Such important thyroid hormones: which ones to take, how to take them correctly. Test for thyroid hormones (normal levels of TSH and T4 hormones) Name of tests for thyroid hormones

The thyroid gland is an organ whose normal functioning is invisible. But as soon as dysfunctions of the endocrine system appear, the whole body suffers and various unpleasant symptoms appear. The doctor prescribes an examination to identify the causes of the disease. The most important indicator in diagnosis is the interpretation of a blood test for thyroid hormones. Let's consider this topic in more detail.

What are thyroid hormones in the body?

The thyroid gland weighs about 15-20 grams, and produces iodinated hormones triiodothyronine (contains three iodine atoms, abbreviated T3) and thyroxine (T4, contains four iodine atoms). Thyroxine hormone is synthesized by thyroid cells in much larger quantities, but its activity is several times inferior to triiodothyronine.

Some scientists believe that thyroxine is needed “as a reserve” from which triiodothyronine is synthesized. These substances in the blood can be in a bound or free state. Free hormones exhibit activity, and in a protein-bound state they are transported throughout organs and tissues.

• With the help of thyroid hormones, the most important processes for the human body are performed:
• Metabolism of proteins, carbohydrates and other important substances;
• Growth of tissues, bones;
• Activity of the nervous, as well as cardiovascular and gastrointestinal systems;

Increased heat production, oxygen consumption by body tissues.

When the functions of the thyroid gland are determined, along with its hormones, they also look at the concentration of thyroid-stimulating hormone (TSH), thyroglobulin, calcitonin, antibodies to thyroglobulin, antibodies to thyroid peroxidase, thyroxine-binding globulin, because Although these substances are not synthesized by the thyroid gland, they affect its activity, and also give a complete picture of the patient’s endocrine system and help to make a more accurate diagnosis. TSH (thyroid-stimulating hormone) is produced by the pituitary gland, and one of its functions is to stimulate the thyroid gland to synthesize the hormones T3 and T4.

When and to whom is the test prescribed?

The study can be prescribed by many specialists, both narrow and broad: endocrinologist, cardiologist, immunologist, therapist, gynecologist and some other doctors who suspect the cause of the problem is related to the endocrine system.

A blood test for thyroid hormones is prescribed for people who have the following symptoms or diseases:

• Sharp weight gain or loss without changes in diet and lifestyle;
• Increase in the size of the thyroid gland;
• Weakness, nervousness, tearfulness, drowsiness, depression, tremor;
• Heart rhythm disturbances;
• Inability to carry a pregnancy to term;
• Decreased sexual desire, impotence;
• Disruptions in the menstrual cycle;
• Anemia;
• Infertility;
• Violation of attention, memory, concentration;
• Developmental delay in children;
• Galactorrhea;
• During thyroid treatment for control;
• Increased cholesterol levels;
• After operations on the thyroid gland, as well as after complete removal of this organ;
• Pituitary tumors.

In addition, tests are prescribed for newborn children, as well as children and adolescents during the period of restructuring of the body, if deviations in growth and other functions are observed.

An endocrinologist is most often involved in interpreting tests for thyroid hormones. But you can’t rely on tests alone. Only by comparing the patient’s complaints, symptoms, results of ultrasound of the thyroid gland and hormone testing, will he be able to make the correct diagnosis.

Proper preparation for research

The concentration of thyroid hormones is influenced by many factors, therefore, for reliable analysis results, proper preparation is necessary. Blood donation is carried out on an empty stomach, and the best time is from 8 to 10 am. The last meal should be at least 8 hours ago. You can drink some plain still water. The day before the test, it is necessary to exclude alcoholic drinks, as well as drinks that contain caffeine, limit physical activity, and avoid emotional stress. You should not smoke at least one hour before donating blood.

The level of hormones also depends on the patient’s nervous state, so before entering the office you need to sit for 10-15 minutes and calm down. Blood is taken from a vein, the procedure is almost painless, but if you are afraid of blood or syringes, you can turn away and be distracted by something. It is better to take hormonal medications after blood sampling. It is not recommended to undergo an ultrasound, x-ray, or ECG before the study, because this also affects hormone levels. Additional consultation with a doctor will be required if the patient is taking oral contraceptives, diuretics, and other drugs that affect the concentration of hormones.

When the indicators are normal

Hormonal levels depend on the gender and age of the patient. In children and older people, the indicators shift, so when deciphering it is necessary to take into account how old the patient is. Also, the concentration of substances in the blood fluctuates depending on the seasons of the year and time of day.

