The endocrine system in our body is responsible for controlling almost all processes in organs and tissues, and they are interconnected. That is why, with pathology of one organ, it can also negatively affect another. For women, this hormone plays a particularly important role, as they are more sensitive to its increase. Read below about what it means if thyroid-stimulating hormone (thyrotropin) is elevated, what it is, its effect on the analysis of hormones T3 and T4 and its effect on the body in a normal state.
The hormone thyroxine: what is it?
Thyroxine (also called T4 hormone) is one of the two most important hormones produced by the thyroid gland. And this synthesis is stimulated by the so-called hormone TSH (thyroid-stimulating hormone). The second very important hormone produced by the thyroid gland is triiodothyronine (or T3). Both of these hormones are iodine-containing. These 2 hormones act as if together.
They perform the same functions, namely influence on activities:
- Hearts;
- Nervous system;
- Reproduction and other organs.
Another function is to improve energy processes and metabolism. The thyroid gland produces thyroxine in 80-90% of cases. It has low activity (not sensitive), but can be converted into an active form, namely triiodothyronine. This process is carried out using the enzyme monodeiodinase. Thyroxine does not bind very readily to thyroid-stimulating receptors, unlike triiodothyronine.
These hormones affect almost all tissues and organs of our body.
The hormone thyroxine affects metabolism (by accelerating it), speed of thinking, energy, and also the heart. The fact that thyroxine speeds up metabolism in the body suggests that people with a deficiency of this hormone may experience weight gain, because the faster metabolic process, the better fats are burned in the body. These hormones also regulate the differentiation of most cells in the body and also influence the growth and development of the body.
Thyroid-stimulating hormone is elevated: what does it mean?
The production of hormones is carried out by the so-called axis, which consists of the hypothalamus, which acts on the pituitary gland, which already affects the thyroid gland. That is, the secreted activity of the thyroid gland is determined by the hypothalamus, acting through the pituitary gland. Thyroid-stimulating hormone is a hormone produced by the pituitary gland. Elevated thyroid-stimulating hormone can cause various diseases.
These diseases are divided into 2 classes:
- Diseases of the thyroid gland are primary;
- Diseases of the hypothalamus and pituitary gland are secondary.
With hypothyroidism (that is, with insufficient production of the thyroid hormones T3 and T4), the pituitary gland sends signals to increase the amount of thyroid-stimulating hormone, which, as we remember, affects the synthesis of T3 and T4 in the thyroid gland. And with thyrotoxicosis (with an increased amount of thyroxine and triiodothyronine in the blood), the pituitary gland reduces the production of this hormone. This relationship is called inverse negative. These two organs of the endocrine system work harmoniously.
This connection must be maintained constantly, but there are cases of damage to the pituitary gland, which entails disruption of the relationship.
This can lead to disagreements between these 2 bodies. For example, the pituitary gland will secrete a lot of TSH, although the body does not need the synthesis of thyroxine and triiodothyronine, or vice versa.
Elevated TSH: what does this mean in women
Most often, an increase in thyroid-stimulating hormone is observed in women. According to statistics, the ratio of the manifestation of this pathology in women relative to men is 10:1. But this is due to the fact that in women the functioning of the thyroid gland is more often disrupted - autoimmune thyroiditis, which is also manifested by an increase in the level of antibodies to TPO (thyroid peroxidase is an enzyme of the thyroid gland).
The reason for the increase in TSH is:
- Thyroid;
- Also hypothalamus;
- And the pituitary gland.
But pathologies of these 2 brain organs occur equally among men and women. It is also worth remembering that an increase in thyroid-stimulating hormone in women can mean a breast tumor.
Free T4: what kind of hormone is it and what do they look for during analysis?
Thyroid free hormone T4 (T4f, ft4, st4) is the same thyroxine, which is one of the most important hormones of the thyroid gland. Free T4 is the active part of this hormone, which acts on metabolism, and total T4 is all the thyroxines in the body (active and inactive).
As for the reasons for the increase in thyroid-stimulating hormone, there are several options:
- Pituitary adenoma. This is a secreting tumor of the pituitary gland, which produces thyroid-stimulating hormone, which causes its increase. This entails an increase in the amount of hormones T3 and T4.
- Lack of sensitivity of the pituitary gland to thyroxine and triiodothyronine. This is a genetic disease, which is characterized by the fact that the pituitary gland reacts to an increase in thyroxine and triiodothyronine. This also entails thyrotoxicosis.
