Amacwecwe afunyenwe ukuba asebenze ngonyango
Ngomhlangano we-2017 we-American Thyroid Association, inani labaphandi libike ngezifundo ezintsha ezibonisa ukuba iifom ye-levothyroxine iyanceda kakhulu kuneepilisi ekuphatheni amaqela amaninzi ezigulane.
I-Levothyroxine ifom ye-thyroxine (T4) yokwenza izidakamizwa, i-hormone ebalulekileyo eyenziwa yi-thyroid. I-Levothyroxine yonyango oluphambili lwe-hypothyroidism, i-thyroid engapheliyo ngokuqhelekileyo ibangelwa kukukhishwa kwe-thyroid, ukuchithwa kwe-radioactive, kunye nokutshatyalaliswa kwethambo ngenxa yesifo esingenasifo sonyango uHashimoto's thyroiditis.
I-generic levothyroxine, kunye namagama aqhelekileyo awaziwayo njengeStyroid kunye neLevoxyl, iifom yeetrogram ze- thyroid i-hormone . Ifomethi ye-levothyroxine yindlela ebaluleke kakhulu kule nkunkuma ithathwa.
Kwiminyaka emininzi, ifayile, i-softgel capsule ifom ye-levothyroxine ifumaneka e-United States phantsi kwegama legama elithi Tirosint . Uphawu lweTirosint lwe-levothyroxine lwenzelwe ngokuyinhloko njenge-hypoallergenic, uhlobo olukhethekileyo lwe-levothyroxine kubantu abaneentsholongwane okanye iingxaki zamathumbu, ubunzima bokuxilisa imithi ye-thyroid, okanye ukunyamezela kwiifomthi kunye nezibophelelo kwi-tablet ye-levothyroxine iziyobisi.
NgoFebruwari ka-2017, i-FDA ivume i-levothyroxine yamanzi, iTirosint-SOL. I-livid levothyroxine sele ifumaneka e-Italy ukususela ngo-2012. I-levothyroxine ye-liquids yayenzelwe enye iigulane ezingenako ukugwinya, ezondliwa yi-tube, kunye nabantwana abane-hypothyroidism.
I-Tirosint-SOL ilindeleke ukuba ifumaneke kumakethi yase-US ngo-2018.
Utywala i-Levothyroxine kunye neeTebhethi
Kwisifundo esithile, abaphandi baseNtaliyane babonisa ukuba iifom ye-levothyroxine egazini yenza ukuba kubekho ukulungeleka kwamanqanaba e-thyroid ngokuthelekiswa namacwecwe. Bavavanya iqela lezigulane ezithatha iiphilisi ze-levothyroxine, zona, nangona ukunyuka kwamayeza, kwakungenayo i -hormone ekhuthaza i-thyroid (TSH) kunye namazinga angamahala e-T4 kwinqanaba leenkcukacha.
Abaphandi baphendulela izigulane ukuya kumlinganiselo ofanayo wamanzi okanye i-softgel levothyroxine kwaye bavuselela izinga labo le-thyroid. Bafumene ukuba iipesenti ezingama-85 zezigulane zafundwa zibonisa ukuphucula okukhulu kumgangatho wabo we-TSH kunye namazinga abo angamahhala eT4. Kwiiveki ezimbalwa emva kokuqala iifom ye-levothyroxine, izigulane ze-hypothyroid zikwazi ukufikelela kumanqanaba e-thyroid kwiindawo ezijoliswe kuzo.
Abaphandi baphetha ngelithi i-levothyroxine ifom yeyona ndlela ifanelekileyo xa kuthelekiswa nokubunjwa kwethebhulethi kwezinye izigulane.
Emva kwe-Thyroidectomy, i-Softgel Capsules ngakumbi
Kwesinye isifundo, abaphandi baqhathanisa ukuphumelela kweephilisi ze-levothyroxine kunye ne-softgels kwizigulane ezine-thyroidectomy yakho yonke i-goiter multiterodular. Ezi zi gulane zazingenayo nayiphi na imiba ye-malabsorption.
