When to check hormones, what tests to take and what to do…

Health Tips

What are hormones?

Hormones are produced by specialized cells that are located in special organs – endocrine glands. The work of these organs is clearly coordinated and has several levels of endocrine regulation:

• The hypothalamus is the highest control center for hormonal activity. Hypothalamic hormones send a signal to the pituitary gland whether it is necessary to activate the work of one or another peripheral gland (adrenal glands, ovaries, thyroid gland, etc.).

• Pituitary – secretes substances that block or, conversely, stimulate the peripheral glands.

• Peripheral glands – thyroid and parathyroid, pancreas, adrenal glands, ovaries in women and testicles in men.

• The pineal gland is a relatively autonomous organ that synthesizes melatonin, and this process occurs only at night in complete darkness (which is why it is so important to sleep without light). Helps to synchronize the rhythms of wakefulness and rest.

Survey Options

Conventionally, survey options can be divided into scheduled and urgent. Scheduled testing is carried out even in the absence of complaints. Considering that in many regions of Russia there is an iodine deficiency in water and food, which can extremely negatively affect the functioning of the thyroid gland, it is recommended that all men and women once a year determine the content of TSH (thyroid-stimulating hormone) in the blood. If the levels of this hormone are higher or lower than normal, then the endocrinologist will prescribe an extended examination of the thyroid gland to establish an accurate diagnosis and select targeted treatment.

An urgent examination option is recommended in the presence of complaints. Many symptoms of endocrine disorders are not always obvious. It is worth paying attention to any change in well-being. However, the following are especially worrisome:

• pigmentation of the mucous membranes, bronze skin tone (may indicate adrenal insufficiency);

• causeless feeling of heat or cold;

• the appearance of edema;

• hair loss;

• fragility of nails;

• dry skin;

• high or low blood pressure;

• weight gain or, conversely, weight loss;

• pain in bones and joints;

• low or too high growth;

• fast fatiguability;

• the presence of discharge from the chest;

• drowsiness or insomnia.

Women should also check the hormonal profile in case of menstrual irregularities and the inability to become pregnant. Sex hormones are also prescribed during perimenopause (the period before the complete cessation of menstruation) for the timely start of menopausal hormone therapy.

What tests to take

Standard hormonal screening in women to detect disorders in the reproductive system includes determining the activity of thyroid-stimulating, follicle-stimulating, luteinizing hormones, prolactin, estradiol, cortisol, testosterone, DEA-C. In the second phase of the cycle, to assess the fact of ovulation and the functional activity of the corpus luteum, the concentration of progesterone is determined. For women who are planning a pregnancy, incl. With the help of IVF, it is also important to know the concentration of anti-Müllerian hormone. This substance allows you to evaluate the ovarian reserve – the number of follicles and, accordingly, the eggs that remain in the ovaries.

In men with disorders in the spermogram and in the presence of signs of androgen deficiency, follicle-stimulating and luteinizing hormones, prolactin and testosterone (total and free) are determined in the blood.

Other hormonal examinations are carried out on the basis of an examination by an endocrinologist. Depending on what diagnosis is assumed, an individual examination program is drawn up. As we said above, TSH is a screening test, so it is recommended for all patients, even in the absence of complaints. The shelf life of hormone testing is 1 year.

To exclude diabetes, as a rule, the first step is to determine the concentration of glucose in the blood. A more targeted examination is a glucose tolerance test, which allows you to assess how the pancreas copes with carbohydrate metabolism under conditions of increased load. To do this, the patient drinks a sweet solution in which 75 g of glucose is dissolved, after which the blood sugar content is assessed.

What to do next

After a detailed hormonal examination, a consultation with a general endocrinologist is required. A gynecologist-endocrinologist deals with gynecological problems, and an andrologist deals with men’s problems. The doctor will study the results of the tests, determine at what level there are violations, establish an accurate diagnosis and select a treatment. The therapy is aimed either at suppressing the increased activity of the glands, or, conversely, at stimulating the “resting” hormone-secreting cells. Usually, hormonal testing is required after 3-6 months to evaluate the effectiveness of therapy.

If you are self-scheduled screening for the detection of hidden pathologies of the thyroid gland and there are no complaints, then the results of TSH can be assessed independently. Permissible limits of the norm are indicated in the form of analyzes. If the indicators are higher or lower than the reference values ​​or are at the upper or lower limit, consultation with an endocrinologist is required.

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