 days before the delivery, it is not recommended to play sports and physically overload the body.
For 2 days, exclude the use of the following hormones: steroid and thyroid.
The day before the analysis, exclude the use of alcohol, as well as tobacco products.
Maintain a calm state, do not overstrain emotionally.
The analysis is taken on an empty stomach, so it is forbidden to eat in the morning before the test. You can drink only pure water without gas.

Also, the doctor can give you individual advice to prepare for the test.

In a healthy person, the concentration of the hormone changes throughout the day. If the analyzes show the uniformity of concentration throughout the day, then this indicates that the TSH hormone is elevated. In this case, problems in the functioning of the thyroid gland or the entire endocrine system are possible.

Antibodies to TSH

In addition to tests for t3 and t4, sometimes they take an analysis for antibodies. The results obtained can also tell about some features of the body. There are 3 types of antibodies to TSH:

Blocking the activity of TSH receptors and increasing the level of t3, t4.
Blocking thyroid stimulation and decreasing sensitivity to TSH.
Causing a long-term increase in the hormones T3 and T4.

The danger of antibodies lies in the fact that they are able to enter the fetus through the placenta, thereby provoking the development of pathologies in babies. Therefore, it is imperative to check whether there is an increased TSH during pregnancy.

Only TSH rises: causes and effects

Often a situation arises when the TSH hormone is elevated, and T3 and T4 are kept normal. The reasons for this may be hard physical labor, emotional overstrain, stress, depression, taking specific medications (iodides, prednisone, etc.). Even TSH is higher than normal after operations to remove the gallbladder.

When only TSH is elevated, this leads to the fact that the change in the indicator is asymptomatic. In this case, the following consequences are possible:

Diseases of a somatic or mental nature: mental disorders in heart disease, mental disorder, decreased activity;
Thyrotropinoma (a rare type of pituitary adenoma);
Starvation;
adrenal insufficiency;
Resistance to thyroid hormones;
Subacute thyroiditis is a disease that manifests itself with inflammation of the thyroid gland;
Toxic goiter, characterized by hypertrophy or hyperfunction of the thyroid gland.
Various tumors, for example, a tumor of the pituitary gland;
Different types of thyrotoxicosis (excess thyroid hormone);
Hashimoto's thyroiditis (inflammation of the thyroid gland of an autoimmune origin);
Preeclampsia (complications during pregnancy in the 2nd or 3rd trimester).

Symptoms of elevated TSH

At the initial stages, nothing says that the thyroid-stimulating hormone is elevated. Subsequently, the following symptoms may indicate this:

Increased weakness, drowsiness, fatigue during any kind of activity, even inactive ones.
Problems with the nervous system: irritability, rudeness, nervousness, bad mood, apathy.
Thinking slows down, concentration decreases.
Noticeable changes in appearance: weight changes with a “+” sign, obesity, unhealthy skin color, puffiness.
Sleep is disturbed, appetite noticeably worsens.
Problems with the digestive system: causeless bouts of nausea, sometimes constipation.
The body temperature remains stable at a low level.

All these manifestations can be seen both together and separately. Therefore, if you notice any of the above symptoms in yourself, then you should contact an endocrinologist as soon as possible.

Treatment for elevated TSH

With elevated TSH, special treatment is prescribed:

The patient is prescribed a number of hormonal drugs of the thyroid type. These can be medicines such as T-rheocomb or Tireot.
Pregnant women are usually prescribed synthetic L-thyroxine in moderate doses.
In some cases, when drug treatment does not help, an operation is performed to resect the lobe of the thyroid gland.

Hormonal preparations prescribed for elevated TSH have the following features:

produce minimal impact on human weight;
practically do not affect the work of the body;
optimize metabolic processes.

Some time after the start of treatment, you will need to see a specialist to check if the prescribed dose is right for you.

