In the general population, the prevalence of various TSH concentrations in the blood is characterized by a lognormal distribution: 70-80% of people have TSH levels between 0.3 and 2 mU/L, while 97% have TSH levels less than 5.0 mU/L. When excluding from the general sample persons who are carriers of antibodies to the thyroid gland, who have a goiter or have close relatives with thyroid pathology, it turns out that in 95% of the resulting sample the TSH level does not exceed 2.5-3 mU/l.
In this regard, in last years In the literature, the question has begun to be actively discussed that this particular range better reflects population norms for TSH levels and that the diagnosis of thyroid dysfunction should be based on it. Here I would immediately like to emphasize (and in relation to thyroid pathology, this, alas, has to be emphasized quite often) that these data were obtained in epidemiological studies that did not imply any clinical intervention. These studies, most notably the most influential NHANES-III, simply described the prevalence of various TSH levels in a population and found that high-normal levels TSH- this is, indeed, quite often the prerogative of persons who are carriers of antibodies to the thyroid gland. We would like to draw the attention of pediatricians to the fact that the NHANES-III study, the results of which are one of the main arguments for changing standards, did not include children under 12 years of age. This, and also, indirectly, the known pattern of transient AIT, which is already rare in children, makes the discussion of the problem of changing TSH level standards in relation to children most controversial.
If we blindly extrapolate the data from an epidemiological study to clinical practice, it turns out that the diagnosis of hypothyroidism should be established when a TSH is more than 2.0-3.0 mU/l.
However, if in epidemiology, after identifying any population pattern, the development of certain socially oriented measures follows, then for a clinician, identifying hypothyroidism means only one thing - prescribing replacement therapy. But epidemiological studies We were only studying the advantages and disadvantages of prescribing replacement therapy, taking into account new standards for TSH levels. So, in this regard, is it legitimate to lower the upper limit for the TSH level as a criterion for diagnosing thyroid dysfunction?
This issue began to be discussed even more actively after a very short term following the publication of Hollowell J.G., et al (2002), guidelines for laboratory diagnostics US National Academy of Clinical Biochemistry, which proposed using a new standard for TSH levels. I would like to note that the main publisher of the guide was the Association of Clinical Biochemists, and not endocrinologists, but it was agreed upon by the European, American, British and other thyroid associations. But was this unconditional agreement or consensus? Considering the opinion of the President of the European Thyroid Association and a number of other European experts, it was rather a consensus. In other words, signing up to this truly valuable guide, which is primarily addressed to laboratory doctors, does not mean agreeing on everything down to the smallest detail.
In Berlin in June 2004, at the Merck symposium (The Thyroid and Cardiovascular risk), a report was made by the President of the European Thyroid Association, Professor Wilmar Wersing, which was called almost the same as this article: “TSH: is there a need to change standards ? (TSH: Is there a need to redefine the normal range?). I would not like to present its contents in my own words, so I provide a complete translation of the abstract of this report, which was published in the materials of the symposium.
“With the help of standards for various laboratory indicators, it is quite difficult to draw the line between normal and pathological, and in clinical medicine, between health and illness. Due to the fact that there is a log-linear relationship between the TSH level and fT4, the level TSH is the most sensitive marker of even slight deficiency or excess of thyroid hormones. Individual differences in TSH levels are significantly less than its interindividual variation, which determines the prevalence of different TSH levels in the population. In other words, a TSH level of 3.5 mU/L could theoretically be normal for one person, but slightly elevated for another. It is extremely difficult to get out of this situation and, even more so, impossible to find out individual characteristics relationships between the hypothalamic-pituitary-thyroid system and, thus, a certain individual level of TSH. Interindividual differences in TSH levels, to some extent, may explain the fact that some patients with subclinical hypothyroidism exhibit various disorders characteristic of thyroid hormone deficiency, while others do not.
A large study, NHANES-III, which was conducted in the United States, showed that in the general population of adults TSH level is 0.45-4.12 mU/l (2.5 and 97.5 percentiles). These data were obtained after logarithmic transformation of TSH levels in the reference population. At the same time, persons with thyroid pathology, goiter, pregnant women, taking a number of drugs, estrogens, androgens, lithium, and having circulating antibodies to the thyroid gland were excluded. The 97.5 percentile for TSH levels was 5.9 and 7.5 mU/L in individuals aged 70–79 years and over 80 years. The lower limit of normal for TSH is 0.4 mU/L, and there is general consensus on this.
Recommendations from the US National Academy of Clinical Biochemistry suggest narrowing the standard for TSH levels to 0.4-2.5 mU/l. The argument for this was again the results of the NHANES-III study, which showed that TSH levels between 2.5 and 5.0 mU/l are detected in only about 5% of the population. It is assumed that this may be due to the inclusion in the reference sample of some individuals with occult autoimmune thyropathies without circulating antibodies to the thyroid gland. Arguments that are expressed in favor of reducing the upper limit of normal TSH to 2.5 mU/l:
- the risk of developing hypothyroidism in the future begins to increase significantly in the population, starting with a TSH level of 2 mU/l (Wickham study);
- in individuals with a TSH of 2-4 mU/L, a number of changes can be detected, such as impaired endothelium-dependent vasodilation, compared with individuals with a TSH in the range of 0.4-2 mU/L;
Arguments against changing the current TSH level standard:
- lack of clear evidence that prescribing thyroxine to patients with a TSH level of 2.5-4.0 has any benefits in terms of long-term prognosis, especially in terms of reducing mortality from cardiovascular pathology;
- classifying the 5% of the population who do not have any diseases will lead to enormous financial costs, as well as emotional and personal disorders in these people.
A possible solution to the problem in the future, theoretically, could be to determine the complex risk of developing various complications (osteoporosis, cardiovascular diseases, depression) for different intervals of TSH levels. As a result, the decision to prescribe thyroxine replacement therapy will be made not only on the basis of TSH levels, but taking into account additional factors such as gender, age, smoking, hypertension, cholesterol levels, diabetes. A similar approach is currently used to make treatment decisions arterial hypertension and dyslipidemia. Until the results of studies stratifying these risks for different TSH levels are available, I recommend using the existing standards, that is, 0.4 - 4.0 mU/L." In my opinion, this essay succinctly describes the main contradictions and gives fairly clear recommendations. Nevertheless, we will dwell on some provisions that have simple clinical justifications.
Firstly, about terminology. Subclinical hypothyroidism in modern literature, they denote an isolated increase in TSH levels with normal T4, and almost all available studies, the results of which can be used as arguments for or against, are based on the upper limit of the TSH norm of 4-5 mU/l. An absolute synonym for the term " subclinical hypothyroidism"in English literature is the term " minimal thyroid deficiency" In English it sounds like “mild thyroid failure.” In both the first and second cases, the upper limit of normal for the TSH level is 4-5 mU/l. I have to write about this because Lately in some articles published in domestic sources, these terms began to live an independent life and the term “mild thyroid failure” was used for cases of TSH 2-4 mU/l, which cannot be considered correct.