• The normal level of free T4 hormone is 0.9–1.8 pg/ml or 10–23 pmol/l, total T4 is 66-181 nmol/l.
• The normal level of free T3 hormone is 3.6–8.0 pg/ml or 5.4–12.3 pmol/l, total T3 is 1.2–3.1 nmol/l.
• The TSH norm is 0.3-4 µIU/ml.

Indicators are indicated for adults. Depending on the laboratory, the normal limits may shift slightly, and slight deviations in the interpretation of blood tests for thyroid hormones are observed.

Changes in indicators - what does it mean?

Before talking about any deviations, you need to make sure that the analysis was taken and done correctly. If there is no doubt about the reliability, then the next point is a comparison of T4, T3 and TSH indicators, as well as the general condition of the patient. Typically, the concentrations of T4, T3 and TSH are inversely related to each other.

If the level of T4 and T3 is increased, the thyroid gland begins to work more actively. This disease is called hyperthyroidism (thyrotoxicosis). There are so-called primary hyperthyroidism, in which TSH in the blood decreases, and secondary, in which TSH values ​​are high. Secondary thyrotoxicosis is usually observed with pituitary adenoma. High antibodies with increased thyroid function indicate Graves' disease, as well as diffuse toxic goiter, Perry syndrome.

With high levels of thyroid hormones, the following symptoms are observed: weight loss, poor sleep, trembling hands, redness of the whites of the eyes, tachycardia with low blood pressure, arrhythmia. The most severe consequences are a malignant tumor of the thyroid gland.

Decreased thyroid function is called hypothyroidism. Primary hypothyroidism is characterized by an increase in TSH, and secondary hypothyroidism is characterized by a decrease in its concentration in the blood, which indicates damage to the pituitary gland. The presence of high antibodies AT-TPO and AT-TG indicates autoimmune processes of the thyroid gland, as well as thyroiditis (Hashimoto's, postpartum).

A decrease in hormone levels causes a slowdown in metabolic processes, which affects a person with the following signs: weight loss, hair loss, lethargy, and fatigue. Complications manifest themselves in the form of inflammation of the thyroid gland.

An overestimated blood test for thyroglobulin indicates that oncological processes are occurring in the body, as well as recurrence of tumors after treatment.

Deviations in indicators lead to damage to the kidneys, liver, lungs, severe neurological diseases and other consequences.

Indicators during pregnancy

The norm of thyroid hormones in pregnant women differs from the usual norm. Slight fluctuations may occur if you feel well. In the first trimester, there is a decrease in thyroid-stimulating hormone, and thyroxine and triiodothyronine increase. For some women, this ratio remains until the end of pregnancy, especially if twins or triplets are expected.

This is not considered a deviation and does not require treatment.

The condition of hypothyroidism is considered dangerous in this period. Decreased thyroid function leads to fetal pathologies, as well as miscarriages. In case of pronounced hypothyroidism, therapy with the hormone L-thyroxine is prescribed.

A study in which the amount of hormones is calculated is considered a mandatory analysis during pregnancy. The specialist should also know whether the patient has complaints and palpate the thyroid gland for diffuse changes.

Thyroid hormones and interpretation of tests for their content are a complex mechanism that needs to be regulated only under the supervision of a doctor. Illiterate intervention in hormonal levels can lead to irreparable consequences. Therefore, under no circumstances should you self-medicate and prescribe medications that will “bring your thyroid hormones to normal.” When prescribing treatment, a competent specialist takes into account many factors, based on the patient’s medical history. You should strictly follow the doctor’s instructions so as not to harm your health.

In contact with

The endocrine system controls all processes that occur in the body. The slightest disruption in her work affects the woman’s health. Most often, the thyroid gland, whose work is regulated by the pituitary gland, is subject to pathological changes. To determine whether a person’s hormonal levels are in order, it is necessary to do a comprehensive analysis.

Thyroid gland: classification of hormones

Thyroid hormones are involved in neutralizing free radicals, producing energy and consuming oxygen by tissues. When conducting research, certain components are analyzed that reveal the presence of deviations, these are:

• Triiodothyronine (T3) controls metabolism and recovery processes in the body.
• Thyroxine (T4) – an active participant in protein metabolism.

These types of hormones (T3, T4) are released excessively when the thyroid gland is working hard. This leads to signs of hyperthyroidism. With such manifestations, doctors make diagnoses: tumors, inflammatory diseases of the thyroid gland, toxic diffuse goiter.

If these hormones are less than normal, then symptoms of hypothyroidism appear.

