Question: Dear Oleg. I in February this year had a miscarriage on the age of 6 weeks and 6 days. I passed the tests for hormones are all normal except for cortisol. 731.339 (a normal value on the table 150-660 nmol / L) analysis rented in the 3rd day of the cycle. I doctor prescribed pills metipred drink 1 month to 1 pill. I am afraid a huge list of side effects. . . Please tell me very seriously whether it was that I have so much to increased cortisol, and how it may affect the further my pregnancy and nurturing
Answer: cortisol – the hormone of the adrenals, but the fact is that it is variation in the level of fasting. Metipred – a drug used to treat VDKN (see FAQ in the "diseases of adrenal glands), and if these side effects do not develop, because when VDKN DEFEATED TOWARDS cortisol (the level can not be increased). Worth visiting endocrinologist. If endocrinologist have reason to believe (by the symptoms, revealed by examination) increased production of cortisol (Cushing's disease) – that he will appoint you to define the content of cortisol in the daily urine, possibly – deksametazonovuyu small sample (used to distinguish normal from non-normal). Maybe not appoint, if no such symptoms.
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Question: Pregnancy 31 weeks. At the 8th week analysis showed that the harmony of DHEA-sulfate increased. Metipred prescribed for 1 / 4 tablet at night. Retake the tests, but the harmony does not greatly decreased, then increased to tablets a day, drank some time, passed once more analysis was normal. reduced to 1 / 2 tablets at night. Sex of the child-boy. Doctor with whom I will give birth in the hospital said to reduce to 1 / 4 and stop drinking it. But my doctor in consultation on vacation and she said to drink it before the end of pregnancy, help with what to do, I rasterennosti who to believe, and that would not harm the child.
Answer: If your doctor on vacation – not looking for a board on the Internet. Come to the reception to another doctor from the same department, who has more right to change the treatment in this situation.
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Question: Good morning, I put the diagnosis – infertility (endometriosis). Before you go for an operation, I would like excl. thyroid disease. I was tested for thyroid hormones, has received the following results – TSH 1,8, ST3-3, 6, ST4-12, 7, AT-TG-75, 5, AT-SRW-0, 2 which may mean the excess of the rules of AT -TG-75, 5? and whether you want this to go to the endocrinologist? Do I need to do ultrasound? Earlier thyroid never were no complaints. In endocrinologist tested three years ago, such as goiter was in order.
Answer: Thyroid hormones in normal (ie, her work is not disrupted). Antibodies to tsitovidnoy gland (AT to TG, etc.) by themselves do not require treatment (and are healthy carriers of antibodies), but in women with carriage of antibodies increased risk miscarriage, and it eliminates the intake of thyroid hormones in small doses (it is safe during pregnancy). If, after the treatment of endometriosis, there will be problems with the onset or pregnancy – Endocrinologist assign you additional treatment (in this case, the effective reception of thyroid hormone (thyroxine) during pregnancy in doses not causing an overdose.
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Question: Planning pregnancy. Excess hair growth on the skin (male pattern) has always been, just never worried about it. Regular menstrual cycle. The doctor said to make the analysis of hormones: in the 2nd phase of 17-OH-progesterone -3.7 (ng / ml) (!!!), DHEA – in normal (2.2 mg / ml) (normal TSH – 1 23) has appointed metipred – 1 tablet of 4mg per day. and if a pregnancy occurs, it probably will leave the drug throughout pregnancy. Do you think in this case, the appointment of the drug obpravdano? On how the drug affects the developing fetus
Answer: Use metipreda (or other drugs from the group of glucocorticoids) reasonable (and safe during pregnancy), if there is a reliable diagnosis VDKN (see FAQ in diseases of the adrenals). But for a reliable diagnosis to improve not only the 17-OH-progesterone, and DHEA. In this situation, appropriate use of genetic analysis, and appeal to a large Endocrinology institution (for example, in Moscow – Enz RAMS, www. Endocrincentr. Ru).
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Question: I have a pregnancy of 10 weeks. After the first birth was diagnosed with hyperthyroidism, and after 4 months of treatment merkazolilom-hypothyroidism. I accept the L-thyroxine for about 4 years, now 100 mg per day. Recent tests-TSH-0, 054, FT4-13, 56. The doctor left the same dose of medication. Anxious, whether chosen me as my treatment and the disease can affect the pregnancy. Thank
Answer: Out of pregnancy reduced TSH with normal T4 spoke to a small excess of hormones cancer. But during pregnancy possible false values of TSH (due to various hormonal changes in the body at this time), so that in this period, do not rely on the TSH and the level of free T4 (who you have in the norm). Incidentally, during pregnancy, the need for hormones gland increases (30-50%), so the doctor will probably adjust the dose during pregnancy.