Further, very important point: today there are fairly clear data on the advisability of treating subclinical hypothyroidism (TSH more than 4 mU/l) only for one group of people - pregnant women. During pregnancy subclinical hypothyroidism carries a risk of developmental disorders nervous systems s in the fetus. There are no such data for other groups, as stated by Prof. Versinga. Yes, of course, the repeatedly discussed Rotterdam study has been published, which found a connection between subclinical hypothyroidism and aortic atherosclerosis and the risk of myocardial infarction in elderly women, but it does not at all follow from this that the prescription of replacement therapy will reduce these risks and, moreover, increase the duration life.
It is quite obvious that the association of two phenomena (subclinical hypothyroidism and atherosclerosis) does not yet imply a cause-and-effect relationship between them. Many other works have been published that indicate the development of a number of pathological changes in persons with subclinical hypothyroidism and regression of these changes against the background of thyroxine replacement therapy. They are described in detail in numerous reviews and monographs on this topic. However, as Prof. rightly points out. Versing, there is no evidence yet about the most important thing: there are no prospective studies that would prove that treatment of subclinical hypothyroidism will lead to an increase in life expectancy and a decrease in mortality from any disease.
But we don’t need to dwell on this too much, since almost all of the listed works operate with an upper limit of normal for TSH of 4-5 mU/l. In this regard, there is no need to talk about the upper limit of the norm of 2.5 mU/l. In other words, what kind of 2.5 mU/l can we talk about when we do not have a definitive answer to the question of whether to treat or not to treat? subclinical hypothyroidism, the diagnosis of which includes the upper limit of normal for TSH of 4-5 mU/l.
Another problem is the increasing number of people with “abnormally high” TSH, that is, with “primary hypothyroidism.” It is quite obvious that lowering the upper norm will lead to an increase in the sensitivity of the test, that is, the diagnosis of hypothyroidism will be established in more persons with this syndrome. However, it is equally clear that an increase in the sensitivity of the test will inevitably be accompanied by a decrease in its specificity, due to which a decrease in thyroid function will be erroneously detected in more people than occurs when using a higher upper limit of normal TSH. In other words, lowering the upper standard for TSH will lead to a significant increase in the number false positive results assessment of thyroid function.
A significant, if not catastrophic, increase in the prevalence of hypothyroidism in the population, which can occur as a result of a decrease in the upper limit of normal TSH, is demonstrated by a recent study by Fatourechi V. et al (2003). The authors analyzed all studies of thyroid function that were conducted in 2001 at the Mayo Clinic in Rochester (USA). A total of 109,618 TSH levels were determined in 94,429 patients. After excluding patients for whom the necessary information was missing (3.5%) in a group of 75,882 people, an analysis of the prevalence of hypothyroidism was conducted taking into account two upper standards for TSH levels: 3.0 mU/L and 5.0 mU/L . The obtained and quite eloquent results are presented in the table.
Table Impact of changing the upper standard TSH level from 5 mU/l to 3 mU/l.
As follows from the data presented in the table, the prevalence of increased TSH levels, that is, essentially hypothyroidism, with a decrease in the upper standard, TSH will increase more than 4 times: from 4.6% (a quite familiar figure) to 20%.
Let’s imagine what this figure will be if we quickly reduce the upper TSH norm to 2 mU/l. According to this study, TSH levels greater than 3 mU/L were detected in approximately 15% of patients under 50 years of age (every 6-7 people).
On paper, the conclusion that only 5% of people have TSH levels in the range of 2-4 mU/l looks quite impressive. What does this look like in real life? Endocrinologists, like no one else, understand the number of diabetic patients who come to see them and the colossal efforts it takes to work with these patients. In this regard, let's remember what the approximate prevalence is diabetes mellitus in the population? Just the same 5% of the population. Population Russian Federation as of July 2004 it was 144 million people. Based on this, approximately 7 million 200 thousand of our fellow citizens (not pregnant, not taking estrogens, lithium, etc.) TSH level is in the range of 2-4 mU/l. If you sum up the entire population of cities such as St. Petersburg, Yekaterinburg, Krasnoyarsk and Tomsk, you get exactly 5% of the population of Russia.
It is precisely this number of people in a situation where we accept the upper norm for a TSH level of 2.0 mU/L that we will diagnose with subclinical hypothyroidism. In itself, this may not be scary, although all these 7 million people will pour into our offices. The worse thing is that we don’t know what to do with them, since it’s difficult, without a reliable evidence base, to cope with those who have a TSH level of more than 4.0 mU/l, subject to normal T4.
But the problems don't end there either. Let's now remember the main source of the problem, laboratory diagnostics, the progress of which led us to the realization that there are subclinical dysfunctions thyroid gland. Many references could be made about interlaboratory variability in determining TSH levels, and no less about the variability in determining TSH levels when using different methods his assessments. But the clinician, as a rule, understands from his own experience that there are very few “sinless” laboratories, or rather, they do not exist by definition. Let's add here general state“park” of equipment used for laboratory diagnostics in our country. We are not always talking about high-quality machines, and the very fact of having a fully automated analyzer does not exclude the use of “handicraft” kits. The hostage of this is the patient, who, based on the research data, is prescribed or not prescribed hormone therapy.
Let's reason further and imagine that we, contrary to common sense, decided to assign these 7-odd million seemingly healthy people replacement therapy. This automatically implies the cost of thyroid hormone preparations, the cost of a huge number of hormonal studies, and the cost of the work of endocrinologists.
And yet... how many of these patients will get better, how many will we prolong their lives or make it, as they say, better quality? It will be worse for those who will be forced to apply for medical care, standing in line first at the laboratory, and then making an appointment with the endocrinologist at 5 o’clock in the morning. But it will be even worse for those who, against the background of a chronic overdose of thyroid hormone drugs, which is inevitable in a certain part of patients in the context of a narrowing of the target TSH range, develop osteopenia and atrial fibrillation.
What is the place of the interval for TSH of 0.4-2.5 mU/l in clinical practice? Apparently, these are pregnant women who are carriers of antibodies to the thyroid gland and who have early stages pregnancy, a highly normal TSH is determined. Does it have a good evidence base? Apparently not entirely, since the question immediately arises about women with highly normal TSH in early pregnancy in the absence of antibodies to the thyroid gland, who do not have goiter, and who receive iodine prophylaxis. What to do with them?
It can be argued that if a patient has already been diagnosed with hypothyroidism (manifest or subclinical, taking into account the “old” TSH standard), then the TSH interval of 0.4-2.0 mU/l should be considered as the target when assessing the adequacy of thyroxine replacement therapy. There is probably some logic to this, and the same recommendations from the US National Academy of Biochemistry recommend doing exactly this. But is there evidence that this is the case? Alas, they are not here yet, unless we consider the results of population-based epidemiological studies as such.
