How to get tested for TSH, T4 and T3 correctly. How to donate and what does the TSH blood test show? The hormone ttg is taken on an empty stomach or

Sooner or later, all people have to take tests for thyroid hormones. Depending on how well the patient prepared for blood sampling to check certain reference values, the exact result of the thyroid hormone norm (free T4 or TSH) will be revealed.

Each person should be well informed about how to donate blood correctly, how to prepare for this procedure and how much to prepare for testing. Many women are interested to know - what day monthly cycle Do you need to pass TSH or T4, T3 free so that the blood tests are revealed as correct as possible? This article will reveal all the answers to questions regarding preparation for testing for thyroid hormones.

The norm of indicators of reference values

The thyroid gland produces 5 main hormones. If you suspect a disease, a certain analysis is submitted.

Thyroid-stimulating hormone

Thyroid stimulating hormone (TSH) is an important indicator in testing, since it is produced by the pituitary gland itself and is responsible for all the work of the thyroid gland. You need to carefully prepare for its analysis. The obtained reference values ​​of the analyzes will tell you a lot.

• if ttg is below normal, then this may indicate thyrotoxicosis or hyperthyroidism;
• if, after passing the analysis, it turns out that TSH is increased, then this indicates that the thyroid gland produces an insufficient amount of hormones, and the pituitary gland is excessively active.

Usually a high TTG indicates:

• hypothyroidism;
• adrenal gland disease;
• mental disorders.

In women, it is given up on any day of the menstrual cycle, on an empty stomach. The normal range of TSH is from 0.4 to 4.0 mU per liter.

Total triiodothyronine

Analysis of total triiodothyronine (T3) is done to determine hyperthyroidism, as well as during the period of hormone replacement therapy with L-thyroxine.

• A high content of reference values ​​in the blood indicates thyrotoxicosis or thyroid insufficiency.
• If triiodothyronine is elevated during pregnancy, then this is not a deviation.
• If blood tests show low triiodothyronine, this indicates hypothyroidism.

Elderly people have their own standards for triiodothyronine, because with age, it gradually decreases. There is also an analysis for free triiodothyronine.

An increased content in the patient's blood may indicate:

• choriocarcinoma;
• liver disease;
• toxic goiter.

Lack of free hormone indicates:

• hypothyroidism;
• exhaustion;
• strong physical stress.

The analysis for free and total triiodothyronine is given by women on any day of the menstrual cycle on an empty stomach. Normal ranges are from 2.6-5.7 pmol per liter(unbound T3).

Thyroglobulin

Thyroglobulin analysis (AT-TG) must be passed:

• if there is a suspicion of thyroid cancer;
• with hepatitis or cirrhosis of the liver.

An elevated level of thyroglobulin in the blood may indicate hyperthyroidism, thyroid cancer, and autoimmune thyroiditis.

You can check the reference values ​​for women on any day of the menstrual cycle on an empty stomach. Normal ranges are from 0 to 18 units per milliliter.

General and free t4

Increased indicators of free and total m4 indicate:

• hyperthyroidism;
• thyrotoxicosis;
• toxic goiter.

Decreased levels of free and total T4 indicate hypothyroidism. If a woman is taking combined oral contraceptives or the person is in a state of chronic nervous tension, then the hormone indicators will be distorted, and these factors must be taken into account.

The obtained value in the blood of the tested patient of free T4 indicates the quality of metabolic processes in human body... Women can take T4 readings on any day of the menstrual cycle on an empty stomach. Free T4 is considered a more informative value than general. Normal values ​​are 9 to 22 pmol per liter(unrelated T4).

Antibody test

Thyroid peroxidase antibodies or microsomal bodies (AT-TPO) are tested in the patient's blood in order to detect autoimmune thyroid disease. Girls can take the test on any day of the menstrual cycle on an empty stomach. The rate of values ​​is up to 5.6 units per milliliter.

The given data on the limits of units of measurement in testing are individual for any of the laboratories where you can check. Each laboratory has its own indicator markers, so the rate is usually indicated on the package insert with the test results. How long the result will be known depends on the laboratory itself, because there are no clear boundaries in this matter.