• Thyroid-stimulating hormone (TSH) secreted by the pituitary gland of the brain. It provides, stimulates and controls the production of T3 and T4. The TSH value decreases when the thyroid gland is active and increases when it is not functioning at full strength. Hormone balance (optimal) is maintained when the brain produces normal TSH. Changes are observed with pathology of the gland, and sometimes with brain tumors.
• Antibody to thyroglobulin (AT-TG) ratio is important for detecting disorders in autoimmune processes.
• Antibody ratio to thyroid peroxidase , which is involved in the formation of T3 (AT-TPO) . If this indicator deviates from the norm, they speak of autoimmune diseases.

What is total T3, T4, how does it differ from free?

Hormones T3 and T4 bind to transporter protein molecules in the bloodstream. Transfer to the organs and tissues that need them is carried out through vessels. However, small amounts of hormones are present in unbound ( free) with protein molecules form.

The total amount of hormone that is bound to proteins and free thyroxine is determined as general. In case of questionable test results, it is its quantity that is indicative.

When should a woman check her hormone levels in her body?

A woman herself can take a laboratory test that determines hormone levels. It is carried out when the gland is enlarged and the following symptoms appear:

• The menstrual cycle is disrupted.
• Tachycardia appears.
• There is a sudden loss or gain of weight.
• The emotional state is disturbed for no reason.
• The thyroid gland enlarges.
• Exophthalmos (bulging eyes) appears.
• Body temperature changes: chilliness or excessive sweating occurs.

For women, pregnancy becomes more difficult if hormonal levels are abnormal. A TSH test is mandatory when planning it, and during pregnancy, hormonal levels must be constantly monitored.

Important! The appearance of the above symptoms cannot be attributed to emotional and physical fatigue. This is how the first signs of endocrine disruption in the body appear. If they appear, you should immediately go to an endocrinologist.

What is the normal level of thyroid hormones in women?

Almost 90% of thyroid secretion comes from T4 (thyroxine). This hormone is mainly composed of protein (small amounts) and iodine. Thyroxine is a depot of iodine, which is vital for the construction of the active hormone T3, which affects the smooth functioning of the body.

The data presented in the table may vary depending on the analysis mechanisms and materials used. Typically, for a particular laboratory, thyroid hormone levels are indicated on the referral sheet.

Name	Units	Normal value	Deviations
Thyroglobulin	ng/ml	thyroidectomy<1– 2, norm< 50, iodine deficiency< 70	More than normal - adenoma, thyroiditis, development of cancer.
T4 free	pmol/l	9 – 21,0	More than normal – hyperthyroidism. Less – hypothyroidism
T3 free	pmol/l	2,63 – 5,68	More than normal hyperthyroidism. Less – hypothyroidism
T4 general	mcg/dl	4,910 – 12,2
T3 general	pmol/l	1,08 – 3,14
TSH	honey/l	0,4 – 4,8	More than normal – secondary thyrotoxicosis or primary hypothyroidism; less than normal – secondary or primary hyperthyroidism.
(AT-TPO) antibodies	IU/ml	>100 – positive result, 30 – 100 – borderline value	Postpartum thyroiditis, development of autoimmune processes.
(AT-TG) antibodies	honey/l	<100	Autoimmune process.

The hormones T4 and TSH are inversely dependent: when one decreases, the concentration of the other increases. It is worth knowing that the level of the T4 hormone decreases first, followed by triiodothyronine.

Important! During pregnancy, the level of thyroid indicators is at its maximum: due to physiological processes occurring in the body, TSH may decrease and thyroxine may increase. But an increase in hormones within significant limits requires the doctor to take urgent measures to bring the indicators back to normal.

Testing for hormones

A common opinion is that in order to obtain objective data when taking an analysis, you need to follow the following rules:

• The day before it is necessary to limit emotional and physical activity; do not eat smoked, spicy, salty foods.
• Before taking the test, you do not need to eat food for 8 hours.
• After the last dose of iodine-containing medications, hormonal contraceptives - 30 days.
• It should be 24 hours since you last smoked or drank alcohol.

After a small amount of venous blood is collected, it is sent to a specialized laboratory. An endocrinologist may prescribe the detection of levels of several hormones. This depends on the woman’s predisposition to a particular disease and symptoms.

It is a fair condition that it is advisable to always take tests in the same laboratory.

Thyroid gland: abnormalities

The secretions of T3 and T4 are responsible for energy metabolism in the body around the clock. They encourage the central nervous system, cardiovascular system and brain to work harmoniously. When their production is disrupted, women develop:

Hypothyroidism

During illness, the concentration of T3 and T4 is reduced. Neuralgic problems arise, chronic fatigue, the musculoskeletal system becomes weaker, and body weight increases. Heart rate slows down, intelligence decreases.