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Question: Dear Oleg! I passed blood for hormones, the following indicators: AT / SRW 27,2 / 0-30. 0, TSH 1. 25 / 0. 3-4,0 (did ultrasound, the doctor said that the thyroid gland is reduced) Be polite. decode the data, to the doctor I caused only a month! advance many thanks.
Answer: These indicators are normal, as you can see yourself (figures in parentheses – limit of normal). A small amount of cancer in itself is not a deviation from the norm and does not require treatment.
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Question: I mnya 17 weeks of pregnancy. A month ago, passed the tests for hormones DHEA and testosterone. As a result, received the following data: DEA-3, 86 (the norm for pregnant 0,25-1,8), testosterone, 1,34 (the norm for pregnant 0,069-5,2). My doctor said it was the threat of miscarriage, and I need to drink dexamethasone for 1 / 4 tablets per day, but in our town these tablets there. . . at the next regularly scheduled doctor told me that they must continue to look for. . . What me and noemu baby faces delay in taking these pills? Thanks in advance
Answer: There is a disease – VDKN (congenital dysfunction of adrenal cortex). There are different forms, but most common in adults in the adrenal glands violated the basic way of synthesis of hormones, the synthesis is "detours", and are a byproduct of adrenal androgens (including DHEA (DGAE-S – is its sulfate) and 17-hydroxyprogesterone) . Adults are relatively common "soft" forms of these disorders that little something to show, but can cause irregularities in the ovaries and miscarriages of pregnancy. Outside of pregnancy, treatment is required if the disease appears excessive growth of hair on the skin, irregular menstrual cycles, problems with the onset of pregnancy. There is a problem hyperdiagnostics this state. A reliable diagnosis can be made in genetic analysis (available in Moscow and others), indirect signs – increasing DHEA or 17-OH-progesterone – less reliable indicator. Treatment, if the diagnosis is correct – the reception of adrenal hormones, which disrupted the synthesis (glucocorticoids). Usually assigned dexamethasone at night, the doctor can replace it by another agent of this group (prednisolone, metipred, etc.) in the morning (dose: 1 tablet = 1 tablet). In your situation, treatment is required, if an obstetrician-gynecologist sees you have signs of a threatened miscarriage (increased uterine tone, the state of uterine throat, etc.). If this or another gynecologist (to whom you can call to check) said that the threat of miscarriage is not – in itself a change in the results of the analysis may not require treatment. P. S. Genetic analysis of VDKN (still referred to as adreno-genital syndrome) is available in Moscow (among others) in the laboratory in vitro (tel. 363-0363).
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Question: Zdravtvuyte, doktorokolo 4 years sick autoimmune tiroeiditom (hypo). Agree thyroxine, triiodothyronine, hormones returned to normal, but antibodies to proksidaze 1000 (rule 35). Because her husband passed 2 ECO, now preparing for 3 IVF. Opinion gynecologist that antibodies have to reduce, otherwise impossible implantation of the fetus. I sprosit1. whether antibodies to reduce glucocorticoids if so, kakimi2. whether they can be taken during pregnancy, if not, when before they become pregnant they should stop prinimat3. after the cessation of how quickly again, the antibodies will grow and what is risk to the fetus. 4. mzhno there with my hypo tireoze take vitamins, which include iodine 150 mcg. Help please, 3 IVF attempt very, very important for us in the road my husband (I mean the moral aspect). If possible please reply to email. e-mail. Thank you.
Answer: Antibodies to the thyroid gland during AIT glucocorticoids do not reduce in any case! "There were some indications that statistically the antibodies to the thyroid gland increase the risk of miscarriage, and that nazanchenie thyroxine during pregnancy lowers this risk. But it turned out that the antibodies harmful to the fetus is not in itself, but due to an increased risk of hypothyroidism during pregnancy their carriers. Therefore, today's recommendations (for women not taking thyroxine), suggests. that the detection of antibodies to TPO in the first trimester of pregnancy even with normal levels of hormones (TSH but closer to the upper limit of normal) should be the appointment of thyroxine. Have the same rules other: during pregnancy dose of thyroxine should be increased by about 50%, need observation endocrinologist and certain hormones during pregnancy, but the level antilel did this has no effect. 4. The need for iodine during pregnancy in hypothyroidism – is almost the same as the others (the thyroid gland needs iodine unborn child), so iodine during pregnancy, you need to take.
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