Thyroid-stimulating hormone (TSH) is produced by the pituitary gland, which is a small gland located in the lower central part of the brain. TSH stimulates the synthesis of thyroid hormones such as T3 (triiodothyronine) and T4 (thyroxine). These biologically active substances are involved in the metabolism of fats, carbohydrates and proteins, as well as in the functioning of almost all human organs. In addition, they regulate many mental functions. In our review, we will try to understand the concentration of this hormone in the blood.
TSH and its functions
Thyroid-stimulating hormone of the pituitary gland regulates the formation of thyroxine and triiodothyronine according to the feedback principle. That is, when the level of the latter increases, they suppress the production of TSH and vice versa. Therefore, for various dysfunctions of the body, these three substances need to be checked together.
If the pituitary gland malfunctions, the TSH level may decrease or increase. In the first case, the patient develops hyperthyroidism (thyroid hyperfunction syndrome), and in the second, hypothyroidism (deficiency of thyroid hormones). The causes of the disorder may be pathologies of the hypothalamus or thyroid gland. The unit of measurement for TSH is the international unit per milliliter.
The normal level of thyroid-stimulating hormone in the blood of women, men and children
The norm depends on the age group of the person, as well as other factors. The highest concentration of this substance is observed in children under 2.5 months - 0.6–10 µIU/ml. By age 5, its level decreases to 0.4–6 μIU/ml, and in adolescents aged 5–14 years, levels are 0.4–5 μIU/ml. The norm for adults is 0.4–4.0 µIU/ml.
Thyroid-stimulating hormone during pregnancy changes in accordance with the period. So, in the first trimester, due to the active restructuring of the female body, it decreases somewhat due to hyperstimulation of the thyroid gland. Additional thyroxine is necessary for the normal formation of fetal organs and tissues. Therefore, until the 12th week of pregnancy, the TSH content in the mother’s blood is 0.2–2.0 μIU/ml. Then the TSH content approaches standard values, and in the third trimester it may even increase slightly.
The secretion of this substance can change during the day. So, at 2–4 am it is maximum. High rates are also observed at 6–8 am. TSH drops to a minimum at 17-18 pm. The normal rhythm of its secretion is disrupted in persons who are awake at night. A slight increase in its content may be observed in older people.
A blood test for thyroid-stimulating hormone is extremely important for determining the condition of the thyroid gland, monitoring the effectiveness of treatment and diagnosing female infertility. The study may also be prescribed if:
- an increase in the size of the thyroid gland;
- symptoms of hyperthyroidism: anxiety, palpitations, insomnia, weakness, decreased visual acuity, photophobia, diarrhea, swelling around the eyes;
- signs of hypothyroidism: constipation, dry skin and hair loss, edema, obesity, cold intolerance, menstrual irregularities.
A blood test can be prescribed by an endocrinologist, gynecologist, neurologist, therapist, pediatrician or surgeon.
You should know!
Since TSH levels change throughout the day, it is advisable to take control blood tests at approximately the same time.
Thyroid-stimulating hormone is elevated: what does this mean?
This phenomenon can be observed if the function of the thyroid gland decreases. Often such an increase is observed during the asymptomatic stages of the disease, when T3 and T4 do not yet exceed the norm. An increase in TSH is accompanied by weakness, decreased concentration, slowed thought processes, irritability, sleep disturbances, pallor, swelling, decreased body temperature, constipation, nausea, as well as the development of obesity, which is difficult to correct.
An increase in its concentration is observed in the following pathological conditions:
- hypothyroidism of various types;
- primary adrenal insufficiency at the stage of decompensation;
- thyrotropinoma;
- the body's immunity to thyroid hormones;
- tumors of the pituitary gland or lungs;
- Hashimoto's thyroiditis;
- mental disorders;
- syndrome of unregulated TSH production;
- gestosis;
- condition after removal of the gallbladder;
- hemodialysis;
- exposure to lead and certain medications: anticonvulsants, antipsychotics, calcitonin, iodides, prednisolone, etc.
High thyroid-stimulating hormone may also occur after intense exercise. In order to reduce the level of this substance in the blood, the doctor may prescribe synthetic thyroxine (T4) to the patient. The desired effect is often achieved within a week after the start of therapy. Upon completion of treatment, the patient must undergo an examination by an endocrinologist, an ultrasound examination of the thyroid gland and a thyroid panel examination. Then inspections must be repeated once a year.
Pay attention!
Treatment of any pathology associated with the endocrine system must be carried out under the strict supervision of a physician. Self-medication is fraught with serious hormonal disruptions.
Reduced level of thyroid-stimulating hormone in the blood
Thyroid-stimulating hormone is reduced in toxic goiter, thyrotoxicosis, T3-toxicosis, hyperthyroidism in pregnancy, pituitary injuries, inflammation or malignant tumor of the thyroid gland, psychological stress, fasting or overdose of hormonal drugs. A decrease in TSH concentration is facilitated by taking steroids, thyroxine, drugs for treating hyperprolactinemia and a number of other medications.
