Maganin Thyroid don Hypothyroidism
Sakamakon labarai mai kyau ga marasa lafiya thyroid: nazarin da aka wallafa a cikin jarida mai daraja da jaridar da ya fi dacewa ya nuna cewa haɗin T4 / T3 ya fi dacewa da T4 kawai / levothyroxine magani ga hypothyroidism! Ga bayanai.
Nazarin binciken kasa da kasa ya ruwaito a cikin Jarida na Turai na Endocrinology ya dubi maganganun maganin maganin maganin T3 na roba a matsayin kari ga T4-kawai (levothyroxine) maganin hypothyroidism.
Wasu nazarin karatun da suka gabata fiye da shekaru goma sun nuna alamar haɗin haɗin. Sauran binciken, duk da haka, ba su sami bambanci ba. Rashin daidaituwa akan wadannan bincike kan T3 ya jagoranci wasu masana - musamman ma wadanda suke da sha'awar ciwon levothyroxine-kawai maganin - don kare cewa babu wani amfani ga Bugu da ƙari na T3. (Wasu daga cikin wadannan "masana" har ma sun yi fasali mai mahimmanci, kuma sun tabbatar da cewa levothyroxine / T4-kawai farfadowa ya fi dacewar T4 / T3.
A kowane hali, a cikin bincike, masu bincike na Danish sun gudanar da binciken makaranta guda biyu, wanda aka yi la'akari da tsarin zinare na zinariya - 59 marasa lafiya. A cikin ƙungiyar haƙuri, an yi amfani da nau'in kwayoyi 50 na saba'in T4 tare da 20 mcg na T3 ko 50 mcg na T4 na makonni 12. Wadanda suka kamu da cutar sun yi "giciye," suna yin kishi ga wasu makonni 12.
An tsara tsarin T4 idan an buƙatar kiyaye matakan TSH.
Gwaje-gwajen gwajin rayuwa (QOL) da kuma rashin tausayi da aka yi a farkon, da kuma bayan lokutan makonni 12 na mako. Halin rayuwa da abubuwan da suka shafi tunanin mutum sun hada da, kiwon lafiyar jama'a, aikin zamantakewa, lafiyar hankali, da karfi, jin tsoro, damuwa, da damuwa.
Abin da masu bincike suka gano shine daga cikin marasa lafiya - 55 daga cikinsu akwai mata - akwai bambanci masu yawa a cikin 7 daga cikin 11 na QOL da rashin ciwo, suna nuna kyakkyawan sakamako dangane da haɗin T4 / T3.
Kusan kashi 49 cikin 100 na marasa lafiya sun fi son haɗin gwiwa, kuma kawai 15% sun fi son ciwon levothyroxine kawai.
Masu bincike sun kammala cewa, a cikin wani binciken inda aka kiyaye matakan TSH, ƙwayar T4 / T3 wanda ya hada da 20 mcg na T3 yau da kullum ya kasance mafi kyau ga lafiyar levothyroxine, lokacin da yake kimantawa da yawan nauyin rayuwa, damuwa da damuwa Sikeli, da kuma yarda da haƙuri.
Doctors sau da yawa suna nuna haɗarin hadarin sakamako tare da T3 farfadowa don dalili ba za a yi amfani da T3 ba, amma wannan binciken ya nuna cewa babu bambanci game da sakamakon illa. A cewar mawallafa, a lokacin zaman lafiya na T4 / T3, mutane biyar sun sami illa masu tasiri ciki har da lalacewar jiki, matsananciyar zubar da jini, da rashin zaman lafiya. A lokacin T4-kawai faril, mutane tara sunyi rahoton irin wannan sakamako.
Abin sha'awa shine, masu binciken Danish sun nuna matsaloli da wasu daga cikin binciken da suka gabata game da maganin T4 / T3 wanda bai samu wata mahimmanci ga maganin T3 ba, yana cewa: "Nazarin da aka haɗa a cikin meta-bincike sun hada da cakuda daban-daban ƙungiyoyin masu haƙuri, ciki har da marasa lafiya tare da ciwon maganin ciwon thyroid da baya, hypothyroidism na sirri, da kuma magunguna da kuma tsayar da hypothyroidism. "
Kuma, a cewar masu bincike na Danish, a cikin ɗaya daga cikin mahimman karatun, "... [ma] marubuta sun kasa yin maganin kututtukan TSH a irin wannan matakin a cikin kungiyoyi biyu masu jiyya, ma'anar magani TSH kasancewa 3 a cikin ƙungiyar haɗin kai da kuma 1.5 mU / l a cikin ƙungiyar monotherapy.
Masu binciken sun ce binciken su ya nuna cewa wani rukuni na marasa lafiya ya kasance yana amfana daga haɗin T4 / T3. Musamman, suna bayar da shawarar cewa akwai wasu dalilai na physiologic dalilin da ya sa subgroup ya amsa ga - ko bukatun - T3, musamman, cewa:
... an gano polymorphism a kwanan nan a cikin jigilar kwayoyin halitta na biyu deiodinase, an halicci enzyme wanda ke da alhakin tsari na samuwa T3 zuwa kyallen takarda, don taimakawa wajen gano ƙananan kamfanonin da za su amfana daga farfadowar T4 / T3. Wani nau'in polymorphism, wanda ke cikin OATP1C1, mai ɗaukar motsa jiki na horrode wanda aka bayyana a shamaki na kwakwalwa, an haɗa shi da gajiya da damuwa.