Visually: the condition of hair, nails, skin is deteriorating, swelling is noted. Disturbances in the sexual sphere (infertility, changes in the menstrual cycle) appear. There are manifestations of interaction between the ovaries, adrenal hormones and thyroid hormones.

With primary hypothyroidism caused by weak thyroid function, the indicators look like this:

AT-TPO	AT-TG	T3	T4	TSH
Norm	Norm	Demoted	Demoted	Above normal

For secondary hypothyroidism , which appears due to dysfunction of the pituitary gland, the analysis data looks like this:

AT-TPO	AT-TG	T3	T4	TSH
Norm	Norm	Demoted	Demoted	Demoted

Hyperthyroidism

The thyroid gland works hard, the content of hormones T3 and T4 in the blood is increased. Tachycardia (accelerated heart rate), hand tremors, emotional agitation occur, sweating and metabolism increase. The result is weight loss and fever.

With hyperthyroidism, hormone levels look like this:

AT-TPO	AT-TG	T3	T4	TSH
Norm	Norm	Promoted	Promoted	Demoted

Important! The hormonal system of women is unstable. When there are deviations in it, various pathologies develop, especially in the field of reproduction.

Today, hormonal abnormalities are successfully treated. If there are changes in the thyroid gland, the doctor prescribes hormonal or iodine-containing medications. In advanced stages, surgical intervention is possible.

Constant monitoring of the thyroid gland allows the cause of the disease to be eradicated in a timely manner: the time it develops into a chronic condition lasts about 15 years. And remember that the thyroid gland is the foundation of any woman’s hormonal health!

Thyroid hormones are highly active biological substances produced by the thyroid gland and pituitary gland. Even minor malfunctions in their operation can cause serious health consequences. To study the thyroid gland, first of all, you need to look at its hormones.

Tests for thyroid hormones

Blood tests for hormones are necessary for diagnosis and subsequent treatment. To get an appointment for tests, you need to determine what tests you need. If a primary test is taken, the following hormones are examined:

• Free T4.
• Free T3.
• Antibodies to thyroid peroxidase.

If the test is taken to determine the disease thyrotoxicosis, in addition to the study of the listed hormones, antibodies to TSH receptors are studied.

If hypothyroidism is treated with thyroxine, the study includes two tests - TSH and free T4.

If there are nodules in the thyroid gland, the following are examined:

• thyroid stimulating hormone TSH;
• free tetraiodothyroxine T4;
• free triiodothyroxine T3;
• TPO (AT to thyroid peroxidase);
• Tumor marker calcitonin.

The latter indicator is an indicator of cancer in the early stages for the nodular form of goiter.

Tests during pregnancy include TSH, T4 free, T3 free. and antibodies to thyroid peroxidase (TPO).

Learn more about thyroid hormones that need to be tested

Thyroid hormones are triiodothyronine (T3) and thyroxine (T4)
.

• Thyroxine (tetraiodothyroxine or T4) is a thyroid hormone that makes up up to 90% of the compounds synthesized by the thyroid gland.
• Triiodothyroxine (T3) is the second thyroid hormone, the activity of which is 100% higher than the activity of T4. Contains three iodine atoms, due to which its chemical activity increases several times. It is widely believed that triiodothyroxine is the main thyroid hormone, and T4 is only the “raw material” for its production. T3 is formed due to synthesis from T4 when the 4-atomic hormone is exposed to enzymes containing selenium.

T3 and T4 are specific thyroid hormones. Their synthesis ensures the normal functioning of the nervous and autonomic systems, as well as the basic metabolism necessary for the functioning of energy-consuming autonomous processes: the conduction of nerve signals, contraction of the heart muscle, etc.

Specific hormones exist in a free or bound state. The test results highlight free hormones T3 and T4. The main part of thyroid substances is associated with protein compounds. When hormones are released into the blood, they combine with the TSH protein and are transported to systems and organs. After transportation is completed, thyroid hormones become free again. The free hormone is active; its study is most informative for assessing the functioning of the thyroid gland.

The subjects of the study are also the substances TSH and TPO:

• TSH is a nonspecific hormone produced by the pituitary gland, a small gland in the brain. The pituitary gland performs the function of regulating the functioning of the endocrine system. TSH is a thyroid-stimulating, “signaling” hormone of the pituitary gland, the effect of which affects the intensity of the thyroid gland.
• TPO is a non-hormone substance that is an antibody. Acts as a destroyer of iodine-containing substances.

All these four substances are considered together, as they form a single mechanism for the functioning of the thyroid gland.

Role of the thyroid gland

The work of a healthy thyroid gland is almost invisible. Failures in its functioning lead to serious consequences, since the thyroid gland provides the basis necessary for the stable functioning of the body. Depending on the type of pathological changes, two options are considered:

• Excess hormones;
• Lack of hormones.