How to prepare for testing

First you need to find out the common mistakes of patients preparing for such a procedure. Many girls are worried - how important it is to get tested on a certain day of the menstrual cycle, and on which one? V in this case there is absolutely no need to try to check your indicators depending on a specific day of the monthly cycle, because without exception, the reference norms, both for males and women, are the same. There are two exceptions:

• girls in a state of pregnancy, because their content is increased;
• in older people, on the contrary, thyrohormones are lowered.

To correctly check thyrohormones, you need to carefully prepare so that the results obtained are not distorted:

• No later than a month before the date of the proposed testing, taking drugs for hormone replacement therapy (TSH, T4, T3) is canceled, but if, on the advice of the attending endocrinologist, it is not possible to cancel, then this item should be skipped.
• At least 3 days before the date of the thyrohormone test, the intake of iodine-containing drugs, minerals and special food is also canceled.
• The day before the check you can not drink alcohol and smoke, and also you can not attend classes in the gym.
• Before the procedure itself, the patient should be at rest for at least half an hour and not worry about anything. To check correctly, you need to take the test on an empty stomach, you can only drink sutra water. Studies using X-ray contrast media should be carried out after passing the test.
• It is best to take it in the morning between 8 and 10 o'clock or before lunchtime.
• In order to pass everything correctly, you can eat no earlier than 12 hours before the scheduled procedure.
• If the patient is taking aspirin, corticosteroids, combined oral contraceptives, or strong sedatives, this must be reported to the laboratory. It is advisable to cancel taking this type of medication on the eve of testing, but if it is not possible to do this, then be sure to inform the doctor.

How is the analysis done

The procedure is carried out from 8 to 11 o'clock. Blood for analysis is taken from a vein. The fence is done as follows:

• A tourniquet is applied to the forearm,
• The skin is treated with an antiseptic,
• A needle is inserted into the saphenous vein, and a small amount of blood is taken.

The resulting sample is sent for research. Results can be obtained the very next day.

It is worth mentioning the cost of the procedure separately. In view of the fact that these studies are not carried out in polyclinics, a person will have to visit medical Center or a laboratory. Average general research the cost of thyroid hormones will cost a person about 5 thousand rubles.

In what cases to take these tests?

Tests for these hormones are taken in several cases.

• girls have severe disruptions to the monthly cycle;
• disruptions in the sexual development of a teenager, lagging behind in mental and physical development from peers;
• hyperthyroidism, hypothyroidism, different types goiter;
• Heart arythmy;
• alopecia (baldness) with a normal body androgen content;
• infertility in girls without obvious menstrual irregularities;
• impotence in men or primary frigidity in girls for no apparent reason.

The thyroid gland is an important organ that requires close attention. It is necessary to monitor her condition, visit specialists on time and take tests.

How to take TTG correctly, you need to know every person who is faced with problems of the endocrine system. Thyroid stimulating hormone is produced by the thyroid gland. Its main function is to control metabolic processes. In the case of a decrease or increase in the level of the hormone, there are problems in work gastrointestinal tract, cardiovascular and nervous systems.

Overview of the hormone

Thyroid stimulating hormone is a product of the anterior pituitary gland. Its receptors are located on the upper layer of the thyroid gland. With an active influence on them, a hormone is produced. With the help of TSH, there is an increase in the consumption of iodine by the cells of the thyroid gland.

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Thyrotropin takes an active part in the biosynthesis of thyroxine, which is responsible for growth hormone. Its content in the blood can fluctuate throughout the day. The highest level of the hormone reaches closer to three in the morning. By the morning, his level will return to normal. The minimum value is fixed in the evening.

With age, the level of TSH gradually increases, its release occurs at night. In women in a position, the indicator is lower, due to the restructuring of the body.

Checking TSH is necessary in the following cases:

• to assess the state of the endocrine system;
• to identify functional disorders in newborns;
• for the diagnosis of female infertility;
• to control the state of the thyroid gland during drug therapy;
• to confirm / refute hyperthyroidism;
• with mental retardation;
• with cardiac arrhythmias;
• with a decrease in sexual desire;
• with the development of impotence.

