TSH at the upper limit of normal. What is TSH and what are its norms in the body when planning a pregnancy? Clinical and diagnostic value of TSH

  1. Svetlana
  • Irina

    Good afternoon Dmitry! Are there ways to cure AIT and is it possible to take metformin with such a diagnosis?
    Thank you in advance.

    1. Dmitry Veremeenko

      Metformin is possible. It is theoretically possible to cure. There is no medical treatment yet

  • Iskander

    Good afternoon, Dmitry.
    Comment on iodine intake. Didn't find any information on the site.
    As far as I understand, a significant part of Russia is iodine-deficient. Given that iodized salt is one of the sources of iodine, as well as the fact that salt intake is recommended to be limited to a minimum (at least for people with high blood pressure), is there any point in taking it additionally for children and adults? Thank you.

    1. Dmitry Veremeenko

      If the endocrinologist did not prescribe on the basis of hormone tests thyroid gland, then no.

  • Dmitry Veremeenko

    2004, University of Calcutta, India. Plants produce many toxic substances to protect themselves from insects and other herbivores. Many foods can be toxic to the thyroid gland. These substances are called goitrogens, and the chemicals responsible for this effect are called goitrogens. Goitrogenic substances suppress thyroid function. They interfere with the production of thyroid hormones. As a result of the compensatory mechanism, the thyroid gland will enlarge to counteract the decrease in hormone production. This enlargement of the thyroid gland is called a goiter. List of foods containing goitrogenic substances: Broccoli, Brussels sprouts, cabbage, cauliflower, greens, horseradish, mustard greens, peaches, peanuts, pears, pine nuts, radishes, swedes, soybeans, strawberries, flax seeds, almonds, apples, cherries, nectarines, plums. Cooking can reduce goitrogens in foods. Boiling up to half an hour in water almost completely destroys them. Dietary intake of iodine (iodized salt) is able to overcome the effect of cyanogenic glycosides in moderate amounts in cruciferous vegetables. But it may not help if you eat a lot of cruciferous vegetables. Soy can cause autoimmune thyroid disease and is often associated with food intolerances. Thyroid peroxidase, thyroperoxidase (TPO) is an enzyme expressed mainly in the thyroid gland. Catalyzes two important reactions during synthesis thyroid hormones: iodination of tyrosine residues of thyroglobulin and fusion of iodotyrosines during the synthesis of thyroxine and triiodothyronine.
    ncbi.nlm.nih.gov/pubmed/15218979

    2018, Shandong University, China. A high fat diet (for 18 weeks) rich in saturated and monounsaturated fatty acids causes abnormal thyroid lipid profile and hypothyroxinemia in male rats. At the same time, free thyroxin T4 is lowered, and thyroid-stimulating hormone(TSH) rises.
    ncbi.nlm.nih.gov/pubmed/29363248

    2016, India. Risk factors for hypothyroidism:
    Excess iodine. Iodine can also have a direct toxic effect on the thyroid through free radicals oxygen and immune stimulation.
    Natural goitrogens found in cabbage, in cauliflower, in broccoli, in turnips, forms of cassava root. Soy or soy-enriched foods can also exacerbate thyroid problems by lowering T4 hormone, increasing autoimmune thyroid disease.
    Thyroid peroxidase (TPO) activity can be increased by intake of polyunsaturated omega-3 fatty acids (fish oil) and monounsaturated omega-9 fatty acids ( olive oil), while TPO activity is reduced by saturated and polyunsaturated omega-6s ( linseed oil) fatty acids.
    Thyroid function can be compromised by high consumption of green tea. In rats, there is a significant decrease in serum T3 and T4 and an increase in TSH levels, along with a decrease in TPO.
    A review of 14 studies found that although soy protein and soy isoflavones did not affect normal function thyroid hormone in people with sufficient iodine intake, but they can interfere with the absorption of synthetic thyroid hormone, causing an increase in the dose of the hormone.
    Peanuts can also cause goiter, but this effect is inhibited by a small amount of potassium iodide.
    Wheat bran inhibits TPO activity.
    Selenium and vitamin B12 deficiencies have also been implicated in autoimmune thyroiditis.
    UV filters to protect the skin from ultraviolet radiation may also alter thyroid homeostasis.
    ncbi.nlm.nih.gov/pmc/articles/PMC4740614

    1. Alexander

      Dmitry, so now it turns out not to eat, for example, Broccoli and all cabbage, but what about Sulfarafan?

      1. Dmitry Veremeenko

        There is. Just if TSH rises above the norm, you need to consider iodine and selenium preparations with an endocrinologist. They help fight it

    2. Alexander

      What is the conclusion from all this? And it's already scary to live.

      1. Dmitry Veremeenko

        What is the conclusion?

  • L.B.

    Dmitry, so having AIT, it is undesirable to use broccoli? I wouldn't want to give it up completely.

    1. Dmitry Veremeenko

      AIT means you are on hormones. If you're on hormones, then you don't care anymore. Only soy causes an increase in the proportion of hormones

  • Heat

    I have TSH - 6.5, all other indicators of the thyroid gland - the norm with a margin.
    I think that if the TSH remains as it is, this is only a plus, for example, the pulse, including from such a TSH, is low at rest with good health and a normal ECG.

    1. Dmitry Veremeenko

      What autoimmune markers do you have and how old are you?

      1. Heat

        Autoimmune markers are not elevated, AIT is not diagnosed. Inflammatory markers are also low (C-reactive protein has fluctuated in recent years from 0.1 to 0.2). True, endocrinologists do not like such TSH, they prescribe to drink Iodomarin, and some of them even take hormones, although my hormones T4 and T3 are in the middle of the norm, although if I had listened to doctors, I would have become disabled 20 years ago.
        By age and health, I belong to the 8th version of the anti-aging plan indicated here.

        I think my TSH is elevated - because I rarely eat and eat a lot of vegetables, including the cruciferous family, I eat little protein, but a lot of fat, I walk a lot and quickly every day. If my TSH does not rise further, then I see in such a current TSH - only a plus.

        1. Dmitry Veremeenko

          From such TSH at your age there can be nodes and even tumors of the gland. Low doses of iodine are still worth taking. I will write an article about this soon.

          1. Heat

            Dmitry, this is certainly a double-edged sword. On the one hand, a relatively high TSH slows down aging, but carries the risk of overgrowth of the thyroid gland, and if T4 and T3 fall below normal, there is a risk of atherosclerosis. On the other hand, low TSH accelerates aging, while it may seem to a person that he is full of strength and energy, but he will age faster.

            So it turns out and you need to maneuver so that TSH is not low and at the same time T4 and T3 do not fall below the norm, and iron does not grow.

            Yes, and I also saw evidence that taking iodine in the form of iodized salt or supplements like Iodomarin increases the risk of AIT, apparently such inorganic iodine acts more quickly and strongly than iodine from food, which can contribute to the onset of AIT and this is with normal TSH and hormones, therefore, taking additional iodine in the form of supplements is recommended to be tested for antibodies to the thyroid gland more often.