Excess thyroid hormones

Determined by a blood test, it is called “hyperthyroidism”, and the disease is thyrotoxicosis. The following symptoms are observed:

• Hyperthermia is a persistent or temporary increase in body temperature from 37.1 - 37.7 degrees.
• Increased mental and motor activity, as a result of which a person becomes overly excitable, nervous and displays aggression.
• Loss of body weight, despite a voracious appetite and consumption of large amounts of food.
• Tremor is a shaking of the fingers and the hands themselves, and sometimes the head.

In the later stages or with a significant increase in hormone levels, the following is disrupted:

• cardiac activity, vascular hypertonicity develops, pressure rises, persistent tachycardia develops even in a calm state.
• the functioning of the nervous system, intelligence suffers, concentration and memory decrease;
• functioning of the digestive system, expressed in frequently recurring constipation and diarrhea, upset stomach and intestines.

With hyperthyroidism, the activity of the entire body is disrupted.

An indicator of hyperthyroidism is a high level of T3 and T4 and a sharp decrease in the pituitary hormone TSH.

Lack of hormones

Low levels of specific substances in the blood are called hypothyroidism. Characteristic symptoms:

• Hypothermia - body temperature drops to 35.5 degrees. The temperature does not return to normal for a long time.
• Reduced pressure to 90-85/60-50, hypotension.
• Swelling of the face, arms and legs due to a decrease in the rate of fluid excretion, disruption of the excretory system and kidneys.
• Insomnia, lethargy, weakness and weakness, disruption of biological rhythm.
• Reduced metabolic rate, which leads to weight gain and obesity.
• Reduced efficiency of other endocrine glands. Leads to loss of libido, sexual dysfunction, menstrual cycle disorders, digestive system problems, and increased or decreased blood sugar levels.
• Deterioration of the skin and nails, dry and sagging skin, brittle nails, and hair loss.

A critical decrease in hormone levels leads to deterioration of cardiac activity. A decrease in the level of thyroid substances together with an analysis of the main hormones will help determine the analysis of antibodies to thyroid peroxidase (TPO).

Problems with the thyroid gland are the cause of reproductive dysfunction. Women who have problems getting pregnant, planning pregnancy and motherhood should take a TSH test.

Hormonal dysfunction is a serious problem for children and adolescents, threatening mental retardation due to underdevelopment of the brain, as well as problems with the nervous system.

The thyroid gland is one of the organs of the endocrine system. It is located in the area of ​​the cartilage of the same name under the larynx. It synthesizes a number of important iodine-containing hormones (T3 and T4), as well as calcitonin, which regulates calcium metabolism in the body. It has mainly 3 lobes:

• right,
• left,
• isthmus.

This organ should not be underestimated, as it performs a number of vital functions. These include:

• maintaining and regulating basal metabolism. All metabolic reactions within the body are controlled,
• ensuring stable temperature,
• preventing bone fragility by inhibiting osteoporosis,
• participation in the process of growth and development of the organism and the central nervous system.

There are cases when pathology of the thyroid gland develops. It can manifest itself as a whole range of different symptoms. To accurately verify the diagnosis and determine the further method of treatment, it is necessary to take blood tests for specific hormones.

How are thyroid hormones synthesized and what are they needed for?

The basis for the creation of these biologically active substances is the amino acid tyrosine. During nutrition, iodine enters the body. For the body to function adequately, it needs to receive approximately 120-135 mcg of this microelement per day. After entering the intestine, it is absorbed by the villi of the epithelium and settles with the bloodstream in the follicles of the organ. There, the process of incorporation of iodine into the matrix of thyroglobulin (protein, precursor of biologically active substances) occurs.

After this, differentiation of hormones into T3 and T4 occurs, depending on the number of microelement molecules in its composition.

You should also know that the amount of T4 synthesized is 20 times higher than T3. But the effectiveness of the latter is 6-8 times higher than the efficiency of thyroxine. That is why we cannot talk about the greater importance of this or that substance.

The main functions that these substances perform in the human body are the following:

1. Activation of the thermoregulation center. Heat production and oxygen absorption increases in all tissues and cells with the exception of the main brain, spleen and testicles. They remain intact. That is why one of the symptoms of thyrotoxicosis or hyperthyroidism remains fever and profuse sweating.
2. Stimulation of the formation of steroids by the adrenal cortex. T3 and T4 play an important role in the process of growth and development of the entire body. When they are deficient, mental and physical retardation is often observed.
3. Increasing the body's intake of vitamins.
4. Activation of nervous and mental activity of the main brain. In areas where the soil contains little iodine, children in schools are regularly given Antistrumin, a drug that contains a 5-day supply of this microelement. This is done to improve their academic performance and normalize the functioning of the central nervous system.