In most cases, abnormalities in the body are associated with the work of hormones, including the endocrine system.

The main indications for the purpose of the study

There are the following main indications for passing the analysis:

• the presence of latent hypothyroidism;
• visible developmental delays in the child;
• the presence of a goiter;
• abnormalities in work cardiovascular systems s;
• persistent depressive states;
• difficulties in conceiving a child;
• impotence in men and decreased sex drive;
• control study of the working capacity of the gland;
• screening for congenital hypothyroidism;
• monitoring the patient after hormone therapy.

In many cases, analysis is required. Especially when prescribing standard therapy and monitoring the general condition of a person after it. Sharp jumps in hormone levels may indicate an incorrect dosage of drugs. With replacement therapy, thyrotropin should not go beyond the optimal level.

Before preparing for the procedure, a person must stop smoking and exclude excessive stress on the body. They can affect the accuracy of the data. It is necessary to donate blood on an empty stomach before 10 am.

The main factors that can affect the level of thyrotropin are distinguished. This may be a syndrome of irregular TSH secretion, the presence of juvenile hypothyroidism, benign tumor, mental and somatic disorders. Lead poisoning, excessive exercise, cholecystectomy, and severe preeclampsia often affect hormone levels. High TSH levels can be triggered by taking anticonvulsants, beta-blockers and antipsychotics. This side effect occurs while taking phenytoin, metoprolol, amiodarone, ferrous sulfate and morphine.

A decrease in the hormone is recorded in the presence of toxic goiter, adenoma, hyperthyroidism in pregnant women and TK toxicosis. This process can be influenced by mental illness and fasting. Drugs such as Dopexamine, Dopamine, Nifedipine, Thyroxin and Piribedil can lead to a decrease in the indicator.

How to prepare for analysis

The analysis is taken on an empty stomach. This means refusing food 8-10 hours before donating blood. You can only drink water, but not in large quantities. Tea, coffee and other sugar-based drinks are prohibited and unnecessary.

In some cases, you will have to give up food in 12 hours. Detailed information will be provided by a specialist directing a person for research. If you need to pass general analysis blood, the last meal is carried out one hour before the manipulation. Breakfast should be, however, preference is given to easily digestible foods. Unsweetened porridge, apple, and tea will do. Two days before the study, it is necessary to revise the diet. It is recommended to exclude fatty, fried and alcoholic beverages. If a feast is expected before manipulation, donate blood a few days later.

To determine the level of thyroid-stimulating hormone, blood must be donated only before 10 in the morning. Otherwise, the result will be unreliable.

Before taking blood from a vein, a few days before the test, physical exertion and emotional stress should be abandoned. Before the very manipulation, you need to calm down and rest for about 15 minutes.

How to donate blood correctly, you need to know in advance. Many people take medications that can distort the analysis results. Therefore, before the study, it is necessary to inform the doctor about the medications taken. Taking medications begins after the examination.

Blood should not be donated immediately after x-rays or other physiotherapy procedures. In women, the stage of the menstrual cycle and other physiological factors may affect the outcome. Therefore, before the study, it is important to check with the doctor on which days you need to visit the laboratory.

Much depends on how to take the test. Correct preparation and delivery of the analysis on time is the key to reliable data.

Diagnostic measures

Determination of the TSH level begins with the collection of venous blood. This should be done in the morning on an empty stomach. As mentioned above, it is advisable not to eat 8-10 hours before the procedure. It is necessary to take the analysis before 11 in the morning.

The method of determination is called chemiluminescence microparticle immunoassay. The blood serum is examined. If there are any abnormalities in the functioning of the thyroid gland, it is necessary to carry out the manipulation 1-2 times a year. It is advisable to do everything at the same time in a specific laboratory. This will reduce the severity of the error.

The day before the proposed procedure, it is necessary to completely exclude junk food. Alcoholic drinks, fried, fatty and starchy foods can affect the reliability of the result. Excessive physical activity and emotional overstrain can negatively affect.