- Lack of sensitivity in general of all organs and tissues of the body to T3 and T4. This is a more serious disease that is characterized by severe growth and development delays, as well as mental problems.
With hyperthyroidism, many serious diseases arise, such as goiter, thyroiditis, etc. It occurs when TSH levels are low. However, this does not apply to pregnant women. Even with subclinical hypothyroidism, they are immediately prescribed T4.
To study the amount of thyroxine, venous blood is used.
The research method is immunochemiluminescent. This study, in addition to the thyroid gland, is also used to study the causes of infertility in women. The unit of measurement is pmol/l.
Normal T4 free hormone
When thyroid-stimulating hormone increases in the blood, disturbances in mood and well-being may occur, since there is a low level of thyroxine and triiodothyronine in the blood. If you ignore the fact of an increase in thyroid-stimulating hormone for a long time, you can get the following symptoms.
Namely:
- Seriously slow down your metabolism;
- Will call speed dial weight;
- Atherosclerosis;
- Hypertension and diabetes.
What to do if the level of thyroid-stimulating hormone has increased? In this case, in no case should you resort to treatment methods folk remedies, since it is not effective specifically in this case. It is best to consult a qualified doctor who will select the right treatment. The doctor, depending on the degree of disruption of the system, will choose the appropriate medications. If TSH is elevated, the doctor should prescribe medications that contain thyroxine and triiodothyronine. When taking the medicine, the level of T3 and T4 in the body will immediately increase to normal, which, accordingly, will reduce the level of thyroid-stimulating hormone to the same norm. The sad fact is that in most cases in this situation you will have to take these drugs for the rest of your life. There is subclinical hypothyroidism.
This is not so scary, so it is treated mainly with a comprehensive method (diet, taking vitamins, etc.).
This study should be carried out more often by women of middle and upper middle age. For women over 20 years of age, the normal level is considered to be from 10.8 to 22.0 pmol. And for pregnant women, this indicator varies, depending on the stage of pregnancy.
The TSH hormone is elevated: what does this mean in women (video)
The value of thyroid hormone is of particular importance for women, since they are more likely to develop thyroid diseases. Also, the value of this hormone plays an important role in the diagnosis of certain diseases, for example, breast cancer. This should be taken very seriously, and most importantly, do not self-medicate, as this is dangerous and fraught with consequences. It is recommended that women aged 35-50 undergo regular testing.
For people suffering from thyroid diseases, it will be useful to know what it means when TSH is elevated and T4 is decreased at the same time. But first of all, it’s worth finding out everything about these substances, where they are produced and what they are responsible for. Only after this can the meaning of these deviations be understood. This is exactly what the article will discuss.
General concepts
There are a large number of glands working in the body of every person. Their role is difficult to overestimate. Some glands are responsible for the normal functioning of the gastrointestinal tract, others are responsible for the nervous or immune system and so on. But for this whole mechanism to work smoothly, a “control center” is needed. This is exactly what the pituitary gland and hypothalamus are. These parts of the brain produce hormones that control the functioning of all glands. If this connection is disrupted, then diseases will “penetrate” the body.
Thus, for the functioning of the thyroid gland, the presence of thyroid-stimulating hormone is required. This substance is produced in the pituitary gland. Further through the bloodstream it enters the thyroid gland, which produces the next hormone. All this is necessary for the normal functioning of the endocrine system.
The thyroid gland releases two main hormones: 
- triiodothyronine, or T3;
- thyroxine, or T4.
The operation of such a chain is quite simple. If a low level of T4 or T3 is detected in the bloodstream, the pituitary gland begins to intensively release the hormone thyrotropin (TSH). It enters the thyroid gland and activates its work. As a result, with normal functioning of the body and the absence of diseases, the required level of T3 and T4 in the blood is achieved.
These substances themselves, which have a protein structure, play an important role. The T4 hormone controls the regulation of energy and plastic metabolism in the human body, and the substance abbreviated T3 helps it.
What are the established standards and what are the symptoms of deviation?
As noted above, the hormone TSH, which is produced in the pituitary gland, serves to activate the thyroid gland. If its level is high, but there is little T4 in the blood, this means that this organ is not working properly. It is urgent to undergo additional examination for timely initiation of treatment.