The question of how much of these substances is needed in the human body for its normal functioning has been well studied. There are special tables and generally accepted indicators that indicate the functional activity of the organ. It is enough to submit the material for examination and wait a little.

When is it necessary to be examined?

It must be understood that such laboratory tests should be carried out to confirm the clinical opinion of the attending physician. However, you can additionally donate blood for preventive tests. There are often situations when the pathological process has already started, but is still proceeding in a latent stage. In this case, you can act proactively and begin to treat the disease at an early stage.

However, the indications for checking the condition of the thyroid gland are the following:

1. Hypo- or hyperthyroidism. Determining the amount of organ hormones can accurately indicate the functional activity of the parenchyma and thyrocytes.
2. Monitoring the quality of treatment and the effectiveness of therapy. This is especially important for diffuse toxic goiter and hypothyroidism.
3. Mental retardation in children's development. They donate blood to verify the possible cause of this pathology. Cretinism is one of many diseases that causes disorders of the central nervous system at an early age.
4. Any increase in the size of the thyroid gland (goiter).
5. Heart rhythm disturbances (arrhythmias, tachycardia, extrasystole).
6. Baldness.
7. Reproductive system disorders with possible infertility.
8. Lack of menstruation.
9. Impotence or decreased desire for the opposite sex.

In all these situations, it is necessary to donate blood for tests to measure the concentration of organ hormones in the serum.

Hormones and active substances

Many patients, when they hear that they need to check the condition of the thyroid gland, do not always know what substances doctors are looking for in their blood and how much of them should be there. The main indicators of the functional activity of the organ include:

1. Hormones of the pituitary gland and hypothalamus (higher regulation organs of the endocrine system):
   • Thyroliberin and thyreostatin. Both substances respectively activate and inhibit the pituitary gland.
   • Thyroid-stimulating hormone (TSH) is the most important biologically active compound that causes the organ to secrete its own regulatory substances. Its amount in the blood increases with weak thyroid function and vice versa.
2. Iodine-containing hormones:
   • Triiodothyronine (T3) – stimulates the process of O2 consumption by tissues. Normal values ​​are 2.5-5.6 pmol/l.
   • Thyroxine (T4) – stimulates the process of protein creation. Normal values ​​are 9-20 pmol/l.
3. Other substances:
   • Calcitonin. Responsible for the process of suppression of osteoclasts and activation of osteoblasts. Prevents bone resorption and protects the skeleton from osteoporosis.
   • Antibodies to thyroglobulin (ATTG). They are specific immunoglobulins that appear when the body’s defense system is disrupted with the development of autoimmune processes. Most often recorded with Hashimoto's goiter. Normal values ​​are 0-15 U/ml.
   • Antibodies to thyroid peroxidase (ATTPO or microsomal antibodies). Specific immunoglobulins for thyroid tissue. The most accurate and sensitive test for identifying an autoimmune process. Normal values ​​are below 5 U/l.

You must understand that it is not always worthwhile to conduct research on absolutely all of the above indicators. The doctor himself determines what he wants to know. The price of tests can sometimes be too high for some patients, so the doctor sometimes thinks twice about which specific tests are desirable for a particular patient.

Preparing for the examination

A very important point in adequately checking the functional activity of the thyroid gland is high-quality tests. If you ignore the appropriate preparation procedure, the results of such a study may be unreliable. In this case, you will have to donate additional blood to confirm or refute the diagnosis.

To avoid any doubts and ensure that the test results are correct, you should adhere to some rules:

1. 30 days before the tests, you must stop using medications that contain T3 and T4. They will significantly affect the final conclusion of the laboratory assistant and will not allow an objective assessment of the functional activity of the organ being studied. Exceptions may include special instructions or recommendations from a doctor.
2. 2-3 days before the patient takes tests, he must exclude foods containing iodine (seaweed, fish oil, potatoes, spinach) from his diet.
3. Immediately 24 hours before the test, you must limit your consumption of alcohol and tobacco. Minimize stress and physical activity.
4. Blood testing must be done on an empty stomach. You should not eat 12 hours before testing.
5. Various x-ray examinations can be carried out only after serum has been submitted to determine the hormones T3, T4 and TSH.

Following these simple rules is enough to get a high-quality, and most importantly, reliable result. Basically, it takes a laboratory assistant one day to decipher test data. If the serum was taken in the morning, then by the evening you can expect the doctor’s conclusions. However, as practice shows, patients receive forms with all the indicators detailed only the next day.

