What hormone regulates the thyroid gland. What does high thyroid hormone levels mean?

The main method for studying thyroid dysfunction is a blood test for the level of certain hormones in it - thyroxine (it is designated as T 4) and triiodothyronine (T 3). However, for the diagnosis of these two indicators is not enough. The work of the thyroid gland is regulated by the pituitary gland, which, depending on the level of T 3 and T 4, produces more or less amount of thyroid-stimulating hormone (TSH) - an assessment of its concentration in the blood is also extremely important for assessing thyroid function. In addition, there is often a need to determine antibodies to thyroglobulin (AT-TG), thyroid peroxidase (AT-TPO) and TSH receptors (AT to TSH). These indicators are not hormones at all, but are studied together with them. There is another important indicator in some cases - thyroglobulin. This is a protein found in the follicles of the thyroid gland, knowledge of the level of which sometimes allows you to verify the diagnosis. The thyroid hormone calcitonin stands apart - its functions are different from other thyroid hormones, but no less important.

We will talk about what each of the above substances is, in what cases it is required to study it, as well as about the features of preparing for analysis in our article.

Thyroxine (T4) total and free

It is the main thyroid hormone, accounting for about 90% of all hormones produced by it. Its second name is tetraiodothyronine. It arose in connection with the structure of the molecule, which includes 4 iodine atoms. Iodine, which is absorbed by thyroid cells from the blood, all goes to the synthesis of hormones.

Most of the thyroxin circulating in the blood is bound to proteins. And the biological effect of this hormone is determined by its free fraction - only 3-5% of the total.

Thyroxine is the precursor of triiodothyronine. It has a multifaceted effect on the organs and systems of our body.

• increases the rate of basal metabolism;
• increases the absorption of oxygen by many tissues of the body (except for the spleen, brain and testicles);
• vitamin-forming (stimulates the production of vitamin A in the liver);
• accelerates protein metabolism;
• reduces the content in the blood and triglycerides;
• excretes calcium in the urine;
• normalizes the rhythm of the heart;
• inhibits the secretion of thyroid-stimulating hormone.

The highest concentration of total thyroxin in the blood is recorded in the morning hours (8:00-12:00), the lowest - late at night. In the autumn-winter period it is more than in summer. During pregnancy, especially after 30 weeks, the level of this hormone is maximum, but the concentration of free thyroxine often becomes lower.

In persons over the age of 40, the amount of thyroxin in the blood gradually decreases slowly.

Indications for research are:

• disturbances in the concentration of thyroid-stimulating hormone in the blood;
• symptoms or.

Training

On the eve of the test, you should abandon intense physical exertion, do not be nervous. In the morning before the study, you can not eat (the laboratory assistant must take blood from the patient on an empty stomach) and you should sit quietly for at least half an hour.

Norms and pathology

The normal concentration of the level of total T 4 in men is from 60 to 135 nmol / l, in women - from 71 to 142 nmol / l.

An elevated level indicates thyrotoxicosis, may be a sign of thyrotropinoma, chronic liver pathology, and also be observed while taking a number of drugs (iodine-containing radiopaque agents and antiarrhythmics, levothyroxine, oral hormonal contraceptives, insulin and others).

A decrease in the level of thyroxine occurs with hypothyroidism (congenital or acquired, primary, secondary or tertiary) and diseases that occur with this syndrome, as well as against the background of taking a number of drugs (antithyroid drugs, corticosteroids, co-trimoxazole, drugs for the treatment of tuberculosis, antifungal and others).

The concentration of free thyroxine in adult men and women varies from 9 to 22 nmol/l.

Diseases not directly related to the thyroid gland are not accompanied by an increase in the concentration of free thyroxine - it remains within normal limits, even if the level of total thyroxine is elevated.

Its concentration increases in diseases accompanied by thyrotoxicosis syndrome.

Triiodothyronine (T 3) total and free

The activity of this hormone significantly exceeds that of its predecessor, thyroxine. It is he who has the main effects of thyroid hormones. Only 1/10 of triiodothyronine is produced by the cells of the thyroid gland itself, the rest of it is synthesized from T 4 in the tissues of the human body.

Actually, the effects of T 3 are similar to those of tetraiodothyronine:

• it activates metabolic processes, in particular, protein, absorption of oxygen by tissues;
• stimulates the delivery of energy to where it is needed;
• stimulates the formation of vitamin A in the liver;
• reduces blood levels of cholesterol and triglycerides;
• enhances the excretion of calcium in the urine.

Regulates the development of the brain in a child, increases the excitability of the nervous system, affects the metabolic processes in the heart muscle.

A certain part of this hormone is associated with blood transport proteins, while the other part circulates in it in a free state. As a rule, experts examine the level of free triiodothyronine, and in doubtful cases, determine the total T 3 .

In the blood of men, triiodothyronine is found in a higher concentration than in women. Its level also directly depends on age, reaching the level of adults by puberty. In persons over 65 years of age, the amount of free T 3 in the blood gradually decreases.

Also, the concentration of this hormone depends on the time of year (more - in autumn / winter, less - in summer), during pregnancy, free T 3, as a rule, is reduced, and returns to normal only after childbirth.

This study is carried out in order to clarify what kind of thyroid disease occurs in a particular patient, and also as a control therapy for isolated T 3 -toxicosis.

Training

Similar to that for thyroxine. Donate blood should be strictly on an empty stomach, after a half-hour rest. To get the most accurate results, on the eve of the analysis, you must follow a diet: exclude fried, fatty foods and alcoholic beverages from the diet. It is impossible to conduct a study after X-ray diagnostic methods, as well as immediately after physiotherapy procedures.

The level of triiodothyronine decreases or increases in the same pathological conditions as thyroxine.

Thyroid Stimulating Hormone (TSH)

This is a hormone that has tropism (that is, affinity) for thyroid cells, designed specifically for it. It is synthesized in the pituitary gland in response to a decrease in the concentration of thyroxine and triiodothyronine in the blood. From the pituitary gland with the blood flow, TSH enters the thyroid gland, and, interacting with its receptors, activates the function of thyrocytes (they begin to intensively produce T 3 and T 4), stimulates the growth processes of the organ itself (the gland increases in volume).

The physiological level of thyroid-stimulating hormone in the blood indicates euthyroidism - the normal functioning of the thyroid gland. At an early stage of its hypo- or hyperfunction, the body tries to compensate for this condition - the pituitary gland secretes an increased or, conversely, reduced amount of TSH, and the level of thyroid-stimulating hormones remains normal for some time.
That is, during the study, only a pathological level of thyroid-stimulating hormone will be detected, which is already a sign of the disease.

The indications for the study are:

• diagnosis of latent hypothyroidism;
• with previously diagnosed hypofunction of the thyroid gland - control of treatment (performed once every 6-12 months);
• diffuse toxic goiter (for the purpose of control - monthly for two years);
• other nature;
• delayed sexual and mental development of the child;
• myopathy;
• hypothermia (decrease in body temperature) of an unclear nature;
• hair loss ();
• depressive syndrome;
• menstrual disorders ();
• infertility;
• decreased sex drive in men and women;

A day before the planned study, the patient must stop smoking and drinking alcohol, exclude intense physical and psycho-emotional stress. Blood sampling is carried out on an empty stomach, in the morning (until 10-11 am). If a patient needs to donate blood for TSH regularly, he should do it at the same time, since the concentration of the hormone varies depending on the time of day.

