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The causes of increase and decrease in thyroid-stimulating hormone

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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With hypothyroidism, the thyroid-stimulating hormone rises. The diagnosis is confirmed by low concentrations of free thyroxine (cT ₄ ), T ₄, T ₃ in the blood. In cases of subclinical mild hypothyroidism, when the level of cT ₄ and T ₄ in the blood is within normal limits, the detection of an elevated thyroid-stimulating hormone becomes crucial. A low level of thyroid-stimulating hormone in hypothyroidism indicates a deficiency of the pituitary or hypothalamus and excludes primary dysfunction of the thyroid gland. The definition of thyroid-stimulating hormone is important for monitoring patients with hypothyroidism who receive daily substitution therapy with levothyroxine sodium. Determining the concentration of thyroid-stimulating hormone, it is possible to optimize the dose of the drug taken.

With hyperthyroidism, the synthesis and secretion of the thyroid-stimulating hormone are suppressed. As a result, primary hyperthyroidism (thyroid disease) is characterized by an increased content of thyroid hormones (T ₄, T ₃ ) in the blood and a deficiency of thyroid-stimulating hormone.

The concentration of thyroid-stimulating hormone increases with thyrotropine-secreting tumors of the pituitary gland (in 90% of cases, macroadenomas, a size of more than 10 mm). At the same time, it must be remembered that long-term hypothyroidism can lead to pituitary hyperplasia with the formation of a pseudotumor, and therefore, all patients should be examined the concentration of CT ₄ before performing an operation on the pituitary gland . Elevated values of PT ₄ testify in favor of pituitary adenoma, low - hypothyroidism.

Diseases and conditions in which the concentration of thyroid-stimulating hormone in the blood serum changes

Increase in the concentration of thyroid-stimulating hormone

Primary hypothyroidism of the thyroid gland
Subacute thyroiditis
Thyroiditis Hashimoto
Pituitary Tumor
Ectopic secretion in tumors of the lung, mammary gland
Endemic goiter
Inflammation of the thyroid gland
Condition after iodine therapy
Thyroid cancer

Reducing the concentration of thyroid-stimulating hormone

Primary hyperthyroidism
Hypothalamic-pituitary insufficiency
Pituitary Tumor
Pituitary Injury
Postpartum necrosis of the pituitary gland
Isenko-Cushing syndrome
The use of acetylsalicylic acid, heparin, thyroid hormones, glucocorticosteroids

trusted-source [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11]

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