Thyroid

Thyroid screening: indications, preparation, how to do, transcript of the results

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To assess the activity of the endocrine organs, special studies are applied. Screening of the thyroid gland means the definition of at least two hormones (free thyroxine and thyroid stimulating hormone, sometimes TK), the implementation of ultrasound and palpation. Quantitative indices of these components and ultrasound picture will allow to establish the state of the organ and the peculiarities of its functioning.

So, let's take a closer look at the screening of the thyroid gland. What is this, tell below.

Purpose

For ultrasound and laboratory studies of the thyroid gland, the main indications are:

  • a sharp increase or decrease in body weight,
  • increased or slower heart rate,
  • excessive sweating
  • tremor of the upper limbs,
  • a change in mental state (attacks of anger, fear, irritability),
  • reduced stamina and feeling of unmotivated weakness
  • insomnia or sleepiness
  • visual impairment,
  • low or high blood pressure
  • pregnancy planning,
  • early gray hair, changes in skin condition and brittle nails,
  • in men, erectile dysfunction, in women, a violation of the menstruation cycle,
  • suspicion of disturbances in the activity of the thyroid gland, if there are no pronounced symptoms,
  • immunity deterioration
  • physical and mental retardation in children,
  • miscarriages or miscarriages in the history of the disease.

All the signs listed above point to thyroid diseases and therefore need timely visits to an endocrinologist, instrumental examinations and analyzes.

Thyroid screening is sometimes suggested for people over forty years old. The study is especially important to conduct at the slightest signs in women after and during pregnancy, after the onset of menopause, when the gland produces a reaction to hormonal imbalances. In addition to diagnostics, this technique is used to conduct screening for oncology of the thyroid gland, to determine the correctness of treatment in a patient with an established diagnosis.

Preliminary preparation for the procedure

To get the most objective result, you need to prepare for the survey correctly:

  • you cannot eat for several hours before the study, drink only non-carbonated water,
  • do not eat fatty foods for 48 hours
  • do not take medications with hormones (steroid or thyroid) for two days, but first you need to consult with your doctor,
  • avoid physical overloads and nervous shocks per day,
  • Do not smoke for two or three hours before the procedure.

All these actions are necessary for the analysis to show the real situation. A certain distortion of the result is observed in the following cases:

  • another exacerbation of the disease,
  • first trimester of pregnancy
  • advanced age (after 75-80 years),
  • conducted on the eve of a radioisotope study.

If the organ is not in order, then the screening of the thyroid gland will show whether there are deviations from the norm, already in the early stages of the disease, but only when the preparation and course of the procedure complied with all the rules.

Special features

To determine the content of hormones, blood is taken from a patient from a vein. This should be done on an empty stomach, since an increase in fat in blood serum may affect the result. First, the amount of TSH is examined. When its concentration corresponds to normal values, it is considered that there is no need for more detailed analysis.

The content of thyroid-stimulating hormone has a daily physiological fluctuations, and therefore the screening should take place no later than twelve hours of the day. The biomaterial taken is centrifuged. The modern method of chemiluminescent immunoassay is based on the combination of serum with specific antibodies that are characteristic of TSH, as well as labeled enzyme.

Ready-made immune complexes with whey material react by emitting a luminescent glow. It is registered with a special device. The characteristic of the result is ready the next day, the laboratory sometimes sends it to the doctor herself.

If the TSH is exceeded, it is possible to judge a decrease in the functional capacity of the organ, or hypothyroidism. The decrease indicates a high production of hormones, that is, hyperthyroidism. In this case, T3 and T4, the hormonal panel (ratio and hormone level) are determined.

Screening of thyroid function is carried out as often as the presence of the disease requires (thyroid cancer, thyrotoxic goiter), especially its course. That is why one patient is prescribed a single screening, another - several procedures per month. If signs of deviation persist, but there are no violations in the analyzes, they should be repeated.