          2. Dmitry Veremeenko

            About the risks of iodine - this is so. It would be best to take an iodine test. And if it is in short supply, then a small dose of norms.

  • Tatyana

    Dmitry, please explain why the article and comments talk about TSH as an autonomous indicator? I used to think that its level depends on the level of thyroid hormones: if they are high, it is low, if they are low, it rises and its increase stimulates the thyroid gland. Or is it not so simple?

    1. Dmitry Veremeenko

      Because t3 and t4 are unstable. And TTG is more stable. Many endocrinologists generally only look at it.

      1. Tatyana

        Thanks! Then the situation is clear. Has handed over in Helix 2 times with an interval in 2 weeks, parameters TTG very different. One endocrinologist diagnosed hypothyroidism (TSH was 2 times higher than normal), and the second laughed and said that this does not happen in such a short period, a change in TSH can occur no more than 3 months. I retaken in Invitro - TSH is normal. - By the way, this is about the quality of Helix's work.

        1. Dmitry Veremeenko

          Apparently beta-blockers were drunk the day before ???)))

  • Galina

    Good afternoon. Dmitry. Please tell me if I need to take iodine, if
    TSH -0.5, and T4-12.7 and T3-3.36?

    1. Dmitry Veremeenko
  • Lydia

    Hello Dmitry! I am 24. I have the following indicators: TSH - 1.15 mU / l (reference values: 0.4-4.0), T4 St. - 12.84 (9.00-19.05), AT-TPO - 14.3 U / ml (<5,6). Есть узел (диагноз — аденоматозный зоб). Пока что никакое лечение эндокринологом мне не назначено, показано только следить за Т4 ,ТТГ и узлом. Меня интересует, реально ли понизить/не допустить дальнейшего повышения антител? Если да, то как? И нужно ли что-то делать в моей ситуации, например, придерживаться какой-либо диеты или что-либо ещё? Если да, то какие это могут быть рекомендации?

    1. Dmitry Veremeenko
  • Galina

    good afternoon Dmitry.
    TSH -0.5, and T4- 12.7 and T3-3.36
    according to hair analysis according to the method of D. Skalny, I have selenium 0.479 (0.2-2)
    iodine 6.87 (0.15-10) zinc at the lower limit 142 (140-500)
    low iron 13.22(7-70)
    lithium increased 0.309 (- 1) do I take it once a week?
    Does this mean I should give up lithium and take zinc in addition?
    and selenium and iodine is not needed?
    Thyroid Energy not to be taken?

    1. Dmitry Veremeenko

      Lithium does not need to be refused 1 tablet per week will not affect.
      Zinc is additionally needed if it is significantly below normal. And so it is not necessary

  • Anastasia

    Good afternoon. I really want to know how without hormones you can lower the level of TSH.
    I got tested and was horrified. Tsh = 65.71 IU / l, and T4 = 8.80.

    1. Dmitry Veremeenko
  • Nina

    Dmitry, hello, I’m 75 years old, there are nodes on the thyroid gland (they don’t grow), at first TSH was not very elevated, but after taking cordarone (a drug for arrhythmia with iodine) for a year, TSH rose to 10, the drug was canceled, trioxin 25 was prescribed - 50 mg. 2 years have passed TSH is still elevated 7-8 against the background of taking hormones. What will you advise, the doctor only increases the dose of L-thyroxine and does not give direction for the analysis of other hormones?

    1. Dmitry Veremeenko

      TSH at 75 is a normal TSH for a centenarian

  • Nina

    Dmitry, thanks for the answer, I didn’t understand what kind of TSH is normal at 75, and is it necessary to drink hormones?

    1. Dmitry Veremeenko

      A 2011 study from the Leiden University Medical Center (Netherlands) confirmed the findings of a previous study. Subclinical hypothyroidism is not associated with a risk of increased overall mortality unless it is of an autoimmune nature. Moreover, there is no association between subclinical hypothyroidism and coronary artery disease, heart failure, or CVD mortality unless TSH levels are greater than 10 mU/L.

      Women over 65 years old TSH norm 0.42–7.15 mU/l (as in centenarians), but control of cholesterol and inflammation markers.
      —
      If you are 65 years of age or older, if your thyroid hormones are normal and only elevated TSH hormone not higher than 10 mU/l, then treatment to lower TSH below 10 mU/l is not required, and, quite possibly, can only shorten life. The only requirement is to control cholesterol levels and inflammatory markers (c-reactive protein and interleukin-6).
      In your case, hormones allow you to control TSH no higher than 10 - well, that's good. Just make sure you don't have high cholesterol and inflammatory markers (c-reactive protein and interleukin-6)

  • Tatyana

    Hello! and with normal thyroid and TSH levels 12 .. and with good health .. do you need to drink hormones? I’m now 47 ... from the age of 30 I was elevated .. refused to drink hormones ... and was slim and felt good ... from 44 I started drinking 50 and recovered by 10 kg .. my skin became worse ... so it turns out until I drank everything was fine ... and the meaning of drinking them .. it was necessary to refuse like that ... but I want to believe the doctors.

    1. Dmitry Veremeenko

      According to research, it is necessary

  • Maksim

    Dmitriy! For the first time today I passed on the thyroid gland.
    Where to run!!!

    TSH - 7.8300 mIU / l (reference 0.350 - 5.500)
    T3 - 1.15 nmol / l
    FT3 - 2.58 pg / ml
    T4 - 61.2 nmol / l
    FT4 - 9.77 pmol/l (reference 11.50 - 22.70)
    AtTG - 251.6 IU / ml (reference 0.0 - 60.0)
    AtTPO - 5600.6 IU / ml (reference 0.0 - 60.00) !!!

    Especially liked the last one!
    I didn't even find it on the Internet.

    ULTRASONIC EXAMINATION OF THE THYROID WITH CFM AND
    REGIONAL L / NODES
    Acoustic access, location: The thyroid gland is located typically, the contours are even,
    clear, heterogeneous cellular structure. Cystic and solid formations
    not found; gland capsule can be traced throughout.
    Dimensions: right lobe: width - 16 mm, thickness -18 mm, length - 46 mm
    volume -7.1 cm3
    left lobe: width - 18 mm, thickness - 19 mm, length - 43 mm
    volume -8.0 cm3
    isthmus: 4 mm
    The total volume is 15.1 cm3, does not exceed the age norm.
    The vascular pattern of the parenchyma of the gland in the CDI mode is enhanced.
    Topographic and anatomical ratio of the thyroid gland with muscles and
    organs of the neck is not changed. Regional l / nodes without features.
    CONCLUSION: Ultrasound - signs of diffuse changes in the structure of the thyroid
    glands of the AIT type.

    I also did biochemistry, there, as always, everything is normal:
    C-protein ultra - 0.27
    Cholesterol - 4.67
    Glyc.hemoglobin 5.20%
    etc. more than 20 indicators, they are all within the reference limits.