When the content of this substance in the blood decreases, the patient develops headaches, blood pressure and body temperature may increase, the heart rate increases, appetite increases, tremors may appear in the body, and a disorder in the functioning of the digestive system often occurs.
The level of thyroid-stimulating hormone is considered low if its level is 0.1 mIU/L or less. In such cases, it is necessary to check the functioning of the cardiovascular system and the levels of T3 and T4. If the cause of the imbalance is nodular goiter, then the patient is prescribed radioiodine therapy, and in the most serious cases, surgery. Patients with Graves' disease are advised to take B-blockers to reduce the symptoms of the disease. In other cases, it is necessary to treat the underlying disease that caused the hormonal imbalance.
An analysis for thyroid-stimulating hormone makes it possible to identify diseases of the endocrine system, as well as pathologies of other organs, in the early stages. This substance is extremely important for energy metabolism in the body. To determine its concentration, the patient must donate venous blood on an empty stomach (fasting from food should be 8–14 hours). Two days before the study, you should stop taking steroid and thyroid medications. During the day before visiting the clinic, you should avoid emotional and physical stress. Three hours before testing you should not smoke.
It should be remembered
The current TSH level reflects the situation over the past 3-6 weeks. Accordingly, a control measurement of its content is recommended to be carried out no earlier than 8–10 weeks after the start of therapy or a change in the dosage of the drugs used.
Wednesday, 03/28/2018
Editorial opinion
Deviations from the normal concentration of the hormone TSH in the blood can occur for a variety of reasons, many of which are considered physiological. Therefore, it is so important to trust the opinion of specialists - endocrinologists, oncologists and other specialized doctors, and not engage in unprofessional diagnosis and subsequent self-medication.
The endocrine system is responsible for the functioning of the human body with the help of special substances called hormones. At the slightest disturbance in its functioning, anomalies in the functioning of internal organs begin to appear, which can even lead to serious illnesses. Through the action of thyroid-stimulating hormone, the body produces two other hormones for the thyroid gland. Therefore, it is worth keeping its level under control.
The hormone discussed in the article is produced by the pituitary gland, the main gland in the endocrine system, which is located in the lower region of the brain. Despite its small size, it performs very important functions. For example, TSH is responsible for the active joint work of triiodothyronine and thyroxine, which are the hormones of the so-called thyroid gland. These active elements are directly involved in the metabolism of substances necessary for the body (proteins, fats and carbohydrates). They are also involved in the functioning of most human organs. Hormones, in addition, are responsible for a person’s mental state.
The pituitary gland is responsible for the production of this hormone in the human body. The main task of this hormone is to control the functioning of the glandular systems. This serves as the basis for classifying it as a regulating hormone. TSH immediately triggers the production of two other hormones in the thyroid gland. Their presence and action are important for the full functioning of the body.
All these hormones are responsible for several processes:
- regulation of material metabolism;
- circulation of energy resources;
- normal development of the body;
- synthesis of protein and vitamin A;
- stabilization of all major human systems (cardiovascular, as well as reproductive, nervous and gastrointestinal tract);
- control of visual and auditory senses.
TSH, in addition to activating the production of hormones, is responsible for increasing the production of phospholipids, nucleic acids and proteins, as well as for saturating the thyroid cells with the necessary amount of iodine. Since the levels of hormones directly influence each other, it can be assumed that an increase in TSH causes a decrease in the levels of other substances. This will later negatively affect the patient’s health.
TSH levels in a healthy person vary throughout the day. Its minimum content in the blood most often occurs at night, and the maximum occurs in the early morning. Therefore, in order to achieve a more accurate result, it is worth taking tests several times.
TSH hormone: the meaning of high levels, their symptoms
An increase in the concentration of the hormone discussed in the article is the first alarming signal about malfunctions in the thyroid gland and its incomplete performance of its functions. And it is not at all necessary that a person will feel changes in well-being in a bad direction. In addition, the indicators of other hormones will remain the same.
Initially, with an increase in TSH, symptoms do not appear, but soon, with an increasing deviation, various organs begin to show signs of unstable functioning of the body and health problems.
Signs of a general nature (usually of a regular nature).
- Cardiovascular system: there is a decrease in blood pressure, a decrease in the frequency of heart impulses.
- Nervous system: there is episodic memory loss, absent-mindedness, forgetfulness, stress, lethargy, drowsiness.
- Reproductive system: hormonal imbalance, inability to conceive a child, decreased libido.
- Gastrointestinal tract: there is a lack of appetite, irregular bowel movements, constipation, an increase in liver size.
In addition to internal disturbances, external changes are also observed.
- Hair. They lose strength, break, fade, and fall out in large quantities.
- Leather. It becomes dry, tight, peeling and cracks appear. Loses its natural color. Swelling appears on the face.
- The timbre of the voice changes.
- A person is able to gain weight even in the absence of appetite; obesity occurs, which cannot be corrected.
- There is a feeling of weakness, a drop in body temperature, severe joint pain, and cramps.
