Karancin maganin jini na jini (TSH) ne wanda wasu likitoci suka dauka don su zama na farko-kuma a wasu lokuta gwajin gwaji kawai kana buƙatar ganewa da kuma sarrafa magungunan ka wanda ke da ƙwayar cuta ko magunguna, wanda ake kira hypothyroidism ko hyperthyroidism . Tambaya na TSH wani lokaci ana magana da shi ta hanyar masu binciken maganin na karshe kamar "gwagwarmayar zinariya" don bincikar cutar da maganin yanayin jinin ku.
Mene ne Test Test TSH?
Jirgin gwajin ya dace da matakan TSH, wani hormone da aka sanya kuma ya saki ta wurin glandarku. Kwancin ku yana tunanin ko kuna da hormone thyroid a jinin ku, kuma idan ya gano kasaran matakan, pituitary ya sake TSH don tayar da thyroid don saki wasu hormone thyroid. Wannan shi ne dalilin da yasa TSH ya tashi yayin da thyroid ba shi da kyau . Wani babban TSH yana nufin cewa glanden gwal yana sakewa da hormone don kokarin samun thyroid don amsa ta hanyar samar da karin hormone thyroid.
A akasin wannan ƙarshen, lokacin da glandonku na gwargwadon ganewa yana da yawa da hormone thyroid yana gudana, to, yana jinkirin saukarwa ko ma yana dakatar da sakewa TSH. Ragewar TSH yana nufin cewa thyroid ba shi da samun sako don sakin hormone, kuma aikin hawan na hormone zai rage.
Tad ɗin Ranar TSH
Tun daga shekara ta 2017, a yawancin dakunan gwaje-gwaje a Amurka tashar tashar tashar tashar TSH ta gudana daga kimanin 0.5 zuwa 4.5 ko 5.0 (mIU / L).
Mai haƙuri wanda matakinsa na TSH yana cikin layin zangon shine ake kira "euthyroid," kuma an dauke shi da aikin al'ada thyroid.
Tsarin ma'ana - wani lokaci kuma ake kira "al'ada na al'ada" - wani ɓangaren muhimmin ɓangare na ciwon maganin maganin karoid da kuma magani, saboda al'ada endocrinology duniya ya ɗauki shi ya zama maɓalli ga ganewar asali da kuma gudanar da aikin thyroid.
Ta Yaya Zama Ranar TSH ta Ƙayyade?
Ana samun tarin bayani na TSH ta hanyar ɗaukar rukuni na mutane a cikin yawan jama'a, auna matakan TSH, da kuma lissafin iyaka wanda ya kamata ya wakilci kewayon matakan TSH a cikin jama'a masu lafiya.
Yin amfani da tsinkayen magunguna, TSH ƙarƙashin ƙasa (0.5 ƙananan TSH) na iya zama alamar hyperthyroidism (maganin mai cike da ƙwaƙwalwa), da kuma TSH akan 4.5 / 5.0 (mai girma TSH) na iya nuna hypothyroidism (maganin rashin jin dadi.)
TSH Tafiyar Gudun Ranar TSH
Ɗaya daga cikin batutuwa masu rikitarwa shine batun batun sauya yanayin "al'ada" don gwajin TSH. A ƙarshen shekara ta 2002, Cibiyar Nazarin Kasuwancin Clinical Biochemistry (NACB) ta ba da sababbin ka'idoji don ganewa da kuma kula da cututtukan thyroid.
A cikin sharuɗɗa, NACB ya ruwaito cewa tashar labaran TSH na da yawa kuma a zahiri hada mutane da cutar thyroid. A lokacin da aka sake yin nazari mai zurfi, wanda ya cire mutane da ciwon maganin thyroid, 95 bisa dari na yawan mutanen da aka gwada suna da matakin TSH tsakanin 0.4 da 2.5. A sakamakon haka, NACB ta bada shawara akan rage tashar ɗaukar bayanai zuwa waɗancan matakan.
Jagoran NACB sun jagoranci shawarwari a watan Janairu 2003 ta Cibiyar Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararru ta Amirka (AACE), ta kira likitocin su "yi la'akari da magani ga marasa lafiya waɗanda suka gwada a waje da iyakokin iyakokin da ke kusa da ƙananan matakin TSH na 0.3 zuwa 3.0. " Sanarwar ta kuma ce: "AACE ya yi imanin cewa sabuwar hanyar za ta haifar da ganewar asali ga miliyoyin jama'ar Amirka waɗanda ke shan wahala daga rashin lafiya, amma sun tafi ba tare da izgili ba har yanzu."
A cikin binciken da aka buga a Journal of the American Medical Association a shekara ta 2003, Dokta Vahab Fatourechi da 'yan binciken' yan uwanta sun kiyasta cewa idan an killace kewayo bisa ga shawarwari na AACE, yawan mutanen da ke dauke da cutar thyroid za su karu daga kimanin kashi 5 cikin dari yawan jama'a zuwa kimanin kashi 20 cikin 100 na yawan jama'a, tare da yawancin mutanen da suka kamu da yawan marasa lafiya da suka fada a cikin hypothyroid / underactive category.
Wannan ya wakilta karuwar yawan masu maganin thyroid a duk fadin duniya, daga kimanin miliyan 15, zuwa kusan kimanin mutane miliyan 60.
Bugu da ƙari, taron hadin gwiwa ya ƙunshi wakilai daga manyan kungiyoyin sana'a da ke cikin maganin maganin jijiyarku - ciki har da Ƙungiyar Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Amurka, Ƙungiyar Thyroid Association ta Amurka, da Endocrine Society - da aka wallafa sunayensu a shekara ta 2004, suna bada shawara akan Kulawa da marasa lafiya tare da matakan TSH na 4.5 zuwa 10.0 mIU / L. An sauke sabon saiti na tunani.
