Uninzi lwabantu abane- hypothyroidism -i-thyroid-engasebenzi phantsi e-United States ngabafazi. Uninzi lwaba bafazi baneminyaka yobudala bokubeletha okanye i- perimenopausal / menopausal . Oku kuthetha ukuba ngelixa bephathwa nge-hypothyroidism, abanye babo baphinda bathathe imishanguzo yemithi efana neepilisi zokukhusela okanye i-hormone yonyango yokutshintshwa.
Ngokomphando ovela kwi-Guttmacher Instutute, ukuqikelelwa kwezigidi ezili-10 + abasetyhini abaphakathi kweminyaka eyi-15 no-44 basebenzisa ipilisi yokukhusela ukulawula ukuzalwa.
Imilinganiselo engama-57 ukuya kwi-75 yezigidi zemithi yokuguqula i-hormone, ezininzi zazo ziquka uhlobo oluthile lwe-estrogen, zibhalwa e-United States. Ezinye iingcali ziqikelela ukuba amaninzi ama-5 ekhulwini kuwo onke amabhinqa angama-post-andopa-menopausal athatha i-hormone yonyango yokutshintsha indawo kunye neyeza le-hormone.
Kubalulekile ukuba kukho nawuphi na umfazi othabatha i -hormone ye-hormone esikhundleni sokunyanga i-hypothyroidism-njenge-levothyroxine okanye i-thyroid-ye-natural -icicated -roid ukuze uqaphele iziphumo ezinokuthi iziyobisi ezine-estrogen zinakho kwi-thyroid kunye nonyango lwe-hypothyroidism. Ngokufanayo, kufuneka uqaphele ukuba unikwe imithi yokumisela i-hormone ye-hypothyroidism emva kokuba usepilisi yokukhulelwa eline-estrogen, okanye sele sele uthabatha i-hormone yonyango yokutshintshwa okubandakanya nayiphi na uhlobo lwe-estrogen.
Iimpembelelo ze-Estrogen kwi-Thyroid
Ukwandiswa kwe-estrogen kunokubangela ukukhulelwa, ukuguqulwa kwemithi ethile kunye nokusetyenziswa kwamachiza afana neepilisi zokukhusela okanye i-hormone yonyango yokutshintshwa. I-Estrogens ezithathwa njengamayeza angabonakala ngesimo se-estrogen efana ne-ethinylestradiol, okanye iiferensi ze-estrogen ezifana ne-estrool, i-estriol, okanye i-estrone.
I-Estradiol yaziwa nangokuthi ngu-17 beta-estradiol.
Ingaba i-estrogen enyukayo iveliswa ngumzimba wakho okanye ithathwa njengamachiza omlomo, ukuba i-estrogen inakho ukuphakamisa amanqanaba akho ye-thyroxine-binding globulin, ebizwa ngokuba yi-TBG. I-TBG iprotheyini ekhethekileyo eyaziwa ngokuba yi "globulin." Indima ye-TGB kukunamathela kwii-hormone ze-thyroid ezine-thyroxine (T4) kunye ne-triiodothyronine (T3) -ukusebenza kwegazi lakho kunye nokunceda ukuthutha loo ma hormone kwiiseli zakho .
Xa i-TBG iphakanyisiwe, i-TBG ibopha ngaphezulu kwe-hormone yakho ye-thyroid, kwaye ngenxa yoko, iyanciphisa inani lama-hormone e-thyroid ekhululekile ekhoyo kwigazi lakho. Oku, kungakhokelela ekunyuseni kwinqanaba lakho le- TSH , enokuthi ivuselele imveliso ye-hormone ephezulu ye-thyroid.
Ngokutsho kophando, emva kweeveki ezintandathu zonyango lwe-estrogen, i-TBG ivela kwinani elikhulu labasetyhini be-hypothyroid. Ukwanda kwe-TBG ngokuqhelekileyo kuphakama malunga neveki ezili-12 emva kokuqala unyango. Ngokufanayo, amazinga e-Free T4 ahlahla-kwaye kwezinye iimeko, i-TSH iphakama-ngendlela efanayo ngeli xesha. Olu tshintsho alubonakali kubasetyhini abangenayo i-hypothyroid.