Important! If you identify at least two of the described symptoms, you should immediately make an appointment with an endocrinologist.
If treatment is not started in a timely manner, there is a high risk of more severe symptoms that pose a serious threat to human health and can lead to severe diseases of the thyroid gland (inflammatory processes, detection of a tumor).
More pronounced symptoms appear as:
- speech retardation;
- noticeable enlargement of the thyroid gland;
- changes in skin color on the neck, discomfort in this area.
Signs of deteriorating human health directly depend on the intensity of the pathological condition and the missing amount of thyroid hormones. Sometimes small increases are not accompanied by any symptoms.
If the amount of the hormone greatly exceeds the norm, then you can be sure of a lack of T3 and T4, after which the first symptoms begin to appear.
Types of hyperthyroidism
- Explicit – TSH levels are increased, T3 and T4 are decreased.
- Subclinical – TSH is elevated, T3 and T4 remain normal. With such hyperthyroidism, symptoms may not appear.
Patients with overt hyperthyroidism often experience the following symptoms:
- external manifestations (swelling of various types, weight gain, pale and dry skin, dullness and brittleness of hair);
- problems with the heart and blood vessels (slow pulse, constant surges in blood pressure);
- emotional adjustment (stress, apathy, irritation, depression);
- general malaise (fatigue, drowsiness, weakness);
- gastrointestinal tract disorders (lack of appetite, problems with stool).
Reasons for increased TSH levels
- adrenal insufficiency;
- tumors – benign and malignant;
- increased iodine content in the blood;
- hyperthyroidism;
- lead poisoning;
- pathologies of the respiratory tract, heart, liver, kidneys;
- lack of sensitivity to thyroid hormones;
- gestosis, manifested by swelling, protein in the urine, or high blood pressure in pregnant women;
- severe stress.
Important! Not in all cases, excessive TSH levels indicate truly serious pathologies. It can grow during physical activity, using a special group of medications, or undergoing radiation therapy.
High TSH in children
The acceptable TSH value varies depending on the age of the child. For a two-month-old baby, TSH should range from 0.5 to 10 mIU/L; for a child under 14 years of age, the norm is from 0.5 to 5 mIU/l.
- delay in physical and mental development;
- lethargy, fatigue;
- lethargy;
- constantly cold extremities.
An increase in TSH is also associated with severe mental impairment and adrenal disease.
During intrauterine development, the indication for examination is the detection of hyperthyroidism in one of the parents.
If the TSH level is above 100 mIU/L, then doctors consider the test results positive. If the disease is congenital, it manifests itself as strabismus, hearing impairment and, even worse, cretinism.
Elevated TSH levels in women
The acceptable TSH level in women is 0.4-4 µIU/ml. However, its maximum value in special cases is a violation. The main thing to know is that the TSH value increases with breast disease.
Women over 50 years of age should undergo periodic examinations, as their likelihood of developing hyperthyroidism increases by 15%.
Features during pregnancy
Hormonal changes may occur in a pregnant woman's body. As a rule, dependence on the duration of pregnancy predetermines the lack of stability in hormone levels. In the early stages, up to 2 months, the hormone is contained in minimal quantities, and by the last months its level increases significantly. Changes in the hormone content are physiological in nature, which is affected by the woman’s mental state and physical activity.
But if a significant increase in the permissible norm is detected in the early stages, then the woman should be under the constant supervision of a doctor, whose recommendations may require additional examination. During the first 2-3 months, the fetus actively develops and is completely dependent on the mother’s hormonal levels, since its own thyroid gland is just beginning to form.
If there is an unacceptable difference between the existing TSH level and the norm, a pregnancy complication occurs. In the first trimester it ends in miscarriage. In later stages, the risk of possible placental abruption and slower fetal development increases.
TSH receptors have an important influence. They are located in the “thyroid gland” and react to TSH, which affects the presence of T3 and T4. Sometimes an increase in thyroid-stimulating hormone leads to a malfunction of the immune system. When it undergoes disturbances, the production of antibodies begins that interfere with its activity. As a result, the work of the thyroid gland stops, its cells cease to be receptive.
Antibodies passing through the embryonic organ increase the likelihood of serious pathologies of the baby’s endocrine system. If abnormalities are present, the pregnant woman should be tested for TSH receptor antibodies in the last trimester.
Normalization of TSH levels
If the hormone level is too high, the specialist will prescribe a thyroid examination. Impaired functioning of the gland increases TSH levels.
Only a qualified specialist can prescribe treatment, and then only if the cause of the increase in hormone levels is accurately detected. A course of treatment is selected for each patient individually. If the cause of the surge is a tumor in the mammary glands, inflammation of the thyroid gland, then treatment will take a lot of time, patience and effort. Benign tumors require complex therapy. The appearance of small tumors does not require surgery.
If the level of the hormone discussed in the article is high and slightly below the norm, as a rule, the doctor prescribes a corrective diet. In addition, the doctor prohibits the patient from taking certain medications and exercising.