Returning to the beginning of the article, namely to the question of the relationship scientific research and clinical recommendations for a wide range of doctors, I would like to say that the issue under discussion is one of the most current problems clinical thyroidology and is being intensively studied. All the baggage of this science, which we actively use, has been accumulated taking into account the TSH standard of 0.4-4.0 mU/l. Even a small change in this standard will entail a revision of many provisions and may become a turning point in the development of this branch of endocrinology. However, partly restraining our research impulse, we have to admit that the problem of changing the upper standard TSH level is still far from evidence-based and rational implementation in healthcare practice.
When doctors prescribe a blood test for the content of thyroid hormones, it is a good idea to find out what function these substances perform in the body and how much there should be at each age. In this article we will find out what is the normal concentration for TSH in the blood, and what is the danger of increasing and decreasing its level, as well as what to do in case of deviations, and what should not be done.
Functions of the hormone thyrotropin
This substance is classified as a thyroid hormone, although it is not synthesized in it. Thyrotropin is synthesized in the anterior lobe of the pituitary gland by special cells. It is classified as a glycoprotein. The process of production and activation of all interacting substances is complex and extremely necessary. TO important functions The hormone also includes the ability to influence other thyroid hormones: T3-triiodothyronine and T4-thyroxine. These substances depend on each other; if the level of T3 and T4 in the blood decreases, then thyrotropin (TSH) increases, and vice versa. Together, these hormones stimulate metabolic processes, promote the production of red blood cells, glucose, nucleic acids, and TSH also takes part in heat exchange and other important processes in the body. Digestion, as well as the nervous system, cannot do without this hormone. genitourinary system. TSH plays an important role in the growth and development of a child.
These standards can be found in all Internet sources and laboratories for collecting tests. However, they have little to do with reality. In fact, the upper TSH threshold at which we can confidently say that a person does not have hypothyroidism is much lower.
Why do you need a TSH test?
A test for hormone concentrations is prescribed in order to understand the nature of diseases, prescribe required dose medications, as well as for the prevention of thyroid pathologies and during routine examinations of pregnant women. Blood TSH levels are recommended for on a regular basis measure women after 50 years. It is also necessary to constantly monitor the TSH level after removal of the thyroid gland. Patients who have been diagnosed with infertility are prescribed a hormonal test.
Doctors often believe that imbalance endocrine system is the reason for the diagnosis, which means that a normal TSH level is needed for pregnancy to occur. However, most often the opposite is true: problems with sex hormones lead to problems with the thyroid gland.
Among the elements of the thyroid gland, TSH is the first to respond to negative changes in thyroid gland, even if the amount of T3 and T4 is still normal.
Proper preparation for analysis is the key to accurate results
It is necessary to measure the level of thyroid-stimulating hormone, following certain rules for taking the test. It is not recommended to consume alcohol, tobacco products, fatty foods two to three days before taking the test. if you accept hormonal drugs, then they may affect the test values, and it is better to suspend such treatment for now. It is recommended to have dinner 8 hours before the test. A blood test for hormones is taken only on an empty stomach, in the morning. You can only drink a glass of plain still water.
To determine changes in the TSH value, it is best to take a blood test at the same time, for example, at 9 am. The optimal time is from 8 to 12 hours.
For women before menopause, it matters on which day of the cycle to take a TSH test and test the norm. It is better to postpone emotional and physical stress for a while, because... they also influence the result. If at least one rule fails, the analysis results will be unreliable.
What numbers are normal?
Today, there are several methods for determining the TSH norm, and normal values This hormone differs between them. But despite this, there are common TSH boundaries norms from 0.4 to 4 µIU/ml (level optimal indicator much lower). In men, the norm ranges from 0.4 to 4.9 µIU/ml, in women from 0.3 to 4.2 µIU/ml. Newborns are characterized by a fairly high level of the hormone TSH and a value of 1.1-17 mU/l is considered normal. The reason is that for the normal formation of the baby’s nervous system, he needs exposure to thyrotropin. Its deficiency at this age indicates congenital pathologies of the endocrine system. With age, the body requires less and less thyroid-stimulating substance, and the norm gradually decreases.
TSH level during pregnancy
A separate topic is the influence of TSH on the course of pregnancy. What is the normal level of thyroid-stimulating hormone in women during this period? You cannot name the same numbers. The thing is that the level of the hormone changes in different trimesters. The most low value in the first trimester. If there are twins or triplets in the womb, thyrotropin levels will remain low until delivery. Minor changes in test results are absolutely normal for this condition, but large deviations from the norm should alarm the doctor, because there is a risk to the fetus. If the hormone level is very high, hospitalization and a detailed examination of the endocrine system are required.
Pregnant patients with thyroid diseases require careful attention; they need to donate blood more often for hormonal indicators. A low level of the TSH hormone usually does not cause concern to the attending physician, however, if the level does not increase after childbirth, this indicates the possible death of pituitary cells (Sheehan syndrome). Therefore, it is important to control the amount of hormones not only during pregnancy, but also after it.
When the results show an increase in level
A test for the concentration of the hormone thyrotropin is prescribed if these symptoms are present:
- Weight constantly increases, despite diets and other measures to reduce it;
- The neck thickens;
- The patient complains of apathy, depression;
- Sleep is disturbed;
- Decreased performance, concentration, and memory;
- Dyspnea;
- Dry skin, hair loss;
- Decreased body temperature;
- Sweating;
- Anemia.
Other complaints from the cardiovascular and nervous systems are possible. Problems with the gastrointestinal tract are characterized by nausea, loss of appetite, and constipation. In the event that elevated TSH in hypothyroidism does not decrease sufficiently for a long time, this can lead to the proliferation of thyroid tissue, which is subsequently dangerous for the development of oncology.
A deviation from the norm in a larger direction is observed for the following reasons:
- Postponed hemodialysis procedure;
- Lack of iodine;
- The body’s reaction to certain drugs (neuroleptics, antiemetics, iodine-containing drugs, etc.);
- Strong physical activity;
- Mental disorders;
- Lack of T3 T4 hormones;
- Vitamin D deficiency;
- Increased levels of estrogen.
Among the diseases in which the TSH level increases are pituitary tumors, severe gestosis, Hashimoto's thyroiditis, and thyrotropinoma. Inflammatory processes The thyroid gland also causes high thyroid-stimulating hormone. Decreased adrenal function and operations during which the gallbladder was removed lead to an increase in thyroid-stimulating hormone.
In all cases, the consequence is a failure in metabolic processes, so the state of increased thyroid-stimulating hormone in mandatory needs monitoring and treatment.
If TSH levels are at the upper limit of normal, the endocrinologist may prescribe treatment if there are complaints from the patient. This condition is the beginning of hyperthyroidism and is best treated with early stage than to suffer from others later serious problems. Therefore, do not be alarmed if your doctor prescribes treatment if your TSH level is within the normal range.