    (54 years old, 70 kg., 185 cm., BMI-20-21, waist at the navel 85-86, lark - lights out at 22, wake up at 5 in the morning)

    1. Dmitry Veremeenko

      To the endocrinologist and sit down on hormones.

      1. Maksim

        Thanks, Dmitry!
        I already signed up!
        Can't raw broccoli be bad? Maybe stop eating it every day?

        1. Dmitry Veremeenko

          Can't unless eating more than 100 grams a day

  • Maksim

    Dmitry, visited the endocrinologist, to my surprise, she said that we would not do anything, after 3 weeks we would retake all the tests for the thyroid gland. She felt the thyroid gland, said that there was a node on the left, 2 ultrasound doctors came, one said a pseudo-node, the other a normal node, they immediately took a sample for cytology and thyroid tumor markers. There, the norm is: thyroglobulin - 17.4 ng / ml (reference 0.2-70.0) and calcitonin less than 2.00 pg / ml (reference 0.4 - 27.7). I am waiting for the results of iodine-zinc-selenium from blood plasma.

    1. Maksim

      The results came: little iodine and zinc,
      and selenium - before the analysis, for about 3 weeks, I ate brazil nuts, 3 pcs. in a day

      Study Result Units Reference values
      Iodine (serum) 0.042* mcg/ml (0.05 – 0.10)
      Selenium (serum) 0.104 mcg / ml (0.07 - 0.12)
      Zinc (serum) 0.613* mcg/ml (0.75 - 1.50)

      Maybe I'm wrong
      but I like it better when you first take tests,
      and then you take vitamins, and not vice versa.

  • Maksim

    And the cytology is ready: nodular colloid goiter, benign. image. according to Bethesda -II diagnostic category.
    Dynamic observation is recommended.

    I read on the Internet - taking into account the analyzes - there is little iodine. I'm going to eat seaweed!

    1. Maksim

      I visited the doctor again. Iodomorin 200 mcg x 1 tablet was prescribed. per day x 3 months and Aquadetrim 2500 IU every day.
      They said that an analysis on D3 can show that there is a lot of it, but it is not a fact that the body uses these reserves correctly.
      This indirectly shows the analysis of parathyroid hormone.

      They also said that such a knot (16 mm) would most likely remain the same, it would not increase, but it would not decrease either.

  • Julia

    Good day everyone!
    Who can advise how to increase T3 free? At the moment I have it = 3.1. T4 and TSH are within normal limits, but the ratio of T3 to T4 is below normal.
    Thank you

  • Ludmila

    Dmitry, please specify where you can read in more detail about the increased risk of atherosclerosis with reduced T4 and T3?
    Also in the comments somewhere you wrote about the effect of taking synthetic T3 hormone on papillomas. This information is very necessary. Please provide links or pointers where it can be read.
    Many thanks

    1. Dmitry Veremeenko

      ncbi.nlm.nih.gov/pubmed/18443261

  • Olga

    Dmitry, hello. Please advise whether it is necessary to drink hormones -ttg-4.46 (normal 0.4-4.2), cholester.-4.58, with react protein 0.09, rheumatoid factor 3.7 (0- 14), glycer. hemoglobin-5%, atherogenic coefficient-2%, glucose 4.38. age 55 years. thanks.

    1. Dmitry Veremeenko
  • Olga

    I will add that in 8 months the TSH increased from 3.16 to 4.46.

    1. Dmitry Veremeenko

      It is a question to the endocrinologist.

  • Elena

    Good afternoon, my TSH is 1.97. I score with a comma! The algorithm gives an excess, although there is a norm of 0.4-4.5. This is mistake???

    1. Dmitry Veremeenko

      Just scored 1.97 in the algorithm - that is, separated by commas. Everything is working. No excess. Perhaps you do not have an Excel program, but the algorithm opens through Open Office?

  • Aida

    Hello Dmitry! The article is very informative, thank you very much. In 2010, I had an operation - a mastectomy (cancer of the left breast pT2NOMO. NALT, ME dated 06/29/2010. 4 courses of APCT according to the FAC scheme. I did not take any hormone-containing and other drugs. 9 cm3, the tissue is homogeneous, low echogenicity, medium-grained. I work out in the gym - strength training. Weight at 53 years old - 56.5 kg. I feel great. Not long ago I had an examination: ultrasound - thyroid gland volume 4.5 cm3, homogeneous, but already coarse-grained.Conclusion: hypoplasia of the thyroid gland.Hypothyroidism?
    Passed on hormones: TSH (III-generation) 7.65 at 0.46-4.7 mlU / L; Free thyroxine T4 - 10.65 at 8.9 - 17.2 pg / ml; Triiodothyronine free T3 - 4.73 at 4.3-8.1 pmol / l; Prolactin 443.7 at 64-395 mlU/l; Thyroid Peroxidase Antibodies (AT-TPO) >1000.0 at 0-35 IU/ml.
    Could explain and give advice. Thank you.

    1. Admin_nestarenieRU

      Enter the data here and the algorithm will prompt
      http://not-aging.com

  • Olesya

    TSH 1.51 mU/l age 37 years. Please tell me this is normal.

    1. Dmitry Veremeenko

      this is normal

      1. Olesya

        Thank you for reassuring me.

  • Dmitry Veremeenko

    The question is not clear to me. What is fundamentally wrong. Where are the research links?

  • Paul

    In fact, only 7 out of 40 subjects had antibodies when taking additional iodine, and this may be because there was not enough selenium. And again, you need to understand that these are people with ALREADY PRESENT autoimmune thyroiditis. There, in addition to iodine deficiency, there are a bunch of other concomitant sores and just stupidly adding additional iodine is not you will help. It’s like with calcium preparations. That is, you are talking about hypothyroidism, but you cite as evidence a study of people with. For example, a long-term iron deficiency leads to depletion of the thyroid gland and vice versa. acidity due to insufficiency of parietal cells Castle factor - a product of the activity of these cells It is clear where the deficiency of B12 comes from? And B12, in turn, is a cofactor for iron absorption along with vitamin C, etc. Further Due to the low level of ferritin, the deiodinase enzyme is blocked (turns low-active T4 into active T3) The thyroperoxidase enzyme is also iron-dependent. The biological effect of thyroid hormones is reduced - hello, HYPOTHYROISIS So many women and children suffer from anemia! And they are offered to live with hypothyroidism and not take iodine in the form of supplements So you tell me what to do Otherwise, the whole article is about not taking iodine
    And you need to do this: Run and run to take tests for B12, ferritin, iron, TSH, ATPO-TG, free T4, zinc, ctkty and eliminate all deficiencies

    1. Dmitry Veremeenko
  • Ekaterina

    Good afternoon, TSH 3.54, T3 free 2.52 pg / ml, T4 free 0.908 ng / dl. Age 40. Should I see an endocrinologist or is everything within the normal range? Thank you.

    1. Dmitry Veremeenko

      and how much T3 and T4 in pmol / l?

      1. Ekaterina

        I have indicators in such units, but I found the conversion coefficients and calculated them. It turns out T3 - 3.87 pmol / l, T4 - 11.69 pmol / l.