Important! A slightly increased TSH will not have a serious impact on a person’s health, and there will be a lot of time left to bring it back to normal.
A slight increase in TSH caused by iodine deficiency requires taking medications that contain this substance. They should be taken for 6 months. At the end of the course, it is worth doing a repeat ultrasound of the thyroid gland and undergoing a TSH examination.
If hyperthyroidism is detected, hormonal medications are prescribed under the regular close supervision of a specialist. Medicines must be taken every day according to the schedule drawn up by the attending physician.
Elevated TSH indicates a malfunction of some organ. As a rule, this is associated with pathologies of the thyroid gland. And in patients who have undergone its removal, the hormone always has high levels.
Most believe that hormonal imbalance does not have a serious impact. Hyperthyroidism cannot lead to death, but it can cause diabetes, excess weight, hypertension and other equally dangerous diseases. Therefore, deterioration in well-being, which was previously not typical for a person, requires passing appropriate tests to be on the safe side. This will reduce the possible risk of developing serious pathologies.
Previously, hyperthyroidism was treated with a natural analogue - ground animal thyroid gland. Nowadays, this technique is practically not used - it has been replaced by synthetic drugs. Their advantage lies in the constant maintenance of proper functioning of the gland.
Upon completion of therapy and the values of T3, T4, and TSH return to normal, patients should be examined every year to ensure that normal values are maintained.
Folk remedies
| Name | How to prepare and take |
|---|---|
| Phytocollection | Mix in equal quantities one of the herb combinations of your choice: celandine, chamomile, wormwood, cocklebur, rose hips; celandine, elecampane, chicory, dill, cocklebur; chopped herbs, chamomile, rose hips, knotweed root, chicory; celandine, horsetail, leuzea root, cocklebur, flax seeds; birch buds, thyme, rowan fruits, elecampane, cocklebur. It is necessary to pour two tablespoons of the mixture into a mug of boiling water, cover with a lid, leave on the fire until it boils, then simmer over low heat for 8 minutes. Then, without straining, pour into a thermos and leave to infuse for 3-4 hours. The average dose to take is 150-200 ml 30 minutes before meals. The treatment course lasts 2-3 months. Afterwards, you can move on to treatment with another collection. |
| Mixture of feijoa and rowan | Eat 2-3 teaspoons on an empty stomach 30 minutes before breakfast. |
| A decoction of coltsfoot, licorice root and St. John's wort | The ingredients are mixed in equal parts, brewed with boiling water, infused for 15 minutes and drunk two glasses daily. |
| Kelp leaf powder | The powder is diluted in water at room temperature and drunk before bed for a month. |
| Apple cider vinegar | Apple cider vinegar is believed to help correct hormonal imbalances. Every morning you need to drink a glass of warm water, to which 3 teaspoons of vinegar and a teaspoon of honey have been added. |
What is the danger of a high TSH level?
If quick measures are taken to reduce thyroid-stimulating hormone to the required level, there is no threat to human health. And if you ignore the symptoms of such a problem, first of all, a person’s mood and general well-being will gradually deteriorate. Elevated TSH levels will lead to slower metabolism, weight gain, diabetes mellitus and hypertension.
Important! Hyperthyroidism in a small percentage of cases ends in death - only in very advanced cases. The most likely threat lies in hypertension and diabetes.
Diagnostics
If you suspect an elevated TSH level, you should be examined by a specialist as soon as possible to make a diagnosis. The analysis is carried out in the morning. Blood is taken from a vein. If the analysis confirms that the hormone is contained in quantities exceeding the norm, an additional examination is prescribed to understand the reasons for this deviation.
You need to know that at night, even in a healthy person, TSH will have high values. This is due to the slowing down of the body during sleep. Therefore, there is no point in taking tests in the evening and at night, since the hormone level will always be slightly elevated. This is especially worth considering during urgent examination as a result of hospitalization.
The results of the analysis also give a general idea of other features of the work of the organs.
There are 3 types of antibodies to thyroid-stimulating hormone:
- stopping the action of TSH receptors and increasing T3 and T4;
- promoting long-term increases in T3 and T4;
- stopping the activity of the thyroid gland and reducing susceptibility to TSH.
The threat from antibodies is expressed in the possibility of their penetration through the placenta to the developing fetus, which can cause pathology in the baby. Therefore, checking TSH levels for pregnant women is mandatory.
Diagnosis of hormone levels in childhood is of particular importance. Its normal value varies depending on the age of the child. Young children are tested for delayed physical and mental development, anemia of the arms and legs at normal body temperature, emotional disorders, weakness, and drowsiness.
Elevated TSH may be associated with mental disorders and adrenal disease. The greatest danger for children is the presence of hyperthyroidism in one of the parents. For such babies, analysis is carried out while they are still in the womb.
Prevention of elevated TSH levels
Let's sum it up
An increased level of TSH in the blood can lead to various pathologies of systems and organs, so it is necessary to monitor your health and regularly have your blood tested. This will allow you to monitor not only TSH levels, but also other hormones, which will make it possible to prevent potential diseases.