Reduced concentration of thyrotropin
A sharp decrease in the level of the hormone TSH, as well as an increase in T3 and T4, indicates the presence of the following diseases:
- Meningitis;
- Thyroid adenoma;
- Encephalitis;
- Diffuse toxic goiter;
- Sheehan syndrome;
- Graves' disease.
A decrease in the hormone thyrotropin is observed with a decrease in the activity of the thyroid gland, which is called hypothyroidism. In the absence of the above diseases, hypothyroidism can be a consequence of various injuries to the pituitary gland, a long diet, or prolonged stressful situations. Concussion is also one of the reasons sharp decline TSH.
Patients complain of the following symptoms:
- Increased appetite;
- Temperature surges;
- Frequent headaches;
- High blood pressure;
- Violation menstrual cycle.
Almost all patients experience an inhibited reaction, causeless mood swings, apathy, nervous breakdowns, slowness of speech. If you notice these symptoms, you should immediately contact an endocrinologist. Of course, a referral for a hormonal test can be given by a local doctor at a clinic, but in order to decipher the meanings correctly and immediately prescribe therapy, it is better to contact a qualified endocrinologist.
How to restore normal hormone levels
If there is a need to intervene in the endocrine system, several features must be taken into account. The TSH hormone level is achieved based on the reasons for the increase or decrease in hormonal concentration in the blood. At the same time, it is considered mandatory to determine the level of other thyroid hormones - triiodothyronine and thyroxine, because they and thyrotropin are inversely related to each other. When immunity is produced in insufficient quantities, the body begins to produce antibodies to TSH receptors and its level decreases.
In this case, active synthesis of T3 and T4 occurs.
The decision to prescribe a particular therapy requires individual approach to every patient. His age, gender, existing chronic, hereditary diseases, and reactions to medications. Endocrine system disorders require a detailed study of the problem and careful selection medical supplies, so you can’t try to normalize hormone levels on your own. Incompetent treatment can worsen the imbalance of TSH T3 and T4 and provoke the development of other pathologies. Treatment with folk remedies is possible only in consultation with the attending physician.
TSH research should be approached responsibly; it is better to study all the nuances in advance. TSH sensitive hormone test is taken as in state clinics and in private medical institutions. Of course, the cost of analysis is paid clinics It will cost more, but the result, as a rule, will be ready faster. When thyroid-stimulating hormone is normal, all processes in the body work normally in a person, he feels good. Therefore, you should not neglect this study; it is better to undergo the examination as soon as possible.
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Hormones - what are they? They are the most important substances that take part in the regulation of various processes: metabolism, reproductive activity, and the mental and emotional state of a person. TSH in women is a thyroid-stimulating hormone, the levels of which can indicate changes occurring in the body.
General information about thyroid-stimulating hormone, together with T3 and T4
TSH is one of the most important regulators of the thyroid gland, which, together with the hormones T3 and T4, promotes the formation of new red blood cells, heat exchange and other processes in the body TTG - what does this abbreviation mean? Thyroid-stimulating hormone, or thyrotropin, is the most important regulator that controls the functioning of the thyroid gland. It is responsible for the production of thyroxine (T4) and triiodothyronine (T3). The latter, in turn, are responsible for the activities reproductive system, metabolic processes fats, proteins and, correct functioning of the heart muscle and the functioning of blood vessels.
TSH, together with T3 and T4, promotes the production of glucose, participates in heat metabolism, and controls the process of red blood cell production.
A special feature of thyroid-stimulating hormone is that its level fluctuates and is diurnal. Its highest value is recorded at 3 am, and from 9 am to 6 pm this indicator decreases.
Thyrotropin is produced by the pituitary gland, which is located in the brain. The norm of thyroid hormones in women and men has different standards, and they differ at different ages.
Important! The norm of T3 and T4 in TSH for women depends on their age. If the TSH value deviates from normal level, then this may indicate diseases of the adrenal glands or pituitary gland, due to which the thyroid gland begins to work incorrectly. Fluctuations in TSH levels and deviations from the norm are also observed during periods of hormonal instability - during pregnancy, during the lactation period, and also during menopause.
Normal TSH levels in women depending on age
The acceptable TSH level in women is an indicator that directly depends on age, hormonal status, availability of purchased or congenital pathologies. For 20 years, 40 years, 50 years, the permissible indicator is different. To determine the TSH norm in women by age, a table of acceptable norms for different age ranges and during pregnancy will help:
It should be noted that as the body ages, the function of the thyroid gland decreases, therefore, in women after 50 years of age (more often at the age of 60-70 years), the lower limit of the TSH indicator is 0.4 μIU/ml, the upper limit is 10 μIU/ml.
Fluctuations in TSH levels are associated with different needs for this hormone at different stages of life.
In addition to the TSH level, it is also necessary to take into account T3 and thyroxine (T4) levels. The norm for the first is about 3.5 - 0.8 µIU/ml, free T3 is 2.62-5.69 pmol/l.
The norm for T4 in women is 0.8-1.8 µIU/ml, free T4 is 9-19 pmol/l.
This hormone thyroxine T4 plays an important role in the sexual development of girls. Its level affects the synthesis of sex hormones.
If TSH is low, then the following abnormalities are observed in girls:
- slowing down the process of puberty;
- delayed onset of menstruation;
- height mammary glands slows down;
- the size of the clitoris and labia are smaller;
- there is no natural interest in sexual activity.
When girls under 8 years of age experience a prolonged increase in TSH, puberty comes prematurely. This manifests itself in enlargement of the mammary glands at an early age, early onset of menstruation and hair coverage armpits and pubis.
Note! In women during pregnancy, the level of thyrotropin hormone differs from the data indicated in the table. In each trimester, its indicators change:
- in the first trimester, the TSH value fluctuates between 0.1-0.4 µIU/ml;
- in the second – 0.2-2.8 µIU/ml;
- in the third – from 0.4 to 3.5 µIU/ml.
During the examination, specialists pay attention to Special attention on changes in the hormones TSH and T4, T3. It is recommended to regularly check their levels during pregnancy, after the age of 40 years (before menopause), and also after 60 years.
The photo shows an example of a table for an immunological study of the thyroid group TSH - T3 total, T3 free, T4 total, T4 free, thyroglobulin, thyroxine-binding globulin, A/T to thyroglobulin, A/T to thyroid peroxidase, A/T to the TSH receptor. In what cases should you take a TSH test?
If there are problems with the hormone TSH there is no bright severe symptoms, therefore, if problems are observed in many “points” of the body at once, then a hormone test should be done first Knowing what TSH is responsible for, it is necessary to realize the importance of timely hormonal studies for a woman’s health in different years of life and her reproductive capabilities.