Elevated TSH in pregnancy

Women who have elevated TSH during pregnancy are advised to pay attention to the following subtleties of this phenomenon:

TSH during the normal course of pregnancy may increase slightly. This is normal, so no need to worry.
If a pathology occurs in the embryo, it is necessary to immediately undergo a course of treatment. This will help to avoid negative consequences and adverse effects on the mental health of the child.
Medical treatment during pregnancy is treated with caution. Drugs are prescribed only when antibodies to TSH are significantly increased, or T4 is produced in a reduced amount.

The human endocrine system regulates the work of internal organs with the help of special substances - hormones. Even a small malfunction in its work entails various troubles for the body, up to serious diseases. Thyroid-stimulating hormone promotes the production of two thyroid hormones. Therefore, it is important to control its value.

TSH or thyroid stimulating hormone

The pituitary gland is responsible for the production of this hormone. The main task of TSH is to control the functions of the endocrine system, therefore it is referred to as regulatory. It stimulates the formation of triiodothyronine (T3) and thyroxine (T4) - thyroid hormones that are of great importance in the body.

They provide the following processes:

regulation of metabolism;
Activation of the growth process;
Protein synthesis;
Synthesis of vitamin A;
Energy metabolism - the breakdown of organic compounds into simple substances;
They are responsible for the normal activity of the cardiovascular, central nervous, reproductive systems and the gastrointestinal tract, for the state of the organs of hearing and vision.

TSH, in addition to stimulating the formation of hormones, performs a number of tasks that are associated with accelerating the synthesis of protein, phospholipids and nucleic acids, as well as the supply of iodine to thyroid cells. Since the concentrations of hormones depend on each other, with an increase in the level of TSH, there is a decrease in the values of T3 and T4, and, consequently, a deterioration in human health occurs.

The TSH level in healthy people changes during the day. The lowest concentration of the hormone in the blood is usually observed at night, and its highest value is in the early morning. Therefore, sometimes it is worth taking tests several times in order to achieve an accurate result.

What does a high thyroid-stimulating hormone mean, and what are the symptoms?

An increase in the level of TSH is the first sign of a malfunction in the thyroid gland, a decrease in its functions. In this case, a person may not experience any ailments, and the indicators of other hormones are normal.

At the initial stage, an increase in TSH is asymptomatic, but soon, with a prolonged deviation, various body systems let you know that not everything is in order with health.

Common signs (usually they are permanent):

From the side of the nervous system :, scattered attention, depression, drowsiness (see also);
From the side of the cardiovascular system : low blood pressure, low heart rate;
From the gastrointestinal tract : loss of appetite, stool retention, liver enlargement;
From the reproductive system : , decreased libido, .

In addition, there are changes in the appearance of a person:

Hair problems are observed - they become brittle and begin to fall out;
Peeling and tightening of the skin worries, cracks appear. The skin is dry and pale;
There is swelling of the face;
In some cases, the timbre of the voice decreases;
There is an increase in body weight with loss of appetite, the development of obesity, which cannot be corrected;
There is a low body temperature, general weakness, pain and cramps in the legs.

If several of the above signs appear, the help of an endocrinologist is immediately required.

Treatment not started on time leads to the appearance of pronounced symptoms that indicate serious diseases of the thyroid gland (inflammation or the development of a tumor in it):

Deceleration of speech from the nervous system;
The appearance of a goiter (or struma), that is;
The neck area has a reddish or bluish tint;
There is discomfort in the neck or its deformation is noticeable.

Why TSH rises: reasons

A high rate of the hormone is most often associated with impaired thyroid function and with iodine deficiency in the body. In addition, it can indicate serious diseases or adverse processes occurring in the body. For example:

adrenal insufficiency;
Various neoplasms, including malignant;
Benign tumor of the pituitary gland leading to hyperthyroidism;
Severe somatic diseases (respiratory system, heart and vascular diseases, kidney and liver damage);
lead poisoning;
An excess of iodine;
Thyroid hormone insensitivity syndrome (this is a genetic disease that is inherited);
Severe preeclampsia in pregnant women (which manifests itself in the form of edema, high blood pressure, the presence of protein in the urine);
Surgical intervention - removal of the gallbladder (cholecystectomy);
Mental disorders.