Phantse isiqingatha sezigulane ezifundwayo zanikwa amaphilisi, kwaye esinye isiqingatha safumana iifolisi ze-softgel kwisifo esifanayo, ngokuqala ngokukhawuleza emva kokuhlinzwa kwe-thyroid. I-TSH yezigulane, i-thyroxine yamahhala (FT4), kunye namazinga ekhululekile e-triiodothyronine (FT3) avanyiwe emva kweveki ezi-6 emva koko emva kweveki ezili-12.
Kwiiveki ezi-6 nakwi-12, izigulana ezithatha iifelsile ze-softgel zazincinci kwizinga le-TSH.
Kuzo zombini iingongoma zokulinganisa, inani lezigulane ezaphakamisa amanqanaba eTSH ngaphezulu kwe-3.5 mcU / ml-ethathwa njenge-hypothyroid kulolu cwaningo-lwaluphakamileyo kakhulu kwizigulane ezifumana amacwecwe. Abaphengululi baphetha ngelithi nakwizigulane ezingenayo i-malabsorption okanye i-digestive issues, i-levothyroxine softgel capsules yayisebenza kakuhle.
Ubungcono TSH Control TSH Emva komhlaza
Olunye uphando lwase-Itali lujonge izigulane ezine-differentiate umdlavuza we-thyroid (DTC) uthatha i-levothyroxine. Ngokutsho kwe-American Thyroid Association, ezi zigulane kufuneka zijolise kumgangatho we-TSH phakathi kwe-0.1 kunye ne-0.5 mU / L-ngaphantsi kwe-end-bottom of the reference range-ukunceda ukukhusela ukuphindaphinda komdlavuza we-thyroid.
Ngenxa yokuba le festile elincinci, kubalulekile ukuba unyango lwe-levothyroxine luhlale luqhubeka nokugcina izinga le-TSH.
Abaphandi bafanisa ukuhluka kwezinga le-TSH kwizigulane eziphathwe nge-levothyroxine ye-liquid, ngokubhekiselele kumacwecwe. Isiqingatha sezigulane zafumana i-levothyroxine ye-liquid, kwaye isiqingatha safumana ipilisi, kwaye bonke babenomlinganiselo ofanayo we-hormone ye-hormone. Amanqanaba amaninzi amazinga eTSH ayenziwe.
Abaphandi babona ukunyuka okukhulu kwamazinga e-TSH kwizigulane ezithatha amacwecwe, xa kuthelekiswa nalabo bathabatha i-levothyroxine. Ngokukodwa, malunga neepesenti ezili-16 zezigulane kwiipilisi azizange zifikelele kwibala elijoliswe kwi-TSH, xa kuthelekiswa nabane-4% kuphela kulabo be-levothyroxine. Abaphandi baphetha ukuba ukusebenzisa i-LT4 levothyroxine kuthelekiswa namacwecwe kubangele inani eliphakamileyo kakhulu lezilwanyana zomhlaza ezigcina ixabiso leTSH elijoliswe kuluhlu lokunciphisa ingozi yokuphindaphinda umhlaza.
Malunga neLiquid Levothyroxine
Njengoko kuphawuliwe, eU.S., i-levothyroxine yeevenkile eyenziwa ngezorhwebo itholakala kwiifomsile zeTrisint ze-softgel brand, kunye ne-Tirosint-SOL liquid. I-Tirosint ayinayo i-sugars, idayi, utywala, isitashi (i-gluten), i- lactose, i-acacia , okanye nayiphi na enye idibeneyo okanye izitya eziqhelekileyo zisetyenziselwa ukwenza amaphilisi e-levothyroxine. Izithako kuphela kwiifomsile yi-levothyroxine, i-gelatin, i-glycerin, kunye namanzi, angenakuphazamisa ukuxhamla okanye kubangele ukubola. I-Tirosint-SOL iqukethe i-levothyroxine kuphela.
I-Tirosint igcinwe ngokukodwa kwizigulane ezinemiqathango efana nesifo sikaCrohn okanye isifo esilumkileyo esiswini esaziwayo ukuba sichaphazele ukugaya okanye ukutywala. Ngenxa yokuba i-hypoallergenic, isetyenziselwa zizigulane ezinezityalo eziziwayo kwiifom okanye izithako ezisetyenziselwa ukwenziwa kwegama lomenzi kunye namacwecwe e-generic levothyroxine.