Interpretation

You need to understand which numbers indicate hyperfunction of the organ, and which, on the contrary, indicate its reduced activity. In any case, doctors do this, and only they can objectively assess certain changes in the patient’s blood. For an ordinary person, it is enough to know how to correctly submit examination material and navigate the following concepts:

• Similar values ​​relative to the average indicators in the “Normal” column – the function of the thyroid gland is not impaired.
• Indicators above normal – hyperfunction. Possible causes should be considered diffuse toxic goiter, thyroiditis, adenoma.
• Indicators below normal – hypofunction. The organ does not produce enough hormones, which can be a consequence of hypothyroidism, Hashimoto's goiter, or cancer.

For medical workers and simply patients who want to know a little more about their illness, there is a special sign. It helps to understand in more detail the pathogenesis and mechanism of development of a particular organ lesion.

To find out how the thyroid gland works in a particular patient, it is necessary to undergo appropriate tests. With proper examination, it will be possible to quickly determine the nature of the organ damage. However, donating the serum is not enough. It is necessary to select adequate therapy. Only in this case will it be possible to cure the patient.

The thyroid gland is an endocrine organ that produces thyroid hormones, which are responsible for growth, metabolic processes, and control the functioning of the reproductive, digestive, circulatory and nervous systems. Hormones provide the body with energy, stimulate mental processes and motor activity. Hyperfunction of the thyroid gland leads to hormonal imbalance; high levels of T3 and T4 lead to poor health and thyrotoxicosis.

Thyroid hormones include:

• TSH is a thyroid-stimulating hormone produced by the pituitary gland of the brain. Thyrotropin regulates the secretion of thyroxine and triiodothyronine.
• T4 – thyroxine, produced by the follicular cells of the thyroid gland, its main function is the regulation of energy and plastic metabolism in the body.
• T3 – triiodothyronine, the hormone is formed after the loss of one iodine atom from the thyroxine molecule. T3 is the more active form.
• Calcitonin is produced by C-cells of the thyroid gland and is responsible for the exchange of calcium and phosphorus.

Hormones are transported in the bloodstream by combining with proteins. Therefore, analyzes usually indicate the values ​​of free thyroxine and triiodothyronine (FT3 and FT4).

Normal thyroid hormone levels for adults:

Important: Results may vary from laboratory to laboratory. Reference values ​​are indicated on the analysis forms. Normally, the results should not be more or less than the limit values.

Causes of elevated thyroid hormone levels

An increase in TSH levels indicates insufficient production of T3 and T4 by the thyroid gland. In this case, the thyroxine level is reduced or remains within normal limits. This condition is called hypothyroidism.

If thyrotropin values ​​are elevated, the patient complains of general weakness, fatigue, hair loss, brittle nails, chilliness, decreased performance and intellectual abilities.

Increased levels of thyroid hormones (T3 and T4) are observed in thyrotoxicosis. At the same time, TSH levels are below the normal level. Characteristic symptoms of the disease:

• weight loss with normal appetite;
• an increase in the volume of the thyroid gland, leading to neck deformation;
• frequent diarrhea;
• tremor of the limbs;
• increased sweating;
• tachycardia;
• irritability;
• tides;
• deterioration of memory and intellectual abilities;
• menstrual irregularities in women, including amenorrhea and infertility;
• erectile dysfunction, gynecomastia, impotence in men;
• exophthalmos – bulging of the eyeballs.

Pregnant women have increased thyroid hormone. This is not considered a pathology, since the expectant mother’s body provides hormones to the growing fetus until the child develops its own thyroid gland.

An increased level of TSH in the blood of pregnant women indicates the development of hypothyroidism. This disease often leads to spontaneous abortion, fetal hypoxia, the appearance of children with mental retardation or congenital pathologies, and difficult childbirth.

The development of medullary thyroid cancer can increase calcitonin levels in the blood. This hormone is an important tumor marker. The analysis is prescribed if a malignant tumor is suspected, and a fine-needle aspiration biopsy is additionally performed. If the results of the test for calcitonin concentration are questionable, then an additional stimulated test is performed with intravenous administration of calcium gluconate.

Tests for thyroid hormones

Blood is taken for analysis in the first half of the day on an empty stomach. If the patient is taking hormonal medications, then the medication should not be taken on the day of blood sampling. Regarding the possibility of discontinuing the medication, you should consult with your doctor. Women take tests on days 5–7 of the menstrual cycle.

10–12 hours before visiting the laboratory, you must refrain from eating, smoking, and drinking coffee. Stress and physical activity should be avoided. You should not drink alcoholic beverages 3 days before the test.

