The condition of high TSH and low free T4 is called hypothyroidism. High TSH hormone may be due to many reasons.
The most common reasons are Hashimoto's Disease (chronic autoimmune thyroiditis) and iodine deficiency.
In Hashimoto's disease, anti-TPO or anti-Tg antibodies are high along with high TSH. is detected. In ultrasonographic examination, it is determined that the thyroid gland is damaged. In iodine deficiency, thyroid autoantibodies may be negative, TSH may be high, and the thyroid gland may be enlarged ultrasonographically. It is also observed that iodine excretion in the urine is very low.
In women with hypothyroidism, problems are detected in the menstrual cycle as well as other symptoms and findings of hypothyroidism. These people may menstruate frequently or their periods may stop. Especially with hypothyroidism, prolactin hormone may also be found to be high. High levels of prolactin can also cause problems in the menstrual cycle.
Therefore, women with hypothyroidism, that is, women with high TSH hormone, may have difficulty getting pregnant. However, when these diseases are treated, as soon as the menstrual cycle returns to normal, the pregnancy problem of these women will be resolved if there is no other pathology.
TSH, fT4, anti-TPO and anti-Tg should be checked in every woman who has difficulty in getting pregnant. Studies have shown that having an ideal TSH level below 2.5 before pregnancy makes pregnancy easier. It has been shown that pregnancy becomes easier with drug treatment, especially in people with high antibodies, even if their TSH is close to normal, and in those who have pregnancy problems. Patients who started taking medication before pregnancy should use thyroid medication throughout pregnancy.
In addition, every woman with a family history of Hashimoto's disease or a history of recurrent miscarriage should have TSH, fT4, anti-TPO and anti-Tg tests if they want to become pregnant. The presence of iodine deficiency should be investigated by looking at iodine intake in urine. It should not be forgotten that Turkey is endemic, that is, very common, in terms of iodine deficiency.
I wish you healthy days.
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