        1. Dmitry Veremeenko

          Then it's subclinical hypothyroidism. That is not yet hypothyroidism. It is worth monitoring cholesterol, markers of inflammation, but it is not worth treating specifically.

          1. Ekaterina

            Thank you very much for your reply. It's just that there are almost all the symptoms of hypothyroidism, and excess weight I was already desperate to lose weight despite the constant monitoring of nutrition and exercise in gym. But that's not the reason.

          2. Larisa

            Dmitry, my TSH is 3.03. T4 is normal. They prescribed euthyrox 25 mg, which made me feel really bad. She stopped drinking it. Tell me what "markers of inflammation" means. After the dental implant surgery, I have a slightly increased content of both leukocytes and erythrocytes. What to do? I am 60 years old.

          3. Dmitry Veremeenko

            TTG 3,03 reduces at your age categorically it is impossible. At your age, if the thyroid hormones are normal, and only the TSH hormone is elevated no higher than 10 mU / l, if at the same time you do not have elevated antibodies to the thyroid gland (there is no autoimmune process), then the treatment, judging by the data of this article, is not required and, quite possibly, can only shorten life. The only requirement is to control cholesterol levels and inflammatory markers (c-reactive protein and interleukin-6).
            ncbi.nlm.nih.gov/pmc/articles/PMC4480281

  • OlegZ*

    Dmitry, please tell me, what is the point of including an analysis for interleukin 6 in DNAOM in the panel, if, according to the open longevity norm, this indicator (indicated in the algorithm) should be less than 1.07 pg / ml, and DNAOM can only give an approximate result "<2". Может, стоит дождаться когда они подтянут свои возможности к нашим потребностям?

    • The article provides information about what tests for TSH hormones are, in what cases they are prescribed, what is the instruction for preparing for their conduct. Reference values ​​for patients of different age and gender are indicated. There is also a video in this article and interesting photo materials.

    TSH is one of the hormones of the anterior pituitary gland responsible for the regulation of the thyroid gland. Thyrotropin is a glycoprotein whose molecular weight is approximately 28 kDa.

    Its effects on the thyroid gland are multifaceted:

    1. Initiation of cellular growth of thyrocytes.
    2. Stimulation of the production of thyroid hormones.
    3. Activation of mitotic activity of gland cells.

    Determination of its content is one of the most important analyzes in the diagnosis of disorders of the glandula thyreoidea.

    The production and release of thyrotropin is carried out under the influence of thyrotropin-releasing hormone, which begins to be synthesized in the hypothalamus as soon as the level of T3 (triiodothyronine) and that circulate in the peripheral blood drops. Therefore, the concentration of TSH and thyroid hormones are inversely related.

    In addition, other neuronal mechanisms influence the release of thyrotropin:

    1. Sleep/wake.
    2. The presence of non-specific stress.
    3. Reducing the ambient temperature.

    The rhythm of hormone production goes astray if the subject is awake at night. During certain phases of pregnancy, there is a drop in TSH production and this is normal.

    Factors affecting the concentration of TSH

    If a person is forced to stay awake at night, then the release of TSH is disturbed. Also, a low level of hormone production is observed during pregnancy and breastfeeding, but this is the norm for such special conditions. The level of production of this biologically active substance can be influenced by a number of medications and the pathology of some organs interconnected with the glandula thyreoidea.

    In addition, heavy physical exertion, severe stress, acute infectious pathologies and prolonged low-calorie diets can lead to a change in the content of thyrotropin.

    Antibodies to TSH

    Thyroid hormone antibodies TSH is a specific type of immunoglobulin that acts against thyroid hormone precursors. They are considered specific markers of autoimmune thyroid pathologies.

    In case of any malfunction in the functioning of the immune system, antibodies to TSH, or rather to its receptors, are formed in the blood serum, which cause their death, due to which the synthesis of thyroid hormones becomes impossible, or vice versa, is carried out in excess.

    There are several types of antibodies:

    • increasing the synthesis of T3 and T4;
    • blocking the connection of TSH with gland receptors.

    An increase in antibodies to TSH is observed in diffuse toxic goiter, autoimmune thyroiditis, idiopathic myxedema, subacute thyroiditis, thyroid cancer, and other autoimmune pathologies. In addition, these antibodies stimulate the production of hormones.

    If an increase in antibodies to TSH is accompanied by an increase in the level of thyroid hormones, the following symptoms occur:

    • an increase in the size of the thyroid gland;
    • increased production of thyroid hormones;
    • exophthalmos;
    • tachycardia;
    • violation of the heart rhythm;
    • convulsions;
    • weight loss;
    • muscle weakness;
    • temperature increase;
    • bone pain;
    • hair loss;
    • violation of menstrual function in women;
    • erectile dysfunction in men.

    In addition, with diffuse toxic goiter, a life-threatening complication, a thyrotoxic crisis, may occur.

    Malfunctions in the production of thyroid-stimulating hormone

    The concentration of TSH can change both up and down. These fluctuations can be caused by the state of the pituitary gland, hypothalamus and / or thyroid gland.

    Some variants of the combination of diseases with the level of T3, T4 and TSH are shown in the table below:

    By analyzing the TSH hormone, it is possible to identify even subclinical stages in the development of glandula thyreoidea pathologies, in which regulatory mechanisms still cope with maintaining the reference levels of T3 and T4 concentration levels. As a rule, when conducting a screening examination of the thyroid gland, the doctor may prescribe only one test for thyrotropin, or may add a test for free thyroxine to it.

    Very rarely, secondary hyperthyroidism can be caused by TSH-secreting neoplasms.

    Diseases that do not directly affect the organs responsible for the rate of TSH synthesis

    Diseases that are not related to glandula thyreoidea, as well as medicinal substances used to treat them, can temporarily change the content of TSH in peripheral blood. As a rule, its level falls in the acute period and rises slightly during recovery.

    Under such conditions, physicians use an extended reference range (0.02 - 10.00 mU/L) for TSH tests, and also determine the content of free thyroxine.

    Replacement therapy

    If the subject takes artificial substitutes for thyroid hormones, for example, L-thyroxine, immediately before taking biological material for analysis, the TSH level will not change, since the normalization of thyrotropin content occurs very slowly (it may take several weeks or even months of continuous medication ). The reason for this is hyperplasia of thyrotrophs, which develops against the background of chronic severe hypothyroidism.

    Therefore, it makes sense to control replacement therapy, using the analysis of thyroid-stimulating hormone as a guideline, no less than one and a half months after the start of treatment, changing the drug, or changing the dosage.

    Pregnancy

    During the period when a woman is preparing to become a mother, the content of thyroid-stimulating hormone in the peripheral blood may undergo physiological changes (read more). Since human chorionic gonadotropin, released during pregnancy, is structurally similar to TSH, it is quite capable of stimulating the production of thyroid hormones.

    For this reason, the first trimester is characterized by a temporary increase in the concentration of thyroxin, which causes a decrease in the content of thyrotropin. In the second and third trimesters, TSH returns to normal.