Rates and deviations

Up to four months in a child, the content of the hormone in plasma varies from 0.7 to 11 µMU / ml, the norm up to one year - from 0.7 to 8.35, from year to seven years - from 0.7 to 6, up to twelve years - from 0.6 to 4.8. The level of TSH to twenty years is from 0.5 to 4.3, in an adult a normal amount of hormone is from 0.3 to 4.2.

All this is able to determine the analysis - screening of the thyroid gland.

The rate in different laboratories may have some differences depending on the specifics of the reagent and equipment. The physiological increase of the hormone is observed during the first three months of pregnancy and with the individual properties of the organism. A certain decrease in the index occurs after physical or emotional stress, sometimes this happens as a result of following a strict diet or fasting.

Screening of the thyroid gland in the laboratory for hormones costs in modern clinics from one and a half to two thousand rubles. Services include the taking of venous blood, the determination of T3, T4 and TSH, the identification of the degree of microsomal antibodies to thyroid peroxidase. Screening of the thyroid gland in the "Gemotest" can also be passed.

Conclusion

Thyroid dysfunction is quite dangerous. Through screening, you can determine the possible risk. If the functioning of the organ is reduced, hypothyroidism develops. If there is a hormonal release or coma during hypofunction from edema, it can be fatal.

It should be noted that the screening of thyroid hormones is not a control procedure when determining organ disorders, since in some cases the result can be shown as normal. In such a situation, it is necessary to go through additional research.

Thyroid screening: features and purpose

Screening of the thyroid gland is a very important method for examining an organ for various pathologies. The basis of the diagnosis is venous blood sampling to determine the amount of thyroid hormones, as well as assessing changes in this indicator. The procedure is especially important for toxic goiter (screening reveals thyroid cancer), as well as monitoring the functions of the organ at different stages of pregnancy.

Hemotest (screening) of the thyroid gland is often used to detect abnormalities of the organ, assess its performance, detect excess / deficiency of thyroid hormones, and also as a control procedure in the treatment of various diseases associated with thyroid malfunction.

Indications for use

Examination of the thyroid gland through hormone screening is appointed by the endocrinologist as mandatory in some cases:

  • If a pre-ultrasound scan or any other study showed an increase in thyroid,
  • When planning to have a baby,
  • If an organ hyperfunction is suspected,
  • If an organ hypofunction is suspected,
  • During pregnancy (in certain situations when there is a risk of miscarriage, premature birth, as well as in the case of pre-gestational diabetes),
  • To identify abnormalities in newborn babies on the first day after birth,
  • If you have a history of patient information about relatives with thyroid abnormalities,
  • To assess the state of the gland during menopause or in the period preceding it,
  • In the appointment / implementation of the treatment course
  • During hormone therapy.

Thyroid screening

In addition to diagnostic applications, the analysis is used to track progress in recovery in patients with already established thyroid diseases.

Iron synthesizes a complex of hormones that are vital. The most necessary thing to know about the anatomy of the thyroid gland:

  • located under the larynx
  • consists of two lobes and an isthmus,
  • each lobe consists of tiny follicles, cells filled with protohormones,
  • iron synthesizes triiodothyronine (T3) and thyroxin (T4),
  • regulates metabolism, energy and heat metabolism in the body.

At the initial stage, diseases of the thyroid gland can proceed without pronounced symptomatology; examination is scheduled to clarify the clinical picture.

To understand the role of the thyroid gland in the body, several facts are enough:

  • hormones T3 and T4, which synthesize iron enter into a chemical reaction in every cell of the body, support oxidative processes and energy metabolism,
  • the work of the thyroid gland is coordinated with other organs of the endocrine system: adrenal glands, pituitary, testicles in men and ovaries in women,
  • thyroid gland disorders destabilize the endocrine system, imbalance hormones, and have a detrimental effect on every cell in the body.

With thyrotoxicosis and hypothyroidism, the quality and longevity is significantly reduced.

Only an examination can clarify the actual hormones, so if you suspect these diseases, a blood test for hormones is prescribed.

Screening of thyroid hormones is used by an endocrinologist for the selection of adequate treatment.

