Antibodies to TSH receptors: analysis

If you came to a polyclinic with complaints aboutexcessive irritability and anxiety, for causeless weight gain or loss, for fatigue, and the doctor prescribes tests for antibodies to TSH receptors, which means he wants to check the condition of your thyroid gland. What is the relationship? The fact is that the TSH receptors "live" in the thyroid gland and are responsible for the synthesis of the most important hormones in it. Any violation of this process can cause the problems mentioned above, and many other troubles. So, about everything in order.

What is TTG

TSH stands for tirotropine, orthyroid-stimulating hormone. It produces a small glandular pituitary gland located near the brain. By acting on special receptors located on the surface of the thyroid gland, hormones of TTG exert a stimulating effect on the production of thyroxine (T4), which in turn affects the increase in thyroid iodine intake. In the future, TSH affects the synthesis of T4 and T3 (triiodothyronine). These two hormones are very important for the growth and development of human cells, for the proper functioning of the GIT, heart, blood vessels, sexual and nervous systems. When an analysis of "Antibodies to TSH receptors" is assigned, there is a suspicion of a violation of hormone production, which can lead to serious diseases, such as:

• hyperthyroidism (Graves' disease or Basedova);
• hypothyroidism;
• thyrotoxicosis.

Antibodies and Receptors

Receptors are those formations in whichwoven nerve endings, sensitive neurons, other particles of intercellular substance, which transform the actions of the stimulus into a nerve impulse. There are a lot of them in the body. In particular, TSH receptors react to hormones of the same name and stimulate their production, which is necessary for the normal operation of many human systems.

Antibodies are a specific kind of proteins(glycoproteins), which are unusually selectively combined with specific types of molecules. This property uses the human immune system. At failures in it antibodies to receptors TTG begin to be developed. They are of several types, differing in their functions.

1. They block the activity of TTG and start to imitate their influence on the thyroid gland (they stimulate its work). As a result, the level of T3 and T4 is increasing, and hyperthyroidism is developing.
2. Stronger than the hormones of TSH, bind to receptors. In this case, the levels of T3 and T4 grow for a long period, since the thyroid cells are stimulated continuously.
3. Do not block, but decrease the activity of hormones TSH, as a result of the thyroid gland becomes insensitive to them (atrophy). There comes hypothyroidism.

When it is necessary to take tests for antibodies to TSH receptors

Such tests are administered at the following indications:

1. Symptoms of hyperthyroidism, which include irritability, increased sensitivity to heat, anxiety, causeless weight loss, problems in the work of the heart, oligoamenorrhea.
2. Symptoms of hypothyroidism: lack of appetite with increasing body weight, apathy, drowsiness, fatigue, hypersensitivity to cold.
3. Graves' disease (diagnosis, control of treatment).
4. Pregnant or planning pregnancy, who have suspicions of Graves' disease or other abnormalities from TSH standards.

Sometimes the need for testing occurs with viral infections, as individual groups of viruses can bind to receptors.

How to pass the test correctly

It is known that the concentration in the blood of thyrotropinnot the same throughout the day. The highest rates it has at 3-4 o'clock in the morning, the lowest - about 5-7 pm. As a rule, the analysis for antibodies to TSH receptors is given in the morning. Before this you can not drink (the exception is water), eat, smoke. Since the last meal, at least 8 hours must pass, and eating fatty foods is highly undesirable. If the tests are conducted to determine the dynamics of changes in the number of antibodies, they must be taken at the same time each time. Blood is taken from the vein. The answer must be ready for the next day.

Why do this analysis

Required serum antibodies to receptorsTTG have a characteristic feature - they appear if a person has a diffuse toxic goiter (Graves' disease). Their presence in the blood serum is a kind of marker proving the presence of the disease. In 85-100% of patients, antibodies are stimulating and about 96% are blocking antibodies. That is, most patients have two forms of antibodies, which requires correction of the prescribed treatment.

In addition to DTZ, the analysis for antibodies to TSH receptors is positive in 15% of patients with Hashimoto's thyroiditis (Hashimoto) autoimmune.

The dynamics of changes in the number of antibodies is clarified,when the patient is already receiving treatment. So, after taking antithyroid drugs, the concentration of antibodies drops, which can serve as an excuse for the complete withdrawal of drugs.

However, in a number of cases, DTZ and Hashimoto's thyroiditisare combined with lupus erythematosus, rheumatoid arthritis and some other conditions. Therefore, with positive analysis it is desirable to conduct other tests to exclude concomitant diseases.

Antibodies in pregnant women

Not all pregnant women are prescribed tests for antibodies to TSH receptors. It must be completed if:

• the woman underwent a course of radioactive iodine therapy;
• surgical treatment of DTZ;
• there are signs of hyperthyroidism;
• takes thyreostatic drugs.

Antibodies to the TSH receptor are able to passthrough the placenta to the fetus and cause him to have hyperthyroidism. In addition to the blood test, patients with suspicion of DTZ carry out scintigraphy, which is contraindicated for pregnant women. For them, perhaps, the only way to protect the child from a disease is to do an antibody test for TSH receptors. The norm for different categories of people is not the same, but on average ranges from 0 to 0.99 Me / l.

This should not be confused with TSH assays. Their norm during pregnancy can increase or decrease and reach a level of 0.2-3.5 Me / l. It is important to carry out tests for antibodies and hormones in the early stages of pregnancy, while in the fetus the thyroid gland does not function independently.

results

After carrying out the analysis on antibodies the level of the protein of interest is revealed:

• less than 1.5 Me / l - negative;
• from 1,5 to 1,75 Me / l - doubtful;
• more than 1.75 Me / l - positive.

If the result of an assay for antibodies to receptorsTTG is negative, it can mean no problems with the thyroid, a successful result of treatment or mistakes made by the laboratory assistant when taking blood. Unfortunately, a negative result is not always an indicator of a normal thyroid gland. In cases of doubt, the doctor may prescribe additional studies.

A positive result means that a person has a DTZ or an autoimmune thyroiditis.

Treatment

When, as a result of the analysis, it was revealed that theantibodies to the TSH receptor, the treatment is prescribed only by the doctor, since the reasons for the deviation may be different. If this is DTZ, the therapy is carried out with the drugs "Mercazolil" or "Methylthiouracil". In recent years, excellent results are achieved with radiodiodotherapy. However, it is contraindicated for pregnant women. In this case, only "Propylthiouracil" is attributed. Monitoring the concentration of antibodies is mandatory.

In some cases, surgical treatment is prescribed.

If this is Hashimoto's thyroiditis autoimmune, treatmentare carried out by the following hormonal means: "thyroxine", "thyroidin", "L-thyroxine" and others, as well as glucocorticoids. Good results are shown by the therapy with white cotton.

In any case, self-medication without a doctor's supervision is contraindicated.