    Important! An increase in the concentration of thyroid-stimulating hormone in the early period indicates a possible latent hypothyroidism that can harm the fetus.

    Indications for TSH testing

    This study is assigned for:

    • alopecia;
    • myopathy;
    • amenorrhea;
    • depression;
    • infertility;
    • hypothermia;
    • impotence;
    • decreased libido;
    • cardiac arrhythmias;
    • hyperprolactinemia;
    • diseases of the glandula thyreoidea;
    • screening;
    • delayed development of the intellectual and sexual spheres of the child;
    • monitoring the patient's condition after treatment with hormone substitutes;
    • conducting control tests, identified diffuse toxic goiter (frequency from one to three times in one and a half to two years), as well as identified hypothyroidism (frequency one to two times per year).

    The direction is prescribed by the endocrinologist, who, in most cases, makes an assessment of the result.

    Study preparation

    To maximize the effectiveness of the analysis, it is important to properly prepare for it.

    1. Refusal to take hormonal drugs or multivitamin complexes containing iodine (only after the permission of the endocrinologist). If it is undesirable to interrupt the course of therapy, warn the laboratory assistant that you are taking any medication constantly.
    2. Refusal to drink alcohol 2-3 days before the planned examination.
    3. A light dietary dinner on the eve of blood sampling, which should be no later than 19.00.
    4. Testing on an empty stomach (it is only allowed to drink a little still water when thirsty) in the morning.
    5. Exclusion of intense physical activity and stress immediately before going to the laboratory.

    In addition, answers to questions of interest to many patients can be found in the table below.

    Note! Surgical interventions, X-ray exposure can negatively affect the results of the examination. After these procedures, it is advisable to postpone the analysis for thyroid hormones for 2-3 months.

    Table 1: Description of the TSH assay:

    Research technology

    For the study, venous blood with a volume of 5 to 10 ml is used. In the case of monitoring the dynamics of changes in the concentration of TSH, the sampling of biological material should be carried out at the same time of day, since the content of the hormone in the peripheral blood is subject to daily fluctuations.

    To determine the concentration of thyrotropin in the entire history of the analysis, 3 generations of analyzers have been developed. The 1st generation is practically obsolete these days, while the 2nd and 3rd are actively used by modern laboratories.

    II generation of analyzers

    It is based on the technology of ELISA (enzymatic immunoassay). The analyzers used in this case have a number of advantages:

    1. Low price.
    2. Small sizes.
    3. Available domestic reagents.
    4. Can be used without complex automated laboratory equipment.

    But the second generation also has a negative side - the low accuracy of the result obtained (the error reaches 0.5 μIU / ml). At the same time, laboratory owners set the price for such analysis only slightly less than when using next-generation analyzers.

    III generation of analyzers

    Here, another technology was taken as a basis - the immunochemiluminescent method. An analysis for TSH carried out with its help has an error that is 500 (!) times less than that of the second generation - 0.01 μIU / ml. Therefore, it makes sense to apply for a study on thyrotropin in laboratories practicing the use of III generation analyzers.

    Deciphering the analysis

    Reading the result of the study is carried out by an endocrinologist.

    Reference TSH concentrations are shown in the table below:

    More often, it is required to conduct a blood test for TSH hormones in people undergoing hormonal changes in the body - who have reached the age of forty - the period preceding menopause. But for those sixty years old and older, such control should be carried out constantly.

    The phase of the menstrual cycle does not affect the concentration of thyroid-stimulating hormone in the peripheral blood, so it can be done on any day. Analyzes should be repeated in the same laboratory complex, since reagents, equipment and technologies in different institutions may differ in both reference values ​​and units of measurement, which can confuse the reading of results.

    Elevated TSH

    In rare cases, an increase or decrease in TSH values ​​may be due to pituitary dysfunction.

    Elevated levels of thyroid-stimulating hormone are observed with:

    • Hypofunction of the thyroid gland - autoimmune thyroiditis or Hashimoto's thyroiditis. It is the most common cause of primary hypothyroidism.
    • Tumors of the pituitary gland, which stimulates the formation of TSH. This condition is rarely diagnosed.
    • Insufficient intake of thyroid hormones during the treatment of hypothyroidism and in patients with a removed thyroid gland.
    • Overdose of antithyroid drugs (thyreostatic) in patients with hyperthyroidism.

    An increase in the level of thyroid-stimulating hormone relative to the norm in patients suffering from hypothyroidism and taking replacement therapy indicates an insufficient effect of the therapy or the violations that it allows. When an analysis of TSH is obtained, what should be done if its level is elevated - treatment, otherwise the risk of hypothyroidism is high.

    Decreased TSH

    Low TSH values ​​can result from:

    • hyperthyroidism;
    • damage to the pituitary gland, which does not allow the production of TSH;
    • taking antithyroid drugs in insufficient dosage;
    • drug overdose in the treatment of hypothyroidism;
    • third trimester of pregnancy.

    If the tests showed low or high TSH, this indicates a problem with the functioning of the thyroid gland, but does not clarify the cause of this condition.

    The table summarizes the findings from the research findings and their potential implications:

    TSH Free T4 Free or general T3 Probable Cause
    high normal normal Subclinical (hidden) hypothyroidism
    high short low or normal Hypothyroidism
    short normal normal Subclinical (hidden) hyperthyroidism
    short high or normal high or normal Hyperthyroidism
    short low or normal low or normal Secondary (pituitary) hypothyroidism
    normal high high Thyroid resistance syndrome

    In the thyroid gland, diseases often develop due to the formation of nodes in the tissues. It is possible to identify them at an early stage by a "happy" accident. With your own hands, it is unlikely that you will be able to feel a knot (seals) in the thyroid gland a little less than 1 cm. Treatment as such is not carried out, but regular examination by an endocrinologist is necessary.

    The thyroid node is well "visible" on special equipment. If there is a rapid increase in the volume of the neck, this may indicate a more serious or malignant disease.

    A very large goiter can compress the pharynx and esophagus, causing difficulty in breathing and dysphagia (difficulty swallowing food). In addition, the recurrent laryngeal nerve is affected, resulting in hoarseness.

    Procedure price

    Tests for the content of thyrotropin are not carried out in all clinics, since reagents are quite expensive, such tests are not performed so often, so many municipal clinics prefer not to spend money on them. But in almost all cities of the country you can find at least one laboratory that still deals with the determination of the concentration of TSH.

    The price of the analysis depends on several inputs:

    • generations of analyzers used by a particular laboratory;
    • the size and status of the locality where the institution is located;
    • qualifications of the staff of the laboratory complex.

    For example, for residents of Naberezhnye Chelny, such a study will cost 200.00 rubles, Kazan - 250.00, St. Petersburg - 450.00, and Moscow - 500.00 - 2,000.00 rubles. Within one city, an analysis for TSH hormones can also cost different amounts - in sleeping areas it is cheaper, and in the center it is much more expensive.