A test for TSH levels in the blood of women should be taken if certain abnormalities are observed:
- psychological and neurological disorders: and, sleep disturbances, irritability, apathy, causeless aggression;
- constant lethargy and weakness;
- decreased libido;
- pain in the throat area;
- active up to baldness;
- inability to get pregnant for a long time;
- – absence of menstruation for several menstrual cycles;
- the temperature often drops below 36 degrees;
- gaining excess weight with lack of appetite;
- increased appetite that is difficult to control;
- constant, persistent headaches;
- the thyroid gland contains seals;
- muscle dysfunction;
- slight trembling throughout the body, especially in the upper extremities.
Adult women also carry out TSH analysis in the following cases:
- if you suspect the presence of autoimmune diseases;
- when planning pregnancy in order to prevent genetic abnormalities in the child;
- during the treatment of certain diseases to monitor the effectiveness of the measures taken;
- if thyroid dysfunction was previously detected as a routine examination.
As a result of the study, a specialist may find that TSH hormone levels are normal, increased or decreased. Deviations affect the female reproductive system and its general condition.
The main reasons for increased thyrotropin levels and treatment approach
If TSH is elevated in women, what does this mean? Elevated TSH in women is the result of a number of pathological disorders at work internal organs. These include:
- tumor processes affecting the pituitary gland;
- adrenal insufficiency;
- damage to the thyroid gland - tumor, trauma, radiation;
- gestosis is a complication of the second half of pregnancy, which is characterized by the appearance of protein in the urine, increased arterial blood levels, and hidden and visible edema.
Other factors that increase the concentration of the thyroid-stimulating hormone TSH include the following:
- lack of iodine in the body;
- excessive physical activity;
- surgical interventions related to the thyroid gland;
- taking some medicines– neuroleptics, antiemetics and anticonvulsants;
- mental disorders;
- surgery performed to remove the gallbladder;
- genetic predisposition.
If permissible norm TSH in women is elevated, the following symptoms are observed:
- failure of the menstrual cycle - scanty discharge, accompanied by painful sensations, uterine bleeding, complete absence menstruation;
- feeling of chilliness, chills;
- heart rate slows to less than 55 beats per minute;
- noticeable weight gain;
- dysfunction digestive system which manifests itself in delayed gastric emptying;
- swelling of the eyelids, lips, limbs;
- muscle weakness.
Note! In the case when high level thyrotropin is associated with pituitary adenoma, observed specific symptoms– vision decreases, regular headaches appear, localized in temporal region, dark or transparent spots appear in the field of vision.
If thyroid-stimulating hormone is contained in a concentration exceeding 4 µIU/ml, combination therapy is indicated, which includes taking potassium iodide and thyroid hormone.
Also, if TSH is elevated, a diet is prescribed, the observance of which will restore the balance of hormones and saturate the body with substances such as manganese, selenium and cobalt - they help the body absorb iodine. If the norm is too high, a properly organized nutrition system is necessary - this is a guarantee of restoration of metabolic processes.
Factors that reduce TSH levels in a woman’s body
If a woman's TSH is low, this may indicate:
- benign tumor process affecting the thyroid gland area;
- damage to the pituitary gland caused by mechanical stress;
- Graves' disease;
- hypothalamic-pituitary insufficiency;
- Plummer's disease.
In addition, TSH can increase due to emotional stress, stressful situations, and calorie deficit.
Under conditions in which the permissible value of the TSH hormone is reduced, the following manifestations are observed:
- sudden, causeless weight loss;
- fragility bone tissue, which manifests itself in bone pain, frequent fractures, multiple caries;
- rapid heartbeat, accompanied by increased arterial blood pressure;
- feeling of sand in the eyes;
- brittle nails and their slow growth;
- sweating and feeling hot;
- increased appetite;
- rapid mood changes;
- frequent bowel movements;
- attacks of weakness of individual muscles of the body and limbs.
Low TSH requires treatment. Usually, the doctor prescribes medications that contain thyroid-stimulating hormone in different doses. During therapy, it is recommended to exclude foods rich in fats and cholesterol from the diet and increase the amount of vegetables consumed.
How to determine the level of the hormone thyrotropin?
A special test is carried out in compliance with a number of strict rules that allow you to obtain the most accurate result Causes and consequences of changes in the normal level of TSH - important question when considering this problem. Violation can lead to complications such as infertility, spontaneous abortion, fetal pathologies acquired during intrauterine development, premature placental abruption.
To determine whether a woman's TSH level is normal, it is necessary to undergo a special test. Before this diagnostic procedure, you need to familiarize yourself with the rules on how to correctly take an analysis to determine TSH and free T4 levels, as well as T3.
- To obtain a high-quality result, women need to donate blood in the morning, from 8 to 12 o’clock, since the largest amount of the hormone is produced during this period;
- It is advisable to carry out the test on an empty stomach, and two days before it, refuse fatty foods;
- a few days before the procedure, it is recommended to stop drinking alcohol and smoking;
- two days before the test you should not use drugs containing steroid and thyroid hormones;
- Before diagnosis, you should refrain from emotional overstrain.
A test to determine free TSH and T4 levels, as well as T3, will identify diseases that pose a serious threat to full life women. It is important for pregnant women to undergo this procedure in a timely manner, as well as for those who have a hereditary predisposition to hormonal disorders. This rule also applies to women over 50 years of age, in whom, as the body ages, all internal processes slow down. An increased or decreased TSH hormone in women in almost all cases indicates abnormalities in the functioning of internal organs.
Knowing what thyroid-stimulating hormone is responsible for in women, it is necessary to realize the importance timely diagnosis its level, identifying pathologies and their treatment. The TSH norm in women differs by age, which is associated with changes in the need for it throughout life. Only a specialist can determine whether these indicators are normal by conducting a test for T3 T4 TSH normal in women.
- Svetlana
Good afternoon Dmitry! Are there ways to cure AIT and is it possible to take metformin with such a diagnosis?
Thank you in advance.
- Dmitry Veremeenko
Metformin is okay. It is theoretically possible to cure. There is no medical treatment yet
Good afternoon, Dmitry.
Comment on iodine intake. Didn't find information on the site.
As far as I understand, a significant part of Russia is iodine deficient. Considering that iodized salt is one of the sources of iodine, and also 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.
- Dmitry Veremeenko
If the endocrinologist did not prescribe thyroid hormones based on tests, then no.
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 chemical substances The agents responsible for this effect are called goitrogens. Goitrogenic substances suppress thyroid function. They interfere with the production of thyroid hormones. As a result of a 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, rutabaga, soybeans, strawberries, flax seeds, almonds, apples, cherries, nectarines, plums. Cooking can reduce goitrogenic substances in foods. Boiling them in water for up to half an hour 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 this 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, thyroid peroxidase (TPO), is an enzyme expressed primarily in the thyroid gland. Catalyzes two important reactions in the synthesis of thyroid hormones: iodination of tyrosine residues of thyroglobulin and fusion of iodotyrosines in 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 a disorder lipid profile thyroid gland and hypothyroxinemia in male rats. At the same time, free thyroxine T4 is reduced, and thyroid-stimulating hormone (TSH) increases.