Wilman Wiersinga, mai binciken likitancin Famed Dutch ya ce T3 zai iya zama mafi kyau, wasu mutane na iya samun karfin halittu don ya fi kyau akan T3
Masanin burbushin halittu mai suna Wilmar Wiersinga ya rubuta rubutun da ke tare, wanda ake kira "Shin muna bukatar karin gwaje-gwajen akan T4 da T3 hadewa a cikin hypothyroidism?"
A cewar Dokta Wiersinga, wasu binciken da suka gabata sun kammala cewa babu wani amfani ga ƙara T3. Duk da haka, a cewar Wiersinga, kimanin kashi 10 cikin dari na marasa lafiya na hypothyroid basu yarda da yadda suke ji akan abin da likitoci zasu kira "daceccen kashi" na maye gurbin levothyroxine ya jagoranci littafin Danish.
Editan, wanda aka buga a cikakken layi, yana nuna kuskuren a cikin binciken da suka gabata da kuma nazarin T4 / T3 hade. Dokta Wiersinga ya yanke shawarar cewa akwai dalilai guda biyu masu karfi don gudanar da ƙarin gwajin gwagwarmaya marasa amfani da aka kwatanta da levothyroxine / T4 kawai maganin monotherapy, zuwa T4 / T3 hadewar farfadowa:
Na farko, gwajin da ya zuwa yanzu sun kasance ba su samu nasara ba wajen yin nazarin kwayoyin halitta na FT4-FT3 a cikin 24 h. Ci gaba da cigaba da sakin shirye-shiryen T3 na iya zama mahimmanci don kai ga burin 'physiological' maye gurbin hormone. Abu na biyu, yawan adadin polymorphisms a cikin deiodinases da masu fitar da hawan gwiwar thyroid sun haɗa da jin dadin jiki, rashin tausayi, damuwa, da kuma fifiko don hadewa. Shin yana iya kasancewa wasu batutuwa da basu gamsu da monotherapy ne masu ɗaukar nauyin wadannan polymorphisms ba, kuma za su sami kyakkyawar amsawa ga hadewa?
A cewar Dokta Wiersinga, ci gaba da shirye-shirye na T3, wanda aka ba shi a matsayin dare guda (tare da levothyroxine sau ɗaya a kowace rana) zai fi dacewa da kula da ilimin lissafi na Free T4 da kuma Free T3 a wasu masu maganin thyroid a tsawon awa 24.
Lura: Saboda haka bari mu sake sake wannan. Half marasa lafiya sun fi son T4 / T3 hade - kawai 15% sun fi son levothyroxine-kawai, DA, ingancin rayuwa da wasu dalilai sun inganta. DA kuma, T4 / T3 farfadowa ba shi da wani tasiri fiye da T4-kadai. (A gaskiya, a cikin wannan binciken, T4-kawai farfesa ya haifar da MORE sakamakon illa.) Ina fatan cewa wasu daga cikin wadanda ake kira thyroid masana - wanda akai-akai ne a kan albashi ga masana'antar levothyroxine - tabbas za su sun fāɗi kan kansu suna ƙoƙari su bayyana bayanan binciken, kuma zai zama abin jin dadin yin kallon su kokarin!
Ainihin labarin jarida cikakke shine karatun ban sha'awa, amma rashin alheri, ba a buga shi a Intanet ba. Kuna iya, duk da haka, saya kwafi a kan layi don $ 25 a shafin yanar gizo na Turai na Endocrinology . Wannan shi ne shakka wanda kake son likitanka ka karanta, don haka ka tabbatar da shi ya sami kofi. Gaskiya, zai iya zama da daraja a saya kofe don ba da likita, idan ya / ba ta so ya koyi game da maganin thyroid.
Ƙarin Bayani akan T4-Only V. T4 / T3 Harkar Jiyya ga Hypothyroidism
- A Dubi T4 kawai vs. T4 / T3 Drug Controversy
- T3 Kwayoyin Tsarin Tutawa na Tikirai na Ingantaccen Rayuwa ga Hypothyroidism: Binciken Neman Ma'anar Mafi yawan Salihai Da Bugu da Ƙari na T3 / New England Journal of Medicine Nazarin 1999
- Bincike ya gano marasa lafiya Yarda da haɗin T4 / T3 Jiyya: Bincike ya nuna Combo Far Associated with Weight Loss / 2005
> Sources:
> Birte Nygaard, Ether Winther Jensen, Jan Kvetny, Anne Jarløv da Jens Faber. "Hanyoyin Haɗuwa tare da Thyroxine (T4) da 3,5,3'-Triiodothyronine Game da T4 Monotherapy a cikin marasa lafiya tare da Hypothyroidism, mai ɗakuna biyu, ƙaddamar da binciken ƙididdiga," European Journal of Endocrinology , Vol 161, Issue 6, 895-902, Disamba 2009 Abstract, (Cikakken rubutu ($ 25))
> Wiersinga, Wilmar "Muna Bukata Har yanzu Ƙarin Tambaya a kan T4 da T3 Comparative Threat in Hypothyroidism?" Jaridar Turai na Endocrinology , Vol 161, Issue 6, 955-959. Cikakken rubutu (kyauta)