Uphando lubona abaninzi abanezigulane baziva ngcono ngeHongelelo lwe-T3
NgoFebruwari 11, 1999 - Umxholo ka-Februwari 11, 1999 we-New England Journal of Medicine ubika ngeziphumo zophando ofumene ukuba "unyango nge thyroxine kunye ne-triiodothyronine luphucule umgangatho wobomi kwizilwanyana ezininzi [hypothyroid]."
Eli nqaku libizwa ngokuthi:
"Iimpembelelo ze-Thyroxine njengoko kuthelekiswa ne-Thyroxine kunye ne-Triiodothyronine kwizigulane ezine-Hypothyroidism"
nguRobertas Bunevicius, uGintautas Kazanavicius, uRimas Zalinkevicius, u-Arthur J Prange, uJr.
Uphando luqhutywe yiZiko le-Endocrinology, iYunivesithi yeeKayun Medical, iKaunas, iLithuania kunye neSebe leengqondo, iSikole seMithi, iYunivesithi yaseNorth Carolina, iChapel Hill.
Indlela okuqhutyelwa ngayo isifundo
Okubaluleke kakhulu, bathatha iqela labantu abangama-33 ababengama-hypothyroid, ngenxa yokugula kwesifo se-thyroid, okanye ukususa i-thyroids ngenxa yomdlavuza we-thyroid. Zonke izigulane zafundwa ngeeveki ezimbini kwiiveki ezintlanu. Ngexesha elilodwa leveki ezintlanu, isigulane samfumana i-levothyroxine yodwa. (I-Levothyroxine yigama eliqhelekileyo lamagama e-brand ezifana ne-Euthyrox, iLevoxyl, i-Levothroid ne-Synthroid.) Ngethuba lesinye isithuba seveki ezintlanu, isigulane samfumana i-levothyroxine PLUS triiodothyronine (T3.) (Qaphela: E-US, igama legama I-T3 "yi-Cytomel.") Kwi-T4 kunye ne-T3 isigaba, i-50 μg yesifo se-levothyroxine yesigulane satshintshwa ngu-12.5 μg we-triiodothyronine (T3).
Iindidi ezahlukeneyo zegazi, iingcamango, iimvakalelo kunye neemvavanyo zomzimba zaqhutywa kwiindidi ezahlukeneyo zovavanyo.
Iziphumo
Ngokombono weziphumo zomzimba, ukungafani phakathi kwe-pulse, uxinzelelo lwegazi, iingcamango kunye neminye imisebenzi eyahlukeneyo ye-T4 yedwa, ngokubhekiselele kwi-T4 kunye ne-T3, yayincinci. Uxinzelelo lwegazi kunye ne-cholesterol ngokwenene yehla kancane kwi-T4 kunye ne-T3.
Apho iziphumo zazimangalisa zisebenza ngqondweni. Izigulane zenziwe ngcono kwiimeko ezahlukeneyo ze-neuropsychological imisebenzi kwi-T4 kunye ne-T3. Isimo sengqondo sengqondo sabasemagqirha sabonisa ukuphucula kwi-T4 kunye neT3.
Ekupheleni kolu cwaningo, izigulane zacelwa ukuba ngaba zikhetha unyango lokuqala okanye lwesibini. Izigulane ezingama-20 zathi zikhetha ukwelashwa kwe-T4 kunye ne-T3, i-11 ayikhethwanga nayiphi indlela, kwaye i-2 kuphela ikhetha i-T4 kuphela. Izigulane ezingama-20 ezikhethileyo i-T4 kunye ne-T3 zixelele ukuba zinegunya elininzi, zixininisekile kwaye ziziva zibhetele.
Abaphandi bathi "unyango kunye ne-thyroxine kunye ne-triiodothyronine luphucule umgangatho wobomi kwizigulane ezininzi."
Abaphandi baphakamisa ukuba iprogram ye-thyroid ye-hormone yokutshintshwa komntu ongenalo i-thyroid gland, okanye i-thyroid yegland ephantse ingasebenzi, iya kuba "ngu-10 μg we-triiodothyronine imihla ngemihla kwifom yokukhululwa ngokuqhubekayo kunye ne-thyroxine eyaneleyo ukuqinisekisa euthyroidism. "
Impembelelo Yonyango Lwenu
Olu pho nonongo lunempembelelo enkulu kubantu abangaziva kakuhle kwi-hormone ye-thyroid yangoku.
Ukuba unesifo esiqhelekileyo se-levothyroxine kuphela, kunokwenzeka ukuba, njengeninzi yezifundo zokufunda, nawe unokuziva ungcono ngokukongezwa komkhiqizo we-T3 umlinganiselo kwisilinganiselo esilinganisiweyo sokulinganisa.
Ukuba uhlala kwi-Armor ye-Thyroid okanye i-Thyrolar, ipesenteji zamanje ze-T3 kulezo ziyobisi zingase ziphakame kakhulu, xa kuthelekiswa nezilinganiso ezicetywayo ezichazwe kulolu cwaningo. Iziphumo ezichanekileyo zingafumaneka ngokuguqula i-regimen yonyango ukuba ihambelane ngokukodwa kwizinga eliphakanyisiweyo elichazwe kweli nqaku.