For 2-3 hours before the manipulation, you must refuse to eat. You can only drink non-carbonated water. By agreement with a specialist, two days before the procedure, it is necessary to stop taking thyroid and styroid hormones.

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After receiving the results of the analysis, it is necessary to go to a specialist for their decryption. You do not need to do this on your own, because during the procedure, the individual characteristics of each patient are taken into account.

Any, even the seemingly most insignificant malfunction of the hormonal system leads to a deterioration in the general condition of a person and can have serious consequences for the whole organism. In addition, the hormonal background affects the appearance and character. All this suggests the need for regular monitoring of hormones. One of the most important indicators is the content of the hormone TSH in the blood. Why do you need to monitor its level and what is the risk of deviation from the norm? We will answer these questions in this article.

TSH is the most important of the indicators of the analysis for hormones

Thyrotropic hormone (thyrotropin, TSH, TSH, thyroid stimulating hormone) is synthesized in the anterior lobe of the pituitary gland and, according to its chemical structure, belongs to the class of glycoproteins (complex proteins containing a carbohydrate component). Tyrotropin is involved in the synthesis of iodine-containing thyroid hormones - triiodothyronine (T3) and thyroxine (T4). They, in turn, are responsible for the work of the gastrointestinal tract, reproductive, reproductive, cardiovascular systems, as well as for metabolic processes in the body and the emotional state of a person. There is an inverse relationship between TSH, T3 and T4: if the level of TSH rises, then the concentration of thyroid hormones decreases, and vice versa.

The synthesis of thyrotropin, in addition to thyroid hormones, is regulated by hypothalamic cells that produce hormones - thyroliberin and thyrostatin. The first stimulates the release of TSH into the blood, and the second blocks the secretion of TSH. The rate of release of thyroid-stimulating hormone depends on the time of day. So, at 2–4 am its level is at its very peak, slightly decreases by 6–8 am, and reaches its minimum value at 5–18 pm. Violation of the rhythm of secretion occurs when a person is awake at night. The amount of TSH also changes during pregnancy and upon reaching old age.

The TSH level is determined by analyzing the patient's blood. In laboratories, various reagents are used to determine this hormone, but the normal limits for research in any way are the same - 0.4-4 mU / l. This is a common figure for adults of both sexes. Its fluctuation can be caused by the time of day, diet, medications, various diseases... When diagnosing pathologies, together with a blood test for TSH, the following studies are also prescribed: determination of total and free T3 and T4, antibodies to thyroperoxidase, analysis for calcitonin.

Indications for the purpose of the study

A specialist prescribes a blood test for TSH primarily for the diagnosis of thyroid diseases. The doctor can prescribe a referral if the following pathologies are suspected:

• an enlarged thyroid gland - goiter;
• infertility;
• cardiac arrhythmia;
• persistent depressive conditions;
• delayed sexual and mental development in a child;
• impotence, decreased libido;
• severe prolapse hair, alopecia.

But the list doesn't end there. An analysis for TSH can be prescribed if the patient has: insomnia, fatigue, weight loss, edema, tremors, menstrual irregularities. People with various forms of hypothyroidism (chronic, congenital) donate blood at least twice a year. The test is also performed to assess the effectiveness of hormonal treatments.

Self-diagnosis at the mirror
In order to detect a goiter (an enlarged thyroid gland), go to the mirror, tilt your head back slightly and swallow saliva, while feeling your throat. Ideally, the thyroid gland should not be visible or palpable. If you feel it while swallowing, it may increase - you should consult an endocrinologist. When the pathology is advanced, the iron is visible even when you are not swallowing. The lower part of the neck is enlarged.

Preparation for analysis for TSH

In order for the results of a blood test for TSH to be reliable, doctors ask you to adhere to some recommendations. A couple of days before the delivery of the biomaterial for analysis, it is worth excluding the use of alcohol, smoking, as well as any physical and emotional overload. It is necessary to give up spicy and fatty foods. If possible, you should stop taking medications, especially hormonal ones. You need to consult your doctor about this. The following active substances in the composition of medicines distort the test results: acetylsalicylic acid, dopamine, potassium iodide, lithium, prednisolone.