How to prepare for a screen

For biochemical research, venous blood is collected, usually in the morning on an empty stomach.

In order for the analysis data to reflect the real situation, you need to follow the recommendations:

  • refrain from eating 4 hours before blood donation,
  • drink only non-carbonated water, do not drink tea, coffee, milk, juice and other beverages,
  • refrain from smoking for 4 hours prior to the study,
  • if possible, eliminate psycho-emotional stress, stress, conflict situations 1 day before the analysis,
  • limit physical activity, for 1 day before donating blood to refrain from sports training, jogging, dancing.

If a patient is taking thyroid or steroid drugs as prescribed by a doctor, then you need to determine how to carry out the cancellation.

Usually drugs are canceled 48 hours before blood donation, but this nuance needs to be coordinated with your doctor.

When to screen

Screening for thyroid disease has indications. The study is appointed by the endocrinologist, if the patient has two or more groups:

  1. Overall well-being. Persistently reduced or elevated body temperature, sweating, chilliness, weakness, decreased performance, rapid fatigue.
  2. Mental changes. Irritability, nervousness, emotional lability, bouts of uncontrolled aggression, fear, despair.
  3. Changes in the reproductive system. Violation of the menstrual cycle in women, the absence of menstruation. Erectile dysfunction in men. Lack of sexual desire in patients of any gender.
  4. Changes in hair and nails. Thin and fragile nails, pale thin hair, hair loss, premature gray hair.
  5. Changes in body weight. Obesity or weight loss with a normal diet and regular exercise.
  6. Changes in the heart and blood vessels. Steady high or low blood pressure. Steady or slow heart rate. Increased or decreased tone of the main and peripheral blood vessels.
  7. Impaired vision and hearing, intolerance to bright light or loud sounds.

These are symptoms of diseases of the thyroid gland, therefore, when a patient discovers several such changes in himself at the same time, he should consult an endocrinologist.

The thyroid gland, the screening of which is especially needed in the elderly in women, is one of the most vulnerable and important organs in the human body, which is sensitive to any hormonal changes.

Therefore, the screen is assigned:

  • in a survey of pregnant women to monitor the course of pregnancy,
  • when examining newborns, to identify primary hormonal pathologies.

When the thyroid gland is examined, screening is necessarily complemented by ultrasound and palpation to detect nodular tumors.

Preparatory actions before blood tests for TSH

How to take ttg, you need to know everyone who is faced with the problems of the endocrine system. Thyroid-stimulating hormone is produced by the thyroid gland. Its main function is the control of exchange processes. In the case of a decrease or increase in the level of the hormone, problems are observed in the gastrointestinal tract, cardiovascular and nervous systems.

General information about 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 active exposure to them, hormone production occurs. With the help of TSH there is an increase in the consumption of iodine by the cells of the thyroid gland.

Thyrotropin is actively involved in the biosynthesis of thyroxin, which is responsible for growth hormone. Its content in the blood can fluctuate throughout the day. The hormone level reaches its highest level closer to three in the morning. By morning, its level is normalized. The minimum value is fixed in the evening.

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

It is necessary to check the TSH 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 monitor the state of the thyroid gland in the process of drug therapy,
  • to confirm / refute hyperthyroidism,
  • with mental retardation,
  • with cardiac arrhythmias,
  • while reducing sexual attraction,
  • 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

Allocate the following main indications for delivery of the analysis:

  • the presence of latent hypothyroidism,
  • visible delays in the development of the child,
  • the presence of goiter,
  • deviations in the cardiovascular system,
  • permanent depressive states
  • difficulty conceiving a child
  • impotence in men and reduced sexual desire
  • control study of the gland,
  • screening for congenital hypothyroidism,
  • observation of the patient after hormone therapy.

In many cases, the analysis is mandatory. Especially when prescribing standard therapy and tracking the general condition of a person after it. Sudden jumps in the level of the hormone may indicate an incorrectly chosen dosage of drugs. In replacement therapy, thyreotropin should not exceed the optimal level.