Izigulane ze-Thyroid: Iimpawu ezilandelayo
1. Phinda uqaphele umsebenzi we-Thyroid Emva kokuqalisa nokuyeka iPilisi okanye iHormone Replacement
Abasetyhini abasempilweni abanamava amaninzi ekusebenzeni kwe-thyroid ngelixa beza kulwa neyeza okanye i-hormone ye-substitution ye-estrogen. Uphando luye lwabonisa ke, ukuba malunga nama-40 ekhulwini kwabasetyhini abathatha imithi ye-hormone ye-thyroid eyongezelelekileyo eyongeza iyeza eline-estrogen iyancipha kwizinga legazi le-T4. Oku kuthetha ukuba iimpawu ze-hypothyroidism ezifana nokukhathala nokufumana ubunzima bunokubuya ngaphandle kokuba umlinganiselo weyeza le-thyroid unyuka. Oku kwasemngciphekweni kubasetyhini abaye basinda kumdlavuza we-thyroid kunye neemfuno zokugcina i-hormone ye-thyroid igxininiswe ukukhusela umdlavuza we-thyroid.
Ngenxa yokuba malunga nesiqingatha sabesifazana be-hypothyroid baya kuba nefuthe nge-estrogen, kubalulekile ukuba i-thyroid yakho ihlaziywe emva kweenyanga ezintathu ukuba unesifo se-hormone ye-hormone esikhundleni sonyango kwaye uqale okanye umise ukukhulelwa komlomo okanye umlomo we-estrogen. Unokudinga ukwandiswa okanye ukunciphisa kwi-dosage yakho yeyeza ye-hormone ye-substitute.
2. Musa Ukuyeka Ukuthatha Iipilisi Zakho Zokukhusela okanye I-Hormone Replacement ngaphandle kokuhlola umsebenzi we-Thyroid
Ngokomphandi uDkt. Robert Utiger, abathile abafazi be-hypothyroid bethatha i-estrogen okanye ulawulo lokuzalwa bangafumana iimpawu, kwaye banqume ukuyeka ukuthatha indawo yabo, ukulawula ukuzalwa okanye i-hormone. Kunoko, ngoDkt. Utiger, ukujonga amazinga e-hormone ye-thyroid kunye nokwandisa iyeza le-hormone yeyeza ye-hormone ingasombulula ingxaki kulabo bafazi.
3. Cinga i-Mini-pilill yokuNyundela
Uninzi lwabasebenzisi beepilisi zokukhusela bathatha "ipilisi" edibanisa i-estrogen kunye neprogesterone. Ezinye zeemveliso ezidumileyo zezi pilisi zenyanga zibandakanya uLo / Ovral, Loestrin, Lybrel, Mircette, Norinyl, Ortho-Novum, Ortho Tri-Cyclen, Seasonique, Seasonale, Yasmin, neYaz. Ezi pilisi zinokuchaphazela amanqanaba e-TBG kunye nomsebenzi we-thyroid.
Iipilisi zokulawula ukuzalwa kokungazalanga i-estrogen azichaphazeli amazinga e-TBG, kwaye ngenxa yoko, akunakwenzeka ukuguqula umsebenzi we-thyroid. Ngamanye amaxesha iipilisi zokukhusela i-estrogen zibizwa ngokuthi "ipilisi ye-mini." Ezinye zegama elidumile lamagama eeprojeni ezi zi-esrogen ziquka uCamila, Errin, Micronor, Nor-QD, Norethindrone, ne-Ovrette. Iipilisi ze-contraceptive free-contraceptive are often used when they are compared to the pills, and there are some questions about whether they are considered as effective.
Iipilisi zokudibanisa zisebenza ngokuthe xaxa ekukhuseleni ukukhulelwa kune "ipilisi ye-mini." Xa kuthathwa ngokuchanekileyo, ipilisi yokuhlanganiswa ibalwa phakathi kwe-91% ne-99.9% esebenzayo. (Xa kuthathwa ngokuchanekileyo, ipilisi ye-mini ifakwe kwi-87% ukuya kwi-99.7% esebenzayo.)
