Тиреотропного гормону, ТТГ – результат, норма, підвищений при вагітності . Здати аналіз ТТГ, Т3 і Т4

тиреотропного гормону, ТТГ – результат, норма, підвищений при вагітності . Здати аналіз ТТГ, Т3 і Т4

Т3, Т4 і тиреотропний гормон: як працює «система зворотного зв’язку»

тиреотропного гормону виробляється гіпофізом і стимулює утворення гормонів щитовидної залози: Т3 – трийодтироніну і Т4 – тироксину.

Вони відповідають за обмін жирів, білків і вуглеводів в організмі, роботу статевої, серцево-судинної системи, шлунково-кишкового тракту, а також за психічні функції.

ТТГ стимулює вироблення гормонів щитовидної залози (Т3 і Т4), а коли їх рівень піднімається, вони пригнічують виділення ТТГ – так працює принцип регуляції «зі зворотним зв’язком».

Таким чином, норма ТТГ і Т4, а також Т3 знаходиться в залежності.

    Гіпотиреоз – знижена концентрація Т3 і Т4. Гіпертиреоз – підвищена концентрація Т3 і Т4. Тиреотоксикоз – отруєння організму гормонами Т3 і Т4 внаслідок їх активної вироблення. Еутеріоз – нормальна вироблення гормонів щитовидної залози.

Незважаючи на те, що щитовидна залоза ТТГ не виробляє тиреотропний гормон, він регулює її діяльність, тому рівень ТТГ звичайно перевіряють разом з гормонами щитовидки.

Як здати аналіз ТТГ і отримати точні результати?

За день-два до того, як здати ТТГ аналіз, необхідно виключити всі фізичні навантаження і куріння. Кров на ТТГ береться вранці, натщесерце. Якщо потрібно відстежити зміну рівня гормону, кожен аналіз проводять в один і той же час доби.

Контроль рівня гормону в крові обов’язковий для пацієнтів з будь-якою патологією щитовидної залози, крім того, здавати кров на ТТГ необхідно для діагностики захворювань.

Результат ТТГ-аналізу допомагає дізнатися, ТТГ підвищений, знижений або в нормі. За рекомендаціями американської колегії терапевтів, потрібно регулярно проводити аналіз на тиреотропний гормон (ТТГ) у жінок після 50 років.

Гормон ТТГ – норма

Норма ТТГ у жінок і чоловіків, згідно з різними стандартами, відрізняється, тому ми не наводимо цифри в цій статті. Щоб дізнатися нормальний ТТГ-показник для вашого організму, зверніться до ендокринолога: він визначить необхідний для вас рівень гормону, а в разі необхідності призначить ТТГ-аналіз.

У здорової людини кількість тиреотропного гормону змінюється протягом доби: найбільша його концентрація в крові доводиться на ранній ранок. Важливо визначати, чи знаходиться відповідно норма ТТГ у жінок старше 40, і тих, хто планує вагітність, з концентрацією гормону у них в організмі, навіть у разі відсутності скарг. У випадках, коли (ТТГ) гормон підвищений або знижений значно, є ризик захворювань, які можуть завдати шкоди маляті.

ТТГ-гормон підвищений

тиреотропного гормону (ТТГ) першим реагує на зниження функції щитовидної залози, часто на безсимптомних стадіях захворювання, ще коли гормони Т3 і Т4 в сироватці крові в нормі.

Якщо ТТГ-аналіз показав, що тиреотропний гормон підвищений, це може бути ознакою:

    важких соматичних і психічних захворювань; недостатності функції надниркових залоз; різних пухлин (пухлина гіпофіза та ін.); тіротропінома; синдрому нерегульованої секреції тиреотропного гормону; синдрому стійкості до тиреоїдних гормонів; підгострого тиреоїдиту і тиреоїдиту Хашимото; важкого гестозу (прееклампсія); холецистектомії; гемодіалізу.

Показник ТТГ вище норми може бути наслідком фізичного навантаження або прийому медичних препаратів, наприклад бета-адреноблокаторів, йодидів, нейролептиків, преднізолону та інших.

При вагітності високий ТТГ не завжди вважається відхиленням від норми, оскільки вагітність часто супроводжується підвищенням ТТГ.

тиреотропного гормону вище норми може спостерігатися після видалення жовчного міхура, проведення гемодіалізу, отруєння свинцем, через несприйнятливості до тиреоїдних гормонів.

Також підвищення рівня тиреотропного гормону відбувається при декомпенсованій первинної надниркової недостатності та деяких формах запалення щитовидної залози. Якщо ТТГ підвищений, лікування потрібно починати якомога швидше, тому що існує ризик захворювання на гіпотиреоз.

Низький ТТГ

У випадку, коли ТТГ знижений, це може вказувати на:

    зниження функції гіпофіза; хвороба Пламмер доброякісне утворення в щитовидці; синдром Шихана (загибель клітин гіпофіза у жінки після пологів); надлишок гормонів щитовидної залози через самопризначеної гормональних препаратів; психологічний стрес.

Найчастіше низький рівень тиреотропного гормону пов’язаний з токсичним зобом або передозуванням препаратів, що містять гормони щитовидної залози. Якщо рівень ТТГ знижений, це може бути наслідком голодування або психологічного стресу. Також зниження рівня гормону можливо на тлі гострого запалення або раку щитовидної залози, пухлини або травми гіпофіза, через яку він не може виробляти гормони.