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

Allocate the main factors that can affect the level of thyrotropin. This may be the syndrome of irregular secretion of TSH, the presence of juvenile hypothyroidism, a benign tumor, mental and somatic disorders. Often, hormone levels are affected by lead poisoning, excessive physical exertion, cholecystectomy, and severe preeclampsia. High levels of TSH can be triggered by the use of anticonvulsants, beta-blockers and antipsychotics. This side effect occurs while taking phenytoin, metoprolol, amiodarone, ferrous sulphate and morphine.

Reduction of the hormone is fixed in the presence of toxic goiter, adenoma, hyperthyroidism in pregnant women and TK-toxicosis. Mental illnesses and starvation can influence this process. Drupexamine, Dopamine, Nifedipine, Thyroxin and Piribedil can lead to a decrease in the index.

How to prepare for the analysis

The analysis is given on an empty stomach. This implies the refusal of food for 8-10 hours before donating blood. You can drink only water, but not in large quantities. Tea, coffee and other beverages based on sugar are banned, their consumption is not necessary.

In some cases, it will take 12 hours to refuse to eat. Detailed information will be provided by a specialist directing a person to a study. If it is necessary to pass a complete blood count, the last meal is carried out an hour before the manipulation. Завтрак должен быть, однако, предпочтение отдается легко усваиваемым продуктам питания. Подойдут несладкая каша, яблоко и чай.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, blood is given a few days later.

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

Before taking blood from a vein for several days before taking the analysis, it is necessary to refuse physical exertion and emotional overstrain. Before the manipulation it is necessary to calm down and rest for about 15 minutes.

How to donate blood, you need to know in advance. Many people take drugs that can distort the results of the analysis. Therefore, before the study, you must inform the doctor about the medications taken. Intake of drugs begins after the survey.

Blood cannot be donated immediately after X-ray or other physiotherapeutic procedures. In women, the outcome can be affected by the stage of the menstrual cycle and other physiological factors. Therefore, before the study, it is important to check with the doctor on which days it is necessary to visit the laboratory.

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

Diagnostic measures

The determination of the level of TSH 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 am.

The method of determination is called a chemiluminescent immunoassay on microparticles. The study is subjected to serum. If there are any deviations in the functioning of the thyroid gland, it is necessary to carry out manipulation 1-2 times a year. It is advisable to do everything at the same time in a particular laboratory. This will reduce the severity of error.

A day before the proposed procedure, it is necessary to completely eliminate junk food. Alcohol, fried, fatty and flour can affect the reliability of the result. Excessive physical exertion and emotional overstrain can negatively affect.

2-3 hours before the manipulation it is necessary to abandon the meal. You can only use non-carbonated water. In consultation with a specialist, two days before the procedure, it is necessary to refuse to take thyroid and styreoid hormones.


Only such a decoction will trigger the thyroid gland regeneration.

Goiter will disappear in 3 days! This remedy has become a sensation in the treatment of the thyroid gland!

Additional individual recommendations on how to donate blood, the patient receives from his attending physician.

After receiving the results of the analysis, you must go to a specialist to decipher them. It is not necessary to do this independently, because during the procedure the individual characteristics of each patient are taken into account.

How to take thyroid hormones to women correctly?

The article contains information on how to take thyroid hormones to women correctly. From it you can learn about the indications for this procedure, the course of its implementation, the pathologies that are detected, and the list of biologically active substances to be determined. There is also an interesting video in this article.

More about the thyroid gland

The thyroid gland produces several biologically active substances that regulate a number of vital systems and functions of the human body:

  1. Fat, protein and carbohydrate metabolism.
  2. Gastrointestinal tract.
  3. Cardiovascular system.
  4. Mental activity.
  5. Sexual function.

Therefore, any pathology of the thyroid gland or the pituitary gland, the organ directly responsible for its work, leads to violations of all the above-mentioned organ systems and individual body functions. And, for women, there are more problems with this than men. After all, the representatives of the weaker sex also add an increase in the probability of miscarriage, the birth of children with disabilities, and even infertility.