To diagnose such deviations, the doctor prescribes the following tests:
- Testing the level of the hormone TSH.
- Blood test for the amount of free hormone T4.
In addition, if there is a suspicion of thyroid disease, additional tests may be prescribed. So, often the doctor prescribes tests for T3 levels and antibodies to TPO.
And in what cases can deciphering studies show such a combination as TSH is increased - T4 is decreased? What abnormalities in the functioning of the patient’s body can this indicate? Doctors consider the normal level of TSH in the blood to be in the range from 0.4 to 4.0 µU per liter. For the T4 hormone, the following limit values exist - from 78 to 153 nmol per liter. If the first indicator is higher than normal and the second is low, then this disease is called hypothyroidism.
The main symptoms of this disease are:
- the patient becomes lethargic and slow;
- more abundant hair loss begins;
- the skin becomes rough and dry;
- the patient’s weight begins to increase, even to the point of obesity;
- disruptions in the functioning of the gastrointestinal tract are observed.
In addition, women may experience problems menstrual cycle. Also, in certain acute forms of hypothyroidism, there is a change in voice and some hearing loss. This occurs due to swelling that appears in the inner ear, larynx and tongue of the patient.
Causes of the disease
Experts identify several causes of hypothyroidism. The main, or primary, include those that are associated with damage to the thyroid gland itself.
The following ailments are distinguished here:
- hereditary diseases. You can indicate both congenital underdevelopment of the thyroid gland and disturbances in the production of hormones;
- if this organ was removed surgically (strumectomy);
- exposure to radiation. If the thyroid gland is irradiated during treatment with radiation therapy, the production of the T4 hormone may be impaired. Also, such processes are observed in people located in the zone of radiation contamination;
- in the presence of iodine deficiency in the body and endemic goiter developing as a result;
- when treated with medications containing radioactive iodine;
- inflammatory processes autoimmune or microbial origin, occurring in the thyroid gland;
- in some cases, a decrease in the level of production of the T4 hormone occurs due to an overdose of a number of medications;
- for oncological diseases of the thyroid gland.
In addition to the primary causes of impaired production of the hormone T4, doctors also identify secondary ones. These include, in particular, diseases such as lesions of the pituitary gland or hypothalamus, inflammatory processes in certain areas of the brain, tumors, and so on.
In some cases, an increase in TSH levels does not lead to normalization of the amount of T4 due to disruption of the action of thyroid hormones.
Doctors include the following diseases and abnormalities as such:
- Autoimmune processes that promote the formation of antibodies to TSH.
- Disturbances in the structure of tissue receptors through which this hormone exerts its effect. Such deviations are most often hereditary.
- Enzymopathies of the kidneys and liver. Because of this disease, the hormone cannot form normally.
As you can see, there are many causes of hypothyroidism. To make a correct diagnosis and begin timely treatment, the doctor must conduct several studies simultaneously. But the main thing is that this disease occurs rather secretively. Sometimes it is detected in the later stages. Therefore, when you first notice symptoms of hypothyroidism, you need to visit a specialist and donate blood for the necessary tests.
It is worth noting that this disease is difficult to treat. Sometimes even the most modern means do not bring the desired result. And in this matter, the main assistant is early diagnosis of the disease. Only in this case there is a better chance of minimizing its consequences.
If a patient is found to have elevated T4 or elevated TSH, then it is necessary to conduct a diagnosis that will help detect the existing pathology. There are chronic diseases that have no symptoms. Therefore, a hormone analysis makes it possible to identify the disease at a very early stage, which reduces the risk of complications to a minimum.
The value of thyroxine and thyrotropin
The state of the hormonal system must be constantly monitored, because even minor disturbances in its functioning will provoke the development of various pathologies. Normal concentrations of TSH and T4 are a fairly significant indicator that the body is not in danger.
Due to the fact that hormones are produced sufficiently, the activity of organs and systems is regulated.
The site of thyrotropin production is the anterior pituitary gland. TSH is a complex protein compound whose structure contains carbohydrates. Thyrotropin has an important task - to control the production of thyroid hormones, that is, T4 and T3.
There is a direct connection between substances. As the content of thyroxine and triiodothyronine decreases, the concentration of thyroid-stimulating hormone will increase. But if the level of T4 and T3 increases, the amount of thyrotropin decreases accordingly.
