Dr. Theodore C. Friedman, MD, Ph.D. shi ne Farfesa Farfesa na Medicine-UCLA, Endocrinology Division, kuma shi ne kuma endocrinologist a cikin zaman kansu aiki. Don ƙarin bayani game da aikinsa, duba www.goodhormonehealth.com.
A cikin wannan labarin, ya ba da ra'ayi game da ganewar hypothyroidism da magani.
Hypothyroidism ganewar asali
Hypothyroidism shine rashin lafiya na yau da kullum.
Yana rinjayar mata fiye da maza, amma na zama daya daga cikin mutanen da suke da shi. Hanyoyin cututtuka na hypothyroidism sun hada da gajiya, karfin gwargwadon hankali, rikitarwa, ciwon tsoka, ciwon haɗin gwiwa , rashin sanyi, rashin daidaituwa na mutum, rashin ƙarfi, asarar gashi , bushe, fata mai sanyi da jinkirin jinkiri. Mutane da yawa marasa lafiya za su yi goiter (kara girman thyroid). Kodayake ya karɓa da yawa tattaunawa, na yarda low jiki yawanci ba alama abin dogara na hypothyroidism.
Halin da ake samu na hypothyroidism yana ƙaruwa tare da karuwa. A wasu kalmomi, tsofaffi muna samun, mafi kusantar rashin takaicin thyroid zai nuna. Babban dalilin da ya fi dacewa da hypothyroidism ( hypothyroidism yana samuwa a cikin glandar giroid kanta), shine Thyroiditis na Hashimoto. Hashimoto ta halin da ake ciki ne . Rundunar ta jiki ta kai hari kan glandar thyroid kuma ta halakar da ita, ta haifar da hypothyroidism. Hashimoto ta Thyroiditis na iya zama bayyanar ƙwayar mahaukaci mai mahimmanci kuma zai iya faruwa a cikin iyalai.
Hypothyroidism na iya zama saboda matsalar rikici (tsakiya hypothyroidism).
Binciken kowane nau'i na hypothyroidism yana da muhimmanci, saboda magani tare da hormone thyroid zai inganta bayyanar cututtuka a marasa lafiya da hypothyroidism, amma ba zai iya taimakawa wadanda ba su da hypothyroidism. A filayen hypothyroidism na farko, glandon thyroid, wanda ke cikin wuyansa, ya kasa samar da hormones thyroid , T4 da T3.
Gwargwadon glandon, wanda yake a cikin kai, yayi amsa ga wannan rashi ta ɓoye ƙarin TSH. Sabili da haka, a cikin mafi yawan lokuta masu mahimmanci na hypothyroidism, T4 da T3 matakan al'ada, amma TSH yana da girma. A lokuta mafi tsanani, matakan T4 da T3 sun sauke. Kodayake al'ada ta al'ada don TSH sau da yawa tsakanin 0.5 da 5 mU / mL, dabi'u a ƙarshen ƙananan al'ada na iya zama mahaukaci. T3 shine karin hormone bioactive idan aka kwatanta da T4, amma T4 ya fi karuwa a cikin wurare.
Hanyar da nake da ita don gano maganin hypothyroidism shine farawa da tarihin hankali da kuma jiki. Sa'an nan kuma wani likitancin likita ya kamata ya yi jarrabawar maganin karoid don sanin idan mai haƙuri yana da goiter. TSH Blood, T4 kyauta, T3 da anti-TPO da ya kamata a gwada. Marasa lafiya tare da karar daɗaɗɗa da / ko gwajin gwagwarmayar TPO mai kyau da kuma TSH mafi girma fiye da 4.0 mU / mL ya kamata a dauke su da hypothyroidism na farko. Marasa marasa lafiya ba tare da wani ciwon gwiwar kaɗa ba kuma ba tare da gwajin gwagwarmaya ta TPO ba amma tare da TSH mafi girma fiye da 7.5 mU / mL ya kamata a yi la'akari da samun hypothyroidism. Marasa lafiya na T4 na kasa da 0.9 MG / DL da TSH kasa da 1,0 MU / mL suna iya zama tsakiyar hypothyroidism. Marasa lafiya da cututtuka na hypothyroidism amma wadanda ba su cika wadannan ka'idodin ya kamata a lura da su a cikin watanni 6 ba.
Hypothyroidism Jiyya
Da zarar an gano hypothyroidism, akwai wasu maganin magani , ciki har da shirye-shiryen L-thyroxine (T4) na roba, Synthroid, Levoxyl da Unithroid), shirye-shirye na L-triiodothyronine (T3) (Cytomel), haɗin T4 / T3 na roba (Thyrolar) da kuma kayan shafa shirye-shiryen thyroid (Armor, Naturethroid, Bio-Throid, da Westhroid). Dukkan shirye-shiryen L-thyroxine sun ƙunshi nau'in mai aiki guda ɗaya, amma sun ƙunshi nau'ukan daban kuma suna da iko daban-daban. Har zuwa kwanan nan, Synthroid ba shi da amincewar FDA, amma yanzu duk shirye-shiryen L-thyroxine sun amince da FDA.