Abanye bancedisa iinzuzo zeTirosint zamanzi: i- calcium , i-iron, ikhofi kunye nobisi ayibonakali ukuphazamisa ukuxutywa kwe-levothyroxine, njengokuba benza ngamacwecwe.
Ngenxa yobume bayo njengezidakamizwa ezikhethekileyo kubaphulaphuli abancinci, kwaye ngenxa yokuba iTirosint iyabiza kakhulu kunezinye iimveliso ze-levothyroxine okanye iiphilisi eziqhelekileyo, kufuneka ukuba zisetyenziswe ngokubanzi kwi-hypothyroidism unyango e-United States.
ILizwi
Iziphumo zophando zibonisa ukuba izigulane ezininzi-kungekhona nje ezo zine-malabsorption okanye i-allergies- zinokuzuza ngokusuka kwiifomu ze-levothyroxine kwiifom ze-levothyroxine. Olunye uphando olushicilelwe kwiphepha le- RD Diet lubonise ukuba phakathi kwezigulane eziyi-1 ezithatha i-levothyroxine, iipesenti ezili-15 zaye zanyuka kwiifomthi kunye nezinye izithako ezifumaneka kwiiphilisi ze-levothyroxine.
Kukho imingeni yokwenza ukutshintshwa kwi-tablet levothyroxine ukuya kwi-capsules iTirosint softgel okanye i-Tirosint-SOL, kodwa kunjalo:
- Ugqirha wakho akakwazi ukuqonda iifomsile zeTirosint okanye i-Tirosint-SOL liquid njengokhetho.
- I-inshorensi yakho, i-HMO, okanye enye i-coverage yezempilo ayinakukulungele ukuhlawula okanye ukubuyisela i-Tirosint. Kule meko, unokufuna umniki-nkonzo wakho wonyango ukuba anikezele "ukusabalalisa njengoko kubhaliweyo" okanye "akukho ndawo yokufaka endaweni / akukho nhlobo".
- Ukuba kufuneka uhlawule i-pocket, i-differential-indleko-leyo ingaba yi-$ 50 ukuya kwii-100 okanye ngaphezulu ngenyanga-inokwenza umtshini ungavumelekanga ngemali.
Ukuba, nangona kunjalo, ufumene nzima ukuba ufikelele kumanqanaba akho okuhlola okujoliswe kuwo okanye ekugqibeleni ukuba uphendule iimpawu zakho eziqhubekayo ze-hypothyroidism, unokufuna ukuxoxa nengcebiso yakho malunga nomncedi wempilo malunga nokuba ngaba utshintsho kunyango lwenu luyacetyiswa.
> Imithombo:
> Benvanga, S. et al. "L-Thyroxine kwi-Oral Liquid okanye i-Softgel Formulation iqinisekisa ukuba iSerum yezinga eliqhelekileyo le-T4 yamahhala." I-Thyroid. Oktobha 2017, 27 (S1): A-166-A-188.
> Fallahi, P et. al. "I-Oral L-Thyroxine kwi-Gel Capsule Versus Formulation Formation kwizigulane ezithunyelwa kwi-Total Thyroidectomy." I-Thyroid. Oktobha 2017, 27 (S1): A-166-A-188.
> McMillan M, Rotenberg K, et al. Ukunyangwa kwamachiza, ukuchithwa kwamachiza kunye nokutya njengento echaphazela unyango lwe-levothyroxine: iziphumo zeProjekthi yokujonga i-CONTROL. Izidakamizwa RD. 2015. Disemba 21.
> Pirola, I. et. al. "TSH Ukuguquka Kwezilwelintshe Ezichaphazelekayo Ngomdlavuza we-Thyroid Olwahlukana Ne-Levothyroxine Liquid Solution okanye ithebhulethi." I-Thyroid. Oktobha 2017, 27 (S1): A-166-A-188.
> Sevilla Alsina, ME et. al. "Indlela engafanelekanga yokuLawula i-Hypothyroidism Emva kokusilela kwe-oral ye-Levothyroxine." I-Thyroid. Oktobha 2017, 27 (S1): A-166-A-188.