ТТГ при вагітності

Норма ТТГ при вагітності – близько 0,2-3,5 мед / л, але в різних лабораторіях із-за різних методик і реактивів результат ТТГ-аналіз може дати відмінний від вищевказаного результат.

Під час вагітності дуже важливо стежити за своїм гормональним фоном і ендокринною системою. Особливо до 10-го тижня, коли у дитини щитовидна залоза ще не функціонує самостійно, і він повністю залежить від гормонів матері.

Рівень ТТГ при вагітності змінюється відповідно стану здоров’я жінки. Тому нормально, якщо він підвищений при вагітності, або ж трохи знижений. Однак значне відхилення концентрації тиреотропного гормону від норми ускладнює перебіг вагітності, а також несе ризик для малюка.

Норма ТТГ при вагітності змінюється протягом усього терміну. У кожному триместрі рівні ТТГ різні: найнижчий показник ТТГ при вагітності зазвичай на 10-12-му тижні – перший триместр, хоча у деяких він може бути знижений і в другому, і в третьому триместрі.

Зниження рівня ТТГ спостерігається у 20-30% жінок при одноплідній і у 100% – при багатоплідній вагітності. У 10% жінок пригнічена вироблення цього гормону, при цьому збільшений рівень Т4.

Нормальний ТТГ при вагітності визначають лікарі. У разі необхідності призначаються додаткові аналізи та обстеження, наприклад:

    тонкоигольная аспіраційна біопсія щитовидної залози; ехографіческое дослідження.

Якщо ТТГ підвищений при вагітності, особливо на ранніх термінах, у багатьох випадках призначають терапію L-тироксином (L-T4).

Що таке антитіла до рецепторів ТТГ?

Рецептори ТТГ – рецептори тиреотропного гормону, які реагують на нього, а також стимулюють вироблення Т4 і Т3. Рецептори ТТГ знаходяться в щитовидній залозі і регулюють синтез гормонів в ній.

Антитіла до рецепторів ТТГ виробляються при порушенні роботи імунної системи.

3 типи антитіл:

1. Антитіла, які блокують роботу рецепторів ТТГ і імітують вплив ТТГ на щитовидну залозу – підвищується рівень гормонів Т3 і Т4.

2. Антитіла, які сильніше зв’язуються з рецептором, ніж ТТГ. Вони викликають довгострокове підвищення рівнів Т3 і Т4.

3. Антитіла, що знижують біологічну активність ТТГ. Вони блокують стимуляцію щитовидної залози, в результаті чого клітини щитовидки стають нечутливими до ТТГ.

Антитіла до рецепторів ТТГ здатні проникати через плаценту і можуть призводити до захворювань щитовидки у новонароджених. У жінок із захворюваннями щитовидної залози проведення дослідження на антитіла до рецепторів ТТГ в третьому триместрі вагітності обов’язково. Це необхідно для виявлення та оцінки ризику розвитку захворювань у плода. Підвищення кількості антитіл до рецепторів ТТГ спостерігається при хворобі Грейвса (дифузний токсичний зоб).

Симптоми: тиреотропний гормон підвищений або знижений відносно норми

Якщо тиреотропний гормон високий, це проявляється наступним чином:

    у вагітної починає трохи потовщуватись шия; загальна слабкість (знижена активність, швидка стомлюваність); психічна загальмованість, неуважність, апатія, уповільнене мислення, можлива дратівливість; порушення сну: вночі безсоння, вдень – сонливість; блідість шкіри, набряклість; типово розвиток ожиріння, важко піддається корекції; зниження температури тіла; нудота, поганий апетит, закрепи.

Якщо гормон ТТГ нижче норми, характерні:

    підвищення температури тіла; прискорене серцебиття; головні болі; підвищений артеріальний тиск; можлива емоційна неврівноваженість, дрібне тремтіння в руках, століттях, у всьому тілі; підвищений апетит; часті розлади шлунка.

ТТГ: лікування

Лікування гормональними препаратами ні в якому разі не можна призначати собі самостійно. Якщо ви помітили перераховані вище симптоми, ТТГ підвищений або знижений, не піддавайтеся спокусі «вилікуватися травами».

тиреотропного гормону вище норми: лікування

Якщо тиреотропний гормон високий і коливається в межах від 7,1 до gt; 75 мкМЕ / мл, це вказує на гіпертиреоз. У випадку, коли ТТГ підвищений, лікування відбувається за допомогою синтетичного тироксину (Т4).

Раніше в лікуванні застосовувалася натуральна висушена і розмелена щитовидка тварин, зараз вона використовується рідко і пацієнтів переводять на синтетичний препарат – більш чистий і який має постійний рівень активності.

Лікування починається з невеликих доз тироксину, доза поступово збільшується, поки в крові не встановиться норма ТТГ і Т4. Оскільки активність власного тироксину у всіх пацієнтів до лікування різна, ваш лікар визначає, який препарат необхідно використати для лікування.

тиреотропного гормону може стимулювати ріст і поширення раку щитовидної залози. Ймовірно, в ході лікування буде поступово збільшуватися доза тиреоїдних гормонів, поки ви не почнете відчувати себе добре, а рівні ТТГ, Т3 і Т4 не повернуться до нормальних. Зазвичай призначають щорічні медогляди пацієнтів, щоб упевнитися, що рівні ТТГ, Т3 і Т4 в нормальному діапазоні.

Низький рівень ТТГ: лікування

Зниженим зазвичай вважається рівень ТТГ в межах до 0,01 мкМЕ / мл. Підвищення рівня гормону для відновлення гормонального балансу повинно проводитися тільки під наглядом ендокринолога.

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