How is the research done?

Blood for analysis of TSH content is taken from a vein, it is preferable to donate it in the morning - from 8 to 10 hours. In the morning before taking the test, it is advisable not to eat anything, it is permissible only to drink non-carbonated water. Blood sampling should be carried out when the patient is at rest and not under stress. Therefore, it is better to sit in the waiting room for 10-15 minutes before the procedure and calm down and catch your breath.

Blood sampling is carried out as follows: a specialist tightens a tourniquet above the elbow. Then he wipes the crotch of the elbow with a cotton swab soaked in alcohol. If the vein is poorly visible, then the patient is asked to work with a brush - clench and unclench a fist. Then blood is taken with a special needle and a cotton swab soaked in alcohol solution is again applied to the injection site. The taken biomaterial is collected in a test tube to be sent to the laboratory. Many methods give an accurate result, including chemiluminescence immunoassay on microparticles. With its help, it is possible to determine even low concentrations of the hormone TSH - up to 0.002 mU / l.

Deciphering the results of a blood test for TSH

The norm of the content of thyroid-stimulating hormone in the blood

We have already mentioned above that the rate of TSH concentration in the blood ranges from 0.4-4 mU / l. It is the same for adult men and women. Indicators vary among children of different ages... This is due to the fact that in the first months of a baby's life, his thyroid gland is just beginning to form and the hormone is produced as it grows. The level fluctuates as a child grows up, until his "thyroid" is finally formed.

Consider the norms of TSH indicators for children of different ages:

• newborns: from 1.1 to 17.0 mU / l;
• 2.5-14 months: from 0.4 to 7.0 mU / l;
• 14 months – 5 years: from 0.4 to 6.0 mU / l;
• 5-14 years: from 0.4 to 5.0 mU / l;
• over 14 years old: from 0.4 to 4.0 mU / l.

Special indicators have been established for pregnant women: 0.3–3.5 mU / l. The norm is a little too low. This is due to the fact that the fetus does not have its own endocrine system, and the mother gives some of her hormones for the intrauterine development of the baby.

But there are other reasons why the level of TSH in the body rises or falls. Let's take a look at these situations.

Increased hormone levels

An increase in the concentration of TSH in the blood indicates that the thyroid gland synthesizes an insufficient amount of iodine-containing hormones. This happens for the following reasons:

• hypothyroidism;
• pituitary tumor;
• Hashimoto's thyroiditis;
• adrenal insufficiency;
• mental illness;
• lead poisoning;
• the use of morphine;
• hormone therapy;
• hemodialysis.

Also, the reason for the increase in TSH can be the intake of certain medications, physical activity, emotional stress, the consequences of surgical operations, for example, removal of the gallbladder.

Hormone levels are low

If a high TSH level in the blood indicates a decreased activity of the thyroid gland, then a low one, on the contrary, indicates an increased activity. When the indicators of three hormones are lowered: TSH, T3 and T4, hypothyroidism is suspected. In the case of insufficient synthesis of TSH with elevated T3 and T4, hyperthyroidism is diagnosed. If T3 and T4 are normal, and TSH is reduced, this indicates a disruption in the work of the pituitary gland, toxic goiter, and the presence of a mental disorder.

With a reduced TSH, the following are most often noted:

• diffuse toxic goiter (70–80% of all cases of hyperthyroidism);
• injury to the pituitary gland;
• thyrotoxic adenoma (Plummer's disease);
• infertility;
• decreased libido, impotence;
• depression;
• hyperthyroidism in pregnant women;
• mental illness;
• cachexia (extreme exhaustion of the body).

Hyperthyroidism is more common in women than in men. This is due to hormonal fluctuations that occur during menstruation, during pregnancy, during menopause. Experts recommend that women regularly visit an endocrinologist and do an ultrasound of the thyroid gland. Up to 30 years - once every three years, from 30 to 45 years - once every two years, after 45 years - once a year. In the absence of alarming symptoms, men are recommended to visit an endocrinologist every 3-5 years.