If a person has been found to have an increase in the level of this hormone in the blood, then one cannot hesitate - one must immediately contact a specialist who will prescribe certain medications and monitor the treatment process. You should not try to cure yourself, as you can only worsen the situation.
Video - Specialist about TSH
Thyrotropin or TSH is an important pituitary hormone that works as a stimulator and indicator for the production of thyroid hormones.
Since the hormonal system is fundamental to the functioning of the entire body, maintaining normal levels guarantees good health and overall health. But women whose reproductive functions are closely related to TSH in particular should turn their attention to thyrotropin when planning pregnancy, since keeping this hormone within the norm is the key to a healthy and full-fledged child.
The role of thyrotropin
Thyrotropin (or more commonly called thyroid-stimulating hormone, TSH) is produced by the pituitary gland, although it is more often referred to as thyroid hormone. The name itself is formed from the parts “thyro” - thyroid gland and “trop” - path, where normalized TSH values indicate the usefulness of the process of providing the body with the thyroid hormone - thyroxine.
Maximum production of thyrotropin begins late at night and decreases in the evening. It stimulates the thyroid gland to produce its own hormones, activates the processing and absorption of proteins and fats.
Thyroxine is a thyroid hormone responsible for an adequate metabolic rate. The sufficiency of thyroxine guarantees the full development of the body, the coherence of all its functions, and the quality of absorption of vitamins and microelements.
If there is a lack of thyroxine in the body, the pituitary gland increases the production of TSH so that more thyrotropin begins to more strongly stimulate the thyroid gland to produce its hormones.
Low levels of thyroxine slow down processes in the body, which can lead to:
It is precisely because of the need to monitor thyroxine levels that it is important to monitor TSH, since it is primarily sensitive to the activity of the thyroid gland.
A single determination of thyroxine cannot be indicative, since normalized levels of this hormone and inflated levels of thyrotropin are often observed, which is called subclinical hypothyroidism - a deficiency of thyroid hormones without pronounced symptoms. This must be stopped in time by treatment to avoid the disease becoming manifest.
During pregnancy
All over the world, it is customary to evaluate the hormone TSH and thyroxine in combination, where the first of them is normalized from 0.4 to 4 μIU/ml, and the second should strive for the upper limit of the laboratory norm. If the TSH value exceeds the norm, a diagnosis of hypothyroidism is made, requiring drug treatment.
However, it is believed that in order to plan pregnancy and properly prolong it, the value should not exceed 2-2.5 (3 for long periods of pregnancy).
Keeping TSH within this limit makes it possible to more likely guarantee not only pregnancy and its early onset, but also the birth of a healthier and more erudite child. Of course, ideal indicators are not a calling card for making a diagnosis of a “prodigy,” but they significantly improve the outcome.
Normalized TSH indicates the sufficiency of thyroxine in the body, which means that there are enough thyroid hormones for both the well-being of the mother and the development of the fetus. Therefore, when planning pregnancy or at the very beginning, it is best to check TSH and free thyroxine in the blood and, if TSH is exceeded, start taking medications on doctor's recommendation.
Reasons for the increase
It increases due to a lack of thyroxine, produced in insufficient quantities by the thyroid gland. The reason for this imbalance may be:
- Damage to the thyroid gland(irradiation, trauma, tumor, complete absence of the thyroid gland if it is removed);
- Pituitary gland damage- a rare cause where the functioning of the pituitary gland itself is disrupted (for example, a tumor);
- Iodine deficiency in the body (thyroxine simply has nothing to transform in the body).
There are three main reasons for high TSH levels, which are most often associated with a lack of thyroxine. But in medical practice, the process of studying the cause of an increase in TSH is practically never encountered - the treatment is the same in all cases, and identification of the cause-effect relationship is not required.
Treatment
Treatment is prescribed by a doctor based on a blood test with the values of thyroid-stimulating hormone and free thyroxine. Rarely, the doctor may ask the patient to undergo an ultrasound examination of the thyroid gland (to avoid stimulation of a hormone-dependent tumor, if any) and/or determination of antibodies. However, more often the doctor stops at studying TSH and thyroxine, as well as palpating the patient’s gland and taking an anamnesis.
A TSH with a value above 4 µIU/ml obliges the doctor to prescribe treatment. If TSH levels fluctuate in the range of 2.5-4, and the patient is a woman planning a pregnancy in the near future, then therapy is also recommended.
The therapy is combined and consists of the administration of thyroid hormone and potassium iodide. Thyroid is available in two names "Euthirox" and "L-thyroxine", and the right to choose one of the drugs remains with the patient. The dosage is determined by the doctor based on weight categories and initial TSH levels without therapy. It is important to note that thyroxine is taken half an hour before meals from 5 to 8 am - during hours of moderate production of your own hormones.
Since maintaining TSH in the normal range is the key to health and healthy offspring, and therapy does not pose a teratogenic or other threat, everyone should promptly worry about assessing their hormonal status and, as a result, treatment, if necessary.