A simultaneous increase in TSH and T4 indicates either incorrectly performed tests (more often), or a rare disease - TSH-producing pituitary adenoma, which is diagnosed in one out of a million inhabitants of our planet.
An analysis to determine TSH levels is appropriate for:
- hypothyroidism or hyperthyroidism;
- slow motion mental development The child has;
- myopathies;
- heart diseases;
- infertility;
- an increase in the hormone prolactin;
- development of alopecia.
The main hormone produced by the thyroid gland is thyroxine, also known as T4. Its concentration is almost 90% of the total amount of all hormones produced by the gland. For triiodothyronine, T4 is the basis.
After 40, the T4 indicator decreases. In pregnant women, especially in the third trimester, there is high level thyroxine.
In order for T4 to reach the appropriate organs, it is transported by a special protein - thyroxine-binding globulin. The amount of thyroxine that is not bound by protein is called free hormone. It is he who performs basic biological actions.
The most accurate data can be shown by a test that measures the content of thyrotropin and free thyroxine. Particular attention is paid to the condition in which free T4 is elevated, as well as when TSH is elevated. The norm for TSH is 0.4-4 mIU/l, for independent thyroxine – 0.8-1.8 pg/ml.
If the T4 value increases
Various factors can increase thyroxine levels.
Free T4 hormone appears in larger volumes due to:
- toxic goiter;
- thyroiditis;
- thyroid adenomas (benign formations with the presence of a node);
- hyperthyroidism;
- excess body weight;
- dysfunction of the thyroid gland in the postpartum period;
- diseases related to kidney or liver pathologies;
- heparin therapy.
Since too much free T4 accumulates, it begins to overly affect the organs. In other words, thyrotoxicosis syndrome is diagnosed.
As a result of the appearance of this disease, many systems suffer:
- Digestive.
- Reproductive.
- Nervous.
- Cardiovascular.
Elevated thyroxine is accompanied by characteristic symptoms:
- excessive sweating;
- fatigue;
- irritability;
- increased heart rate;
- arrhythmia;
- obvious weight loss;
- tremor in the limbs.
Since fats are broken down much faster due to excess T4, the patient begins to lose weight. However, such weight loss is not considered physiological, because it is caused by a malfunction of the organs. If the increased concentration of this substance continues, calcium will be washed out of the bones, leading to fractures and osteoporosis.
If the TSH level increases
Initially, there may be no signs that could indicate an increase in the concentration of thyroid-stimulating hormone.
But when the increased rate remains too long, you should expect to see:
- Weakness and instant fatigue.
- Lethargy and inattention.
- Irritability.
- Apathetic state.
- Problems with sleep.
- Poor appetite.
- Nausea.
- Constipation.
- Swelling.
- Pallor of the skin.
- Extra pounds that are almost impossible to get rid of.
If the analysis provided data on an increased TSH ratio, the deviation from the norm may have been caused by:
- pituitary tumor;
- thyroid diseases, which are accompanied by a decrease in the production of T4 and T3;
- a syndrome in which there is irregular secretion of gland hormones;
- surgical intervention, as a result of which the gallbladder was removed;
- adrenal insufficiency;
- Hashimoto's thyroiditis (subacute and acute forms);
- severe gestosis in pregnant women;
- damage to the body by lead;
- excessive iodine intake;
- insensitivity of the pituitary gland to thyroid hormones, which has a genetic predisposition.
When a change in value occurs only once, this does not mean the presence of a disease. The substance may be produced more as a result of taking certain medications.
In women over 45, the presence of increased levels of thyrotropin is a fairly common phenomenon, since at this age the risk of developing thyroid pathologies increases.
Regular examinations will help prevent the development of many serious diseases. And if, if the indicators increase, the doctor prescribes treatment, you should do everything necessary to bring the body’s condition back to normal.
Patients who are being treated with antipsychotics or drugs containing iodine, and at the same time exposed to heavy physical activity, have an increased TSH with normal T4 and T3.
In addition, the concentration of thyroid-stimulating substance increases slightly during pregnancy. This situation is not a pathology and does not require treatment. In all other cases, an elevated level of hormonal substances requires immediate initiation of therapy due to the risk of hypothyroidism.
Preparing for a blood test for thyroid hormones
Here are a few simple rules, the implementation of which will increase the reliability of the tests, and medical professionals do not advise neglecting them.