What diseases lead to increased thyroid hormones?

TSH levels may increase due to:

• pituitary tumors;
• traumatic brain injuries;
• thyroid hormone resistance syndrome;
• diffuse toxic goiter;
• multiple endocrine neoplasia;
• ectopic secretion of hormones by tumors of the breast and lungs;
• adrenal insufficiency.

The cause of thyrotoxicosis, in which the production of thyroxine increases, is toxic goiter, hormone-producing tumors or metastases, Graves' disease, Hashimoto's thyroiditis. With hyperfunction of the thyroid gland, metabolism accelerates; incoming vitamins and nutrients do not have time to be processed and absorbed. An increased concentration of hormones in the blood causes symptoms of intoxication: nausea, vomiting, diarrhea, yellowing of the skin.

Treatment methods for hyperthyroidism

What to do with thyrotoxicosis, what treatment is necessary for elevated thyroid hormones? There are several types of therapy:

• conservative;
• treatment with radioactive iodine;
• surgical intervention.

The conservative method consists of taking thyreostatics (Mercazolil, Tyrosol, Propicil), which suppress the secretion of thyroxine. The drugs are prescribed as monotherapy or in combination with thyroxine analogues (“block and replace”). Research shows that the second method is more effective and is capable of causing lasting remission. Treatment may be accompanied by the development of side effects, and relapses often occur (50%). In case of intolerance to thyreostatics, β-blockers are prescribed.

Radioiodine therapy is considered a more effective method for elevated thyroid hormones. Patients take I-131, which can accumulate in the tissues of the thyroid gland and destroy its cells. This leads to hypothyroidism, which is the main goal of treatment. Then thyroxine replacement therapy is prescribed. After using radioactive iodine, remission occurs in 90% of cases, relapses occur in only 3% of patients.

Indications for surgical intervention are a significant increase in the volume of the thyroid gland, the presence of nodes, intolerance to thyreostatics, and retrosternal localization of the thyroid gland. The surgeon performs partial excision of the organ in order to develop hypothyroidism.

Treatment of toxic adenoma or diffuse, multinodular goiter begins with taking thyreostatics in combination with β-blockers. Then surgical removal of the thyroid gland or part of it is performed.

In patients suffering from tissue resistance syndrome to thyroid hormones, therapy is selected strictly individually, taking into account the characteristics of the disease. Triiodothyroacetic acid gives good results.

Therapeutic diet

Elevated thyroid hormones can be stabilized not only with medication, but also by following a special diet. An integrated approach speeds up recovery. Since thyrotoxicosis accelerates metabolism, it is necessary to consume high-calorie foods rich in proteins, fiber, vitamins and minerals. And foods containing large amounts of iodine must be excluded from the diet (nuts, seafood, sea fish).

Allowed foods for elevated thyroid hormones:

• dairy products;
• bakery products;
• all types of cereals, except rice and legumes;
• lean meats - turkey, rabbit, veal;
• fresh vegetables and fruits, except melon, grapes, plums;
• freshwater fish;
• drinks - berry juice, jelly, chamomile and rosehip infusions.

Prohibited foods include chocolate, cabbage, fatty meats and fish, alcoholic and energy drinks, strong tea or coffee. Diet therapy should be carried out in conjunction with the main treatment. This will help achieve lasting improvement, get rid of the symptoms of the disease and reduce the risk of relapse.

Bibliography

1. Thyroid diseases. Treatment without errors. – M.: AST, Sova, VKT, 2007. – 128 p.
2. Henry, M. Kronenberg Diseases of the thyroid gland / Henry M. Kronenberg et al. - M.: Reed Elsiver, 2010. - 392 p.
3. Sinelnikova, A. 225 recipes for thyroid health / A. Sinelnikova. – M.: Vector, 2013. – 128 p.
4. Ivanova, V. Thyroid diseases and diabetes / V. Ivanova. – M.: Newspaper World, 2013. – 128 p.
5. Danilova, N. A. Diseases of the thyroid gland. Effective methods of treatment and prevention / N.A. Danilova. – M.: Vector, 2012. – 160 p.
6. Restoration of the thyroid gland - Ushakov A.V. – Patient Guide
7. Khavin, I.B. Diseases of the thyroid gland / I.B. Khavin, O.V. Nikolaev. – M.: State Publishing House of Medical Literature, 2007. – 252 p.

⚕️Melikhova Olga Aleksandrovna – endocrinologist, 2 years of experience.

Deals with issues of prevention, diagnosis and treatment of diseases of the endocrine system: thyroid gland, pancreas, adrenal glands, pituitary gland, gonads, parathyroid glands, thymus gland, etc.