The endocrine system in the body is a kind of hormone center that controls the functioning of various organs. The pituitary gland helps the thyroid gland produce hormones. This part of the brain synthesizes thyroid-stimulating hormone (TSH). When it is produced normally, the hormones T3 and T4 also enter the body in the required quantities. As soon as a failure occurs, the balance between these substances is disrupted.
When TSH is elevated, the two thyroid hormones are produced in insufficient quantities, which negatively affects the functioning of the heart, gastrointestinal tract, nervous and reproductive systems.
What does an elevated TSH mean?
If T3 and T4 are normal, then there is no need to worry about the TSH level, since it is also produced in the right amount. Before understanding the features of the growth of TSH levels, it is worth understanding what this hormone is.
Thyroid gland
Thyroid-stimulating hormone or thyrotropin is a biologically active substance that can regulate the amount of hormones produced by the thyroid gland. It is often called regulatory. Thyrotropin can perform several functions at once:
- ensure energy metabolism;
- speed up metabolism;
- regulate protein production;
- accelerate growth;
- ensure full mental development.
When TSH is higher than normal, the hormones T3 and T4 stop performing their functions because there are fewer of them. These two hormones are responsible for:
- coordinated functioning of the cardiovascular system;
- strengthening the organs of vision and hearing;
- normal functioning of the gastrointestinal tract;
- retinol synthesis;
- normal metabolism.
There are many reasons that can cause an increase in TSH, but only an endocrinologist should determine them.
What should the norm be?
Before judging methods for lowering TSH, it is worth knowing what the acceptable limits are in the test results. It is worth considering that the TSH norm for females and males is different. There are separate indicators for children and pregnant women.
TSH is normal:
- for men – 0.3–4 µIU/l,
- for women – 0.4 – 4.1 µIU/l,
- for pregnant women – 0.34-3.1 µIU/l,
- for newborns – 0.6–12 µIU/l,
- for children under 5 years old – 0.4–7 µIU/l,
- up to 14 years – 0.3–5.1 µIU/l.
Why does thyrotropin increase, and what to do? These are the most frequently asked questions from patients in the endocrinologist's office. Sometimes thyroid hormones, which are produced less when TSH is elevated, can simply “take away” a person’s proper sleep, strength, good mood and well-being in a few months. To understand this situation, you need to understand the reasons for the increase in TSH.
For what reasons does TSH increase?
When a patient has an elevated TSH level, the doctor begins to go through all possible treatment options. But the main thing is to find the cause of this condition. Without identifying it, the disease cannot be cured forever. The most common provocateurs of TSH growth are:
- diseases of the heart, blood vessels, liver and kidneys (somatic diseases);
- renal failure;
- neoplasms of various types in the pituitary gland;
- pathological changes in the thyroid gland itself;
- poisoning with toxic substances;
- excess iodine;
- removal of the gallbladder;
- genetic diseases;
- hormone insensitivity syndrome;
- gestosis in pregnant women;
- mental illness.
When TSH is higher than normal, this does not mean that a person has some kind of disease. Often TSH is elevated due to taking medications that affect hormone production. Thyrotropin is a fairly sensitive substance, so with any change in hormonal levels, it actively increases or decreases in quantity.
The TSH level should be checked together with thyroid hormones, since high TSH is often noticed with normal T4 and T3. When T3 and T4 are elevated and TSH is reduced, the thyroid gland itself needs to be treated. This condition can also be observed in autoimmune diseases.
Signs of elevated TSH
When a slight increase in thyrotropin begins, a person may not notice it at first. Over time, the condition gradually worsens. When the condition becomes critical, the person will feel changes in many organs.
Symptoms Symptoms of elevated TSH include:
- poor memory;
- absent-mindedness;
- apathy, depression;
- sudden change of mood;
- low blood pressure;
- bradycardia;
- poor appetite, but weight increases for no reason;
- irregular bowel movements;
- digestive problems;
- liver enlargement;
- severe decrease in libido;
- irregular menstrual cycle;
- infertility;
- swelling on the face and limbs;
- hand tremors;
- severe weakness;
- hair loss, peeling skin and brittle nails;
- cramps in the legs and arms;
- low body temperature.
When TSH levels are elevated, but T3 and T4 remain normal, these symptoms may not appear. Often patients with this problem notice several of the described changes in the functioning of their body. The most common symptoms are listed here, but this does not mean that they can all occur at the same time.
In advanced situations, when treatment is not started on time, the following symptoms may appear:
- enlargement of the neck in the thyroid gland area;
- bluishness and redness of the skin in this area;
- slow speech;
- a feeling of discomfort in the throat due to a deformed neck area.
You cannot delay visiting a doctor. If TSH is stabilized in time and returned to normal, then all functions of organs and systems will restore their normal functioning. For diagnosis, it is enough to take a blood test for biochemistry. The list of tests is indicated only by an endocrinologist.
Treatment: how to reduce TSH?
The main task for the doctor is not only to treat the patient, but also to accurately determine the cause of his condition. Various medications help lower TSH levels.