The normal level of thyrotropin is different in children of different ages, in persons over 14 years of age it ranges from 0.4 to 4.0 mU / l.

Elevated TSH may indicate the following conditions:

• thyrotropinoma;
• syndrome of resistance (insensitivity) of tissues to thyroid hormones;
• hypothyroidism - primary, secondary, juvenile;
• some forms of thyroiditis;
• preeclampsia (in pregnant women);
• intense physical activity;
• contact with toxic substances, in particular lead;
• taking a number of drugs (anticonvulsants, beta-blockers, antiarrhythmics, neuroleptics, antiemetics, radiopaque, furosemide, mercazolil, prednisolone and others).

Decreased TSH in such conditions:

• diffuse toxic goiter;
• hyperthyroidism of pregnant women;
• Sheehan's syndrome;
• thyrotoxicosis due to self-administration of thyroxin;
• pituitary injury;
• psycho-emotional stress;
• lack of nutrients, starvation;
• taking glucocorticoids, anabolic steroids, beta-agonists, thyroid hormones, somatostatin, drugs for the treatment of hyperprolactinemia and other drugs.

thyroglobulin (TG)

It is a precursor protein of thyroxine and triiodothyronine, which is present in the contents of the thyroid follicles. It is produced exclusively by three types of cells: thyrocytes, follicular and papillary cancer cells. In diseases accompanied by an increase in the thyroid gland in volume, the level of thyroglobulin also increases. This indicator is of particular diagnostic value after the removal of the thyroid gland for. In this state, the concentration of thyroglobulin in the blood tends to zero (after all, there are no thyrocytes, there is simply nowhere for the protein to be produced). If, after the operation, the protein level does not decrease or first decreases, and after some time grows again, this indicates a recurrence of the neoplasm. In persons with a preserved thyroid gland, this study is not informative - it has no diagnostic value, and therefore should not be carried out.

The normal concentration of thyroglobulin in the blood is less than 60 ng / ml.

In terms of preparation for the analysis, the following points should be noted: blood must be taken before a biopsy or radioisotope scan of the thyroid gland, after the operation, this indicator should be monitored at least 1.5 months later.

Antibodies to thyroglobulin (AT-TG)

They are produced by the cells of the human immune system due to prolonged contact of the contents of the follicles (containing thyroglobulin) with the blood in case of thyroid diseases of an autoimmune nature and oncopathology. An increase in their titer is more typical for adults than for pediatric patients.

The normal level of AT-TG in the blood serum is 0-18 U / ml.

An increase in the concentration of these substances is noted with:

• Basedow's disease;
• autoimmune thyroiditis;
• idiopathic forms of hypothyroidism;
• some genetic pathologies, in particular, with.

An increase in the titer of antibodies to thyroglobulin is not always a sign of pathology. It can also occur in healthy people, especially older men. On the basis of this study alone, a diagnosis cannot be made - its verification is possible only after a comprehensive assessment of the clinical picture and the results of additional research methods, taking into account the patient's complaints, anamnesis data and an objective examination.

No special preparatory measures are required for the analysis.

Antibodies to thyroid-stimulating hormone receptors

There are special membrane structures on thyrocytes - thyroid-stimulating hormone receptors (TSH receptors) - through them the effects of thyrotropin are realized, interacting with them, it stimulates or inhibits the production of T 3 and T 4. If for any reason the immune system begins to produce antibodies to these receptors (that is, an autoimmune process takes place), their functioning is disrupted.

There are 2 types of antibodies to TSH receptors: blocking and stimulating. The former lead to hypothyroidism and thyroid atrophy, while the latter, on the contrary, contribute to an increase in the level of thyroid hormones in the blood serum. The detection of a large number of antibodies to TSH receptors in the blood, regardless of their type, is already a sign of pathology.

1. The patient has already been diagnosed with thyrotoxicosis syndrome, but it is necessary to find out its cause, nature.
2. The patient is diagnosed with Graves-Basedow's disease, he is receiving therapy and needs to evaluate the effectiveness of treatment (it is effective if the concentration of antibodies to TSH receptors with each subsequent study is lower than in the previous one).
3. The pregnant woman previously suffered from thyroid pathology. In such patients, in the third trimester of their pregnancy, a study of the level of antibodies to TSH receptors in the blood is carried out and, based on the data obtained, the probability of damage to the fetus by them is assessed.

Preparation for the test consists only in refusing to eat 8-10 hours before blood sampling while maintaining the drinking regimen (we would like to note that the patient should drink only pure water, and not any other drinks).

Normally, the level of antibodies to TSH receptors is less than 1 U/L. If their concentration increases to 1.1-1.5 U / l, this is a doubtful result, and if the values ​​\u200b\u200bare exceeded by 1.5 U / l, the result is positive.

Antibodies to thyroid peroxidase (microsomal antibodies, AT-TPO)

Thyroid peroxidase, or thyroperoxidase, is an enzyme that plays an important role in the synthesis of thyroxine and triiodothyronine. Antibodies to it block the activity of the enzyme - the production of T 3 and T 4 is reduced. That is, this research method allows you to detect an autoimmune process - the work of the immune system against thyroid cells. If AT-TPO are found in a pregnant woman, this is a sign indicating a risk to the fetus and a high likelihood of her developing thyroiditis after childbirth.

In some cases, a slightly elevated level of antibodies is also found in people who do not suffer from thyroid pathology. To date, there are still discussions about whether this is a variant of the norm or indicates a predisposition to autoimmune thyroiditis.

Indications for the determination of antibodies to thyroperoxidase are:

• thyrotoxicosis in newborns;
• Graves' disease or an increased concentration of the same antibodies in the mother of a newborn (of course, blood is taken from him);
• verification of a disease accompanied by hypothyroidism or thyrotoxicosis, differential diagnosis;
• peritibial myxedema (dense edema localized in the shins).

To make a diagnosis, the results of this research method alone are not enough; it must be interpreted in conjunction with the data of other laboratory and instrumental diagnostic methods.

Special preparation for the analysis is not required.

Normally, the level of AT-TPO should be less than 5.6 U/ml.

Calcitonin

This is a hormone of protein nature, which is produced in the C-cells of the thyroid gland located between the follicles, as well as in the thymus and parathyroid glands. It is an antagonist of parathyroid hormone (a hormone produced by cells of the parathyroid glands) - it stimulates the deposition of calcium in bone beams, reducing its level in the blood. But the main role of this hormone is different - it is a tumor marker!

Cells that synthesize calcitonin (C-cells) can become a source of a very dangerous malignant neoplasm - C-cell carcinoma or medullary cancer. This tumor is resistant to almost all chemotherapy drugs, does not respond to radiation therapy, and does not accumulate radioactive iodine. It grows slowly, but early metastasizes to many organs of our body. This disease can be defeated only if it is detected early.