Ukuba unesifo se-hormone ye-hormone esikhundleni sakho kwaye ufuna ukuqinisekisa ukuba unyango lwakho lwe-thyroid aluyi kuphazamiseka ngamapilisi okukhusela nge-estrogen, nangona kunjalo, kufuneka uxoxe nge "ipilisi ye-mini" kunye nomsebenzi wakho wezempilo.
4. Khawucinge ngePatching Patch
Kukho isiqalo sokulawula ukuzalwa, esetyenziswe kwesikhumba, esinokudibanisa kwama-hormone, sithunyelwa nge-transdermally (ngesikhumba), njengeepilisi zomlomo. Ezinye iimpawu ezidumiweyo zecatch ziquka uOrv Evra noXulane.
Ezi zixhobo zokulawula ukuzalwa azichaphazeli amanqanaba e-TBG, kwaye ngenxa yoko, akunakwenzeka ukuguqula umsebenzi we-thyroid.
Ukuba unesifo se-hormone ye-hormone esikhundleni sakho kwaye ufuna ukuqinisekisa ukuba unyango lwakho lwe-thyroid aluyi kuphazamiseka ngamapilisi okukhusela nge-estrogen, kufuneka uxoxe ngeendlela zokusebenzisa isiqalo sokulawulwa kokuzalwa kunye nonyango wakho wezempilo.
5. Cinga nge-Transdermal Iifom ze-Hormone Replacement Therapy
Uphando lubonise ukuba kuphela iifom zomlomo ze-estrogen zinempembelelo kumanqanaba e-TBG. Iimpawu zamagama ezidumiweyo zomlomo (iipilisi) iindlela ze-estrogen kuphela okanye i-hormone yonyango yokutshintshwa kwendawo equka i-Activella, i-Angeliq, iCenestin, i-Enjuvia, i-Estrace, i-Femhrt, i-Femtrace, i-Menest, i-Prefest, i-Premarin, ne-Prempro.
Ukuba uqwalasela i-hormone yonyango yokufaka indawo efaka i-estrogen, kufuneka ucinge iifom transdermal ze-estrogen kuphela okanye i-hormone yonyango yokutshintshwa, njengama-patches, iigels, okanye iipilisi zamanzi kunye nokufaka. Iimpawu ezidumileyo ziquka isiqwenga se-Alora, isiqwenga seClimmara, isiqwenga se-Combipatch, i-gel Divigel, isiqalo se-Extraderm, isiqalo se-vaginal, i-EstroGel i-gel, i-Evamist spray, i-Minivell patch, i-Vagifem yamacwecwe kunye ne-Vivelle patch.
> Imithombo:
> Agren, U et. Al. "Iimpembelelo ze-contraoptive oral contraceptive ene-nomegestrol kunye ne-17β-oestradiol xa kuthelekiswa nomnye oqukethe i-levonorgestrel kunye ne-ethinylestradiol kwimakishi ye-endocrine". 2011 Dec; 16 (6): 458-67. i-doi: 10.3109 / 13625187.2011.614363. Epub 2011 Septemba 26.
> Guttmacher Institute. Usetyenziso lwezoNyango eMelika: I-2016 Inqaku leNkcazo. " https: //www.guttmacher.org/fact-sheet/intraceptive-use-united-states
> Pinkerton, J, uSorooro, N. "Uxilongo lwe-hormone ye-bioidentical." Ukuqeda umva, 2015; 1 I-DOI: 10.1097 / GME.0000000000000420
> Raps, M et. Al. "Ukusetyenziswa kwemithi yokukhusela i-hormonal kuholele kumanqanaba e-TBG aphakamileyo, amanqanaba e-TSH aphakamileyo." I-Thromb Res. 2014 kuMatshi; 133 (4): 640-4. i-doi: 10.1016 / j.thromres.2013.12.041. Epub 2014 Jan 7.
> Santin, A et al. "Indima ye-Estrogen kuMsebenzi weTroid kunye neMimiselo yoKhula." I-Thyroid Res. 2011; Ngo-2011: 875125. Ishicilelwe kwi-intanethi ngo-Meyi 4. i-do: 10.4061 / 2011/875125