Thyrolar da dessed thyroid shirye-shirye yiwuwa suna da mafi girma T3 / T4 rabo fiye da kyawawa kuma ta haka ne, Na sau da yawa ba da ƙananan yawa daga cikin wadannan shirye-shirye supplemented tare da T4.
Yawancin masu amfani da maganin ƙarshen halitta sunyi amfani da shirye-shiryen L-thyroxine na farko don magance dukkanin hypothyroidism. Kodayake yin amfani da L-thyroxine (T4) idan aka kwatanta da L-triiodothyronine (T3) na iya zama abin mamaki yayin T3 shine karin kwayar thyroid hormone, T4 an fi amfani dashi akai-akai. Wannan shi ne saboda sabobin tuba sun juya T4 zuwa T3 don kula da matakan physiologic T3. Ta haka ne, gudanar da T4 ya haifar da sakamakon T3 da T4. Kamar yadda T4 ya fi zaman lafiya fiye da T3, T4 ya ba da magungunan jini, yayin da T3 farfadowa take kaiwa zuwa matsayi mai girma bayan shan magani da ƙananan matakan kafin zuwan gaba. Armor thyroid ne mai tsada tsada shiri. Saboda Armor thyroid ya zo ya samar da alade thyroids, wasu Endocrinologists ji cewa akwai babban kwaya zuwa kwaya canji, amma wannan shi ne wanda ake iya shakkar aukuwarsa ya zama gaskiya.
Wani binciken da aka wallafa a New England Journal of Medicine a 1999 ya nuna cewa ƙwayar T4 zuwa T3 zai iya zama rashin lafiya a wasu marasa lafiya kuma dole ne a bi da wani ɓangare na marasa lafiya tare da T4 da T3 . Sauran binciken da aka buga a cikin Journal of Clinical Endocrinology da Metabolism a shekara ta 2003 ( duba labarin a yanzu ) ya nuna cewa ba a buƙatar kariyar T3 zuwa T4 ba domin yawancin marasa lafiya da hypothyroidism. Ina bayar da shawarar cewa mafi yawan marasa lafiya za su fara a shirye-shirye na T4, wanda zai inganta bayyanar cututtuka a cikin mafi yawan marasa lafiya. Na gano cewa mafi yawan marasa lafiya sun fi son Levoxyl ko Unithroid zuwa Synthroid , amma wannan ya bambanta da kowane mai haƙuri. Bayan farawa ta farko tare da T4, na daidaita nauyin T4 har sai TSH ya kasance tsakanin 0.5 da 2 mU / ml. Idan sun kasance masu nuna alama ko da yake an gyara TSH, to, za a iya ƙara ƙwayoyin T3 da aka ba su biyu ko sau uku a rana tare da hankali ga T4. Idan marasa lafiya farawa tare da matakan T3 maras jini, to, ni na fi dacewa in bi da su tare da T4 da T3. A T4 da T3 , na yi amfani da gwaje-gwaje na jini don tabbatar da T4 kyauta da T3 masu kyauta a cikin ƙananan al'ada. Tash yawancin Tash yana shafewa akan hadewa .
A yawan marasa lafiya za su sami cigaba a kan T4 da T3 farfadowa. Ga wadanda ba su inganta ba, Ina bayar da shawarar da wasu lokuta tare da kayan aikin maganin thyroid, yawanci Armor, tare da haɗin T4. Wannan haɗin yana buƙatar lokacin da ake cike da nauyin maganin thyroid yana da rabo mafi girma t3 / T4 fiye da kyawawa kuma yana buƙatar ƙarawa tare da T4 na roba don cimma daidaito na al'ada na duka kwayoyin. Bugu da ƙari, Ina so in kyauta T4 da T3 kyauta a cikin mafi girma na al'ada. Marasa lafiya tare da tsakiyar hypothyroidism za a iya bi da su tare da duk wani shirye-shiryen da aka samu ga marasa lafiya da na farko hypothyroidism. Bambanci shi ne cewa kulawa ya kamata a kula da shi ta hanyar neman T4 kyauta kuma kyauta T3 a cikin matsakaicin na al'ada, kamar yadda TSH ke matsawa tare da jiyya mai kyau. Magunguna tare da tsakiya da na farko hypothyroidism kuma ya buƙaci a bi da su ta hanyar neman kyauta T4 da kuma free T3 a cikin mafi girma na al'ada. An gano ni ne tare da jigon hypothyroidism na farko a watan Fabrairun 2003. Wani likitan ilmin likita ya yi nazarin glandar da nake ciki kuma an gano ni da goiter. Hanyoyin jini na nuna TSH na 8 mU / mL da kuma maganin anti-TPO mai karfi. Ina da tarihin tarihin iyali na Hashimotos Thyroiditis amma na yi sa'a na zama mai matukar damuwa kafin magani. Ni yanzu a kan 150 mg a rana na Levoxyl, da TSH na 1.9 mU / mL kuma jin mai girma. Na rasa 'yan fam a kan T4 na farfadowa kuma sunadaran cholesterol na inganta.
An wallafa shi a intanet, 2003