Since the source of medullary carcinoma is precisely C-cells, which synthesize calcitonin, its concentration in the blood in this pathology increases significantly. This allows you to diagnose cancer! Also, an excess of the normal level of calcitonin (more than 100 pg / ml) occurs in leukemia and some other malignant neoplasms. A slight excess of the normal values ​​​​of calcitonin (the norm for women is up to 5.0, for men - up to 8.4 pg / ml) can be determined in women during pregnancy, with Zollinger-Ellison syndrome, pancreatitis, and chronic kidney failure.

Determine the level of calcitonin in the blood serum mainly in such situations:

• with suspicion of C-cell carcinoma of the thyroid gland;
• for the purpose of dynamic observation after removal of the thyroid gland due to medullary carcinoma, evaluation of the effectiveness of the operation;
• for the purpose of examining the next of kin of such patients (screening).

Preparation for the study includes the rejection of intense physical activity (they help to reduce the level of calcitonin) 72 hours before blood sampling, one day - refusal to drink alcohol, 60 minutes - smoking cessation.

Which doctor to contact

In addition to the endocrinologist, doctors of many specialties can prescribe tests to determine the function of the thyroid gland. This organ secretes hormones that regulate the functioning of the heart, brain, and reproductive system. That is why you should not be surprised if a cardiologist, neurologist or gynecologist gives a referral for research.

Conclusion

Thyroid hormones play a critical role in regulating many of our body's functions. A decrease or increase in their level disrupts the coordinated work of organs and worsens the patient's condition. If you suspect a pathology of the thyroid gland, in the first place, of course, you should seek help from an endocrinologist. He will examine and prescribe an examination, which includes the determination of certain indicators of the functioning of the thyroid gland or organs associated with it (in particular, the pituitary gland, the immune system). A timely examination will identify the problem at an early stage, and this will significantly increase the patient's prognosis for recovery!

A specialist at the Moscow Doctor clinic talks about a blood test for thyroid hormones:

- the largest of all endocrine glands. Its cells produce hormones - biologically active substances that regulate the functioning of the gastrointestinal tract, heart and blood vessels, metabolism, and sexuality of a person.

Pathology of the gland in most cases occurs in the fair sex. Blood test for thyroid hormones in the diagnosis and evaluation of the treatment of hypothyroidism, diffuse toxic goiter and other thyroid diseases. In addition, this analysis is recommended for those suffering from infertility, mental retardation, lack of menstruation, a significant decrease in libido and impotence.

How to understand the results of the analysis

TSH () is synthesized in the pituitary gland and only regulates the formation of thyroid hormones. Normally, it is 0.4 - 4 μIU / ml.

Antibodies to TPO, TG and TSH receptors are not hormones, but proteins that are produced by the immune system and only participate in the production of T3 and T4. In a healthy person, antibodies to TPO are below 35 IU / ml, antibodies to TG are about 35 IU / ml, antibodies to TSH are in the range of 1.5 - 1.75 IU / l.

An increase or decrease in the production of T3, T4 and TSH means a malfunction of the thyroid gland. Test scores will vary depending on the age of the patient.

How to Prepare for an Analysis

The list of diagnostic studies that can be performed in the laboratory is amazing: for example, there are more than a hundred tests to determine the endocrine status. They are not cheap, and it is important for the patient to know what indicators the doctor needs in the first place.

What thyroid hormones to take in order to determine the existing problems as accurately as possible and outline a plan for further therapeutic actions: let's figure it out.

Drawing up an examination plan is the task of a competent endocrinologist, who must prescribe laboratory tests after collecting complaints and a complete clinical examination. If a doctor's consultation is not possible for any reason, you will have to follow the general rules presented in our review and video in this article.

Before you figure out which hormones to take thyroid tests for, you need to learn more about them. The thyroid gland is an important endocrine organ that regulates the main metabolic processes in the body and controls the work of the cardiovascular (see), digestive, urinary, nervous and other systems.

The body performs all these functions due to the production of thyroid hormones, which are distributed with the bloodstream throughout the body and have a stimulating effect on target cells.

The main thyroid hormones are:

1. Tetraiodothyronine - T4, thyroxine (free, total);
2. Triiodothyronine - T3 (free, total);
3. Calcitonin.

thyroxine

Tetraiodothyronine is the main thyroid hormone. It accounts for up to 90% of all biologically active substances produced by the gland. The chemical composition of the hormone is simple: two residues of the amino acid thyroxine and four molecules of iodine.

It is interesting. It is the thyroid gland that remains the main consumer of molecular iodine entering the body.

Triiodothyronine

Triiodothyronine (pictured) is another thyroid hormone. Its activity is 10-12 times higher than that of thyroxine, and its chemical composition is distinguished by the presence of three (instead of four) iodine molecules attached to an amino acid residue.

It is known that only 10% of the total triiodothyronine is synthesized in the thyroid gland. Most of it is formed directly in the cells of the body from T4. Like pulling the pins of a grenade, the removal of one atom of iodine converts the less active thyroxine into triiodothyronine.

Thyroxine and triiodothyronine affect all tissues of the body, so there are receptors for them on the surface of any cell.

Hormones:

• activate metabolic processes;
• stimulate the synthesis of proteins and nucleic bases (RNA);
• increase body temperature;
• control the processes of growth and development of the body in childhood;
• increase heart rate;
• promote the growth of the endometrium in women;
• enhance metabolic processes in the tissues of the nervous system.

Note! The terms "free" or "total" in the description of the analysis for T3 and T4 imply the connection of the hormone with carrier proteins. After the production of glandular cells of the endocrine organ, hormones are almost immediately picked up by special transport proteins and become inactive. The biologically active form of the substance is acquired again only after delivery to the target organs. Therefore, in laboratory diagnostics, there is a division: “free” means an active hormone, “total” means the sum of active and plasma protein-bound tri- or tetraiodothyronine.

Thyrocalcitonin

Thyrocalcitonin (calcitonin) is a lesser known thyroid hormone that is produced by the parafollicular cells of the endocrine organ (see). By chemical nature, it is a peptide (protein) compound.

This biologically active substance takes part in phosphorus-calcium metabolism:

• enhances calcium uptake by osteoblasts - bone cells;
• stimulates bone growth;
• inhibits the activity of osteocluster cells that destroy bone tissue.

Important! Usually, the determination of calcitonin is not included in the standard thyroid examination. Meanwhile, this hormone is a kind of oncomarker, and its increase is of great importance for the early diagnosis of medullary cancer.

What else regulates the thyroid gland

To the question of the patient "What hormones to take for the thyroid gland?" doctors often refer to terms like TSH, anti-TG, anti-TPO. What it is? What role do they play in the normal functioning of the body?

Thyroid-stimulating hormone

A test for (thyrotropin, TSH) is often prescribed along with a T3 and T4 study. Often this substance is called thyroid hormone, but in fact it is not. Thyrotropin is produced in the cells of the pituitary gland - an endocrine gland located at the base of the brain, and at the same time is the coordinator of the thyroid gland.

TSH is produced in response to a decrease in the level of thyroxine and triiodothyronine in the body, and then delivered to the thyroid gland with the bloodstream. Interacting with a special area of ​​the glandular organ, it stimulates the production of thyroid hormones. A high level of T3 and T4 on the principle of feedback inhibits the production of thyroid-stimulating hormone.

Antibodies to TSH receptors, thyroglobulin and thyroid peroxidase

Antibodies are special proteins that the immune system produces to destroy foreign elements - viruses, bacteria, "defective" cells of the body with violations of genetic information. All antibodies have strict specificity and can only interact with the cells they were designed to kill.

In diseases that are classified as autoimmune, the body's defense system, for reasons not fully understood, begins to produce antibodies against its own healthy tissues, including thyroid cells, causing its irreversible destruction and persistent endocrine dysfunction. There are several types of autoimmune pathology that differ in the specificity of the produced antibodies.

(TPO, thyroperoxidase) - specific immune proteins synthesized in the body against one of the enzymes directly involved in the synthesis of T3 and T4.

Note! It has been proven that an elevated level of anti-TPO is diagnosed in 3-5% of the male and 7-10% of the female population of the world. This does not always indicate an autoimmune pathology, but irreversible inhibition of thyroid function occurs at a high concentration of anti-TPO 4-5 times more often.

(TG) - a precursor protein of thyroxine and triiodothyronine, which is produced by thyroid cells - increases less frequently, in 1-2% of men and women. An increase in the level of antibodies to thyroglobulin is observed in diffuse toxic and chronic autoimmune goiter.

Along with the determination of thyroglobulin itself, anti-TG in patients with a removed thyroid gland is of great importance in the diagnosis of relapses of follicular and papillary cancer.

Antibodies to TSH receptors (rTTH) are immune proteins produced by the protective systemic organism against receptors that are located on the surface of thyroid cells and are responsible for transmitting the stimulating effect of thyroid-stimulating hormone to the endocrine organ. An increase in their concentration is observed in diffuse toxic goiter (Basedow's disease) and is considered as a prognostic sign of the possibility or impossibility of exclusively drug treatment.

Note! The analysis for anti-rTTG is prescribed only for DTG. Otherwise, its definition will be uninformative.

What thyroid hormones should be given to a patient who wants to undergo primary thyroid diagnostics?

The minimum that will allow drawing incomplete conclusions about the functioning of the thyroid system of the body can be considered tests for:

• T3 (general);
• T4 (general);

The average price of such a complex in private laboratories is 1200 rubles. If these analyzes deviate from the norm, as well as if a thyroid disease is suspected, based on typical complaints, anamnesis and clinical manifestations, an extended examination is required.

The standard medical instruction for laboratory diagnosis of patients with various thyroid pathologies is presented in the table below.

Which tests to take for thyroid hormones largely depends on the clinical symptoms of the disease and the results of laboratory tests for thyroid hormones (T3, T4) and TSH. It is desirable that the examination plan and further tactics for managing the pathology be drawn up by a doctor, because it is not so easy to conduct an examination and palpation of the thyroid gland with your own hands.

A complete diagnosis gives a complete picture of the features and course of the disease and greatly facilitates treatment.

Hypothyroidism refers to chronic insufficiency of thyroid hormones at the level of peripheral tissues of the body. As a result, there is a decrease in the intensity of metabolic processes and at the same time the vital functions of the body.

The term used for severe hypothyroidism is myxedema.

Thyroid hormone deficiency occurs for several reasons.

1. The first reason, which is also the most common, is due to a decrease in the synthesis of thyroid hormones.
2. It happens much less often that hormones are present in sufficient quantities, but there is immunity of tissue receptors to them.
3. The third reason is that the hormones in the blood are in a bound state with special carrier proteins (albumins, gamma globulins) and are in an inactive state.

Anatomy and physiology of the thyroid gland

At the microscopic level The thyroid gland is made up of follicles. The follicle is a kind of capsule consisting of thyrocytes (thyroid cells). Thyrocytes with one surface face the inside of the follicle and synthesize a follicular fluid called colloid (contains hormones T3, T4, amino acids, thyroglobulin).

On the other hand, thyrocytes are attached to a membrane consisting of connective tissue. The union of several follicles is called a lobule.

Thyrocytes produce iodinated thyroid hormones T3, T4.
Between the follicles are parafollicular cells that synthesize the hormone calcitonin, which is involved in calcium metabolism in the body.

Produce iodinated thyroid hormones in several successive stages. All of the following processes occur in thyrocytes with the direct participation of special enzymes - peroxidases. The function of thyrocytes is dual:
One side they synthesize the hormones T3, T4, which are deposited and stored in the follicular fluid in an inactive state, as a reserve.
At the first stage there is an absorption by the thyroid gland of inorganic iodine from the blood, which is in an inactive state.
At the second stage iodine is organized by attaching it to the protein thyroglobulin, namely to the residues of tyrosine (a non-essential amino acid) present in its composition.
When one molecule of iodine is added, monoiodotyrosine.

When two molecules of iodine are added, a diiodotyrosine.

On the other hand with a lack of all the same iodinated hormones, a colloid is used to form new portions of active T3, T4, which then enter the bloodstream.


Third stage is marked by the fact that condensation of iodotyrosines occurs, and are formed:

• Triiodothyronine (T3)- with the addition of monoiodotyrosine and diiodotyrosine. Contains three molecules of iodine. It is contained in the blood in small quantities and is the most functionally active.
• - with the addition of diiodotyrosine and diiodotyrosine. It contains four molecules of iodine. Thyroxine in the blood is in large quantities, compared with triiodothyronine, but unlike it is the least active.

Thyrocytes capture thyroglobulin molecules from the colloid in combination with T3 or T4 hormones. with the help of special peroxidase enzymes, they break the bond of thyroglobulin with thyroid hormones, with the release of the latter into the bloodstream. In this process, monoiodotyrosine and diiodotyrosine are partially formed, which are fed back to the formation of iodinated hormones and deposited as a depot in the colloidal fluid.

Types of hypothyroidism and causes of the disease

hypothalamus - the main regulatory body exercising "oversight" of the work of the organs of internal secretion. Regulation is carried out through the development of:

1. Liberians- stimulate the pituitary gland
2. statins- depresses the pituitary gland

The classification of pathological phenomena occurring in the thyroid gland is made taking into account the primary cause that disrupts the functioning of the gland.
Primary hypothyroidism diseases that are directly related to the pathology of the thyroid gland are considered. These include:

1. Congenital disorders of the formation and development of the organ
2. genetic defects
3. Inflammatory, autoimmune processes in the thyroid gland
4. After treatment with drugs that inhibit the synthesis of thyroid hormones (mercasolil)
5. Iodine deficiency in the body (endemic goiter)

1. Congenital malformation of the pituitary gland
2. Brain injury with damage to the pituitary gland
3. Massive bleeding
4. Tumors of the pituitary gland (chromophobic adenoma)
5. Neuroinfections (of the brain)

Symptoms of a decrease in thyroid hormones in the blood (hypothyroidism)

Mechanisms for the development of symptoms of the disease
To understand the importance of thyroid hormones for ensuring the functions of organs and systems, we will give some examples of metabolic disorders:

1. From the side of protein metabolism there is a decrease in the synthesis of important protein compounds. Protein, as you know, is a "building" material for cells, tissues and organs. The lack of protein leads to a delay in the development of rapidly dividing tissues:

• Gastrointestinal tract (GIT)- manifests itself in the form of indigestion, constipation, flatulence (increased gas formation), etc.
• Albumins- proteins that maintain oncotic blood pressure. In other words, they keep the liquid part of the blood in the bloodstream. The absence of these leads to swelling of the subcutaneous adipose tissue.
• Decreased muscle activity manifests itself in the form of weakness, lethargy.
• Decreased activity of the central nervous system, there is slowness, apathy, insomnia

1. Disorders of carbohydrate metabolism. The use of glucose for the energy needs of the body is reduced. The synthesis of adenosine triphosphoric acid (ATP), which is necessary for all energy processes in the body, is reduced. It also reduces heat production, which leads to a decrease in body temperature.
2. Changes in fat metabolism there is an increase in cholesterol, and other fatty fractions that increase the risk of atherosclerosis and obesity.

General symptoms:

1. lethargy
2. Drowsiness
3. Apathy
4. Weakening of memory
5. constipation due to a decrease in the sensitivity of smooth muscle fibers of the gastrointestinal tract to stimulating impulses emanating from the nervous system. The number and intensity of peristaltic contractions of the intestine decrease, which leads to a delay in fecal masses.
6. Decreased: libido (sex drive), potency (in men). Occurs as a result of a decrease in the activity of metabolic processes at the level of sex hormones, which are also under the stimulating effect of thyroid hormones.
7. Violation of the menstrual cycle.

1. Big puffy face
2. Puffiness of the eyelids

1. The eyes are sunken, the palpebral fissures are narrowed. The tone of the muscles that lift the upper eyelid and the circular muscles of the eyes decreases
2. The skin is dry, cold on palpation (due to a decrease in blood flow in small vessels)

The patient complains about:

1. Feeling constantly cold
2. Breakage and hair loss
3. Weakness, brittle nails

Cardiovascular system (CVS)

• The slowdown of metabolic processes leads to the establishment of bradycardia (decrease in the number of heartbeats, less than 60 beats / min.).

• Due to the relaxation of the cardiac muscles, the boundaries of the heart expand.

• There is a decrease in appetite. It is explained by a decrease in the acidity of gastric juice.
• constipation due to weakness of the motor muscles of the intestine.
• Macroglossia- an increase and pastosity of the tongue, often with imprints of teeth.

• Apathy, lethargy
• Insomnia at night and sleepiness during the day
• Decreased intelligence, memory
• Decreased reflexes

• Voluntary movements slow down
• Increases the time required for muscle contraction and relaxation
• The duration of tendon reflexes slows down. Occurs due to slow muscle relaxation

How is the concentration of hormones in the blood regulated?

Due to the reduced amount of thyroid hormones (thyroxine, triiodothyronine), the secretion of thyrotropin-releasing hormone TRH by the hypothalamus reflexively increases. This hormone has a stimulating effect on the synthesis of not only thyroid hormones, but also on the synthesis prolactin- a hormone necessary for lactation in women during pregnancy.

Excessive amount of prolactin disrupts menstrual function in women:
Dysmenorrhea- violation of the periodicity of the appearance of the menstrual cycle. It manifests itself in the form of a delay in the onset, or vice versa, the appearance of the menstrual cycle too often.
Amenorrhea- absence of a menstrual cycle for at least six months in a row.
Infertility- rare in the most severe cases of untreated hypothyroidism.

Features of hypothyroidism in childhood
If hypothyroidism appears from birth as a result of genetic disorders, or other anomalies, then lags are noticeable during the childhood period of life:

1. In physical development

• Poor weight gain
• Lagging behind in growth
• Late starts holding his head, sitting, walking
• Delayed ossification of the skeleton
• Fontanelles close late

1. In mental development

• There is a delay in the development of speech skills
• At school age: decrease in memory, intellectual abilities

1. In sexual development

• Late appearance of secondary sexual characteristics:
• Hairiness of the axillary region, above the bosom
• Late menstruation and other changes

Pregnancy with hypothyroidism

Despite the fact that pregnancy can occur against the background of hypothyroidism, children are born on time and are quite healthy. This phenomenon is explained by the fact that thyroid hormones do not penetrate the placental barrier and have absolutely no effect on the development of the fetus.

Treatment of hypothyroidism in pregnant women is no different from that in non-pregnant women. The only thing that can be noted is a slight increase in the doses of the drugs taken.

If appropriate treatment is not taken during pregnancy, then the risk of complications associated with the course of pregnancy increases:

• Spontaneous abortions in 1-2 trimesters
• Miscarriages in the 3rd trimester
• preterm birth

hypothyroid coma

1. A pronounced decrease in all types of metabolism
2. loss of consciousness
3. Persistent hypothermia (decrease in body temperature below 35 degrees)
4. Decrease or loss of reflexes
5. Bradycardia (number of heartbeats less than 60 beats/min.)

There are no characteristic key factors leading to the development of coma. It can only be noted that such a state develops against the background of:

1. Acute infections (pneumonia, sepsis)
2. Diseases of the cardiovascular system (heart failure, myocardial infarction)
3. Surgical interventions
4. Food poisoning and many other factors

Diagnosis of hypothyroidism and its causes

Laboratory diagnostics

Tetraiodothyronine (T4, thyroxine)- the norm is 65-160 nmol / l.

Then determine the level of thyroid-stimulating hormone of the pituitary gland (TSH). In the case of a primary lesion of the thyroid gland, when there is a constant lack of thyroid hormones, reflex excitation of the pituitary gland occurs and a large amount of TSH is released into the blood. TSH has a stimulating effect on the thyroid gland, "forcing" it to synthesize more hormones T3, T4.
Pituitary thyroid stimulating hormone (TSH)- the norm depending on age is:

• From 1.1-1.7 honey/l. - in newborns
• Up to 0.4-0.6 honey / l. - at the age of 14-15 years

The test is usually carried out in the morning on an empty stomach. Measurement of hormone levels is carried out by special radioimmunological methods.

The essence of the study is that normally administered thyroliberin stimulates the pituitary gland and, at about 30 minutes, the content of TSH in the blood increases. Approximately after 2 hours, all indicators come to the initial level, that is, the content of thyroliberin and thyroid-stimulating hormone of the pituitary gland in the blood decreases.

For primary hypothyroidism When the hypothalamus and pituitary gland are intact and working normally, the following changes occur:

• The initial level of TSH is increased.
• 2 hours after stimulation with thyroliberin, the TSH level does not return to normal, but remains at an elevated concentration.

• The initial level of TSH is reduced.
• After stimulation with thyroliberin, the TSH level does not increase and remains at the same level as before the administration of thyroliberin.

• Low initial (before the introduction of thyroliberin) concentration of TSH.
• An increase in the concentration of TSH after stimulation with thyroliberin (the function of the pituitary gland is not impaired, therefore, with artificial stimulation, the secretion of thyroid-stimulating hormone of the pituitary gland increases).

Instrumental examination methods

Thyroid Scan

In hypothyroidism, a reduced ability to absorb radioactive iodine by the thyroid gland is revealed. The results of the study are reflected in the scan (graphic recording of the absorption capacity of the thyroid gland).

Ultrasonographic examination (ultrasound)
One of the modern and absolutely painless research methods. It is used to clarify the diagnosis. It helps to identify various pathological disorders, areas of compaction, the degree of enlargement and other structural changes in the thyroid gland.

Treatment of hypothyroidism

With the appearance of hypothyroidism in childhood, treatment immediately after diagnosis, in order to avoid complications associated with impaired growth and development of the child.

There are several types of drugs that contain triiodothyronine or tetraiodothyronine. These drugs include:

1. L-thyroxine tablets of 0.025, 0.05, 0.1 grams
2. Triiodothyronine tablets of 0.1 grams
3. Thyreocomb- the combined preparation contains T3, T4, as well as potassium iodide
4. Tireocom- a combination drug consisting of T3 + T4

1. blood pressure
2. Periodic blood levels of pituitary thyroid-stimulating hormone, T3, T4
3. Serum cholesterol concentration
4. Possible changes in the electrocardiogram (ECG). Weekly

In the heart muscle there are beta-adrenergic receptors, the excitation of which has a stimulating effect on the work of the heart. Thyroid hormones have a stimulating effect on these receptors, thus increasing the strength and frequency of heart contractions. In coronary heart disease, a sharp increase in the concentration of thyroid hormones in the blood can cause significant damage to the heart. To prevent this from happening, take beta-blockers that reduce the sensitivity of the beta receptors of the heart, and thus prevent the risk of complications from cardiac activity.

Dieting
It is very important for patients with hypothyroidism to get good nutrition. All nutritional ingredients must be present in the diet in sufficient and easily digestible form. It is recommended to eat boiled food. Eliminate fried, fatty foods from the diet.
Limit:

1. Foods rich in cholesterol

• Animal fats (butter, sour cream, lard, etc.)

1. Products containing a large amount of salt (to avoid increased tissue swelling)

• Salted fish (herring, ram)
• Pickles (pickles, tomatoes)

How to evaluate the effectiveness of treatment for hypothyroidism?

1. Disappearance of clinical symptoms
2. Restoration of the patient's ability to work
3. Acceleration of physical development (height, weight) in children
4. Normalization of the cardiovascular system and pulse (normal 60-80 bpm)
5. Restoration of normal laboratory parameters of thyroid hormones:

• TSH level
• levelT3
• level T4

Autoimmune thyroiditis, what is its role in the development of hypothyroidism?

So what is autoimmune thyroiditis? This is a chronic damage to the thyroid gland by its own immune cells, that is, the body "digests" its thyroid tissues, damaging its follicles. And there are no follicles - there is no production of thyroid hormones, as a result - hypothyroidism.

Causes of autoimmune thyroiditis:

1. Burdened heredity- this disease is often detected in close relatives.
2. Malfunctions in the immune system- the appearance of antibodies to follicles (from the group of T-lymphocytes).
3. Acute and chronic bacterial or viral diseases with damage to the thyroid gland (most often these are subacute thyroiditis).
4. The postpartum period in women, which is associated with changes in the immune system against the background of powerful hormonal stress.
5. The presence of other autoimmune processes in the patient(rheumatic diseases, glomerulonephritis, celiac disease, multiple sclerosis and many others).
6. Excess iodine in the body.
7. Increased radioactive background.
8. Diabetes, severe course.
9. Unknown reasons.

Symptoms of autoimmune thyroiditis:

• May take place asymptomatic course(especially at the beginning of the disease), in this case they talk about subclinical hypothyroidism.
• Symptoms of hypothyroidism(given in the articles section Symptoms of a decrease in thyroid hormones in the blood).
• At the beginning of the course of the disease, with an increase (hypertrophy) of the thyroid gland, mild symptoms of hyperthyroidism(weight loss with increased appetite, protrusion of the eyeballs, hypertension, tremor of the limbs, excitability of the nervous system, insomnia, and so on), which are quickly replaced by symptoms of hypothyroidism.
• Increase or decrease in the size of the thyroid gland.
• Diffuse (scattered and widespread) or nodular changes in the structure of the thyroid gland.
• Hoarseness of voice (with an increase in the thyroid gland), sore throat.

Complications of autoimmune thyroiditis:

• persistent hypothyroidism(irreversible);
• chronic fibrous thyroiditis (Riedel's goiter)- replacement of thyroid tissue with connective tissue;
• hypothyroid coma;
• "malignancy" of thyroid nodules (development of oncological pathology).

6. Fine needle biopsy of the thyroid gland- puncture of thyroid tissue using a special tool, this procedure is carried out for the purpose of further cytological examination (qualitative and quantitative evaluation of cells). In autoimmune thyroiditis, a significant decrease in the number of follicles and thyroid hormones is determined, the follicles are changed, deformed, and most of the material is represented by lymphocytes, plasma cells, eosinophils. This method can indicate the autoimmune nature of the damage to the thyroid gland, and also allow to exclude the oncological process.

Treatment of autoimmune thyroiditis:

• replacement therapy for hypothyroidism thyroid hormone preparations ;
• spring-autumn courses glucocorticoids (prednisolone) according to individual schemes;
• immunomodulators (according to indications);
• correction of those conditions that may have caused the development of autoimmune thyroiditis.

Subclinical and transient hypothyroidism, what is it?

subclinical hypothyroidism

The only way to detect subclinical hypothyroidism is to determine an elevated level of TSH in the blood. Less commonly, this form of hypothyroidism slightly decreases the level of thyroid hormones T3 and T4. Many scientists believed that this condition is not a pathology, but just a laboratory error. But numerous studies of this phenomenon have proven that half of such cases without treatment after some time turn into hypothyroidism with characteristic clinical symptoms.

So it is very important to identify and treat hypothyroidism precisely at the stage of the absence of clinical manifestations.

But even with subclinical hypothyroidism, there are some symptoms that mask functional thyroid insufficiency:

• depressive and apathetic states;
• deterioration in mood;
• poor concentration of attention;
• problems with memory, intelligence;
• weakness, drowsiness;
• rapid weight gain with poor appetite;
• manifestations of atherosclerosis, increased cholesterol levels;
• arterial hypertension;
• ischemic heart disease, heart attack;
• on the ECG - signs of thickening (hypertrophy) of the myocardium;
• premature termination of pregnancy;
• menstrual disorders in women (painful menstruation, bleeding, cycle longer or shorter than 28 days, in some cases, the absence of menstruation or amenorrhea).

Subclinical hypothyroidism can be temporary, that is, transient, or transient.

Transient hypothyroidism

The most common example of this condition is transient hypothyroidism in newborns. The development of this syndrome in babies is associated with the imperfection of the hypothalamic-pituitary system (the highest level of regulation of thyroid hormones by the central nervous system) and is a violation of the adaptation of the newborn to the outside world after birth.

The main causes of transient hypothyroidism in newborns:

1. deficiency or excess of iodine during pregnancy.
2. prematurity , birth earlier than the 34th week of pregnancy.
3. intrauterine growth retardation.
4. intrauterine infections.
5. prolonged fetal hypoxia with complicated pregnancy or difficult childbirth (hypoxic-ischemic encephalopathy).
6. maternal thyroid disease (autoimmune thyroiditis, endemic goiter, thyrotoxicosis with the use of drugs that inhibit the production of thyroid-stimulating hormones).

Transient hypothyroidism must be distinguished from congenital hypothyroidism:

The main manifestations of transient hypothyroidism in newborns:

What does a child with cretinism look like?

• The child does not walk until the age of 4-5, the gait is disturbed;
• does not gain weight and height;
• lags behind in mental and mental development : does not speak, “mumbles”, does not understand ordinary speech, does not remember elementary things, is not interested in new things, and so on;
• the tongue is enlarged due to swelling of the submucosal layer, it falls out of the oral cavity, as it does not fit in the mouth;
• crooked teeth;
• rounded face (“moon” shape), “stupid” facial expression;
• narrowing of the eye gap, often strabismus, decreased vision;
• poor hearing due to hearing loss;
• the nose becomes wide, flattened;
• deformation of the bone skeleton, skull;
• muscle weakness;
• violation of the heart rhythm;
• later - inferior puberty in both girls and boys.

Hypothyroidism in women, what are its features?

• Women are more likely to suffer from autoimmune thyroiditis, the most common cause of hypothyroidism.
• A powerful factor in the development of hypothyroidism in women is pregnancy and childbirth (and almost all women experience this at least once in their lives), especially accompanied by iodine deficiency, preeclampsia, anemia and bleeding.
• Women are more sensitive to hormonal changes, as it happened physiologically, so they more often have symptoms of hypothyroidism and its “mask” than men. Men are more likely to have an asymptomatic course of the disease, which is rarely diagnosed - few of them go to take tests for preventive purposes.

Features of the course of hypothyroidism in women:

1. In most cases, a chronic lack of thyroid hormones affects the level of sex hormones:

• increases the level estrogen by disrupting the processes of inactivation (destruction) of the hormone, that is, these estrogens are less active;
• increases production prolactin ;
• raises the level testosterone (male sex hormone);
• leads to imbalance levels follicle-stimulating (FSH) and luteinizing (LH) hormones (hormones of the hypothalamic-pituitary system that regulate female sex hormones), since TSH, FSH and LH are very similar in their chemical structure.

2. Unreasonable excess weight in women- this symptom always brings a lot of anxiety to a woman. Even against the background of a strict diet and proper nutrition with an active lifestyle does not lead to weight loss. This symptom is very specific to a lack of thyroid hormones.

3. Manifestations of a mental disorder in women more pronounced than in men. This is due not only to the direct effect of hypothyroidism on the central nervous system, but also to the imbalance of female sex hormones. Among the symptoms of disruption of the central nervous system for women, the most characteristic and pronounced are changeable mood, prolonged depression, severe lethargy.

4. However, if a woman is pregnant, there is a risk of developing congenital hypothyroidism in the fetus, since thyroid hormones are involved in the development of the baby's nervous system inside the womb in the last weeks of pregnancy. Also, a common cause of hypothyroidism is a lack of iodine, which accompanies the child during his stay in the mother's tummy.

The principles of diagnosis and treatment of hypothyroidism in women are no different, are given in the relevant sections of the article. Replacement therapy with thyroid hormones in women with infertility leads to normalization of hormone levels after an average of 3 months, against this background, a long-awaited pregnancy may occur. And taking hormones during pregnancy will help to avoid the severe consequences of hypothyroidism for the mother and child.

Thyroid nodules, can they be accompanied by hypothyroidism?

Thyroid nodules are very common. According to some data, every second person in the world has nodular forms of thyroid disease. But only 5% of these formations are dangerous and require therapy. Nodes can be identified during routine examination and palpation of the thyroid gland, and additional research methods will provide more reliable information.

The nodes are small (less than 10 mm) or large (more than 1 cm), single or multiple.

The nodes are often asymptomatic or, less commonly, may be accompanied by clinical manifestations:

• symptoms of hyperthyroidism (excess thyroid hormones);
• symptoms of hypothyroidism;
• symptoms of compression of the altered thyroid gland, pain in the thyroid gland;
• symptoms of inflammation and intoxication.

The diagnosis is made only on the basis of laboratory data (TSH, T3, T4, autoimmune antibodies), thyroid ultrasound, scintigraphy and the results of a fine needle biopsy of the nodes with a cytological examination of the biopsy.

Many benign formations, in which the size of the nodes do not reach large volumes and do not manifest clinical symptoms, require only periodic monitoring and correction of iodine deficiency. Such diseases include nodular colloid goiter- the most common cause of nodes in the thyroid gland, develops against the background of a lack of iodine.

If, in the presence of nodes, a violation of the function of the thyroid gland occurs, then most often it is an excess of thyroid hormones or hyperthyroidism. This is due to the fact that tumors often consist of specialized (or differentiated) cells capable of producing "extra" thyroid hormones.

The nodular form of autoimmune thyroiditis is characterized by the development of symptoms of hyperthyroidism first, then the formation of hypothyroidism.

Cause of hypothyroidism nodes of a cancerous tumor of the thyroid gland can become, especially if the cellular composition of the tumor is represented by undifferentiated cells, and the node itself is large.

So, summing up , we can say that the nodes rarely lead to the development of thyroid hormone deficiency. However, people with benign thyroid nodules need to be on the lookout for early symptoms of hypothyroidism or an elevated TSH level, as this may indicate the development of thyroid cancer. After all, many of us know that any benign process can be “malignant”, that is, degenerate into cancer.

Hormone treatment, benefits and risks?

Myth #1. “Against the background of taking hormones, there is a set of excess weight.” Indeed, in some cases, glucocorticosteroids, sex hormones can lead to excess weight. But this happens with the wrong choice of the type of hormonal drug, the method of its administration and dosage, as well as in the absence of control of laboratory parameters against the background of hormonal therapy. In the treatment of hypothyroidism, thyroid hormone preparations, on the contrary, contribute to the normalization of weight.

Myth #2. “Hormones are addictive and after their withdrawal, the course of the disease is aggravated.” Yes, against the background of a sharp cessation of taking hormonal drugs, a withdrawal syndrome occurs, which can lead not only to a worsening of the disease, but even to the death of the patient. Withdrawal syndrome will not occur if the dose of the drug is gradually reduced before stopping. In case of hypothyroidism, which requires not lifelong, but temporary hormone replacement therapy, the doses of the drug are also gradually reduced before cancellation under the control of the level of TSH, T3 and T4 in the blood.

Myth #3. "All hormonal drugs have a large number of side effects." Everyone, even a herbal and vitamin preparation, has a risk of developing side effects. Thyroid hormones, in principle, do not cause side effects if an adequate (not exceeded) dose of the drug is prescribed. An overdose of thyroid hormones can lead to the development of symptoms of hyperthyroidism. Therefore, hormonal therapy for hypothyroidism is carried out under the control of the level of thyroid hormones in the blood.

Myth number 4. "Indications for hormonal therapy are only extremely severe conditions." Although hormones are used for diseases with severe clinical manifestations and for life reasons, hormone therapy can also be recommended in situations where the patient does not have specific symptoms of the disease or the disease does not pose a threat to the patient's life (for example, oral contraceptives (birth control pills), hormonal ointments for skin diseases and so on). Thyroid hormones are strongly recommended for subclinical and transient hypothyroidism, the main features of which are laboratory tests.

Myth number 5. "Hormone preparations can be used irregularly." All hormonal drugs must be used at a certain time of the day, strictly by the hour. This is necessary because normally in the body all hormones are secreted at a set time of day and in a strictly necessary dose, regulating all processes in the body. So, glucocorticosteroids are recommended to be used in the morning immediately after waking up, on an empty stomach, and oral contraceptives - at any time of the day. Thyroid hormones are best taken once in the morning, on an empty stomach, 30 minutes before meals. But the main condition for all hormones is the intake strictly by the hour, daily. Irregular intake of any hormones (today I drink, tomorrow I don’t drink) is not acceptable under any circumstances, since, firstly, it can lead to a withdrawal syndrome, and secondly, it does not give a positive therapeutic result.

Myth number 6. "The use of hormonal drugs for the treatment of children leads to irreversible consequences." In childhood, there are also a lot of diseases that require hormone therapy, and hormones are prescribed for health reasons. The risk of side effects from taking hormonal drugs is much lower than from those diseases that require this type of treatment. In the case of congenital hypothyroidism, the lack of treatment with thyroid hormones leads to irreversible consequences, and not the medication itself. Cretinism is a serious disease that has irreversible changes in the health and life of the child.

Myth number 7. "Hormonal drugs can be replaced by other types of medicines or traditional medicine." In the case of hypothyroidism, diabetes mellitus and other endocrine diseases, hormone therapy cannot be replaced by anything. These diseases occur due to a violation of the production of vital hormones and, unfortunately, at this stage, treatment can only be aimed at replacing one's own hormones with artificially synthesized ones. Not a single herb, lotion and “panacea pill” can restore the function of the endocrine glands and normalize hormone levels. As for hypothyroidism, self-medication and the time lost for experiments can lead to negative consequences regarding absolutely all metabolisms, systems and organs, and mental state.

So, we can highlight the main principles of thyroid hormone replacement therapy:

1. Any insufficiency of thyroid hormones (even a subclinical form) requires hormone replacement therapy.
2. The selection of doses and determination of the duration of the course of therapy should be determined individually, according to the level of thyroid hormones in the patient's blood.
3. Treatment with thyroid hormones should be carried out only under the control of the level of TSH, T3, T4 and autoimmune antibodies to the thyroid gland.
4. Childhood and pregnancy is not a contraindication, but is a mandatory indication for the treatment of hypothyroidism with thyroid hormone preparations.
5. Hormone therapy should be timely, long-term, regular, continuous and controlled.
6. Traditional medicine in the treatment of hypothyroidism can only be used in parallel with thyroid hormones, and not instead of them.
7. The use of thyroid hormones with the right approach is safe. The risk of developing irreversible consequences of hypothyroidism is much higher than from taking hormonal drugs.

Do not self-medicate, life-threatening!

The thyroid gland is a specific endocrine organ that is located in the neck of many animals and humans. It has the ability to produce and store hormones that regulate metabolism and energy. Since this endocrine organ is responsible for most of the processes occurring in the human body, if its normal functioning is disturbed, this will inevitably affect the state of health.

Possible symptoms of thyroid disease

There are certain symptoms that may indicate certain diseases associated with the endocrine organ. If you notice any of the symptoms, you should definitely contact an endocrinologist to diagnose suspected diseases. The specialist will conduct an ultrasound and prescribe a blood test for hormones. There is a certain norm of thyroid hormones. If the results of the analyzes show any deviations, then it is necessary to carry out appropriate treatment. Symptoms that may indicate thyroid disease include:

• increase or decrease in body weight in a short time;
• irregular menstruation;
• poor condition of nails, hair and skin;
• problems with the stomach or intestines;
• cardiovascular diseases;
• memory impairment;
• weakness, irritability, tearfulness;
• reduced immunity, frequent colds;
• increased sweating;
• hand trembling.

Thyroid hormone analysis. Norm and rules of delivery

If there are any health problems that indicate the possibility of thyroid diseases, the endocrinologist will definitely prescribe a special blood test from a vein. To obtain a reliable result, it is necessary to take this analysis on an empty stomach.

• it is best to take blood at the beginning of the day;
• before the study, do not take hormones and medications that can affect the result;
• before passing the analysis, exclude stress, excessive physical activity;
• within half an hour before blood sampling be in a calm state.

Main characteristics

The main indicators that will help evaluate the work of the endocrine organ:

• total and free T3;
• total and free T4;
• antibodies to TG;
• antibodies to TPO.

Total and free T3 (triiodothyronine)

The norm of thyroid hormones T3 is:

• total - 1.2-2.8 nmol / l;
• free - 2.8-7.1 pmol / l.

T3 above normal

• thyrotoxicosis;
• the presence of a disease such as goiter, which is a consequence of a lack of iodine in the body;

T3 below normal

A low level occurs when:

• inflammatory diseases of the endocrine organ;
• in elderly people or in patients with various serious diseases;
• long-term use of certain medications.

Total and free T4 (thyroxine)

The norm of thyroid hormones T4 is:

• total T4 - 60-160 nmol / l;
• free T4 - 7-22 pmol / l.

T4 above normal

High concentration in the blood is possible with:

• hyperthyroidism resulting from nodular or toxic diffuse goiter, cancer of the gland, acute thyroiditis;
• overdose of the drug "Thyroxine";
• taking certain contraceptives;
• pregnancy;
• cirrhosis and hepatitis of the liver.

T4 below normal

A low level occurs when:

• hypothyroidism resulting from the removal of the entire thyroid gland or part of it;
• inflammatory diseases of the gland;
• diseases of the adrenal glands, accompanied by a large release of cortisol;
• pituitary tumors;
• nephrotic syndrome;
• a large lack of iodine in the body;
• long-term use of certain medications.

TSH (pituitary thyrotropin)

The norm of thyrotropic thyroid hormones is 0.3-5.0 mIU / ml.

TSH above normal

An increase in blood concentrations is possible with:

• hypothyroidism resulting from the removal of the entire endocrine organ or part;
• thyroid cancer;
• pituitary tumors;
• the presence of tumors of the lungs, mammary glands;
• the use of certain medications.

TSH below normal

A low level occurs when:

• hyperthyroidism resulting from nodular or diffuse toxic goiter, cancer of the gland, acute thyroiditis, tumors or injuries of the pituitary gland;
• overdose of the drug "thyroxine";
• the use of certain medications.

TG (thyroglobulin)

The norm of TG is 1.4-78 ng / ml.

TG above normal

An increase in blood concentration is possible with:

• malignant lesions of the endocrine organ;
• treatment with radioactive iodine.

TG below normal

A low level occurs with an overdose of certain drugs.

Antibodies to TG (thyroglobulin)

The norm is 0-115 IU / ml. A high concentration of antibodies can be observed when:

• Graves' disease;
• differentiated endocrine organ carcinoma;
• thyroiditis Hashimoto;
• idiopathic myxidema;
• pernicious anemia;
• subacute thyroiditis Querviain;
• other autoimmune diseases and chromosomal disorders (Down syndrome, Turner syndrome).

Antibodies to TPO (thyroid peroxidase)

The norm is 0-30 IU / ml. Exceeding this level of antibodies is an indicator of genetic predisposition and, together with an elevated level of TSH, makes it possible to predict the development of hypothyroidism in the future.

These are the main indicators. Thyroid hormones, along with some other examinations, will make it possible to make a diagnosis and, if necessary, prescribe adequate treatment. You should always remember what important functions the thyroid gland has. Most health problems are associated with it. It is necessary to constantly carry out preventive measures, visit an endocrinologist and carry out the studies prescribed by him.