    Questions to the doctor

    Elevated TSH in tests

    Recently, in company with my mother (she has a goiter), I decided to get tested for the thyroid gland. I got the results: TSH - 8.2 mU / l, T3 and T4 are normal. What kind of analysis - TTG? What can his rise mean? Do I need to treat the thyroid gland, provided that I have no special complaints?

    Hello! TSH is a pituitary hormone that can be called the main regulator of the thyroid gland. An increase in its concentration can have a lot of reasons, however, with normal T3 and T4, most likely indicates subclinical hypothyroidism.

    I advise you to additionally undergo an ultrasound of the thyroid gland and contact an endocrinologist to resolve the issue of the need for hormone replacement therapy.

    Thyrotropin changes in analyzes

    Hello! For the first time examined the thyroid gland after a miscarriage for a period of 10 weeks. Then she was diagnosed with autoimmune thyroiditis (there were signs of inflammation on ultrasound + TSH - 9 mU / l) and prescribed Euthyrox 50 mcg. Recently passed or took place inspection - TTG - 0,024. The doctor said that it was not enough, and immediately canceled the hormones. I repeat the examination after 2 months, TSH is even lower - 0.009. With what it can be connected, in fact I do not drink hormones?

    Hello! To answer this question, you need to undergo an additional examination (ultrasound, AT to rTSH and AT and TPO, St. T4). It is imperative to find out the cause of the developed thyrotoxicosis and, if necessary, start treatment with thyreostatics.

    Laboratory diagnosis of hypothyroidism

    Valentina, 46 years old: Hello! Recently I took tests for hormones, TSH was 18.2 μIU / ml, T4 7.3 pmol / l. A familiar physician said that the first one just rolls over. What indicators TTG norm or rate in my case? And what should I do next?

    Hello! The reference values ​​​​of thyrotropin for your age are 0.3-4.0 μIU / ml, T4 St. - 10-22 pmol / l. Indeed, the level of thyrotropin significantly exceeds the norm: such a laboratory picture indicates insufficient functional activity of the thyroid gland, or hypothyroidism.

    First of all, you need to do an ultrasound of the thyroid gland and contact an endocrinologist who can draw up a further plan for examination and therapy.

    Planning for pregnancy with low TSH

    Ekaterina, 33 years old: I have such a situation. My husband and I are planning our first pregnancy (the age is no longer young), but I have problems with the thyroid gland. TSH - 0.01. The doctor prescribed Tyrozol, but they need to be treated for at least a year. We really want a baby, can I get pregnant without taking pills?

    Hello! Pregnancy on the background of thyrotoxicosis, which, judging by the level of TSH, you have, is a dangerous undertaking. Of course, conception can occur, but gross hormonal disorders are highly likely to provoke a miscarriage, premature birth, and other serious consequences. Therefore, before planning a pregnancy, be sure to complete the full course of treatment and make sure that the levels of TSH and T4 have returned to normal.

    TSH and pregnancy

    Evgenia, 28 years old: Hello. Two years ago, I was diagnosed with hypothyroidism, I am seen by an endocrinologist, I drink L-thyroxine at a dosage of 50 mcg per day. Now we are actively planning a pregnancy with my husband, I am undergoing a preventive examination. According to the results of tests for hormones TSH at the upper limit of the norm, T3 and T4 are normal. The doctor insists on increasing the dose of hormones to 75 mg/day, associating this with the forthcoming pregnancy. Is it justified?

    Hello Evgenia! To answer your question in detail, you need to know a lot of nuances, from the history of your disease to the dynamics of laboratory tests over the past months. But in general, I agree with your doctor: without increasing the dosage of L-thyroxine in early pregnancy, you may develop subclinical and then overt hypothyroidism.

    In this case, the correction of hormone therapy is a preventive measure to maintain your health and normal gestation.

    A small gland weighing half a gram at the base of the brain is, without exaggeration, the command post of the endocrine system. The pituitary gland controls the activity of most of the endocrine glands through secreted hormones. Among them is TSH (thyroid-stimulating hormone, thyrotropin, thyrotropin). Thyroid-stimulating hormone regulates the activity of the thyroid gland.

    The pituitary gland is the central command post of the endocrine system.

    How does the pituitary-thyroid ligament work under normal conditions? TSH stimulates the thyroid gland to produce more thyroid hormones triiodothyrotine (T3) and thyroxine (T4). These are important substances that control the processes of energy production in the body. When the concentration of T3 and T4 reaches the required level, the pituitary gland reduces the secretion of TSH. If the content of thyroid hormones falls below a certain threshold, the pituitary again increases the secretion of thyrotropin.


    Thyrotropin

    TSH norm

    The rate of thyroid-stimulating hormone depends on the age of the person. Other factors also influence its level. Therefore, the norm is determined in a wide range.

    1. Most TSH is found in the blood of newborns and infants up to two and a half months (0.6-10 μIU / ml).
    2. Then the normal parameters of thyrotropin change. If TSH at the lower limit of the norm remains unchanged, then the upper limit decreases. By the age of five, the norm is 0.4-6 μIU / ml.
    3. In adolescents, the TSH level in the range of 0.4-5 μIU / ml is considered the norm.
    4. In adults, thyrotropin is normally 0.4-4 μIU / ml.

    However, in some pathologies, an analysis of TSH will show the content of thyroid-stimulating hormone in the blood below normal. What to do in this case and how to treat low TSH? There is no single answer to these questions. And that's why.


    Hormones T3 and T4

    There is an inverse relationship between TSH and the hormones T3 and T4, therefore, the level of thyrotropin in the blood cannot be considered without linking with the amount of thyroxine and triiodothyronine. There are various situations when a low thyrotropin level is observed. Each has its own symptoms and causes and negatively affects human health.


    This is what the thyroid gland looks like in Basedow's disease

    Situation 1. Thyroid dysfunction

    1. A common disease of the thyroid gland, when thyroid-stimulating hormone is reduced, is Basedow's disease.

    Typical symptoms:

    • uniform enlargement of the gland with the formation of a goiter;
    • bulging eyes.

    Pathological activity of the thyroid gland leads to an increased release of T3 and T4 into the blood. The pituitary gland reacts to their excess by reducing the secretion of thyrotropin. However, the thyroid gland does not perceive this signal.

    1. An increased concentration of T3 and T4 is observed with nodular toxic goiter. With this pathology, nodes (tumor formations) are formed, which leads to increased secretion of T3 and T4. As a result - TTG is lowered.
    2. Hashitoxicosis, or autoimmune thyroiditis, destroys the tissues of the gland, which is accompanied by an increased release of hormones into the blood.
    3. Another reason is the functional autonomy of the thyroid gland, which is formed with prolonged iodine deficiency.
    4. TSH is below normal with inflammation of the thyroid gland (acute thyroiditis).
    5. Increased activity of the thyroid gland differs in trophoblastic thyrotoxicosis.
    6. High levels of thyroid hormones are observed in follicular adenocarcinoma.
    7. It is possible to raise T3 and T4 above the norm by inadequate treatment of diseases. For example: an overdose of thyroid hormones, excessive intake of drugs with a high content of iodine, long-term therapy with interferon.