Cost of TSH blood test

The price for a blood test for TSH depends on the level of technical equipment of the laboratory and the reagents used in it for the study of biomaterial, as well as on the region in which it is located.

For example, in Nizhny Novgorod, a laboratory assessment of thyrotropin will be carried out for 300–350 rubles. Samara medical laboratories offer to undergo an analysis for an average of 320 rubles. In Yekaterinburg, the level of thyroid-stimulating hormone will be analyzed for 250-290 rubles. Diagnostic laboratories in Ufa will carry out the study for 260-300 rubles. Prices can also vary considerably within the same city. For example, in Moscow clinics, a blood test for TSH is performed for 350-500 rubles. The cost depends on the research method, the territorial location of the clinic, and the speed of preparation of the result.

Whatever result of a blood test for TSH you get, you do not need to panic, because deviations are not always associated with serious pathologies. Only a specialist can decipher and comment on the result, as well as diagnose the disease.

Wednesday, 28.03.2018

Editorial opinion

Please note that if you need to donate blood for a second test, you need to at the same medical facility as for the first time. And you need to do this at the same time. Otherwise, you risk getting skewed test results. If you are undergoing hormone therapy, then the TSH level should be checked 2 months after starting it.

Thyroid stimulating hormone (TSH, thyrotropin) is a hormone secreted by the anterior pituitary gland and is the main regulator of the normal functioning of the thyroid gland. Hormonal imbalance can lead to a number of serious physical or mental disorders. The study is recommended to take place regularly every year, since many diseases have a long latent course. Moreover, many of them are detected at the stage when drug therapy is already ineffective.

Important: if it is necessary to monitor the effectiveness of the chosen treatment tactics, a second analysis is carried out at least 2 months after its completion. This fact is due to the fact that the analysis for TSH shows the situation in the pituitary-thyroid gland system over the past 4-6 weeks.

Research method: immunochemiluminescent. Term: 1 day excluding the day of taking the biomaterial. Price: 450 rubles.

The hormone TSH is a tropic hormone synthesized by the anterior pituitary gland. The role of TSH in the body of women and men is to maintain and regulate the synthesis of thyroid hormones: and.

The thyroid-stimulating hormone receptor belongs to serpentines (seven-coil receptors). Their function is to transmit an intracellular signal to activate the cell's response, which is accompanied by an increase in iodine consumption. In this case, the enzyme adenylate cyclase begins to actively catalyze the process of converting adenosine triphosphate (energy source) into cyclic adenosine monophosphate (cAMP). The accumulation of cAMP leads to the fact that TSH increases the production of triiodothyronine (T3) and thyroxine (T4). The synthesis time is reduced to 1 minute.

Control regulation is carried out according to the "feedback" principle. In other words, the lower the concentration of T3 and T4 in the blood, the greater the amount of TSH.

What does the hormones TSH and free T4 affect?

The importance of T3 and T4 for the normal development of human organism is difficult to overestimate. Their main functions include:

• regulation of metabolism and maintenance of homeostasis;
• normalization of oxygen metabolism in tissues;
• maintaining blood pressure;
• regulation of thermoregulation;
• participation in the regulation of the cardiovascular system;
• stimulation of the processes of erythropoiesis in the bone marrow;
• control over the process of protein biosynthesis - the main "building" material of living organisms;
• growth stimulation.

Thus, the rate of production of T3 and T4, which, in turn, are directly involved in the growth and development of the whole organism, depends on the level of thyroid-stimulating hormone (TSH).

When is the study scheduled?

A referral to a patient can be ordered by a general practitioner, pediatrician, endocrinologist, neurologist, or surgeon. The main indication for the study is an increase in the size of the thyroid gland, diagnosed by ultrasound. Pathology may be accompanied by hyper- (excessive) or hypothyroidism (insufficient production of hormones).

Symptoms indicative of hyperthyroidism:

• frequent tachycardia;
• unexplained weight loss;
• insomnia;
• diarrhea of ​​unknown etiology;
• stomach ache;
• emotional instability, anxiety, aggressiveness;
• poor heat tolerance;
• deterioration of vision;
• hand tremor;
• apathy, depression and weakness.