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 gland through oxygen free radicals and immune stimulation.
Naturally occurring goitrogens are found in cabbage, cauliflower, broccoli, turnips, and cassava root forms. Soy or soy fortified foods can also worsen thyroid problems by decreasing the T4 hormone, increasing autoimmune diseases thyroid gland.
Thyroid peroxidase (TPO) activity may be increased by consumption of polyunsaturated omega-3s 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 impaired 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 had no effect on... normal function thyroid in people with sufficient iodine intake, but they can interfere with the absorption of synthetic thyroid hormone, forcing 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 deficiency are also 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
- Alexander
Dmitry, now it turns out that you don’t eat, for example, Broccoli and all the cabbage, but what about Sulfarafan?
- Dmitry Veremeenko
Eat. It’s just that if TSH rises above normal, you need to consider iodine and selenium supplements with an endocrinologist. They help fight it
- Dmitry Veremeenko
- Alexander
What is the conclusion from all this? It’s already scary to live.
- Dmitry Veremeenko
What is the conclusion?
- Dmitry Veremeenko
Dmitry, does this mean that if you have AIT, it is undesirable to eat broccoli? I wouldn't want to give it up completely.
- Dmitry Veremeenko
AIT means you are on hormones. If you are on hormones, then you don’t care anymore. Only soy causes an increase in hormone levels
My TSH is 6.5, all other thyroid indicators are within normal limits.
I think that if TSH remains as it is, this is only a plus, the pulse, for example, also from such TSH - low at rest with feeling good and normal ECG.
- Dmitry Veremeenko
What are your autoimmune markers and how old are you?
- Heat
My autoimmune markers are not elevated, AIT has not been diagnosed. Inflammatory markers are also low (C-reactive protein has fluctuated in recent years from 0.1 to 0.2). True, endocrinologists don’t like this TSH, they prescribe Iodomarin, and some of them even take hormones, although my T4 and T3 hormones are in the middle of the normal range, although if I had listened to the doctors, I would have become disabled 20 years ago.
In terms of age and health, I belong to the 8th option of the anti-aging plan indicated here.I think my TSH is elevated - because I rarely eat and eat a lot of vegetables, including cruciferous vegetables, 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 this current TSH as only a plus.
- 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
- Heat
Dmitry, this is of course 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 when T4 and T3 fall below normal, there is a risk of atherosclerosis. On the other hand, low TSH accelerates aging, while a person may think that he is full of strength and energy, but he will age faster.
So it turns out that you need to maneuver so that TSH is not low and at the same time T4 and T3 do not drop below normal, and the gland does not grow.
Yes, and I also saw data that taking iodine in the form of iodized salt or supplements like Iodomarin increases the risk of AIT, apparently this inorganic iodine acts more quickly and strongly than iodine from food, which can contribute to the occurrence of AIT, and this is with normal TSH and hormones, so those taking additional iodine in the form of supplements are recommended to get tested for thyroid antibodies more often.
- Dmitry Veremeenko
About the risks of iodine - this is true. It would be best to get tested for iodine. And if it is in short supply, then a small dose is normal.
- Heat
- Dmitry Veremeenko
- Heat
Dmitry, please explain why the article and comments talk about TSH as an autonomous indicator? I’m used to thinking 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 work of the thyroid gland. Or is it not that simple?
- Dmitry Veremeenko
Because t3 and t4 are unstable. And TSH is more stable. Many endocrinologists generally only look at it.
- Tatiana
Thank you! Then the situation is clear. I tested it in Helix 2 times with an interval of 2 weeks, the TSH levels are very different. One endocrinologist diagnosed hypothyroidism (in 2 times TSH was above 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 in 3 months. I re-tested at Invitro - TSH is normal. — By the way, this is about the quality of Helix’s work.
- Dmitry Veremeenko
Apparently you took beta blockers the day before???)))
- Dmitry Veremeenko
- Tatiana
Good afternoon. Dmitry. Please tell me if I need to take iodine, if
TSH -0.5, and T4 - 12.7 and T3 - 3.36?
- Dmitry Veremeenko
Hello Dmitry! I am 24. My indicators are: 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?
- Dmitry Veremeenko
good afternoon Dmitry.
TSH -0.5, and T4-12.7 and T3-3.36
According to hair analysis using the method of D. Skalny, my selenium is 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 is increased 0.309(- 1) do I take it once a week?
So should I give up lithium and take extra zinc?
But selenium and iodine are not needed?
Should I not take Thyroid Energy?
- Dmitry Veremeenko
There is no need to give up lithium; 1 tablet per week will not have any effect.
Zinc is additionally needed if it is significantly below the norm. And that's not necessary
Good afternoon. I really want to know how to lower TSH levels without hormones.
I took tests and was horrified. Tsh = 65.71 IU/l, and T4 = 8.80.
- Dmitry Veremeenko
Dmitry, hello, I am 75 years old, I have nodules on the thyroid gland (they are not growing), at first TSH was not very elevated, but after taking cordarone (a drug for arrhythmia with iodine) for a year, TSH increased to 10, the drug was stopped, trioxin 25 was prescribed - 50 mg. 2 years have passed, TSH is still elevated 7-8 while taking hormones. What do you recommend? The doctor only increases the dose of L-thyroxine and does not give a referral for analysis of other hormones?
- Dmitry Veremeenko
TSH at 75 years old is normal TSH for a centenarian
Dmitry, thank you for your answer, I didn’t understand what TSH is normal at 75 years old, and should I take hormones?
- Dmitry Veremeenko
A 2011 study from the Leiden University Medical Center in the Netherlands confirmed the findings of the 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 the TSH level is greater than 10 mU/L
Women over 65 years of age have a TSH norm of 0.42–7.15 mU/l (as in centenarians), but control cholesterol and inflammatory markers.
—
If you are 65 years of age or older, if your thyroid hormones are normal, and only the TSH hormone is elevated no higher than 10 mU/L, then treatment to lower TSH below 10 mU/L is not required, and, quite possibly, may only shorten life. The only requirement is to monitor cholesterol levels and inflammatory markers ( C-reactive protein and interleukin-6).
In your case, hormones allow you to control TSH no higher than 10 - that’s good. Just make sure that cholesterol and inflammatory markers (c-reactive protein and interleukin-6) are not high.
Hello! and if the thyroid gland is normal and TSH is 12... and if you feel well... do you need to take hormones? I’m now 47...from the age of 30 I was elevated...I refused to take hormones...and I was slim and felt good...from 44 I started drinking 50 and gained 10 kg..my skin became worse...so it turns out that until I didn’t drink everything was fine... and the point of drinking them... I should have refused... but I want to believe the doctors.
- Dmitry Veremeenko
According to research, it is necessary
Dmitriy! I had my thyroid tested for the first time today.
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)!!!
I especially liked the last indicator!
I couldn't even find this on the Internet.