In order to avoid such troubles should be regularly examined by an endocrinologist. This doctor, in identifying abnormalities in the thyroid gland or pituitary gland, will prescribe an analysis of the content of hormones produced by them in the blood. The survey price is available, the waiting time for the result is no more than one day.

Under what symptoms should pass an extraordinary examination by an endocrinologist?

Every woman must pass annually a medical commission, one of whose members is an endocrinologist.

However, there are a number of symptoms, feeling that you should not wait for the next commission, but you must immediately visit the office of a specialist:

  1. Dysmenorrhea.
  2. Algomenorrhea.
  3. Postmenstrual syndrome.
  4. Weakness.
  5. Insomnia.
  6. Recurring headache.
  7. Trouble sleeping
  8. Excessive hairiness.
  9. Reduced or weakened sexual desire.
  10. Repeated spontaneous abortion.
  11. Infertility.

The appearance of one or more of these symptoms should prompt a woman to visit an endocrinologist and promptly start the prescribed treatment.

In what cases do doctors prescribe screening for thyroid and pituitary hormones?

Analysis of hormones in women of the thyroid gland is carried out with a number of different diseases:

  1. Hypothyroidism.
  2. Hyperthyroidism.
  3. Delayed sexual and mental development of minors.
  4. Goiter of various origins.
  5. Heart rhythm disorders.
  6. Alopecia.
  7. Infertility
  8. The absence of menstruation.
  9. Reduced sexual desire.

In addition, these tests are assigned when conducting control studies of patients suffering from hypothyroidism and diffuse toxic goiter.

Preparing and conducting research

To exclude any factors that could affect the result of the study, it is necessary to follow several important rules before carrying out the procedure:

  • It is necessary to donate blood on an empty stomach (a few hours before the hemotest is better not to eat any food, only drink non-carbonated water),
  • If the patient is undergoing hormone therapy, taking medication for a couple of days before the procedure should also be excluded, after consulting with your doctor (without fail),
  • During the day before the hemotest should be overvoltage (both physical and emotional),
  • A few hours before the procedure, you should refrain from using alcohol and smoking tobacco,
  • If a child under 5 years old will undergo the procedure, then within 30 minutes before it, it is necessary to drink it gradually with purified water (100-150 ml each).

It should be borne in mind that screening of the thyroid is not a control procedure for the detection of organ pathologies, since in some cases it may show a normal result. In such a situation, it is imperative to undergo additional laboratory tests.

How the results are deciphered

For proper decryption, knowledge and experience are needed, therefore, the interpretation should be entrusted to the attending physician. General information on regulations:

  1. Triiodothyronine, T3. Revealed in a free and general form. The norm for the total in adults is 0.90 - 2.80 nmol / liter. Norm for free - 2,6 - 5,6 nmol / liter
  2. Thyroxine, T4. Similarly, it has two forms, free and common. The norm for the total in adults is 62.0 - 150.8 nmol / liter. The rate for the free 9.0 - 19.0 nmol / liter.

In pregnant women, fluctuations in hormone levels depend on the duration of pregnancy and on individual characteristics.

In children - from the age and development of the thyroid gland.

Digital values ​​alone are not enough to interpret the results; the history and data from other studies are taken into account when making a diagnosis.

If diseases of the thyroid gland are revealed, then the observation passes in dynamics.

For example, in cases of toxic goiter, patients are screened once every three months on prescription.

This allows not only to know the hormonal background at the moment, but also to evaluate the effectiveness of therapy.

Early detection of diseases is a guarantee of the fastest possible cure.

Screening is possible after consulting an endocrinologist at a private or public clinic.