Signs of hypothyroidism include:

• irregular menstruation in women;
• impotence in men;
• decreased sex drive;
• excess hair loss;
• depressive disorders;
• lethargy;
• decreased memory;
• stool problems (constipation);
• dry skin;
• swelling.

For newborn babies at risk of thyroid disease, the study is mandatory immediately after birth to exclude congenital hypothyroidism.

How to get tested for TSH on an empty stomach or not?

Preparation for the analysis of TSH is of decisive importance for the reliability of the results obtained.

Hormonal studies of TSH in the blood are carried out strictly on an empty stomach. For children, an interval after the last meal of 4 hours is allowed, for adults the minimum is 8 hours. Drink plenty of clean, non-carbonated water.

When preparing for a blood test for TSH, it is necessary not to smoke for 3 hours before collecting the biomaterial, and also, in agreement with the doctor, exclude any drugs for 2 days. The importance of the rule is due to the risk of obtaining false positive results due to the ability of some drugs to increase or decrease the secretion of the hormone.

Alcohol is excluded a few days before the study.

It is known that the indicator is characterized by daily fluctuations. So, its maximum values ​​are noted in the interval between 2 and 4 o'clock in the morning, and the minimum - from 17 to 19 o'clock in the evening. From 6 to 8 in the morning, the concentration is slightly reduced, therefore, the optimal time for a blood test for TSH is considered to be from 9 to 11 in the morning.

In addition, the indicator is extremely sensitive to physical and emotional stress. Its secretion is impaired when awake at night before donating blood. Physical training in the evening before the visit to the laboratory department will also have to be postponed.

The above rules are identical for both sexes and all ages. However, questions often arise - how to take TSH correctly to women and does the stage of the menstrual cycle matter? The lab staff may ask the patient about the phase of the cycle or the gestational age.

Such information is necessary for the selection of reference (normal) values. However, a patient can take a TSH test on any day of the menstrual cycle, unless the doctor has previously indicated the necessary phase for delivery.

Normal TSH in the analysis

It was found that the TSH content in the blood of patients of different ages is different. When selecting normal values, the doctor takes into account the patient's age, as well as the presence and duration of pregnancy. The standard units of measurement are μIU / ml, in which all values ​​will be given below.

The normal value for newborn babies up to 4 months is in the range from 0.7 to 11. The values ​​are similar for full-term and premature babies.

At the age of 4 months to 1 year, the norm is 0.7 - 8.5, then up to 7 years from 0.7 to 6.

Acceptable values ​​for children from 7 to 12 years old are in the range of 0.6 - 5.

Puberty for a teenager is accompanied by significant hormonal changes. So, the value of thyrotropin from 12 to 20 years should be in the range from 0.5 to 4.4.

For people over 20, the standard values ​​are 0.3 to 4.2. After 60 years, there is a slight increase in the concentration of thyrotropin. This is due to a physiological decrease in the amount of T3 and T4.

Articles about norms and transcripts of TTG:, incl. ,

Norm and deviation after removal of the thyroid gland

After surgical removal thyroid secretion of T3 and T4 stops, and the pituitary gland tries to maximize their content by excessive production of thyrotropin for this. To compensate for the lack of T3 and T4, drugs based on them are prescribed for life.

The rate of thyrotropin after surgery is from 0.3 to 4.0 mU / ml.

In the first days, the patient has a high level of TSH after removal of the thyroid gland, which is a variant of the physiological norm. However, subsequently, its value should return to the normal range. It is important to properly prepare for the collection of biomaterial, as many drugs lead to false positive results.

Low values ​​of thyrotropin after surgery indicate an overdose of hormonal drugs or pathology in the work of the pituitary-hypothalamic region of the brain.

Why does thyroid-stimulating hormone rise?