ULTRASOUND STUDY OF THE THYROID GLAND WITH CDC AND
REGIONAL L/UNITS
Acoustic access, location: The thyroid gland is located typically, the contours are smooth,
clear, heterogeneous cellular structure. Cystic and solid formations
not found; the 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 gland parenchyma in the Color Doppler mode is enhanced.
Topographic-anatomical relationship of the thyroid gland with muscles and
organs of the neck are 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, everything is normal there as always:
C-protein ultra - 0.27
Cholesterol - 4.67
Glyc.hemoglobin 5.20%
etc. more than 20 indicators, they are all within reference limits.
(54 years old, 70 kg, 185 cm, BMI 20-21, navel waist 85-86, early bird - lights out at 10pm, gets up at 5am)
- Dmitry Veremeenko
See an endocrinologist and start taking hormones.
- Maksim
Thank you, Dmitry!
I've already signed up!
Can raw broccoli be harmful? Should I stop eating it every day?- Dmitry Veremeenko
Can’t unless you eat more than 100 grams per day
- Dmitry Veremeenko
- Maksim
Dmitry, I visited an endocrinologist, to my surprise, she said that we won’t do anything, after 3 weeks we’ll have to take all the thyroid tests again. I felt the thyroid gland, said that there was a nodule on the left, 2 ultrasound doctors came, one said - a pseudonodule, the other - a normal node, they immediately took a sample for cytology and tumor markers of the thyroid gland. 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'm waiting for the results of iodine-zinc-selenium from blood plasma.
- Maksim
The results came: not enough iodine and zinc,
and selenium - before the analysis, for about 3 weeks, I ate 3 Brazil nuts. in a dayStudy Result Units Reference values
Iodine (serum) 0.042* µg/ml (0.05 – 0.10)
Selenium (serum) 0.104 µg/ml (0.07 - 0.12)
Zinc (serum) 0.613* µg/ml (0.75 - 1.50)Maybe I'm wrong
but I like it better this way, when you get tested first,
and then you take vitamins, and not the other way around.
And the cytology is ready: nodular colloid goiter, good quality. 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'll go eat some seaweed!
- 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 of D3 may show that there is a lot of it, but it is not a fact that the body uses these reserves correctly.
This is indirectly shown by a test for parathyroid hormone.They also said that such a node (16 mm) will most likely remain so, will not increase, but will not decrease either.
Good day everyone!
Can anyone advise on how to increase free T3? At the moment I have it = 3.1. T4 and TSH are within normal limits, but the T3 to T4 ratio is below normal.
Thank you
Dmitry, please specify where I can read in more detail about the increased risk of atherosclerosis with low T4 and T3?
Also, in the comments somewhere you wrote about the effect of taking the synthetic hormone T3 on papillomas. This information is really needed. Please give me links or a tip where I can read this.
Thank you very much
- Dmitry Veremeenko
ncbi.nlm.nih.gov/pubmed/18443261
Dmitry, hello. Please advise whether I need to take hormones - TSH-4.46 (normal 0.4-4.2), chol.-4.58, react protein 0.09, rheumatic factor 3.7 (0- 14), glycerated hemoglobin - 5%, atherogenic coefficient - 2%, glucose 4.38. age 55 years. thank you.
- Dmitry Veremeenko
Let me add that in 8 months the ttg increased from 3.16 to 4.46.
- Dmitry Veremeenko
This is a question for an endocrinologist.
Good afternoon, my TSH is 1.97. I'm using commas! The algorithm shows an excess, although the norm is 0.4-4.5. This is mistake???
- Dmitry Veremeenko
I just entered 1.97 into the algorithm - that is, separated by commas. Everything is working. No excess. Perhaps you don’t have Excel, but open the algorithm through Open Office?
Hello Dmitry! The article is very informative, thank you very much. In 2010, I had an operation - mastectomy (cancer of the left breast pT2NOMO. NALT, ME dated June 29, 2010. 4 courses of APCT according to the FAC regimen. I did not take harmonium-containing or other drugs. Medical examination was carried out according to plan. In 2017, an ultrasound scan of the thyroid gland showed volume 1 .9 cm3, homogeneous tissue, low echogenicity, medium-grained. I work out in the gym - strength training. Weight at 53 years old - 56.5 kg. I feel great. I recently underwent examinations: ultrasound - thyroid gland volume 4.5 cm3, homogeneous, but already coarse-grained. Conclusion: hypoplasia of the thyroid gland. Hypothyroidism?
Tested for 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; Free triiodothyronine T3 - 4.73 at 4.3-8.1 pmol/l; Prolactin 443.7 at 64-395 mlU/l; Antibodies to Thyroid Peroxidase (AT-TPO) >1000.0 at 0-35 IU/ml.
They could explain and give recommendations. Thank you.
- Admin_nestarenieRU
Enter your data here and the algorithm will tell you
http://not-aging.com
TSH 1.51 mU/l age 37 years. Please tell me this is the norm?
- Dmitry Veremeenko
This is fine
- Olesya
Thank you, you reassured me.
- Olesya
The question is not clear to me. Which is fundamentally wrong. Where are the research links?
In fact, only 7 subjects out of 40 developed 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 EXISTING autoimmune thyroiditis. There, in addition to iodine deficiency, there are a bunch of other associated diseases and simply adding additional iodine does not will you help? It’s like with calcium supplements. That is, you are talking about hypothyroidism, but you cite as evidence a study of people with For example, long-term iron deficiency leads to depletion of the thyroid gland and vice versa. Here the connection is like this. For the absorption of iron, good acidity of the stomach is needed, and this is provided by the thyroid gland. With a lack of T3 and T4, a decrease occurs acidity due to insufficiency of parietal cells Castle factor is a product of the activity of these cells. Is it clear where B12 deficiency comes from? And B12, in turn, is a cofactor for the absorption of iron along with vitamin C, etc. Further, due to the low level of ferritin, the enzyme deiodinase is blocked (converts low-active T4 into active T3) The enzyme thyroid peroxidase is also iron-dependent. The biological effect of thyroid hormones decreases - hello, HYPOTHYROIDOSIS. 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 needs to be done. Otherwise the whole article is about not needing to take iodine
And this is what you need to do: Run and get tested for B12, ferritin, iron, TSH, ATPO-TG, free T4, zinc, ctkty and eliminate all deficiencies
- Dmitry Veremeenko
Good afternoon, TSH 3.54, free T3 2.52 pg/ml, free T4 0.908 ng/dl. Age 40. Should I contact an endocrinologist or is everything within normal limits? Thank you.
- Dmitry Veremeenko
and how much T3 and T4 are in pmol/l?
- Catherine
My indicators are in these units, but I found the conversion factors and calculated them. It turns out T3 - 3.87 pmol/l, T4 - 11.69 pmol/l.
- Dmitry Veremeenko
Then this is subclinical hypothyroidism. That is, not yet hypothyroidism. It is worth monitoring cholesterol and markers of inflammation, but there is no need to treat specifically.