In what cases is assigned

Indications for laboratory and ultrasound studies of the thyroid gland are:

  • a sharp decrease or increase in body weight of the patient,
  • slowing or increasing heart rate,
  • hand tremor
  • excessive sweating
  • change in mental status (irritability, anger, bouts of fear),
  • reduced stamina and a feeling of unmotivated weakness,
  • visual impairment,
  • drowsiness or insomnia
  • high or low blood pressure
  • skin condition change, early gray hair, brittle nails,
  • pregnancy planning,
  • erectile dysfunction in men and menstrual disorders in women,
  • suspected abnormalities in the thyroid gland in the absence of severe symptoms,
  • mental and physical lag in childhood
  • reduced immunity
  • miscarriage or miscarriages in history.

All of the above signs indicate that the thyroid gland is ill and therefore require timely access to an endocrinologist, as well as analysis and instrumental studies.

Sometimes screening is offered to people after 40 years of age. It is especially important to conduct a study with the slightest symptoms in women during and after pregnancy, after the onset of menopause - iron responds to hormonal imbalance. In addition to diagnostics, this technique is used to determine the correctness of therapy in a patient with an already made diagnosis, as well as to screen for thyroid cancer.

Preliminary preparation for the survey

To obtain the most objective result, it is necessary to prepare for the examination:

  1. Before the analysis, do not eat for several hours and drink only non-carbonated water.
  2. For 48 hours do not take fatty foods.
  3. Do not take drugs with hormones (thyroid or steroid) for 2 days, but first consult with your doctor.
  4. During the day, avoid nervous shocks and physical overload.
  5. Do not smoke for 2-3 hours before.

All these actions are required in order for the analysis data to reflect the real situation. Some distortion of the result occurs in such cases:

  • first trimester of gestation,
  • another exacerbation of the disease,
  • advanced age (over 75-80 years),
  • radioisotope research conducted on the eve.

If the thyroid gland is not in order, its screening will show a deviation from the norm at the earliest stages of the disease, but only if the preparation and conduct were in accordance with the rules.

How to do screening for thyroid function

To determine the concentration of hormones in humans, blood is drawn from a vein. This should be done on an empty stomach, since an increase in serum fat may affect the result. First, the TSH level is examined. If its concentration corresponds to normal, then it is considered that a more detailed study is not necessary.

The level of thyroid stimulating hormone has physiological daily fluctuations. therefore, a blood test (screening) should be completed no later than 12 noon. The resulting biomaterial is centrifuged. Modern methods of chemiluminescent immunoassay is to combine serum with special antibodies characteristic of TSH and labeled enzyme.

The resulting immune complexes react with the whey material with the emission of fluorescent light. It is registered by a special device. The description of the result obtained can be obtained the next day, sometimes the laboratory itself sends it to the attending physician.

If TSH is higher than normal, then we can talk about hypothyroidism (a decrease in the functional ability of the organ). A decrease in TSH indicates an increase in hormone production (hyperthyroidism). Then the definition of T3 and T4, that is, the hormonal panel (hormone levels and their ratio), is carried out. Since thyroxin contains the main amount of active substances, its determination is crucial and requires special attention.

The frequency of the study of the thyroid gland (screening) depends on the purpose, the presence of pathology (thyrotoxic goiter, cancer of the thyroid cancer) and the characteristics of its course. Therefore, one person is assigned a single screening, and another - several times a month. If the signs of thyroid disorder are preserved, but there is no deviation in the analyzes, they should be repeated.

Norms and pathology

In a child up to four months of age, the amount of hormone in plasma is 0.7–11 µMU / ml, then up to one year the norm ranges from 0.7–8.35, from 1 to 7 years — 0.7 to 6, to 12 years - 0.6-4.8 µMU / ml. After 12 years and up to 20, the level of TSH is 0.5-4.3, while in an adult the range of a normal amount of a substance is 0.3-4.2 µIU / ml.

In different laboratories, the rate may differ slightly depending on the characteristics of the equipment and reagent. The increase in TSH of physiological origin is noted during the first three months of pregnancy and on the individual characteristics of the organism. Some reduction in thyroid-stimulating hormone occurs after psychoemotional or physical exertion, sometimes a reduced result occurs as a result of starvation or adherence to a strict diet.

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