High TSH levels in children and adults can indicate a number of conditions:

• hypothyroidism is a long-term lack of thyroid hormones. The last stage of the pathology in children is accompanied by cretinism, and in adults - myxedema (severe edema of the mucous membranes). The high prevalence (20 cases per 1000 people) is often accompanied by late detection. The situation is explained by the low specificity of symptoms for early stage... In this case, the level of TSH in hypothyroidism increases sharply, and the value of T3 and T4 decreases in proportion to the severity of the pathology;
• pituitary adenoma is a tumor of glandular tissue of unknown etiology. Pathology accounts for one sixth of all cases of brain tumors. The danger is a prolonged asymptomatic course. Therefore, often at the stage of detection, drug therapy does not give the desired effect, surgical removal is required;
• autoimmune thyroiditis (Hashimoto's thyroiditis) is a chronic inflammation of the thyroid tissue. The more pronounced the inflammation, the greater the lack of T3 and T4. The prevalence among children does not exceed 1.5%, and among adults - 11%. Women get sick 4 - 8 times more often than men. Adequate and timely health care determines a favorable prognosis;
• in the syndrome of uncontrolled secretion of thyrotropin, there is an absence of inhibitory mechanisms for its synthesis by the pituitary gland. Moreover, its increase does not depend on the content of thyroid hormones in the blood;
• oncology of the thyroid or breast, as well as lungs;
• various mental disorders;
• primary adrenal insufficiency;
• juvenile hypothyroidism;
• thyrotropinomas;
• lead intoxication;
• severe somatic pathologies.

Causes of low thyrotropin levels

Deviation from the norm downward is observed in diffuse toxic goiter, which belongs to autoimmune pathologies. The condition is characterized by excessive secretion of thyroid hormones (hyperthyroidism), which accumulate and exhibit toxic effects. According to the rule of "reverse regulation" in this case, the level of TSH drops significantly in hyperthyroidism.

The prognosis for diffusely toxic goiter is favorable in the case of timely diagnosis and the appointment of adequate treatment. Patients should avoid excessive exposure to sunlight, stress, overwork, excessive physical exertion, as well as taking iodine-containing drugs and food.

A similar decrease in the indicator is characteristic of Plummer's disease - this is a benign tumor of the thyroid gland. Women are more susceptible to illness, men get sick 4-6 times less often. The reason is a genetic mutation leading to a long-term, consistently high synthesis of T3 and T4. The prognosis of the outcome is often favorable, even a spontaneous cure is not excluded. However, there are isolated cases of the degeneration of pathology into a malignant one.

Critical depletion of organism (cachexia) also leads to inhibition of the secretion of thyrotropin. In this case, the person dramatically loses weight. As a rule, cachexia is a secondary disease in the underlying pathology. In this case, treatment is reduced to identifying and eliminating the root cause, and then symptomatic therapy to restore the human body.

A low TSH value with a normal free T4 value is observed in elderly patients and pregnant women, in patients with postpartum pituitary necrosis, thyrotoxic adenoma, pituitary trauma, latent thyrotoxicosis, as well as in self-medication T4.

What does this mean - TSH is increased, and T4 is normal?

An elevated TSH level with a normal T4 value indicates latent (subclinical) hypothyroidism. This is the first stage of the clinical form of the disease, which is characterized by damage to the thyroid gland and disruption of its normal functioning. Clinical picture does not have pronounced pathological signs.

The disease is diagnosed in 20% of women over 50 years of age. Differential diagnosis consists of determining the value of the hormones of the thyroid gland and the pituitary gland. The reasons are:

• pathological intrauterine organ development;
• iodine deficiency;
• removal of the thyroid gland;
• injury to the thyroid gland;
• the need for a long drug treatment drugs that inhibit the work of the thyroid gland;
• inflammation or cancer of the gland.

Treatment of latent hypothyroidism consists of the use of hormones, vitamins, and diet. At the same time, sugar, fatty types of fish and meat are completely excluded from the diet, butter and soy products.

After full course treatment, the patient is re-examined. If there is a consistently high increase in TSH, and the level of T3 and T4 is also within the normal range, then a conclusion is made about the ineffectiveness of the selected methods. The question of correction or transfer to alternative methods of therapy is being resolved.