Sanin ganewa yana dogara akan gwajin jini
Idan kai ko wanda kake ƙauna yana da alamun ko alamun bayyanar glandon thyroid (wanda ake kira hypothyroidism), yana da muhimmanci a ga likita don cikakkiyar kimantawa. Don bincika matsalar maganin thyroid, likitanku zai tambaye ku tambayoyi game da tarihin lafiyarku da na iyali, kuyi nazari na jiki, da kuma gwada jini (mafi mahimmanci, hormone mai maganin maganin kawo, ko gwajin TSH).
Idan likitanku ya bincikar ku da hypothyroidism, zai kuma so ya san dalilin da ke faruwa a bayan ciwon kuɗin ka, kamar yadda wannan zai tsara tsarin shirin ku. Don bayyana "me yasa" a bayan likitanku na hypothyroid, zaka iya buƙatar ƙara gwaji, kamar gwaji na jini.
Nemo Doctor
Mutane da yawa suna likita da hypothyroidism da likita ko likitancin su . Duk da haka, na farko kula likitoci da bambancin kwarewa a gudanar da thyroid cuta.
Darasi na farko shine ya ko dai ko likitan likitan ku na jin dadin ku, ko kuma idan ya kamata ku tuntube tare da wani likitancin likita (likita wanda ke ƙwarewa wajen magance matsalar hormone).
A ƙarshe, zaku iya ganin likitan gwagwarmaya sau ɗaya, sannan kuma likitanku na farko su kula da ciwon maganin karoid. A madadin haka, likitanku na iya yin dukan maganin thyroid a kowace shekara idan wannan shi ne yanayin.
Yi nazari
Lokacin da ka ga likita a karo na farko tare da alamu ko bayyanar cututtuka masu tsitsawa ga hypothyroidism, zaka iya sa ran samun cikakken tarihin likita da bincike na jiki.
Bayan nazarin duk wani sabon bayyanar cututtuka da ke nuna alamar jikinka na iya ragewa (alal misali, fata mai laushi, da wuya cikin sauƙi, rashin haƙuri, ko maƙarƙashiya), likitanku zai tambayi wasu tambayoyi game da tarihin lafiyar ku, irin su:
- Kuna da wata cuta na autoimmune (alal misali, arthritis rheumatoid ko ciwon sukari na type 1?)
- Kuna da wani dan iyali wanda ke da hypothyroidism?
- Shin kun taba yin tiyata?
- Kuna shan magunguna da ke haifar da hypothyroidism kamar sindarone ko lithium?
- Kuna shan duk abin da ke dauke da abubuwan kyin?
- Shin kun taɓa yin radiation zuwa wuyanku, don yin magani da lymphoma ko ciwon kanji da wuyan ku?
Bugu da ƙari, tarihin likita, likitanku zai bincika thyroid don kara girma (wanda ake kira goiter) da lumps (nodules). Kwararku zai kuma bincika alamun hypothyroidism kamar ƙananan jini, ƙananan jini, busassun fata, kumburi, da ƙyama.
Labs da gwaje-gwaje
Sakamakon ganewar asirin hypothyroidism yana dogara ne akan gwaje-gwajen jini.
Karoid-stimulating Hormone (TSH)
Tadarin TSH shine gwajin farko da ake amfani dashi don ganewar asali da kuma gudanar da hypothyroidism . Amma labs daban-daban sau da yawa suna da ƙananan dabi'u daban-daban ga abin da aka sani da "tashar TSH."
A yawancin labs, layi na TSH yana gudana daga 0.5 zuwa 4.5. Tamanin TSH na kasa da 0.5 an dauke hyperthyroid, yayin da tasirin TSH fiye da 4.5 an dauke yiwuwar hypothyroid.
Dabbobi daban-daban zasu iya amfani da ƙananan iyaka daga ko'ina daga 0.35 zuwa 0.6, kuma kofa na sama daga ko'ina daga 4.0 zuwa 6.0.
A kowane hali, yana da mahimmanci a gare ka ka fahimci layin kewayawa a lab inda aka aiko da jininka, saboda haka ka san matsayin da kake bincikarka
Idan an gwada gwajin jini ta farko na TSH, ana maimaita sau da yawa, kuma ana gwada gwajin T4 na thyroxine kyauta.