    Situation 2. Pituitary dysfunction

    1. A low level of TSH is present not only in thyroid pathologies. This may be due to the functional inability of the pituitary gland to produce the required amount of the hormone.
    2. A low rate is observed with tumors of the pituitary gland or hypothalamus.
    3. Thyrotropin is lowered when brain tumors put pressure on the pituitary gland.
    4. Hypophysitis (an autoimmune disease of the pituitary gland of an inflammatory nature).
    5. Thyroid-stimulating hormone is lowered in infectious lesions of the brain.
    6. Head injuries, brain surgery in the pituitary gland, and radiation can lower the level of TSH.

    Situation 3. Other reasons

    Low TSH is caused by causes that are not related to the activity of the thyroid gland or pituitary gland. The symptoms of low thyrotropin in these cases differ from the signs that are observed in pathologies of the thyroid gland or pituitary gland.

    1. Low levels of thyroid-stimulating hormone with normal T4 result from a stroke or heart attack.
    2. Sometimes, with a normal rate of B and T3, this is a reaction of the pituitary gland to stress.
    3. Even with a normal content of thyroid hormones, a reduced level of thyrotropin is possible during starvation.

    Which low TSH is more dangerous for the body?

    If you do not take into account extreme cases (cancer, stroke, heart attack), it is worse for the body when TSH is at the lower limit of normal and less due to excessive thyroid activity (hyperthyroidism). This means that there is a real threat of thyrotoxicosis (poisoning with hormones T3 and T4).

    What are the symptoms of thyrotoxicosis?

    1. A person sweats excessively when there are no external factors.
    2. Cardiopalmus.
    3. Dyspnea.
    4. Feeling of heat bursting from within.
    5. Weight is lost, although appetite is increased.
    6. The nervous system suffers - people become fussy, irritable, cannot find a place for themselves.

    Why is low thyrotropin dangerous in combination with thyrotoxicosis?

    1. The cardiovascular system suffers.
    2. Vegetative-vascular dystonia and myocardial dystrophy may develop. Serious disorders of the nervous system are possible.

    Doctors assess this situation as life-threatening, since an excessive concentration of thyroxine and triiodothyronine destroys tissues and organs.


    Depression

    With a low level of thyrotropin and a low content of thyroid hormones (hypothyroidism), there is no threat to life, but its quality deteriorates. Hypothyroidism has the following symptoms:

    • low blood pressure and weak pulse;
    • weight gain with poor appetite;
    • puffiness;
    • lethargy;
    • low temperature;
    • depressed mood.

    Treatment

    How to increase TSH if it is less than normal or very low? Treatment for low TSH is prescribed depending on the pathology that caused it. However, regardless of it, the content of the hormones TK and T4 is adjusted, since they are important for the life of the body.

    The deficiency of these substances compensates for the treatment with thyroxin. Then an analysis is prescribed for TSH and T4 free. According to its results, the dose of thyroxine is adjusted.

    When there is an excess of T3 and T4 in the blood, thyreostatic drugs are prescribed, which reduce triiodothyrotine and thyroxine, and thereby increase the level of TSH.

    It is better not to try to increase TSH with folk remedies. There are many reasons for its low content, so home treatment can be wrong with unpredictable consequences. Hormones require a professional attitude.

    For more information on the topic, see the video:

    More:

    TSH norms during pregnancy, optimal indicators for the birth of a healthy baby?

    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.

    In order to understand how the hormonal system of the body works, it is necessary to understand some of the nuances of human physiology. In comparison with internal organs, for example, the gastrointestinal tract, digestion, heart or brain, it is impossible to touch and say exactly under which rib it is located. The hormonal system is the finest delicate structure. However, a minimal failure in its work can lead to a number of health problems.

    What is the "hormone TSH"?

    The production of hormones and control over their full functioning in the human body is the main task of the thyroid gland. This system of internal secretion predetermines the implementation of many natural processes. Any disturbance in the functioning of the thyroid gland, associated with the nature of the performance of hormones or their amount produced, can be fixed during the appropriate diagnosis.

    The TSH hormone produced by the thyroid gland is produced by the pituitary gland, or rather, its anterior lobe. The purpose of this substance, in fact, is to control and coordinate the functions of the thyroid gland. Just like any other thyroid hormone, it affects the hormonal balance of the body as a whole through its effect on T3 and T4. These substances are also produced by the thyroid gland.

    The importance of having a blood test for thyroid stimulating hormone

    In the case of thyroid hormone, this indicates that the level of T3 and T4 in the body is too low. Such indicators may indicate the development of a pathology called "hypothyroidism". The process of its occurrence is determined by these thyroid hormones. in the event that the functioning of the main producing organ has decreased in direct proportion. Disturbances in the work of the thyroid gland are fraught with serious complications in the life of the whole organism.

    An increase in the production of hormones leads to damage to the cells of the thyroid gland, which threatens to disrupt the functioning of all organs and systems of the body. Restore damaged cells can help modern means - peptide bioregulators. In Russia, the first brand of peptide bioregulators was cytamines - a line of 16 drugs aimed at different organs. To improve the function of the thyroid gland, a peptide bioregulator has been developed -. Components for Tyramine are obtained from the thyroid glands of cattle, they are a complex of proteins and nucleoproteins that have a selective effect on thyroid cells, which helps to restore its function. Tyramine is recommended for use in violation of the thyroid gland, hypo- and hyperfunction, tumor processes in the glandular tissue. As a prophylactic agent, Tyramine should be used by people living in areas endemic for thyroid diseases. Tyramine is also recommended for seniors and the elderly to maintain thyroid function.

    Analysis of the thyroid gland TSH is extremely important in the process of diagnostic examination of the organ. When drawing conclusions and making a diagnosis, this indicator is taken into account as a determining one, since it is he who is able to quickly respond to the slightest pathological change. While T3 and T4 have not yet responded to the presence of certain markers in the blood, the TSH hormone of the thyroid gland has already demonstrated with its lightning-fast reaction about the identified malfunctions in the hormonal system.

    In what cases may this diagnosis be required?

    There must be good reasons for a physician to refer a patient for this type of diagnostic test. Indications for the procedure are such cases:

    • exclusion or confirmation of hyper- or hypothyroidism;
    • clarification of the diagnosis regarding the pathology of the thyroid gland or related organs and systems;
    • control over the recovery process in order to timely identify the need to make adjustments to the treatment;
    • obtaining the results of an additional stimulation test;
    • timely management of T4 suppression present in the so-called cold nodule and goiter.

    Periodic TSH testing is the key to timely treatment

    In addition, this analysis of thyroid hormones can reveal a lot of other problems with the most important systems for the human body. TSH in patients who have undergone surgery or who have chronic diseases should be under the constant supervision of a specialist. The responses of this analysis clearly reflect the state of the thyroid gland.