- Avoid taking hormonal medications for a month, having previously agreed with your doctor. It is not recommended to discontinue therapy on your own.
- Four days before the study, stop taking medications containing iodine (in consultation with your doctor).
- One day, give up any physical activity, smoking, alcohol-containing liquids.
- Biomaterial is given on an empty stomach.
- The best time in the morning is before 10 o'clock.
- The individual's state should be relaxed and calm. It is not advisable to be nervous and worry.
Increased TSH level with normal T4: reasons
Factors influencing changes in hormonal balance:
- the activity of the adrenal glands is impaired;
- failure in the synthesis of hormonal substances;
- the presence of neoplasms of both benign and malignant nature;
- condition after severe psychological trauma;
- late toxicosis;
- insufficient intake of iodine into the body from the outside;
- radioiodine therapy;
- the result of surgical interventions on the thyroid gland;
- drug therapy with drugs that suppress the formation of thyroid hormones;
- lead poisoning;
- carrying out a hemodialysis procedure.
The doctor diagnoses subclinical hypothyroidism with elevated TSH and normal T4 and T3. In this case, the clinical picture is absent or weakly expressed. Additionally, other types of studies are prescribed to confirm the disease.
Signs of hormonal imbalance
A normal level of free thyroxine and an increased level of thyroid-stimulating hormonal substance in most cases is manifested by a general deterioration in the individual’s condition. Untimely recognition of the disease and lack of treatment will quickly lead to serious pathological conditions.
Symptoms of elevated TSH with normal T4:
- the functions of the digestive tract are impaired;
- there is a decrease in appetite or it is completely absent;
- apathy occurs;
- insomnia;
- general weakness;
- physical activity is significantly reduced;
- fatigue sets in quickly;
- In pregnant women, the size of the thyroid gland increases.
Subclinical hypothyroidism
One of the most common causes of this disease is considered to be damage to the cellular tissue of the thyroid gland and, as a result, a decrease in the synthesis of hormones, leading to various diseases. Subclinical hypothyroidism is diagnosed after examining the biomaterial if elevated TSH is detected with normal T4 and normal T3. Signs of subclinical hypothyroidism include:
- increased body weight and a diagnosis of obesity;
- failure in the normal functioning of the digestive system;
- hair loss;
- dry dermis;
- inhibited reactions of the individual;
- slowness;
- lack of energy and vigor;
- predominant state of lethargy;
- dry mucous membranes;
- decreased libido;
- depression;
- menstrual irregularities.
After diagnosing the disease with elevated TSH and normal T4, the doctor prescribes the necessary therapy and also recommends a set of preventive measures aimed at reducing the risk of developing hypothyroidism. It is important to remember that this disease is inherited.
Features of the manifestation of subclinical hypothyroidism in women
A low concentration of the thyroid hormonal substance responsible for the absorption and movement of testosterone in a woman’s body is hypothyroidism. Triiodothyronine, which forms the basis of the thyroid hormone, enters into various chemical interactions in the bloodstream and affects the functioning of the body. When the synthesis of a hormonal substance is disrupted, the amount of estrogen decreases, which ultimately leads to the inability to conceive. The female half of humanity is more susceptible to this pathology. And this is due to the peculiarity of the structure of the genital organs.
What does elevated TSH mean with normal T4 and acceptable T3 values in women according to the results laboratory research? When such a ratio is identified, hypothyroidism is diagnosed, the symptoms of which do not appear in women. However, this is one of the reasons for the impossibility of conceiving a baby, miscarriages early pregnancy. In addition, the disease provokes abnormalities in the development of the fetus.
Treatment of subclinical hypothyroidism
Diagnosing pathology with elevated TSH and normal T4, the doctor prescribes special therapy, the purpose of which is to normalize the amount of hormonal substances and iodine in the individual’s body. Additionally, a course of multivitamin complexes with a high content of minerals is recommended. It is important to remember that therapy is carried out under the supervision of a medical specialist and in accordance with his instructions. In addition, medical professionals may additionally recommend the use of herbal medicine. The following medicinal raw materials are used to prepare decoctions:
- chamomile;
- rose hip;
- St. John's wort;
- elecampane;
- cocklebur;
- celandine;
- Rhodiola rosea;
- yarrow;
- licorice;
- coltsfoot;
- birch leaves and buds;
- rowan fruits.