Free Thyroxine (T4)
Idan TSH yana da girma kuma T4 kyauta ba shi da kyau, an gane ganewar asalin hypothyroidism .
Idan TSH yana da girma, amma T4 kyauta ta zama al'ada, an gane asali na hypothyroidism . Jiyya na hypothyroidism na yaudara ya dogara da wasu dalilai.
Alal misali, likitan ku na iya bi da hypothyroidism idan kun kasance da bayyanar cututtuka irin su gajiya, ƙwarewa, ko ciki, ko kuma kuna da wata cuta ta mutum, misali, cutar celiac.
Shekaru, haka ma, za ta taka rawar a cikin shawarar likitanka. Yawanci, akwai ƙofar mafi girma don farawa da maganin maye gurbin maganin hormone a cikin tsofaffi; wannan shi ne saboda tushen su na TSH ne a kan iyaka na al'ada.
Kasancewa da kwayoyin TPO (duba ƙasa) yana taka rawar a cikin shawarar likitan ku. Idan kana da hypothyroidism da magungunan TPO masu kyau, likita za su iya fara maganin hormone na karoid, don hana ci gaba na hypothyroidism mai zurfi a cikin hypothyroidism.
Sakamakon ganewar asali na tsakiya ko na biyu na hypothyroidism abu ne mai sauki. Tsarin hypothyroidism na tsakiya yana nuna jigilar glandes ko matsalar hypothalamus. Wadannan kwakwalwa suna sarrafa glandar thyroid kuma zai iya lalacewa daga ciwace-ciwace, cututtuka, radiation, da cututtukan cututtuka irin su sarcoidosis, a tsakanin sauran dalilai.
A tsakiyar hypothyroidism, TSH ba shi da kyau ko al'ada kuma T4 na kyauta bashi da al'ada ne ko maras kyau.
TPO Antibodies
Kwayoyin maganin thyroid peroxidase (TPO) sun bada shawara akan ganewar asali na thyroiditis na Hashimoto, wanda shine mafi yawan sanadin hypothyroidism a Amurka. Wadannan kwayoyin cutar sannu-sannu suna kaiwa ga glandar thyroid, don haka ci gaba da hypothyroidism yana da mahimmanci, yayin da thyroid ya zama ƙasa da ƙasa da ikon samar da hormone thyroid.
Wannan yana nufin cewa mutum zai iya samun "kwayoyin TPO" tabbatacce, amma al'ada na thyroid aiki na wani lokaci; a gaskiya, zai iya ɗaukar shekaru don aikin thyroid aiki don ya ƙi zuwa maƙasudin zama hypothyroid. Wasu mutane ko da suna da magungunan TPO masu kyau kuma basu cigaba da zama hypothyroid.
Duk da yake likitanku ba zai iya magance ku ba tare da maganin maye gurbin maganin hormone idan kwayoyin TPO ba su da tabbas amma TSH yana cikin layin kulawa na al'ada, zai iya lura da TSH a tsawon lokaci.
Hoto
Yayinda gwaje-gwaje na jini shine gwaji na farko don bincikar hypothyroidism, likitanku na iya yin umurni da hotunan tahonka idan ya lura (ko kuma kawai yana so ya duba) goiter ko nodules a jarrabawar jiki. Hanyoyin dan tayi zai iya taimakawa likita ya ƙayyade girman nauyin nodule kuma yana da siffofi masu dadi don ciwon daji. Wasu lokuta, an yi amfani da kwayar ingarta (wanda ake kira bege mai mahimmanci, ko FNA) don samo samfurin kwayoyin halitta a cikin wani nodule. Wadannan kwayoyin za a iya nazarin su a hankali a karkashin wani microscope.
A cikin yanayin hypothyroidism na tsakiya, ana yin hotunan don bincika kwakwalwa da kuma glandon kwakwalwa. Alal misali, MRI na glandan pituitary zai iya bayyana wani ciwon zuciya, kamar adenoma pituitary.
Binciken Bambanci
Alamar cututtuka na hypothyroidism suna da matukar damuwa kuma za'a iya kuskure ko kuskure ga wani yanayin lafiya.
