What to watch with TSH Schilddrüse and Wechseljahre?

During menopause, hormonal shifts can significantly impact thyroid function. An elevated TSH (above 2.5–4.0 mU/L) may indicate incipient hypothyroidism, whose symptoms—fatigue, weight gain, mood changes—often overlap with menopausal complaints. A low TSH (<0.3 mU/L) suggests hyperthyroidism. Crucially, TSH alone is insufficient; measuring free T3, free T4, and thyroid antibodies (TPO-Ab, Tg-Ab) is necessary for a complete assessment. Estrogen fluctuations can alter thyroid-binding globulin, so if hormone replacement therapy (HRT) is used, thyroid medication doses may need adjustment. TSH screening during menopause is reasonable, but interpretation must consider the full clinical picture. Evidence is based on clinical practice guidelines and observational data, not large RCTs. Caveat: Do not self-medicate with thyroid hormones; medical evaluation is essential.