Kusan kusan shekarun da suka gabata, masana'antun gwaje-gwaje na Amirka sun yi amfani da tsohuwar hanyar tunani kuma likitoci sun rabu. Daga cikin likitoci na al'ada, mafi yawancin ci gaba da ƙi ƙin maganin hypothyroidism sai dai idan sakamakon gwajin TSH ya kasance a waje da tashar gargajiya na gargajiya kuma an nuna su kamar yadda dakin gwaje-gwajen ya zama mahaukaci.
Jeffrey Garber, MD, FACE, ta yi magana game da rigingimu a madadin Cibiyar Harkokin Ƙwararrun Ƙwararru ta Amirka (AACE). A cewar Dokar Garber, ba a bin umarnin yin aiki a matsayin maye gurbin hukunci na aikin likita. Duk da yake a cikin rubuce-rubucen da aka wallafa, Dokta Garber ya ce ba ya jin cewa yin maganin hypothyroidism ne mai yawan gaske, ya ce a cikin aikin, ba ya jinkirta kula da wani mai haƙuri da TSH a cikin maƙallin kewayon idan yayi hukunci da shi ya zama mai taimako.
Said Garber:
Tsarin TSH ba daidai ba ne ya kamata ya zama wani abu mai mahimmanci. Amma kamar yadda sau da yawa aka gani a maganin, ya fi sauƙi a yarda a kan iyakar. Lokacin da kake kusa da abin da ke da iyaka, yana da wuya kira. Muna bukatar mu gane cewa yana da ci gaba. Idan mutane sun sani cewa wannan rukuni na da ƙila za su sami ciwon maganin thyroid fiye da ƙungiyar da ke da ƙananan, ba zai ba ka magani ba kuma ba ya ce ba daidai ba ne, ya ce ya bi shi, kuma watakila yana hulɗar.
Matsalar ga marasa lafiya: "TSH naka na al'ada ne"
Tashi na TSH yana da ƙalubale a gare ku a matsayin mai haƙuri.
Lokacin da likitanku ya samu rahoto na gwajin, duk abin da ke cikin tashar shafukan yanar gizo ba za a lakafta shi azaman mahaukaci ba. Wannan yana nufin, idan likitanku ya dogara akan matakan da aka yi da kuma ƙaddamar da abubuwa a kan matakan da ke waje da ƙididdiga, ba za a gano ku ba ko kuma a gyara lafiyar ku.
Ƙarshe, ana gaya muku jarrabawar TSH ne "al'ada" ba bayani mai amfani ba. Abin da kuke bukata ya san ku daga likitanku shine amsoshin tambayoyi guda huɗu:
- Mene ne ainihin lambar sakamakon gwajin TSH ?
- Mene ne wurin ɗaukar hoto a lab inda aka gudanar da sakamakon gwajin?
- Wadanne jerin labaran da kake bi a cikin bincikar maganin cutar da maganin thyroid?
- Menene matakin ku na TSH da kuka fi dacewa da mafi kyawun maganganun da nake gani?
Tabbatar cewa za ka gano amsoshin tambayoyin waɗannan tambayoyi kafin ka bar likitanka ya fitar da matsalar maganin thyroid, ko kuma gaya maka cewa thyroid ne "al'ada," musamman idan kana fuskantar bayyanar cututtuka .
Kalma Daga
Idan aka fuskanci masu binciken likita ko wasu likitoci wadanda ba su son ganowa ta hanyar wani ma'ana fiye da fassarar fassarorin TSH, yana iya zama lokaci don samun ra'ayi na biyu daga wani likitan gwagwarmaya, ko kuma fadakar da bincikenka don haɗawa da cikakkiyar MD, likita mai yaduwa , ko wata horarwa da lasisi .
Mafi yawan masu aiki suna kawo wasu dalilai fiye da gwajin TSH a cikin ganewar asali da kuma kula da cututtukan karoid, ciki har da:
- Ƙarin ƙarin gwaje-gwajen jini , kamar T4 kyauta, free T3, da kuma bayanan antibody
- Binciken kwakwalwa na alamun da kake gani na thyroid cuta, ciki har da canje-canje a cikin hanzari, kumburi da kuma edema na fuska da tsauraran hali, raunin gashi a jikin mutum da asarar gefuna na girare, da sauran alamomi masu ladabi
- Gwaje-gwaje-gwaje don tantance zubar da hankalinka , atrophy, da nodules
- Tarihin lafiyar mutum da iyali
- Manufar maganin "mafi kyau" matakan TSH da ƙuduri na bayyanar cututtuka
> Sources:
> Braverman, L, Cooper D. Werner & Ingbar's Thyroid, 10th Edition. WLL / Wolters Kluwer; 2012.
> Fatourechi V, Klee GG, Grebe SK, et al. Hanyoyin rage girman iyakar al'ada na TSH. JAMA. 2003; 290: 3195-3196.
> Garber, J, Cobin, R, Gharib, H, et. al. "Ayyukan Gudanar da Harkokin Gudanarwa na Hypothyroidism a cikin Manya: Cikin Shaɗin Ƙungiyar Ƙungiyar Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararruyar Amirka da Ƙungiyar Ƙasa ta Amirka." Endocrine Practice. Vol 18 No. 6 Nuwamba / Disamba 2012.
> Gursoy A, et. al. "Wadanne ƙarancin hormone da ke motsawa da yarinya ya kamata a nemi a cikin marasa lafiya na hypothyroid a karkashin tsarin L-thyroxine sauyawa?" Int J Clin Pract. 2006 Jun; 60 (6): 655-9