Binciken Sakamakon Bincike na Nasarawa
Dangane da alamun bayyanarku na musamman, likitanku zai gwada ku don wasu hanyoyin kiwon lafiya (musamman idan TSH al'ada ne). Wadannan sun haɗa da:
- Anana
- Abun kamuwa da kwayoyi (misali, mononucleosis ko cutar Lyme)
- Dandalin Vitamin D
- Fibromyalgia
- Dama ko damuwa
- Abincin barcin
- Harkar ko cutar koda
- Wani magungunan kamuwa da jini (misali cututtukan celiac ko rheumatoid arthritis)
Binciken da ke Saukewa akan Bincike na Ginin Jiki
Duk da yake hypothyroidism na farko shi ne mafi kusantar yin laifi a bayan TSH mai girma, akwai wasu ƙwayoyin da likitanku za su tuna. Alal misali, gwaje-gwajen jinin karoid wanda ke goyan bayan ganewar asibiti na tsakiya hypothyroidism na iya zama daga magungunan nonthyroidal.
Lyness maras nama
Mutanen da ke cikin asibiti da rashin lafiya mai tsanani ko kuma waɗanda suka sami karfin kututturewa, magunguna, ko ciwon zuciya na iya samun thyroid aiki jini gwaje-gwaje daidai da tsakiya hypothyroidism (low TSH da low T4) -wannan, "rashin rashin lafiya" ba kullum magani magani.
A wannan misali, aunawar gwajin jini da ake kira baya T3, mai tasowa na T4, zai iya taimakawa wajen rarrabe tsakanin tsaka-tsakin tsakiya na tsakiya da rashin rashin lafiya. Ake T3 yana ɗaukaka a rashin rashin lafiya.
A cikin rashin lafiya marasa lafiya, aikin jinin aikin karoid ya kamata ya daidaita idan mutum ya dawo daga rashin lafiya. Kodayake, wasu mutane suna inganta TSH mai girma bayan dawowa. A cikin waɗannan mutane, maimaita TSH a makonni hudu zuwa shida yakan nuna al'ada TSH.
Ba da izini ba
Hypothyroidism da ƙananan hanzari zasu iya zama tare, kamar yadda suke yi a cikin yanayin da ake kira mikiyar polyglandular na autoimmune. Wannan ciwo yana samuwa ne daga matakai na kwamin gwiwa wanda ya shafi glanders, musamman ma da glandon thyroid (haifar da hypothyroidism) da kuma gland (wanda ke haifar da rashin lafiya).
Ɗaya daga cikin manyan haɗarin da ake haɗuwa da wannan ciwo shine maganin hypothyroidism (ba a canza maye gurbin thyroid) kafin zalunta hypoadrenalism (wanda ke buƙatar corticosteroid jiyya), saboda wannan zai haifar da rikici na rayuwa. Abin baƙin ciki da wannan ciwo, ana iya rasa hypoadrenalism saboda TSH mai girma da kuma alamun bayyanar da ke tattare da wadanda aka gani a hypothyroidism.
TSH-samar da Pituitary Adenoma
Idan TSH yana da girma, yana da muhimmanci a duba T4 kyauta. A cikin hypothyroidism na farko, T4 kyauta ya zama low, amma idan mutum yana da TSH-secreting tumo, T4 kyauta za a daukaka.
> Sources:
> Ƙungiyar Amirka Thyroid Association. (2013). Littafin Bayani ga marasa lafiya da iyalansu .
> Braverman, L, Cooper D. Werner & Ingbar's Thyroid, 10th Edition. WLL / Wolters Kluwer; 2012.
> Garber J et al. Ka'idojin Gudanar da Harkokin Clinic don Hypothyroidism a cikin Adult: Cikin Shaɗin Ƙungiyar Amirka na Ƙwararrun Ƙwararrun Ƙwararrun Cututtukan Halitta da Ƙungiyar Thyroid Association. Endocrine Practice . 2012 Nov-Dec, 18 (6): 988-1028.
> Gaitonde DY, Rowley KD, Sweeney LB. Hypothyroidism: sabuntawa. Am Fam Likita. 2012 Aug 1, 86 (3): 244-51.
> Upala S, Yong WC, Sanguanke A. Babbar rashin lafiya ta jiki wanda aka ba shi a matsayin likitancin hypothyroidism a cikin mai haƙuri da ciwon polyglandular. N Am J Med Sci . 2016 May, 8 (5): 226-28.