Important! It is strictly forbidden to prescribe, cancel, or change the dosage of prescribed medications on your own. Only an endocrinologist can select appropriate reducing medications and set their dosage.
Each situation requires an individual approach, so the doctor must send the patient for an ultrasound examination of the thyroid gland for diagnosis. If necessary, he may send the patient for additional MRI studies.
Treatment of hyperthyroidism Examples of treatment for high free thyrotropin:
- If changes in hormonal levels occur due to breast cancer, then treatment takes a long time. Chemotherapy and surgery become its mandatory element. After successfully combating the tumor, thyroid treatment will continue.
- If the patient has been diagnosed with iodine deficiency, then treatment is based on taking iodine-containing tablets. This often occurs when TSH is elevated but T4 is normal. The patient’s diet necessarily changes, increasing the number of foods rich in this element.
- If hyperthyroidism is established, then treatment is based only on taking hormonal drugs. The dosage regimen, number of tablets and duration of treatment are prescribed by the attending physician.
Any concomitant diseases that are caused by hormonal imbalance should disappear after the situation normalizes. If this does not happen, then the appropriate doctors should deal with the treatment of acquired diseases: cardiologists, neurologists, gastroenterologists, gynecologists.
What does high TSH mean for pregnant women?
Often an excess of TSH frightens women during pregnancy, but what does this hormone mean at the time of bearing a child? Increased production of thyroid-stimulating hormone is dangerous not only for the health of the mother, but also for the baby in the womb.
The first 10 weeks of pregnancy are considered one of the critical moments. During this period, the fetus does not yet have its own thyroid gland, so it cannot provide its body with hormones. To do this, the mother's thyroid gland shares its hormones with the baby.
If TSH is elevated at such an early stage, this can negatively affect the health of the fetus.
Important! A slight increase in this hormone can be noticed when a pregnant woman is physically overworked or due to stress..
To examine the mother's body, doctors recommend undergoing ultrasound examinations on a regular basis. An additional diagnostic step can be considered a biopsy of the thyroid gland. But these examinations are prescribed only in cases of very strong growth of TSH.
If it is not possible to lower TSH, then in the early stages the woman remains at risk of miscarriage. In order not to lose your child, it is worth monitoring the health of the thyroid gland in advance. To do this, you need to take hormone tests at least once a year.
When thyroxine and thyrotropin increase sharply in the later stages, this can provoke placental abruption or intrauterine growth retardation of the baby.
How does high TSH affect a child’s body?
A reduced amount of T3 and T4, but a high TSH negatively affects the child’s body. The norm is different for each age, but it is worth undergoing a hormone test in the following cases:
- if the child gets tired quickly at the slightest physical exertion;
- if he constantly wants to sleep;
- when there is a delay in mental or physical development;
- when the child is inhibited and unable to concentrate.
It is worth paying attention to the temperature of the child’s extremities. If the body temperature is normal, but the hands and feet are cold, this may also be a signal of an increase in TSH. Often this condition can be associated with a problem with the adrenal glands or serious mental disorders.
As a preventive measure, doctors recommend taking hormone tests during the period of intrauterine development. This is especially important for those parents who already had hypothyroidism. If, according to the diagnostic results, TSH exceeds 100 mIU/l, then the result can be considered positive. The child may have strabismus, deafness, or neurological cretinism. The list of possible developmental pathologies is quite large, so it is important to carry out timely diagnosis.
To monitor the level of the TSH hormone, you need not only to undergo a timely examination, but also to monitor your diet. Doctors develop an appropriate diet for patients with hypothyroidism that promotes the accumulation of iodine. If TSH is elevated, it is enough to take prescribed medications. You can increase TSH a little using traditional methods, but it is better to consult a doctor before using any method. Do not underestimate the power of herbal preparations, infusions or decoctions.
TSH or thyroid-stimulating hormone plays an important role in the functioning of the endocrine system. It acts directly on the thyroid gland, stimulates its function, activates its absorption of iodine and ensures the synthesis of thyroid hormones, which stimulate growth and overall development of the body.
TSH production is regulated through hypothalamus thyroid hormones. The concentration of thyroid-stimulating hormone is related to the content of thyroid hormones; with a deficiency of the latter, the TSH content increases.
Analysis of TSH concentration is considered the most accurate method for assessing the condition of the thyroid gland and is used for its diagnosis.
An increase in TSH occurs when thyroid hormones decrease, and often indicates iodine deficiency in the body. By analyzing the amount of thyroid-stimulating hormone, it is possible to diagnose thyroid pathology:
- Hypothyroidism is a condition characterized by a lack of thyroid hormones.
- Thyroiditis is inflammation of the thyroid gland.
- Pituitary tumor.
- Tumors of the lung, breast.
- Endemic goiter.
- Thyroid cancer.
Reasons
The reasons for the increase in thyroid-stimulating hormone are due to thyroid dysfunction.
One of the important catalysts of the pathological process of the thyroid gland is the insufficient intake of iodine in the human body, and the development of diffuse non-toxic goiter against its background.