But not always elevated TSH indicates serious illness. Its level increases with physical exertion, radiation exposure, taking certain pharmaceuticals - neuroleptics, estrogen-containing hormonal contraceptives, normothymic drugs (lithium preparations), iodides and others.

Elevated TSH in children

In children, the TSH rate depends on age. If in two-month-old children the normal TSH is 0.6-10 mIU / l, then in adolescents under 14 years old it is in the range of 0.4-5 mIU / l. The level of the hormone in the child's body is not constant, so they make an analysis in dynamics. The study is prescribed if the child has:

Delayed mental and physical development;
and hands at normal body temperature;
Drowsiness;

An increase in TSH is also associated with diseases of the adrenal glands and severe mental disorders.

An indication of diagnosis in the prenatal period is the disease of the parents with hypothyroidism. If the TSH index exceeds 100 mIU / l, then the analysis is considered positive. Congenital hypothyroidism manifests itself in the form of neurological cretinism,.

Elevated TSH in women

The norm of TSH for women is in the range of 0.4-4 μIU / ml. But the maximum threshold in some cases is considered a deviation. It is important to know that the value of TSH increases with the development of a breast tumor.

Women over 50 years of age are advised to have a routine test, as they have a 12% increased risk of developing hypothyroidism.

Features during pregnancy

In the body of a pregnant woman, hormonal changes occur. Therefore, during pregnancy, hormone levels at different times differ from each other. Usually, in the first weeks, the concentration of the hormone is lower than in the later ones. Hormone fluctuations are a physiological feature that depends on the emotional state of the woman and her physical activity.

However, if in the first weeks a significant excess of the norm was revealed, then the pregnant woman should be constantly monitored by a doctor who can prescribe additional examinations: an echographic examination and a biopsy of the thyroid gland. After all, for the first 10 weeks, a developing child is completely dependent on maternal hormones, since his thyroid gland is just being formed.

A significant deviation of TSH from the norm complicates the course of pregnancy. In the early stages, this can provoke a miscarriage, and in later periods, the likelihood of placental abruption and intrauterine growth retardation increases.

TSH receptors are of no less importance. They are located in the thyroid gland and react to thyroid-stimulating hormone, thereby causing the production of T3 and T4. In some cases, an increase in TSH is associated with a violation of the immune system. When it fails, it begins to produce antibodies that block its activity. As a result, it stops stimulating the thyroid gland, and its cells lose sensitivity to it.

Antibodies cross the placenta and increase the risk of developing various diseases of the endocrine system of the newborn. Therefore, if the expectant mother has diseases of the endocrine system, then she must be prescribed a study for antibodies to TSH receptors in the 3rd trimester.

How to normalize TSH

Treatment is prescribed only by a specialist after identifying the exact cause of the increase in hormone concentration. For each person, it is selected individually:

If the jump in the indicator occurred against the background of breast cancer, inflammation of the thyroid gland, then the treatment will be long and difficult. With benign formations, patients undergo complex treatment. With the formation of small tumors, they do without surgical intervention.
With a low increase in TSH associated with a lack of iodine and the formation of goiter, iodine-containing drugs are prescribed. They are used within six months. After treatment, it is necessary to re-do an ultrasound of the thyroid gland and take an analysis for TSH.
If diagnosed with hyperthyroidism, treatment with hormonal drugs is prescribed under the strict supervision of the attending physician. Medicines are taken every day according to the scheme proposed by the specialist.

Previously, for the treatment of hypothyroidism, natural raw materials were used - ground animal thyroid gland. Now it is used extremely rarely, giving preference to synthetic drugs. Their advantage is a constant level of activity. After undergoing such treatment and having normalized TSH, T3 and T4, patients should undergo an annual physical examination and take tests to make sure that their levels are normal.

Video: Problems with TSH - is it possible to get pregnant?

In the next video, Dr. Myasnikov will tell you why TSH is important. What does it mean if it is elevated or at zero: