Hypothyroidism with high tsh: Hypothyroidism diet: Can certain foods increase thyroid function?
Hypothyroidism diet: Can certain foods increase thyroid function?
Is there any truth to the hypothyroidism diet? Can certain foods increase thyroid function?
Answer From Ann Kearns, M.D., Ph.D.
Generally, there’s no hypothyroidism diet. Although claims about hypothyroidism diets abound, there’s no evidence that eating or avoiding certain foods will improve thyroid function in people with hypothyroidism.
However, adequate dietary iodine is essential for normal thyroid function. In developed countries, thyroid disease from iodine deficiency has been nearly eliminated by iodine additives in salt and food. Eating a balanced diet makes taking supplemental iodine unnecessary. In fact, too much iodine can cause hyperthyroidism in some people.
Other supplements such as soy, taken in large amounts, may have an impact on thyroid hormone production but won’t cause hypothyroidism in people who are not also iodine deficient.
Avoiding dietary extremes will ensure thyroid health. If you have concerns, talk with your doctor about taking a multivitamin with minerals.
If you have hypothyroidism, take thyroid hormone replacement medication as directed by your doctor — generally with an empty stomach. It’s also important to note that too much dietary fiber can impair the absorption of thyroid hormone replacement medication. Certain foods, supplements and medications can have the same effect.
Avoid taking your thyroid hormone at the same time as:
- Soybean flour
- Cottonseed meal
- Iron supplements or multivitamins containing iron
- Calcium supplements
- Antacids that contain aluminum, magnesium or calcium
- Some ulcer medications, such as sucralfate (Carafate)
- Some cholesterol-lowering drugs, such as those containing cholestyramine (Prevalite) and colestipol (Colestid)
To avoid potential interactions, eat these foods or use these products several hours before or after you take your thyroid medication.
Supplements containing biotin, common in hair and nail preparations, can interfere with the measurement of thyroid hormone. Biotin does not affect thyroid hormone levels, but supplements should be stopped for at least a week before measuring your thyroid function so that your thyroid status is accurately reflected.
Ann Kearns, M.D., Ph.D.
- Thyroid disease: Can it affect a person’s mood?
- Hypothyroidism: Can calcium supplements interfere with treatment?
June 01, 2021
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Hypothyroidism: Symptoms and Treatments of Hypothyroid Disease
Hypothyroidism (Underactive Thyroid)
Part 1: Too Little Thyroid Hormone
Hypothyroidism is a condition in which the thyroid gland is not able to produce enough thyroid hormone. Since the main purpose of thyroid hormone is to “run the body’s metabolism,” it is understandable that people with this condition will have symptoms associated with a slow metabolism.
While the estimates vary, approximately 10 million Americans are likely to have this common medical condition. In fact, as many as 10% of women may have some degree of thyroid hormone deficiency.
When your thyroid gland isn’t able to produce normal amounts of thyroid hormones, you’ll receive a diagnosis of hypothyroidism. Photo: 123rf
Hypothyroidism is more common than you would believe, and millions of people are currently hypothyroid and don’t know it. For an overview of how thyroid hormone is produced and how its production is regulated, check out our thyroid hormone production page.
Causes of Hypothyroidism
There are two fairly common causes of hypothyroidism. The first is a result of previous (or currently ongoing) inflammation of the thyroid gland, which leaves a large percentage of the cells of the thyroid damaged (or dead) and incapable of producing sufficient hormone.
The most common cause of thyroid gland failure is called autoimmune thyroiditis (also called Hashimoto’s thyroiditis), a form of thyroid inflammation caused by the patient’s own immune system.
The second major cause is the broad category of “medical treatments.” The treatment of many thyroid conditions warrants surgical removal of a portion or all of the thyroid gland. If the total mass of thyroid producing cells left within the body is not enough to meet the needs of the body, the patient will develop hypothyroidism. Remember, this is often the goal of the surgery for thyroid cancer.
But at other times, the surgery will be to remove a worrisome nodule, leaving half of the thyroid in the neck undisturbed. Sometimes, this remaining thyroid lobe and isthmus will produce enough hormone to meet the demands of the body. For other patients, however, it may become apparent years later that the remaining thyroid just can’t quite keep up with demand.
Similarly, goiters and some other thyroid conditions can be treated with radioactive iodine therapy. The aim of the radioactive iodine therapy (for benign conditions) is to kill a portion of the thyroid to prevent goiters from growing larger or producing too much hormone (hyperthyroidism).
Occasionally, the result of radioactive iodine treatment will be that too many cells are damaged so the patient often becomes hypothyroid within a year or two. However, this is usually greatly preferred over the original problem.
Learn More about Hypothyroidism: Hypothyroidism Slideshow: Causes, Symptoms, and Treatments
There are several other rare causes of hypothyroidism, one of them being a completely “normal” thyroid gland that is not making enough hormone because of a problem in the pituitary gland. If the pituitary does not produce enough thyroid stimulating hormone (TSH) then the thyroid simply does not have the “signal” to make hormone. So it doesn’t.
Symptoms of Hypothyroidism
- Weight gain or increased difficulty losing weight
- Coarse, dry hair
- Dry, rough pale skin
- Hair loss
- Cold intolerance (you can’t tolerate cold temperatures like those around you)
- Muscle cramps and frequent muscle aches
- Memory loss
- Abnormal menstrual cycles
- Decreased libido
If you have one or more of these symptoms contact your doctor.
Each individual patient may have any number of these symptoms, and they will vary with the severity of the thyroid hormone deficiency and the length of time the body has been deprived of the proper amount of hormone.
You may have one of these symptoms as your main complaint, while another will not have that problem at all and will be suffering from an entirely different symptom. Most people will have a combination of these symptoms. Occasionally, some patients with hypothyroidism have no symptoms at all, or they are just so subtle that they go unnoticed.
If you have these symptoms, you need to discuss them with your doctor. Additionally, you may need to seek the skills of an endocrinologist. If you have already been diagnosed and treated for hypothyroidism and continue to have any or all of these symptoms, you need to discuss it with your physician.
Potential Dangers of Having Hypothyroidism
Because the body is expecting a certain amount of thyroid hormone, the pituitary will make additional thyroid stimulating hormone (TSH) as a way to prompt the thyroid to produce more hormone.
This extra work at signaling the thyroid gland to keep producing TSH may cause it to become enlarged, leading to he formation of a goiter (termed a “compensatory goiter”). Left untreated, the symptoms of hypothyroidism will usually progress. Rarely, complications can result in severe life-threatening depression, heart failure, or coma.
Hypothyroidism can often be diagnosed with a simple blood test: the thyroid hormone panel. In some persons, however, it’s not so simple and more detailed tests are needed. Most importantly, a good relationship with a good endocrinologist will almost surely be needed.
Hypothyroidism is completely treatable in many patients simply by taking a small pill once a day. However, this is a simplified statement, and it’s not always so easy. There are several types of thyroid hormone preparations and one type of medicine will not be the best therapy for all patients.
Many factors must be considered in establishing a personalized plan for the treatment of hypothyroidism and it is different for every patient.
Questions to Ask Your Doctor
- What is the cause of my underactive thyroid (hypothyroidism)?
- Do I have Hashimoto’s disease?
- What do the results of my blood test mean?
- How long will I need medicine for my hypothyroidism and what are the side effects?
- What TSH level will you use as a target for me?
- After I’m in the optimal range, how often do you suggest I come back for blood tests to make sure my dosage needs haven’t changed?
- Am I at risk for related health problems?
- How quickly can I expect relief from my hypothyroid symptoms?
- Are there any lifestyle changes I can make to relieve my symptoms?
Once you have the answers to these questions, your doctor will have a better understanding of your concerns and needs, and can take all the information into consideration in formulating a thyroid management plan in discussion with you.
Updated on: 02/17/21
Hypothyroidism: Overview, Causes, and Symptoms
Treatment of Hypothyroidism – American Family Physician
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Hypothyroidism – Endocrine and Metabolic Disorders
L-Thyroxine, adjusted until TSH levels are in midnormal range
However, in patients with heart disease, therapy is begun with low doses, usually 25 mcg once a day. The dose is adjusted every 6 weeks until maintenance dose is achieved. The maintenance dose may need to be increased in pregnant women. Dose may also need to be increased if drugs that decrease T4 absorption or increase its metabolic clearance are administered concomitantly. The dose used should be the lowest that restores serum TSH levels to the midnormal range (though this criterion cannot be used in patients with secondary hypothyroidism). In secondary hypothyroidism the dose of L-thyroxine should achieve a free T4 level in the midnormal range.
Liothyronine (L-triiodothyronine) should not be used alone for long-term replacement because of its short half-life and the large peaks in serum T3 levels it produces. The administration of standard replacement amounts (25 to 37.5 mcg twice a day) results in rapidly increasing serum T3 to between 300 and 1000 ng/dL (4.62 to 15.4 nmol/L) within 4 hours due to its almost complete absorption; these levels return to normal by 24 hours. Additionally, patients receiving liothyronine are chemically hyperthyroid for at least several hours a day, potentially increasing cardiac risks.
Similar patterns of serum T3 changes occur when mixtures of T3 and T4 are taken orally, although peak T3 is lower because less T3 is given. Replacement regimens with synthetic T4 preparations reflect a different pattern in serum T3 response. Increases in serum T3 occur gradually, and normal levels are maintained when adequate doses of T4 are given. Desiccated animal thyroid preparations contain variable amounts of T3 and T4 and should not be prescribed unless the patient is already taking the preparation and has normal serum TSH.
In patients with secondary hypothyroidism, L-thyroxine should not be given until there is evidence of adequate cortisol secretion (or cortisol therapy is given), because L-thyroxine could precipitate adrenal crisis.
Myxedema coma is treated as follows:
Supportive care as needed
Conversion to oral T4 when patient is stable
Patients require a large initial dose of T4 (300 to 500 mcg IV) or T3 (25 to 50 mcg IV). The intravenous maintenance dose of T4 is 75 to 100 mcg once a day and of T3, 10 to 20 mcg twice a day until T4 can be given orally. Corticosteroids are also given because the possibility of central hypothyroidism usually cannot be initially ruled out. The patient should not be rewarmed rapidly, which may precipitate hypotension or arrhythmias.
Hypoxemia is common, so PaO2 should be monitored. If ventilation is compromised, immediate mechanical ventilatory assistance is required. The precipitating factor should be rapidly and appropriately treated and fluid replacement given carefully, because hypothyroid patients do not excrete water appropriately. Finally, all drugs should be given cautiously because they are metabolized more slowly than in healthy people.
Symptoms, Causes, Treatment & Medication
What is hypothyroidism?
Hypothyroidism is a condition where there isn’t enough thyroid hormone in your bloodstream and your metabolism slows down.
Hypothyroidism happens when your thyroid doesn’t create and release enough thyroid hormone into your body. This makes your metabolism slow down, affecting you entire body. Also known as underactive thyroid disease, hypothyroidism is fairly common.
When your thyroid levels are extremely low, this is called myxedema. A very serious condition, myxedema can cause serious symptoms, including:
This severe type of hypothyroidism is life-threatening.
In general, hypothyroidism is a very treatable condition. It can be controlled with regular medications and follow-up appointments with your healthcare provider.
How does my thyroid work?
The thyroid gland is a small, butterfly-shaped organ located in the front of your neck just under the voice box (larynx). Picture the middle of the butterfly’s body centered on your neck, with the wings hugging around your windpipe (trachea). The main job of the thyroid is to control your metabolism. Metabolism is the process that your body uses to transform food to energy your body uses to function. The thyroid creates the hormones T4 and T3 to control your metabolism. These hormones work throughout the body to tell the body’s cells how much energy to use. They control your body temperature and heart rate.
When your thyroid works correctly, it’s constantly making hormones, releasing them and then making new hormones to replace what’s been used. This keeps your metabolism functioning and all of your body’s systems in check. The amount of thyroid hormones in the bloodstream is controlled by the pituitary gland, which is located in the center of the skull below the brain. When the pituitary gland senses either a lack of thyroid hormone or too much, it adjusts its own hormone (thyroid stimulating hormone, or TSH) and sends it to the thyroid to balance out the amounts.
If the amount of thyroid hormones is too high (hyperthyroidism) or too low (hypothyroidism), the entire body is impacted.
Who is affected by hypothyroidism?
Hypothyroidism can affect people of all ages, genders and ethnicities. It’s a common condition, particularly among women over age 60. Women are generally more likely to develop hypothyroidism after menopause than earlier in life.
What’s the difference between hypothyroidism and hyperthyroidism?
In hypothyroidism, the thyroid doesn’t make enough thyroid hormone.
The difference between hypothyroidism and hyperthyroidism is quantity. In hypothyroidism, the thyroid makes very little thyroid hormone. On the flip side, someone with hyperthyroidism has a thyroid that makes too much thyroid hormone. Hyperthyroidism involves higher levels of thyroid hormones, which makes your metabolism speed up. If you have hypothyroidism, your metabolism slows down.
Many things are the opposite between these two conditions. If you have hypothyroidism, you may have a difficult time dealing with the cold. If you have hyperthyroidism, you may not handle the heat. They are opposite extremes of thyroid function. Ideally, you should be in the middle. Treatments for both of these conditions work to get your thyroid function as close to that middle ground as possible.
Symptoms and Causes
What causes hypothyroidism?
Hypothyroidism can have a primary cause or a secondary cause. A primary cause is a condition that directly impacts the thyroid and causes it to create low levels of thyroid hormones. A secondary cause is something that causes the pituitary gland to fail, which means it can’t send thyroid stimulating hormone (TSH) to the thyroid to balance out the thyroid hormones.
Primary causes of hypothyroidism are much more common. The most common of these primary causes is an autoimmune condition called Hashimoto’s disease. Also called Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis, this condition is hereditary (passed down through a family). In Hashimoto’s disease, the body’s immune system attacks and damages the thyroid. This prevents the thyroid from making and releasing enough thyroid hormone.
The other primary causes of hypothyroidism can include:
- Thyroiditis (inflammation of the thyroid).
- Treatment of hyperthyroidism (radiation and surgical removal of the thyroid).
- Iodine deficiency (not having enough iodine — a mineral your thyroid uses to make hormones – in your body).
- Hereditary conditions (a medical condition passed down through your family).
In some cases, thyroiditis can happen after a pregnancy (postpartum thyroiditis) or a viral illness.
What causes hypothyroidism in pregnancy?
In most cases, women with hypothyroidism during pregnancy have Hashimoto’s disease. This autoimmune disease causes the body’s immune system to attack and damage the thyroid. When that happens, the thyroid can’t produce and release high enough levels of thyroid hormones, impacting the entire body. Pregnant women with hypothyroidism may feel very tired, have a hard time dealing with cold temperatures and experience muscles cramps.
Thyroid hormones are important to your baby’s development while in the womb. These hormones help develop the brain and nervous system. If you have hypothyroidism, it’s important to control your thyroid levels during pregnancy. If your baby doesn’t get enough thyroid hormone during development, the brain may not develop correctly and there could be issues later. Untreated or insufficiently treated hypothyroidism during pregnancy may lead to complications like miscarriage or preterm labor.
Does birth control affect my thyroid?
When you’re on birth control pills, the estrogen and progesterone inside of the pills can affect your thyroid-binding proteins. This increases your levels. If you have hypothyroidism, the dose of your medications will need to be increased while you’re using birth control pills. Once you stop using birth control pills, the dosage will need to be lowered.
Can hypothyroidism cause erectile dysfunction?
In some cases, there can be a connection between untreated hypothyroidism and erectile dysfunction. When your hypothyroidism is caused by an issue with the pituitary gland, you can also have low testosterone levels. Treating hypothyroidism can often help with erectile dysfunction if it was directly caused by the hormone imbalance.
What are the symptoms of hypothyroidism?
The symptoms of hypothyroidism usually develop slowly over time – sometimes years. They can include:
- Feeling tired (fatigue).
- Experiencing numbness and tingling in your hands.
- Having constipation.
- Gaining weight.
- Experiencing soreness throughout your body (can include muscle weakness).
- Having higher than normal blood cholesterol levels.
- Feeling depressed.
- Being unable to tolerate cold temperatures.
- Having dry, coarse skin and hair.
- Experiencing a decrease sexual interest.
- Having frequent and heavy menstrual periods.
- Seeing physical changes in your face (including drooping eyelids, as well as puffiness in the eyes and face).
- Having your voice become lower and hoarser.
- Feeling more forgetful (“brain fog”).
Will hypothyroidism make me gain weight?
If your hypothyroidism is not treated, you could gain weight. Once you are treating the condition, the weight should start to lower. However, you will still need to watch your calories and exercise to lose weight. Talk to your healthcare provider about weight loss and ways to develop a diet that works for you.
Diagnosis and Tests
How is hypothyroidism diagnosed?
It can actually be difficult to diagnose hypothyroidism because the symptoms can be easily confused with other conditions. If you have any of the symptoms of hypothyroidism, talk to your healthcare provider. The main way to diagnose hypothyroidism is a blood test called the thyroid stimulating hormone (TSH) test. Your healthcare provider may also order blood tests for conditions like Hashimoto’s disease. If the thyroid is enlarged, your provider may be able to feel it during a physical exam during an appointment.
Management and Treatment
How is hypothyroidism treated?
In most cases, hypothyroidism is treated by replacing the amount of hormone that your thyroid is no longer making. This is typically done with a medication. One medication that is commonly used is called levothyroxine. Taken orally, this medication increases the amount of thyroid hormone your body produces, evening out your levels.
Hypothyroidism is a manageable disease. However, you will need to continuously take medication to normalize the amount of hormones in your body for the rest of your life. With careful management, and follow-up appointments with your healthcare provider to make sure your treatment is working properly, you can lead a normal and healthy life.
What happens if hypothyroidism is not treated?
Hypothyroidism can become a serious and life-threatening medical condition if you do not get treatment from a healthcare provider. If you are not treated, your symptoms can become more severe and can include:
- Developing mental health problems.
- Having trouble breathing.
- Not being able to maintain a normal body temperature.
- Having heart problems.
- Developing a goiter (enlargement of the thyroid gland).
You can also develop a serious medical condition called myxedema coma. This can happen when hypothyroidism isn’t treated.
Will I have the same dose of medication for hypothyroidism my entire life?
The dose of your medication can actually change over time. At different points in your life, you may need to have the amounts of medication changed so that it manages your symptoms. This could happen because of things like weight gain or weight loss. Your levels will need to be monitored throughout your life to make sure your medication is working correctly.
Can hypothyroidism be prevented?
Hypothyroidism cannot be prevented. The best way to prevent developing a serious form of the condition or having the symptoms impact your life in a serious way is to watch for signs of hypothyroidism. If you experience any of the symptoms of hypothyroidism, the best thing to do is talk to your healthcare provider. Hypothyroidism is very manageable if you catch it early and begin treatment.
Are there any foods I can eat to help my hypothyroidism?
Most foods in western diets contain iodine, so you do not have to worry about your diet. Iodine is a mineral that helps your thyroid produce hormones. One idea is that if you have low levels of thyroid hormone, eating foods rich in iodine could help increase your hormone levels. The most reliable way to increase your hormone levels is with a prescription medication from your healthcare provider. Do not try any new diets without talking to your provider first. It’s important to always have a conversation before starting a new diet, especially if you have a medical condition like hypothyroidism.
Foods that are high in iodine include:
- Dairy products.
- Meat, poultry and seafood.
- Edible seaweed.
- Iodized salt.
Work with your healthcare provider or a nutritionist (a healthcare provider who specializes in food) to craft a meal plan. Your food is your fuel. Making sure you are eating foods that will help your body, along with taking your medications as instructed by your healthcare provider, can keep you healthy over time. People with thyroid condition should not consume large amounts of iodine because the effect may be paradoxical (self-contradictory).
Can hypothyroidism go away on its own?
In some mild cases, you may not have symptoms of hypothyroidism or the symptoms may fade over time. In other cases, the symptoms of hypothyroidism will go away shortly after you start treatment. For those with particularly low levels of thyroid hormones, hypothyroidism is a life-long condition that will need to be controlled with medication on a regular schedule. It can be controlled very well and you can live a normal life with hypothyroidism.
Thyroid Function Tests – Managing Side Effects
What Is A Thyroid Function Test?
Your thyroid gland is an important part of our metabolism, and our body’s functioning.
The thyroid gland controls metabolism, or energy derived from the foods that you
eat, and maintains your normal body temperature, and heart rate. Your appetite and
your digestive system will also be affected by your thyroid gland.
The thyroid gland is also important in muscle and bone development, as well as normal
brain and nervous system functioning. The thyroid gland is located in the
middle of your neck.
There are many thyroid hormones. Each has a different role. It all starts with iodide,
a salt that is now found in most brands of table salt.
The iodide that you ingest is taken in by the thyroid gland. Here begins a complex
- Once converted to iodine, your serum T4, (called thyroxine) hormone is formed.
- The thyroxine hormone is converted into a more potent or active form of hormone,
your serum (blood) T3. This is also called triiodothyronine. These T4 and T3 hormones
will circulate in your body, and regulate your metabolism.
- Your FT4I (free thyroxine index) is another test used to measure your thyroid function.
- All of these thyroid function tests are all indicators
of your thyroid gland function.
- Thyroid stimulating hormone (TSH), is the most common test that is ordered if your
healthcare provider thinks that your thyroid gland is not functioning properly.
A gland, called the pituitary gland, secretes TSH. TSH is responsible for taking
iodide out of your blood stream, and into your thyroid gland. TSH is also responsible
for production of the thyroid hormone.
- If you have an abnormally high or low TSH level, whether
it is elevated or decreased, your healthcare provider may order serum (blood) T3, serum T4, or FT4I tests. While there are many other tests that can be performed,
these are the most common tests for diagnosing hyperthyroid or hypothyroid,
and the most specific indicators as to how well your thyroid gland is functioning.
- Based on your laboratory values of your thyroid function tests,
and your symptoms, your healthcare provider may decide whether or not to treat your
disease, whether it be hyperthyroidism or hypothyroidism.
- In cases of hyperthyroidism, your TSH level will be decreased, because there is
too much thyroid hormone in your blood. Your TSH levels will be decreased, if:
- You have Grave’s hyperthyroidism. This is the most common cause of hyperthyroidism.
For many reasons, your body is producing too much of the thyroid hormone.
- Your thyroid gland is too large, or you may have a thyroid tumor producing too much
of the thyroid hormone
- Your thyroid is infected, or inflamed, producing too much thyroid hormone
(resulting in hyperthyroidism).
- Your thyroid gland was injured, or removed, and you are taking too much thyroid
hormone in a pill form, as a replacement.
- In cases of hypothyroidism, the thyroid function test – TSH will be
increased, because there is not enough thyroid hormone in your blood.
Your TSH levels will be increased, if:
- Your thyroid gland is not working as it normally should
- Your thyroid gland is infected or inflamed, as in Hashimoto’s thyroiditis, or autoimmune
thyroiditis. This occurs when your body is attacking your thyroid gland, for some
unknown reason. Thyroiditis can also be seen after pregnancy.
- Your overactive thyroid gland was removed, and you are not taking enough hormone
pills to replace the normal thyroid hormone that was lost, thus resulting in high
- You may have a damaged thyroid gland.
- Too much or too little iodide intake- Either you are not taking enough iodide in
your diet, or you are taking too much iodide in your diet. Too much iodide will
suppress the hormone production.
- Certain medications, such as lithium (for a psychological condition, called bipolar
disorder), or amiodarone (for heart rhythm abnormalities), may cause low TSH levels
or hypothyroidism. Thalidomide, a drug that is used in many forms of cancers because it prevents new blood cell formation to tumor cells (anti-angiogenesis), may
cause hypothyroidism with long-term use.
- Radiation to the neck area may cause hypothyroidism (as in head and neck cancer)
Normal levels of thyroid hormones in thyroid function tests:
Symptoms of Hypothyroidism and Hyperthyroidism:
- If you have a hyperactive (over active) thyroid, you may notice these symptoms:
- Weight loss, eye or vision changes.
- Palpitations, rapid heartbeat, shakiness, sweating, feeling “hot”
- Diarrhea, stomach and bowel abnormalities or anxiety
- Insomnia (trouble sleeping), fatigue, weakness, or hair loss
- An enlarged thyroid gland, or a goiter, may result
- If you have a hypoactive (under active) thyroid, you may notice these symptoms:
- Weight gain, depression, forgetfulness, decreased concentration or fatigue
- Hoarseness, feeling cold or sluggish, hair loss, dry skin, round puffy face (seen
with a severely depressed thyroid gland), or tingling in your hands/feet
- High cholesterol, constipation, irregular or heavy menstrual periods in pre-menopausal
women, low sex drive or infertility.
Things You Can Do About Thyroid Malfunction:
If you notice any of these symptoms, visit your healthcare provider for an examination.
The diagnosis of hypothyroid and hyperthyroid include a history (your family and
health history may place you at risk), physical examination, and key
thyroid function tests. Sometimes, an ultrasound or the
thyroid gland may also be ordered. There are treatments for each of these diseases.
Follow your entire healthcare provider’s instructions regarding laboratory testing
for your disease, and follow up care depending on the results. .
- Try to exercise. Make a daily walk alone, or with a friend or family member a part
of your routine. Even light walking or aerobic activity may help you to promote
the flow of oxygen in your lungs and blood (oxygenation), and make you feel better.
- Follow a good diet. In general, increase your intake of fresh fruits and vegetables.
Limit your intake of fats. Eat carbohydrates (such as sugars and pastas) in moderation.
- Make sure you tell your doctor, as well as all healthcare providers, about any other
medications you are taking (including over-the-counter, vitamins, or herbal remedies).
These can cause interactions with other medications.
- Remind your doctor or healthcare provider if you have a history of diabetes, liver,
kidney, or heart disease.
- Keep yourself well hydrated. Drink two to three quarts of fluid every 24 hours,
unless you are instructed otherwise.
- If you experience symptoms or side effects of your disease or therapy, especially
if severe, be sure to discuss them with your health care team. They can prescribe
medications and/or offer other suggestions that are effective in managing such problems.
- Keep all your appointments.
Drugs That May Be Prescribed by Your Doctor:
If you have an overactive thyroid (hyperthyroidism) your doctor or healthcare provider
- Drugs to decrease your thyroid levels – may include Methimazole (Tapazole®), or propylthiouracil (PTU). These pills are used once a
day, to decrease your thyroid hormone production. You may need to take this once
a day, at the same time each day, for a year or longer, to treat your hyperthyroidism.
- Propranolol – this is a medication to treat your hyperthyroidism. Also used to treat
heart problems, including palpitations, it will decrease your resting heart rate.
- If you are on any of these medications, you must follow your healthcare provider’s
recommendations, including medication schedule, and follow up visits.
If you have an underactive thyroid (hypothyroidism) your doctor or healthcare provider
- Levothyroxine: This is a synthetic form of a thyroid hormone that will normalize
all of your thyroid functioning. It is given in a pill form. You may not see a change
in your symptoms for 3 to 6 weeks. You may take this pill once a day, with or without
- You will be required to have periodic thyroid function tests particularly
checking your TSH levels to monitor the effectiveness of your dose.
Based on your condition, and when you were diagnosed, your healthcare provider will
arrange a schedule that is right for you.
- There are many drug interactions with the thyroid hormone. Make sure your tell all
your healthcare providers what medications you are taking, so that your dose can
be maintained at a “therapeutic” level.
- You will be required to have periodic thyroid function tests particularly
Return to list of Blood
Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
Subclinical hypothyroidism or isolated high TSH in hospitalized patients with chronic heart-failure and chronic renal-failure
This was a retrospective study analyzing existing data of hospitalized patients admitted to the Medicine Division of our medical center for any reason. During the study period, TSH level was measured for all patients as part of the admission profile after an overnight fast, and if TSH level was found to be increased, then FT4 level was also measured. The study included all patients hospitalized in the internal medicine departments as well as Geriatrics, Cardiology, Nephrology and Neurology. Patients in Intensive Care Units and Oncology departments were not included. The data were collected from electronic medical records. All patients over the age of 18 who were hospitalized between the years 2013–2016 with subclinical hypothyroidism and a TSH level above normal (4.95 mIU/L) and up to < 12 mIU/L were identified. This TSH cutoff was chosen because we wanted to include the highest TSH that is not associated with deterioration to overt hypothyroidism. Next, all patients who had at least one recurring admission within at least 6 months were included. In addition, all patients who had a recurring admission within at least 1 year were included. From each hospitalization, laboratory data were collected on admission including thyroid function tests, C-reactive protein (CRP), and creatinine. The blood was drawn in the morning after an overnight fast. In addition, patients with congestive heart failure (systolic or diastolic) and advanced chronic renal failure with a calculated glomerular filtration rate (eGFR) less than 30 ml/min/1.72 m2 (chronic kidney disease, CKD, stages 4 and 5) were identified. Chronic renal failure was determined according to chronic renal failure diagnosis in the patient history and based on eGFR of less than 30 ml/min/1.72 m2. Heart failure diagnosis was based on patient history diseases list and was verified according to the laboratory and imaging tests, as well as drug therapy. On recurrent admissions it was determined whether the thyroid function tests had improved, had not changed or had worsened.
Patients with thyroid disorders who needed pharmacologic treatment in the first hospitalization, or with a thyroid function test that was performed after transfer from another department, were excluded from the study as well as patients who took medications with a significant effect on thyroid function (in any hospitalizations) including levothyroxine, anti-thyroid drugs, amiodarone, systemic corticosteroids, phenytoin, carbamazepine, rifampicin, lithium, interferon, interelekin-2, and tyrosine kinase inhibitors.
A change in thyroid function during the last re-admission was determined according to the following: TSH level within the normal level was defined as an improvement, an increased TSH level but less than 12 mIU/L was defined as no change, and a TSH level over 12 mIU/L or initiation of levothyroxine treatment was defined as worsening of thyroid function. We included all TSH levels in readmission cases, and did not limit them to 12 mUI/L as had been done in the inclusion criterion during the first admission.
In order to examine the association between background diseases (heart failure and chronic renal failure) and gender, and worsening of SCH, we considered the cases with improved or unchanged TSH on re-admission as one group and compared them to patients who had worsening in hypothyroidism on re-admission. The relationship between age, TSH and CRP levels on first admission, and worsening of hypothyroidism on re-admission was analyzed twice. First, the data from all groups of TSH on re-admission (improvement, no change, and worsening) were analyzed, and again the groups were divided into those who had worsening in TSH or initiation of thyroxine treatment, and those who did not worsen.
TSH and FT4 levels were measured using chemiluminescent microparticle immunoassay in the Architect i2000SR (Abbott Diagnostics, Illinois, USA), in which the normal ranges for TSH were 0.35–4.98 mIU/L, for FT4 9–19 pmol/L (0.7–1.48 ng/dL) and for FT3 2.6–5.7 pmol/L (1.71–3.71 pg/ml). CRP levels were analyzed using an immunoturbidimetric assay on the Architect System (Abbot Diagnostics, Illinois, USA) in which the normal range was 0.2–5 mg/L.
Quantitative data were described using averages and standard deviations, median, and range. Qualitative data were described by frequencies and percentages. Comparisons between groups of patients were conducted using Wilcoxon rank sum test for quantitative data and Chi square test, Fisher’s exact test for qualitative data or Fisher-Freeman-Halton Exact Test. Logistic regression was used to confirm the independent correlations with hypothyroidism exacerbation. The statistical analysis was performed using SPSS 19, a p value less than 0.05 was considered significant.
The study was approved by the Galilee Medical Center’ Institutional Review Board (NHR009914). All procedures were carried out according to relevant guidelines.
Informed consent was waived by the Galilee Medical Center IRB.
90,000 insufficient formation of thyroid hormones: causes, symptoms, diagnosis and treatment methods on the website “Alpha Health Center”
The difficulty in diagnosing hypothyroidism is that a disease characterized by a violation of the production of thyroid hormones is often latent. It has several varieties and stages, including latent, when the symptoms of hypothyroidism are weak or not manifested at all. Because of this, it is difficult to detect pathology on your own, without contacting a specialized specialist and an appropriate examination.At the same time, with early diagnosis, the prognosis of treatment is favorable.
The Alfa Health Center Clinic in Moscow invites you to make an appointment with an endocrinologist with over 7 years of experience. Here you can go through a complex of laboratory tests and receive a personalized plan of therapeutic measures.
Forms and causes of the disease
Hypothyroidism is often called a disease of megacities: due to the poor environmental situation and the lack of iodine prophylaxis in large cities, it is more common than in rural areas.The disease affects people of different social status and gender. However, it is 5 times more common in women. The age of the patient is also important: after 40 years, the likelihood of developing an endocrine disorder increases.
How thyroid hypothyroidism manifests itself can be determined by its form:
The primary form of pathology is a condition that develops as a result of damage to the thyroid gland.It is characterized by an increase in the production of a hormone called thyroid-stimulating hormone. It develops due to autoimmune disruptions, as well as as a result of previous drug treatment of diffuse and diffuse nodular goiter, or iodine deficiency. Congenital hypothyroidism is also distinguished, most often due to insufficient development of the thyroid gland.
The secondary form is the result of damage to the hypothalamic-pituitary system, that is, individual sections of the GM, in which the production of TT is disrupted and the functions of the thyroid gland deteriorate.
There is information about the tertiary form of hypothyroidism that it is a consequence of pathological lesions of the hypothalamus. Both of these forms develop due to trauma, surgery, tumors and other conditions that provoke disturbances in the hypothalamus or pituitary gland.
To understand how hypothyroidism develops, it is worth considering the role played by thyroid hormones, as well as the functioning of this organ.Thyroid hormones are involved in the regulation of metabolic processes, and also stimulate the functioning of internal systems, including the nervous, immune and cardiovascular. The pathological state of the gland will certainly affect the processes of growth and multi-vector development of the body, the activation of the functions of the adrenal glands, mammary and gonads. It is not surprising that deviations in the secretion of hormones of this gland have an extremely negative effect on health and well-being, the work of many organs and systems.
Hypothyroidism is a disease that develops gradually and is difficult to diagnose.The reason is that most of its clinical manifestations are nonspecific. Symptoms characteristic of hypothyroidism are characteristic of other diseases as well, and sometimes can be attributed to general malaise, overwork, and chronic fatigue. At the same time, the severity of symptoms does not show a correlation with the severity of the disease: sometimes, in patients with laboratory signs of this syndrome, there are no external manifestations of the disease.
Rapid weight gain
A common symptom of hypothyroidism is rapid weight gain.It is associated in the overwhelming majority of cases not with the accumulation of fat reserves, but with swelling. Hypothyroidism is usually accompanied by a decrease in metabolic rate and fluid retention. It also leads to weight gain.
The increase in body weight can be associated with other reasons: decreased physical activity and eating disorders. Failures and disruptions in the work of the endocrine system that occur during hypothyroidism are accompanied by causeless weakness, lethargy, and rapid fatigue.As a result, a girl or a man pays less attention to physical activity and gains weight.
Hypothyroidism is often accompanied by an increase in the level of “bad” cholesterol. The reason lies in a decrease in the activity of lipoprotein lipase, which leads to a deterioration in the mechanism of excretion of atherogenic lipids.
With an exacerbation of hypothyroidism, symptoms of puffiness appear:
- Puffiness and swelling of the face;
- swelling and swelling of the nasal mucosa;
- Difficulty in nasal breathing;
- lip augmentation;
- the appearance of distinguishable imprints of the dentition on the tongue;
- hearing impairment;
- Thickening of the vocal cords – the voice becomes harsh.
Also, with hypothyroidism, there may be swelling of the upper and / or lower eyelids of one or both eyes, inflammation of the serous membranes of the pleura, peritoneum, pericardium.
In case of hypothyroidism, symptoms can also be expressed in regular dry skin, its thickening and coarsening. Patients complain of brittle nails and splitting, hair loss. However, these symptoms can indicate both thyroid disorders and a number of other endocrine disorders.
Diagnosis of hypothyroidism in old age can be difficult due to the fact that changes in the condition of the skin, nail plates and hair are often interpreted as normal manifestations of aging. Also, these symptoms are characteristic of secondary mucinosis, dimphostasis, amyloid lysene. Despite the similarities in external manifestations, the mechanism of development of these diseases is different.
Sexual and Reproductive Function
Frequent symptoms of hypothyroidism in girls and women are irregularities in the menstrual cycle, its frequency, soreness, and an abundance of discharge.The disease can also manifest itself as changes in the breast and mastopathy. Hypothyroidism in women in position increases the risk of miscarriage or placental abruption.
In men, hypothyroidism often leads to erectile dysfunction and decreased libido.
The clinical symptoms of hypothyroidism often include a variety of malfunctions in the digestive system. Patients complain of decreased appetite, regular nausea and constipation.Gallbladder dysfunction often occurs. These symptoms can be a manifestation of other diseases, but if they are accompanied by any other signs of hypothyroidism, a visit to an endocrinologist is required.
Cognitive functions and psychoemotional state
What else is insidious hypothyroidism – symptoms can manifest itself in impaired cognitive functions. Patients report complaints of forgetfulness, absent-mindedness, drowsiness, and tearfulness. In 8-18% of cases, hypothyroidism is associated with depression.
Violations can also manifest themselves in a decrease in tissue sensitivity, in particular polyneuropathy and deterioration of reflexes. With a severe form of hypothyroidism and the absence of therapy, it is possible to reduce intellectual abilities and even develop dementia. Their appearance can be prevented only with the help of timely diagnostics.
According to statistics, from 10 to 80% of cases of the disease are accompanied by sleep apnea syndrome. This symptom is more common in older men.There are two explanations why hypothyroidism manifests itself in this way:
- Decrease in the activity of the respiratory center, leading to impaired ventilation of the lungs;
- Protein sweating into the muscles of the pharynx and tongue, which is also accompanied by obstruction.
For this reason, patients with sleep apnea syndrome are shown to be examined for the presence of disorders in the endocrine system, in particular the thyroid gland.
Hypothyroidism also leads to a complication of the course and exacerbation of bronchial asthma.
Latent thyroid hypothyroidism, the symptoms of which are difficult to diagnose, is often similar to the manifestations of thoracic or cervical osteochondrosis. Patients complain of weakness in the hands, tingling and burning sensations, unpleasant “goosebumps” on the skin. With hypothyroidism, myalgia (muscle pain) in the upper extremities is possible.
Disorders in the work of the musculoskeletal system are rarely associated with malfunctions of the endocrine system.But if there are no other reasons for the appearance of these symptoms (injuries, the presence of other chronic pathological conditions), it is advisable to check the state of the thyroid gland.
With hypothyroidism, patients are prescribed a planned ECG. It allows you to identify abnormalities in the work of the heart muscle and blood vessels. Typical consequences of hypothyroidism are circulatory failure, weak and infrequent pulse, low blood pressure. ECG allows not only to diagnose the syndrome, but also to notice and prevent cardiovascular complications in time.
One of the earliest symptoms of hypothyroidism in women and men is the development of diastolic arterial hypertension. The disease is accompanied by a change in the total peripheral resistance of blood vessels. Also, hypothyroidism plays an important role in the development of coronary artery disease.
The syndrome is diagnosed by determining the concentration of TT, or thyroid-stimulating hormone. In adult patients, its value normally varies within 0.3-4.2 μIU / ml. Also, the patient is prescribed a study to determine T4 (free thyroxine).
Treatment of hypothyroidism in most diagnosed cases consists of lifelong replacement therapy. Exceptions are cases in which a violation of TT production is associated with side effects of drugs or any other substances. The drug of choice for this disease is levothyroxine sodium.
The condition of a patient with hypothyroidism after the appointment of therapy will improve gradually.The first signs of improvement after properly selected treatment are observed no earlier than 2-3 weeks later. A pronounced therapeutic effect is usually achieved after a few months.
Diet plays an important role in the treatment of hypothyroidism. Patients with this disease are advised to reduce the consumption of easily digestible carbohydrates – to give up baked goods, jam, honey, jam, sugar.
Self-control of the patient over his condition is no less important.In order to diagnose secondary hypothyroidism in time, it is useful to keep a diary, registering changes in body weight, blood pressure and pulse rates, and general well-being. This measure helps to reduce the risk of developing complications of hypothyroidism and eliminate the side effects of hormone replacement therapy.
Diagnostics and treatment of hypothyroidism in Moscow
In the “Alpha Health Center” you can get an endocrinologist’s advice and go through the necessary complex of laboratory tests.Reception is by appointment. We work every day, seven days a week. Call us!
90,000 10 Thyroid Health Rules Everyone Should Know
Thyroid hormones affect every cell in the human body.
It is especially important for women to remember this, because a dysfunction of the thyroid gland can cause health problems for women.
CF “Kvitna” turned to the chief physician of the Kiev City Clinical Endocrinological Center, Doctor of Medical Sciences, Professor, Honored Doctor of Ukraine – Nikolai Vasilyevich Gulchiy to remind women of the rules for the prevention of thyroid diseases.
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Thyroid hormones are important for the functioning of every cell in the body
The thyroid hormone thyroxine is very important for the functioning of every cell that makes up a person. The thyroid gland produces it and transports it into the blood, which, in turn, carries thyroxine to all cells of our body. It saturates the cell, sitting on the receptors of the cell nucleus, and waits for the cell to use it.The cell uses it in order to obtain energy for work, that is, thyroxine participates in a biochemical reaction in the cell, and the cell, as a result of utilizing drops of fat and protein inside it, receives energy, heat and removes water.
Thyroid hormones affect the reproductive organs of a woman
It affects every cell in the body. The egg is also a cell, it needs energy during maturation. If there is a good hormonal background inside the cell, such a cell has a sufficient amount of energy, in particular, when it comes to an egg, it has enough energy for maturation and fertilization, and pregnancy proceeds normally.When there is little hormone, then the egg is immature, without energy, and menstruation goes on, and pregnancy does not occur, and if the amount of the hormone is insufficient, early pregnancy can fail. That is why, before planning a pregnancy, it is imperative to examine the hormonal background not only of the ovaries, but also the hormonal background of the thyroid gland. In my medical practice, I have repeatedly met cases when a girl’s hormonal background was low, and she examined everything except him, and everything was in order, except for the thyroid hormones, and as soon as we raised the hormonal background, pregnancy began.
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In the human body, all hormones are interconnected through the pituitary gland
In the body, all hormones are interconnected. The “command” of all hormones “sits” in the pituitary gland – it is the central gland at the base of the brain that produces the controlling hormones. Some control hormones are produced in the same lobule of the pituitary gland, and in order for the hormone to be produced, the lobule must be excited (anything is produced in a state of arousal).When a certain lobule of the pituitary gland is excited about some other hormone, and another hormone is produced in that same lobule, then during arousal it is also produced. For example, in hypothyroidism, a lobule of the pituitary gland is excited to produce thyroid-stimulating hormone to stimulate the thyroid gland, since it needs stimulation due to a lack of hormones. But, simultaneously with thyroid-stimulating hormone, prolactin begins to be produced in the same lobule, and it affects the female sphere, inhibiting the follicle with a stimulating hormone, then the egg does not mature either.Therefore, some changes in one hormone can provoke changes in another, thus causing various female problems.
Changes in thyroid hormone can cause changes in the mammary glands
Ovarian hormones affect the mammary gland, but since thyroid hormones through the pituitary gland and controlling thyroid-stimulating hormone are associated with prolactin, changes in thyroid hormone can cause changes glands that belong to the female sphere.Therefore, women always need to check thyroid hormones, control their levels, and normalize them if necessary.
Today there are ready-made hormones that normalize the work of all cells, including the cells of the glandular epithelium of the mammary gland, the endometrium of the uterus, since they contain thyroid-stimulating hormone receptors. Therefore, I emphasize once again that the interconnection of the endocrine glands is close and their synergistic action should always be, and especially during pregnancy.
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Thyroid screening must be done before and during pregnancy
We recommend checking the thyroid hormone content in the cells of women who are preparing for pregnancy or becoming mothers, regardless of whether there was surgery in the thyroid gland or not, because hormones that it produces are of great importance for the cells of the whole body, also for the cells of the baby, because the baby is also made up of cells and he needs thyroid hormones for the energy of the cells, for reproduction and growth.Therefore, pregnant women need to check thyroid hormones every 2-3 months, and if they are normal, then the woman and the child are all right.
We have a lot of experience in this, because after the Chernobyl accident, quite a lot of girls were operated on with a diagnosis of thyroid cancer, now they are on substitution therapy, that is, they take ready-made hormones, and I do not see any problems in terms of pregnancy or bearing child and on examination everything is going well.
Signs of hormonal imbalance in the thyroid gland
As a rule, the woman herself cannot notice any special changes in the state of the endocrine system, however, there are sharp changes when there are very few hormones, then:
- overweight actively arises;
- weakness occurs;
- drowsiness appears;
- dry skin;
- edema occurs.
All these signs are inherent in women, when hormones are clearly not enough. Also, a woman can feel a significant excess of hormones, then she:
- is actively losing weight;
- sweating appears;
- hand tremors, tremors;
- heart palpitations.
This is if the amount of hormones is significantly reduced or increased, if the deviations are not significant, then the woman does not feel these signs, because the deficiency or excess is acquired slowly.
Thyroid hormones must be checked from childhood
It is important to check the hormonal background not only for women, but also for men and children, because men also have a hormone-dependent organ. It is especially important to monitor the hormonal background of children, because the child is growing and the need for hormones is great, and the energy costs are high enough, and the more the child works mentally or moves, the more thyroid hormone is spent.
It is important to check all thyroid hormones comprehensively
To be sure of your health, you need to check the amount of hormones T3, T4 and the pituitary tereotropic hormone (TSH), which controls the hormone of the pituitary gland, because it shows whether there are enough hormones in the body.A high level of TSH in the body indicates that the body does not mind if there were more hormones. Low TSH levels – indicates that the body is well saturated with the hormone. It is important to check all these hormones: T3, T4 and TSH in a complex manner, because the TSH indicator alone, let’s say low, creates a picture of thyrotoxicosis in a patient, that is, when there are more hormones than needed. However, as a rule, the hormone TSH is low in 3 cases: when the thyroid hormone approaches the upper limit of the norm; when he is at the upper limit of the norm; and when it is above normal.This indicator is “above normal” – we are not satisfied, therefore, it is not enough to determine whether TSH is low.
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Saturation of the body with iodine does not always provide the body with thyroid hormones
There are myths that “If there is no iodine, the child will be undeveloped.” In fact, iodine is needed for the production of the hormone, and saturation of the body with iodine does not always ensure success, because the thyroid gland is not always able to produce the hormone from iodine.There are various diseases, such as autoimmune thyroiditis, chronic thyroiditis, Riedel goiter, multinodular goiter, when part of the gland falls out of function, in such cases iodine is not always able to provide hormone production. Iodine can be given, the content of iodine in the urine can be determined and it will be high, because the gland has not taken it, it must be excreted, and there is no hormone in the gland, since the gland did not produce it. Therefore, the most effective method for both pregnant women and children is to determine whether the gland produces the hormone in sufficient quantities.Sometimes, if we see the ability of the gland to produce a hormone from iodine, we prescribe iodine, as well as other trace elements such as selenium, and in cases where we see that the thyroid gland does not produce the hormone from iodine, then it is not effective, therefore it is necessary to give ready hormone.
The pathology of the thyroid gland is currently affected not only by the consequences of the Chernobyl nuclear power plant, but also by the ecology of large cities
In Ukraine, there are endemic areas of varying degrees of iodine deficiency.It is the Chernobyl region that is an average degree, but iodine deficiency was and is now and, of course, the thyroid gland captures as much iodine as it needs. When there was a shortage of iodine supplies to the thyroid gland, it was saturated with iodine, which appeared in the air as a result of the explosion at the Chernobyl nuclear power plant – iodine 131 and iodine 132, which played a latent effect on the cells of the thyroid gland on its genetic apparatus, especially in young people, when the thyroid gland formed, and today we observe that before Chernobyl there were 3.5 cases of thyroid cancer per 100,000 population, and now 13 cases per 100,000 population.But thyroid cancer itself existed before Chernobyl, and it still exists today. And here the influence of heavy metal salts should also be noted – this is the ecology of large cities, including Kiev, which has its own oncogenic effect. Our recent research, culminating in the dissertation of our employee, testifies to the relationship between pollution in certain areas of the capital and the growth of oncology, in these areas.
The use of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in patients with differentiated thyroid cancer after initial treatment
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Thyroid hormone blood test – Medical tests and laboratories
If you watch an advertisement on TV, then there are often advertisements about the benefits and necessity of iodine for our body. This applies to both drugs (Iodomarina, for example) and food.
And iodine, which enters our body from the outside, is important for the normal functioning of the thyroid gland. Because it is part of the hormones that it produces – thyroxine and triiodothyronine (T4 and T3 – contain 4 and 3 iodine atoms in the molecule, respectively).These hormones affect the metabolism of proteins, fats, carbohydrates, the activity of the respiratory, cardiovascular and nervous systems, affect the immune system and fertility. Thyroid hormones are especially important for the normal physical and mental development of a child during the first three years of life. If the thyroid gland is not producing enough hormones from birth, mental retardation may develop. They are also necessary for older children for growth and normal development, as well as for adults, as they participate in the metabolism and energy in the body.
Thyroid hormone tests are laboratory tests that help your doctor assess how well your thyroid is functioning. In addition to determining the level of thyroid hormones, the determination of thyroid-stimulating hormone (TSH, TSH) is usually used to diagnose the state of the thyroid gland.
- Thyroxine total (T4) The vast majority of this hormone in the blood is bound to a special protein called thyroxine-binding globulin (TSH).Less than 1% of thyroxine is in a free state. Total T4 includes both free and protein-bound thyroxine. However, only free thyroxine has the ability to influence metabolism. Free thyroxine (Free thyroxine, FT4). In the blood serum, either FT4 is determined directly, or the free thyroxine index is the ratio of the bound and free fraction of the hormone.
- Total triiodothyronine (total T3, Total Triiodthyronine) is also predominantly (more than 99%) in the blood in a protein-bound form.The content of triiodothyronine in the blood is approximately 30-50% of the T4 level. But, despite this, triiodothyronine has a higher activity than thyroxine. It is partially synthesized by the cells of the thyroid gland, but most of it is formed in organs and tissues from thyroxine by deiodination.
- Free triiodothyronine (Free T3, Free Triiodthyronine) – not associated with protein carriers fraction of T3.
- Calcitonin – thyroid hormone.which regulates calcium metabolism in the body.
- Thyroid-stimulating hormone (TSH, TSH, thyrotropin) is produced by the anterior pituitary gland, increasing the synthesis of hormones by the thyroid gland according to the feedback principle. Those. with a decrease in the level of T3 and T4 in the blood, the amount of TSH in the serum increases, and vice versa. The level of TSH in the blood makes it possible to assess the functional state of the “controlled” gland. During the day, fluctuations in the level of the hormone are noted: the peak concentration is observed in the pre-morning hours and significantly decreases in the evening.The TSH level is the most sensitive marker of even a small deficiency or excess of thyroid hormones, and fluctuations in its values are determined earlier than changes in the level of thyroxine and triiodothyronine occur. Despite the fact that the normal values for TSH depend on the method of research in this particular laboratory, the generally accepted norms for thyrotropin are considered to be the level of the hormone 0.4 – 4.0 mU / L
In addition, for the diagnosis of autoimmune diseases of the thyroid gland, the level of antithyroid antibodies is determined:
- Antibodies to thyroglobulin (AT-TG, anti-thyroglobulin autoantibodies)
- Antibodies to thyroid peroxidase (AT-TPO, microsomal antibodies, anti-thyroid peroxidase autoantibodies)
- AT to rTTG – antibodies to TSH receptors
- AT-MAG – antibodies to the microsomal fraction of thyrocytes
Other laboratory tests for evaluating the performance and diagnosis of thyroid disease are less common in clinical practice.
- Thyroglobulin – thyroxine precursor protein, the main substance of the thyroid colloid, from which thyroid hormones are formed
- Thyroxine-binding globulin (TSH) is a protein that specifically binds T4 and T3 and inactivates them.
- Thyroxine-binding capacity of human serum or plasma (Thyroid hormone uptake test, Thyroid Uptake)
Preparation for blood tests for thyroid hormones
– it is preferable to take tests in the morning, from 8 to 10 o’clock
– on an empty stomach (last meal 10-12 hours before the examination)
– psycho-emotional and physical comfort (calm state without overheating and hypothermia)
– on the eve of the study, exclude physical activity, alcohol intake, refrain from smoking
– during the initial check of the level of thyroid hormones, cancel drugs that affect the function of the thyroid gland 2-4 weeks before the study
– when monitoring treatment, exclude taking drugs on the day of the study and be sure to note this in the referral form (as well as about the use of some other drugs – aspirin, tranquilizers, corticosteroids, oral contraceptives)
Indications for the study of thyroid hormones and TSH
– Diagnosis of abnormalities in the function of the thyroid gland in patients with suspected hypo- and hyperthyroidism (with an increase in the thyroid gland, with the appearance of symptoms of metabolic disorders and changes in body weight to confirm the clinical diagnosis of thyroid diseases)
– control of ongoing treatment (assessment of the effectiveness and control of the dosage of drugs)
– condition after thyroid surgery
– diagnosis of congenital hypothyroidism in newborns
– for prophylactic purposes in pregnant women, in residents of endemic areas with iodine deficiency, when using contraceptives
– examination of women with infertility
I will write about where you can go to examine the condition of the thyroid gland next time.