- Catherine
Thank you very much for the answer. It’s just that there are almost all the symptoms of hypothyroidism, and excess weight I was already desperate to lose weight despite constantly monitoring my diet and working out in the gym. But that means that this is not the reason.
- Larisa
Dmitry, my TSH is 3.03. T4 is normal. They prescribed Eutirox 25 mg, which made me feel really bad. She stopped drinking it herself. Tell me what “markers of inflammation” means. After dental implantation surgery, I have a slightly increased level of both leukocytes and erythrocytes. What to do? I am 60 years old.
- Dmitry Veremeenko
It is absolutely impossible to reduce TSH 3.03 at your age. 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 treatment, judging by the data in this article, is not is required and, quite possibly, can only shorten life. The only requirement is to monitor cholesterol levels and inflammatory markers (C-reactive protein and interleukin-6).
ncbi.nlm.nih.gov/pmc/articles/PMC4480281
- Catherine
- Dmitry Veremeenko
- Catherine
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 prevalence of thyroid diseases is increasing every year. Therefore, people interested in maintaining their health regularly take iodine preparations for prevention and visit the laboratory once a year to find out the result of their blood test for thyroid-stimulating hormone. This helps them control the situation, and if necessary, they have the opportunity to consult a doctor in time and undergo a proper examination.
If you experience any complaints from the nervous system (weakness, impaired concentration, memory loss, drowsiness, hyperexcitability, etc.), you should consult a doctor and not self-medicate.
And one of the specialists you need to visit will be an endocrinologist. He will refer the patient for an appropriate examination, and if the result is the normal level of the TSH hormone, then treatment will need to be done by a neurologist. If there are deviations, then the endocrinologist will continue therapy.
Much depends on the coordinated functioning of the endocrine system. With a lack or excess of hormones, complaints about well-being appear immediately. Thyroid-stimulating hormone (TSH) plays a large role in the chain that controls the functioning of the thyroid gland.
If this chain is broken, then problems appear - hypothyroidism (low thyroid function) or hyperthyroidism (increased thyroid function). A TSH hormone test allows you to determine its amount, so the doctor can make a diagnosis.
Thyroid-stimulating hormone stimulates work. If there is little thyroxine (T4) and triiodothyronine (T3) in the blood, then the amount of TSH increases greatly. If T4 and T3 are sufficient, then TSH decreases.
If you take a blood test for TSH in a “decent” laboratory, then reference values will always be indicated in a specially designated line. This is the range within which a normal result should be.
If the result is higher or lower than normal (in the case of the thyroid gland, you should be wary if it is on the border of normal), then you should definitely consult a doctor. Typically, thyroid-stimulating hormone is 0.4-4.0 µIU/ml.
Sometimes laboratories provide other data, in which the normal result ranges from 0.8-1.9 µIU/ml. In such cases, we are talking about determining TSH using an ultrasensitive method.
Women have to visit an endocrinologist somewhat more often during their lives than men. This is due to the fact that problems with the menstrual cycle, and, accordingly, childbirth, are becoming more common every year.
If the TSH norm in women during examination is within the reference range, then the cause of reproductive dysfunction lies in some other problem.
Recently, it has been generally accepted that the lower the TSH, the better. An indicator at the upper limit of normal 3.5-4.0 µIU/ml may already indicate a latent course of hypothyroidism. Therefore, if there are relevant complaints, the doctor may prescribe treatment, even if the TSH result is within standard limits.
In such cases, there is no need to worry, and we must remember that each person is individual. What is normal for one is pathological for another.
Small doses of L-thyroxine will improve the functioning of the thyroid gland, and the norm of the TSH hormone in women will be closer to the lower limit. If against this background the complaints went away and, in particular, pregnancy occurred, then the doctor’s assumptions turned out to be correct.
The result of such a trial treatment should be assessed no earlier than three to four months, since the body needs time to adapt to the new amount of thyroid hormones in the blood.
When interpreting thyroid hormone tests, the doctor should always consider the patient's general condition. Particular attention is paid to pregnant women.
In the first trimester, they must undergo a blood test for TSH, since even hidden hypothyroidism or hyperthyroidism can harm the developing fetus. in the first trimester it is 0.4-2.0 µIU/ml.
Normal TSH in men
Men see an endocrinologist much less frequently and at a later age. This is due to the fact that genetically they are less predisposed to thyroid diseases. Any examination by an endocrinologist should begin with an ultrasound, a blood test for TSH and thyroid hormones (T3 and T4).
It is also useful to know your TPO antibody levels. The TSH norm in men is the same as in women and is 0.4-4.0 µIU/ml. In the presence of nodes, changes in TSH analysis and a high level of antibodies to TPO, a puncture of the thyroid gland should be performed under ultrasound guidance.
Normal TSH in children
When diagnosing congenital hypothyroidism in a child, this is the task of neonatologists in the maternity hospital. They conduct screening to detect this disease, since in this case, timely treatment is the only chance to get a positive result.
Otherwise, children become disabled, as they develop in conditions of severe lack of thyroid hormones.
TSH norm in children, µIU/ml:
- in newborns – 1.1–17;
- in children up to 2.5 months – 0.6–10;
- in children under 2 years old – 0.5–7;
- in children under 5 years old – 0.4–6;
- in children under 14 years of age – 0.4–5;
- in children over 14 years old – 0.3–4.
In newborns, TSH is much higher than in adults. The older the baby gets, the better his thyroid gland works. The amount of T3 and T4 hormones increases, and TSH gradually decreases. By the age of 14, the reference range levels out and becomes like that of an adult.
Decoding TSH
If you suspect a thyroid disease, you should contact a therapist or endocrinologist. The doctor will refer you for an appropriate examination, which will help determine the diagnosis.
Decoding TSH does not seem so difficult if you understand the principle of feedback between the thyroid gland and the pituitary gland. If we approach this issue more simply, then a high TSH indicates reduced thyroid function (hypothyroidism). A low TSH, on the contrary, indicates increased production of thyroxine (hyperthyroidism).
When interpreting the analysis, it should be remembered that hypo- and hyperthyroidism are only syndromes that accompany certain diseases.
For example, hypothyroidism often occurs with autoimmune thyroiditis, and hyperthyroidism often occurs with diffuse toxic goiter. But these diseases can mask thyroid cancer.
Therefore, if on ultrasound the lump has characteristic signs of cancer or nodes more than 10 mm in diameter, it is necessary to perform a puncture biopsy to exclude this serious disease.
An integrated approach to examination and treatment will help to identify the disease in time and stop its progression. If the blood test for TSH and free T4 is normal, then most likely there are no problems with the thyroid gland.
But doing an ultrasound will not be superfluous, since this method shows the structure of the organ, but does not reflect its function. Determination of hormonal levels in addition to ultrasound examination is the “gold” standard for diagnosing thyroid diseases. Therefore, they should not be neglected.
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