Thyroid diseases can also be caused by other factors:
- Genetic– chromosomal abnormalities in which the threshold of sensitivity to iodine deficiency increases.
- Bacterial and viral infections.
- Influence of external negative factors: radiation exposure, carcinogens that lead to the development of thyroid tumors.
TSH may rise in the serum for some time after enhanced iodine therapy.
Symptoms
In pathological conditions of the thyroid gland, accompanied by elevated TSH, as a rule, general symptoms, characteristic of a decrease in thyroid hormones are apathy, memory impairment, increased sensitivity to cold, drowsiness, weight gain with decreased appetite, swelling of the legs and face, thinning hair and brittle nails, constipation, pale and cold to the touch skin. Moreover, these conditions are permanent.
Symptoms characteristic of certain conditions are neck deformity, visible enlargement of the goiter, slow speech, redness and cyanosis in the neck area. The above signs indicate serious diseases - tumors and inflammation of the thyroid gland.
The problem with the development of thyroid diseases lies in nonspecific symptoms in the early stages. As a rule, general symptoms (drowsiness, apathy, memory impairment, etc.) do not cause much concern for most people.
They refer to general fatigue of the body and consult a doctor only when such specific signs appear as neck deformation against the background of a significant increase in goiter, which may indicate the onset of tumor development, which requires serious, specific and long-term treatment.
Therefore, with prolonged manifestations of apathy, chilliness and unreasonable weight gain, you should consult an endocrinologist.
Elevated TSH in women
Particular importance is given to diagnosing TSH concentrations in women, mainly during pregnancy. This is due to the fact that the ratio of the incidence of hypothyroidism between men and women is 1:10.
U pregnant women the risk of developing hypothyroidism increases from 2 to 5%, in women over 50 years old - up to 12%. In addition, the value of thyroid-stimulating hormone increases in breast tumors.
Pregnant women in the second half of pregnancy may develop gestational hypothyroxinemia due to insufficient iodine intake. Minor increase TSH during pregnancy – up to 4.0 mIU/l– is the norm. Also, analysis values may increase under severe emotional and physical stress.
Elevated TSH in children
Norms for thyroid-stimulating hormone concentrations in children change with age. In the first 2 months of a baby’s life, this figure can increase to 10 mIU/l. Up to 14 years of age TSH is normal in children can vary from 0.4 to 7 mIU/l, then - no higher than 4 mIU/l.
The concentration of thyroid-stimulating hormone in children is constantly changing, so the analysis should be carried out over time. Diagnosis of TSH in children is prescribed in the presence of pathological symptoms. Indications for a TSH test in childhood to identify hypothyroidism are the following symptoms: delayed physical and mental development, drowsiness, cold extremities to the touch at normal body temperature.
If parents suffer from hypothyroidism, then the diagnosis of this pathology in the child is carried out neonatally in the prenatal period. The analysis is considered positive if the hormone concentration in the fetus exceeds 100 mU/l.
Elevated TSH in children can be due to other reasons: severe emotional and physical disorders, diseases of the adrenal glands.
Treatment
Treatment for elevated thyroid-stimulating hormone is determined by the cause that caused this deviation. If the TSH value is increased against the background of tumors and inflammatory processes of the thyroid gland, lung and breast cancer, then in these cases serious and long-term specific treatment is required.
Benign tumors of the thyroid gland are subject to complex therapy; if the tumor is small in size, then treatment is carried out without surgical intervention. Diagnosed thyroid cancer is treatable and is characterized by high patient survival even in severe, advanced stages of the disease.
If there is a slight increase in the hormone caused by the formation of a goiter that has developed against the background of iodine deficiency, it is prescribed iodine therapy: “Iodomarin”, “Iodine-Active”, “Iodide”, “Iodine balance”, for 6 months. After this period, repeated laboratory diagnostics and ultrasound of the thyroid gland are performed. The recommended iodine intake for healthy people is 100 mcg for children and 200 mcg for adults. In case of iodine deficiency, the dose is doubled, respectively: children - 200 mcg, adults - 400 mcg.
If hypothyroidism is diagnosed, replacement therapy is necessary. levothyroxine therapy, which is calculated in accordance with the patient’s body weight – 1.6 mcg/kg. The drug is taken daily in the morning, half an hour before breakfast. Thyroid hormone preparations are also prescribed: “Eutirox”, Triiodothyronine”, “Iodtirox”, “Bagotirox” and glucocorticoids “Prednidazole”.
Complications
If the cause of an increase in TSH is not diagnosed in a timely manner and its subsequent elimination, there is a risk of developing conditions that pose a threat to human life. Against the background of a lack of iodine in the body, iodine deficiency develops, which is further complicated by goiter, impaired cognitive function, and hypothyroidism. Children have delayed growth and general physiological development.
There are more than 20 million people in the world with mental retardation caused by iodine deficiency. Children with congenital hypothyroidism suffer from neurological cretinism, deafness, and strabismus.