    If any serious changes are detected at the initial stage or current unfavorable processes in the organ are detected and if treatment is started early, the patient's chances for a full recovery increase several times. In order to avoid complications and take appropriate measures to prevent deterioration of the patient's well-being, it is necessary to regularly conduct control TSH testing.

    Preparing for analysis

    It is highly undesirable to ignore the need for this simple test for the TSH hormone of the thyroid gland. After all, a procedure that is simple in execution technique is capable of giving a detailed informative answer. In the fight for the health of a patient with thyroid problems, this TSH test plays a huge role. The norm of its indicators allows you to make sure that the patient is in a satisfactory condition.

    Before taking a blood test to detect the TSH hormone, it is advisable to strictly follow some rules.

    By following the advice that doctors give about taking a test to determine the level of hormonal balance, the patient will be able to exclude as much as possible the likelihood of receiving false information in the results of the analysis.

    Basic rules to follow before taking the test

    So, what do you need to do to get your TSH test right?

    1. It is necessary to pass the study on an empty stomach. You can use only clean running water. 8-10 hours before the diagnosis, it is advisable not to eat anything.
    2. The analysis should be preceded by a diet. Refusal of fatty, smoked, fried, spicy and sour products will avoid the likely distortion of the study results.
    3. A few days before undergoing a clinical diagnosis, it is important to completely eliminate alcoholic beverages, regardless of the strength.
    4. Do not play sports and do not overdo it with power loads. At least a week before the examination, it is important to exclude any physical exercise.
    5. Also, a couple of weeks before the laboratory diagnosis of blood, it is necessary to exclude the use of any medications as much as possible. If the current course of therapy cannot be interrupted in any case, or a serious malfunction of the whole organism occurs without the use of drugs, it is necessary to provide the doctor with the entire list of medications taken before undergoing the procedure. Since they are potentially capable of affecting blood test data, specialists always try to take them into account.

    Why is it necessary to prepare specifically for the study?

    In addition, the recent passage of x-rays, ultrasound can distort the results of the examination. Elevated levels of TSH (thyroid hormone) can provoke stressful situations. Nervousness, unrest, frustration - all this contributes to the intensive release of chemicals in the body.

    With a responsible and high-quality approach to the procedure, the result of a blood test for the level of thyroid-stimulating hormone will maximally correspond to the real picture of the patient's health. Thanks to accurate information, it is possible to take timely preventive measures to prevent thyroid diseases or begin treatment of an already existing progressive pathology. In some patients, such restrictions can cause a lot of indignation, but in order to obtain reliable data on the state of the organ, desires and ambitions should be neglected. This is the only way to avoid re-analysis.

    How to decipher the analysis on TTG - norm or not?

    As a rule, a TSH test is considered mandatory for patients with disorders in the body associated with the functioning of the thyroid gland. Surgical treatment of this organ in the past is also a direct indication for regular testing. In order to correctly decipher the analysis and determine whether the level of the hormones being investigated is normal, or there are deviations in the blood, the endocrinologist relies on several fundamental points.

    Firstly, male and female levels of thyroid-stimulating hormone should normally differ from each other. In the fairer sex, it can significantly exceed the values ​​\u200b\u200bthat in a blood test for men reflect thyroid hormones (TSH). The norm for women is about 4.2, while in men the figure rarely exceeds 3.5. However, this is not the limit. During pregnancy, thyroid hormones can also increase. TSH (the norm in women allows you to determine the degree of increase in the concentration of substances in the blood) in expectant mothers sometimes reaches 4.7.

    What determines the level of thyroid-stimulating hormone in the blood?

    In addition, thyroid-stimulating hormone in the body can change its concentration depending on many features due to the biorhythm, age, the presence of other chronic diseases, etc. When compiling an anamnesis, it is extremely important to provide the specialist with detailed information on this issue.

    A highly qualified doctor is capable of making objective conclusions from the test results and predicting further developments. He can clearly answer questions about certain indicators in the analysis, whether they are the norm, or serve as direct evidence of severe disorders in the body.

    Often, patients themselves try to decipher the test results for the TSH hormone of the thyroid gland. False conclusions and experiences of benefit have not yet been brought to anyone, therefore it is better for a doctor to interpret the testimonies of the analysis.

    Causes of elevated TSH

    In case of deviations from the results, it is urgent to take effective measures. You should figure out if there is a threat to health if the thyroid hormone (TSH) is elevated. What to do in this case depends on the reason that provoked an increase in its concentration in the blood. The main factors that contribute to this are:

    • separate forms of thyroiditis;
    • post-surgical syndrome in case of complete removal of the thyroid gland or its individual lobe;
    • benign or malignant tumors of the pituitary gland;
    • thyroid cancer;
    • cancerous processes of the breast, lungs or other organs;
    • malfunctions of the adrenal glands;
    • complicated degree of toxicosis at a long gestational age;
    • absence of the gallbladder due to removal;
    • mental and somatic diseases.

    How does an increase in thyroid-stimulating hormone manifest itself?

    Numerous manifestations of such disorders are difficult to single out as a separate group of characteristic symptoms.

    Signs of an increase in the TSH hormone in the body are:

    • lethargy, lethargy, general weakness;
    • disruption of the sleep-wake cycle;
    • inhibition of reaction, slow thinking;
    • inattention;
    • psycho-emotional disorders that do not manifest themselves earlier (tantrums, capriciousness, irritability);
    • rapid weight gain with an almost completely absent appetite;
    • nausea, vomiting;
    • constipation;
    • swelling of the body;
    • decreased body temperature.

    Decreased blood test values ​​for TSH: causes

    With reduced levels of thyroid-stimulating hormone, urgent action should also be taken, since this condition also indicates the presence of problems in the patient's body:

    • benign formations of the thyroid gland;
    • Plummer's disease;
    • Sheehan's syndrome;
    • decreased performance of the pituitary gland;
    • severe emotional stress;
    • incorrect and uncontrolled intake of drugs;
    • starvation or significant dietary restrictions (due to the lack of sufficient calories with strict diets, including single-component diets).

    Symptoms of low thyroid-stimulating hormone

    With a reduced level of TSH in a patient, as a rule, there is an increase in blood pressure, subfebrile temperature. Rapid heartbeat, trembling limbs or the whole body are also signs of low levels of thyroid-stimulating hormone in the blood.

    Severe headaches in this case are not uncommon, and they often lead to mental disorders, malfunctions of the digestive system. In this case, a person may experience an unnatural appetite.

    Treatment of disorders provoked by a lack or excess of TSH

    Taking into account the presence or absence of characteristic symptoms, the attending physician will prescribe the correct specific treatment. You cannot categorically take any drugs on your own. The consequences of unreasonable drug therapy can be the most deplorable.

    In the case, mainly its synthetic analogue or T4 is used. Doses and duration of the treatment course are set by a specialist, since each patient has an individual susceptibility to the actions of drugs of this type. Dangerous disorders and malfunctions in the functioning of other organs and systems are the result of arbitrary treatment. An effective method of controlling the hormonal system in the human body is a systematic examination. Only in this way can appropriate measures be taken in time to prevent or treat the disease.