Elevated TSH and TPO during pregnancy
As mentioned above, a slight increase in indicators does not cause concern. A threat arises with a significant increase in concentration. If the results of a blood test reveal that TSH is elevated during pregnancy with normal T4, then this condition does not require any intervention. Stabilization of hormonal levels will be necessary in cases of increased concentrations of both TSH and T4. In addition, treatment will be required in cases of a significant increase in thyroid-stimulating hormone levels above the permissible values, i.e. above 7 mU/l. Timely therapy and fulfillment of all prescriptions of the treating doctor, and in this case an endocrinologist, are able to:
- adjust hormonal background;
- reduce the risk of miscarriage and the occurrence of pathologies in the unborn baby.
Before planning to conceive a child, it is mandatory to undergo tests to determine the concentration of the following hormonal substances in the blood:
- thyroid-stimulating hormone, abbreviated name TSH;
- free thyroxine, or T4.
In addition, such a laboratory test is prescribed again immediately after pregnancy.
If abnormalities are detected in the quantitative expression of T3 or T4, TSH, as well as the manifestation of symptoms of hyperthyroidism, an analysis is prescribed for the enzyme thyroid peroxidase, or TPO for short, which has a significant effect on the synthesis of triiodothyronine and thyroxine. And thyroid-stimulating hormone stimulates the work of this enzyme.
The insidious disease hyperthyroidism disguises itself as conditions that occur during pregnancy. It should be remembered that existing problems with the thyroid gland have a negative impact on both health expectant mother, and on the body of the pregnant baby. According to research results, a pregnant woman may have an increased TPO with normal TSH and T4, and in addition, an increased TSH level. The reason for this picture lies in the following. As a result of hormonal changes, the pituitary gland synthesizes a large amount of thyroid-stimulating hormonal substance, which is neutralized by antibodies to thyroid peroxidase. At the end of pregnancy or earlier, a failure may occur as antibodies disable more and more thyroid cells. As a result, a severe exacerbation is provoked. TPO easily penetrates and is especially dangerous for the fetus, causing disruption in the functioning of the unborn baby’s body while still in the womb.
Subclinical hypothyroidism in children
IN childhood This pathological condition manifests itself in disruption of the normal functioning of the thyroid gland. Against the background of weak current symptoms, the disease develops, and it can only be identified based on research results. If T4 is normal, then subclinical hypothyroidism is diagnosed.
Adults are also susceptible to this pathology. Lack of treatment for the disease in childhood leads to serious consequences, which manifest themselves:
- disorders of mental and physical development;
- development of autoimmune thyroiditis;
- irreversible processes in the body.
Detection of the disease on early stage and timely initiation of therapy is a prerequisite for the future full life of the baby.
Elevated with normal TSH
A slight increase in the concentration of free thyroxine is detected on initial stages the following pathologies:
- subacute thyroiditis;
- autoimmune chronic thyroiditis.
Based on the results of laboratory tests, a diagnosis of thyrotoxicosis and hypothyroidism is made. However, the level of thyroid-stimulating hormone, and not T4, is decisive in this case. Thus, a decrease or increase in thyroxine levels with normal TSH is not a pathology and, accordingly, no therapy is required.
Decrease in TSH level with normal T3 and T4
A low concentration of thyroid-stimulating hormone and normal production of the hormonal substances T3 and T4 indicate that there is no need for it. Reasons that provoke a decrease in TSH concentration:
- starvation;
- prolonged stress;
- mental disorders;
- uncontrolled use of drugs containing hormonal substances;
- lack of protein in the diet.
In addition to drug therapy, you can increase TSH with normal T3 and T4 by changing your lifestyle: quit smoking and alcohol-containing drinks, review your diet, which needs to be tailored to take into account the increased need for proteins, vitamins and carbohydrates. The products consumed should help normalize the patient's stool. It is recommended to completely eliminate foods that stimulate the cardiovascular and nervous systems, as well as all tea and coffee drinks, chocolate. Hot and spicy foods are acceptable in limited quantities.
Conclusion
If you suspect a malfunction of the endocrine system, as well as to make an accurate diagnosis, it is necessary to evaluate the hormonal levels that form the thyroid gland and pituitary gland.
You can check it by submitting biomaterial for hormones in the direction of the treating doctor. Interpretation of laboratory test results will help to build the correct tactics for patient management.