Ukuba unesifo se-hormone esikhundleni sakho kwaye ungaziva kakuhle, ndincoma ukuba uxelele ugqirha wakho ngokukhawuleza malunga nale sifundo yophando, kwaye uzenzele ikopi yale nqaku.
Ukuba uya kubelana naluphi na ulwazi ngogqirha wakho, ngelo xesha, ungaphinda ufune ukwabelana ngekopi yeBritish Medical Journal inqaku elibonisa ukuba ixabiso ngaphezu kwe-TSH ye-2 ingabi "yinto eqhelekileyo," kodwa emele Amanqanaba angavumelekanga abonakalisa i-thyroid esele yinkqubo yokungaphumeleli.
Unokuyalela ikopi ngokubiza iSebe leNkonzo yeNkonzo yabathengi eNew England, kwi-1-800-THE-NEJM
I-Bigger Umfanekiso yezilwanyana ze-Thyroid
Oku kunenjongo yokuphandabuza, ukuqinisekisile kwimeko yokuphanda iziphi izigulane ezininzi, mna kunye nabagqirha, ndiye ndithatha iminyaka emininzi: i-levothyroxine-kuphela i-hormone yokutshintshwa kwe-thyroid ayishiyi ipesenti yezigulane ze-hypothyroid eziziva kakuhle, kwaye ezi gulane zivakale kwaye zisebenza kangcono xa i-T3 yongezwa kwi-hormone yabo yokutshintshwa.
Kuyathakazelisa ukuba oku kunika isizathu sokuba izigulane ziziva zilungelelanise zonke iilori ze-thyroid njenge-Armor ye-Thyroid, i-Westhroid kunye ne-Naturethroid, equle i-T4 kunye ne-T3 ngokwemvelo, kunye ne-T4 / T3 yeziyobisi izilwanyana. thabatha. Kwezinye iimeko, izigulane zongeze i-Cytomel (i-synthetic T3) okanye ukukhululwa kwexesha T3 kwiyeza eliqhelekileyo levothyroxine kunye neziphumo ezingcono.
Kudala, izigulane ziye zaxelelwa ukuba bonke abayidingayo ngonyango lwe-levothyroxine ukuba bangene "kwibala eliqhelekileyo le-TSH," kwaye unyango lwe-thyroid lubhekwa luphelele. Ixesha kunye nexesha, abantu abaye bahlushwa ngeempawu - kuquka ukukhathala, ukuxinezeleka, iingxaki zengqondo, kunye nokunye - batyelwa ukuba xa i-thyroid yeyona ndlela iqhelekile, ezi ngxaki azizange zihambelane ne-thyroid. , uxinzelelo, i-PMS, okanye nje "entloko yakho." Izigulane ezenze kakuhle iminyaka kwiArmor, zatshintshela kwi-Synthroid, umzekelo, kwaye zikhalaza ngokungakhange zizive kakuhle zaxelelwa ukuba "zigugile."
Khawucinge ngale ngxelo esandula kutsho kwiThe Bridge, incwadana yekota nganye evela kwi-Thyroid Foundation yaseMelika, intlangano efuneka ukuba ibe yinkcazo yemiba yesigulane kunye nokukhuthaza:
"Iimvavanyo ze-TSH zichanekile, kwaye ukuba i-TSH yakho iyinto eqhelekileyo, ukukhubazeka kwe-thyroid ayikho imbangela yale mpawu."
UDouglas Ross, uMcebisi ngezeMpilo kwi-Thyroid Foundation yaseMelika
Akuqinisekanga ukuba izigulane zinyanzelwanga, zichithwa, zigqitywa, kwaye ziphantsi kwexesha elide njengoko ziye zenziwa ngonyango oluqhelekileyo, imibutho ye-thyroid namaqela ezonyango.
Okwangoku, oogqirha ababemisela imithi ye-thyroid njenge-Armor - okanye i-Thyrolar yabalingani-yabasebenzi-babhalwa njengezicukuthwane, okanye bengenakuziphendulela, okanye kwezinye iimeko, bada bakhuliswa kwiindleko ze-levothyroxine kuphela zenzelwe kwiibhodi zonyango .
Masithembele ukuba olu lwazi lubangela isigulane kunye nemibutho yezokwelapha, kunye nogqirha, ukuqala ukuphulaphula ngakumbi izigulane - kwaye kungekhona kwiinkampani zonyango.
Ngokucacileyo, bekuye indawo yokuthengisa yeenkampani ezifana ne-Knoll Pharmaceutical, i-manufactuer ye-Synthroid, ukuba i-levothyroxine yedwa yonke into efunayo. Ukulandela emva kwesemva kunye nokugqithisa yonke into ibe yi-hordes ye-endocrinologists enokuvuyela ngokuxhamlayo kwi-Knoll kunye nokunikezelwa kwayo kwemali yenkxaso, inkxaso-mali yeprojekthi, iimali zeenkomfa, kunye ne-freebies galore, kwaye banqwenela ukubetha i-levothyroxine imali.
Ukuhamba phambili kwababantu babefana noRichard Guttler, ozibiza ngokuthi "i-thyroidologist" kwaye uxhawula izigulane i-$ 150 okanye ngaphezulu - "efunekayo kwangaphambili" - "Inkonzo Yesibili" kwi-Intanethi. Kunyaka ophelileyo, wagxotha ngokukrakra izigulana ezikhalazo ngeempawu ezingaphendulwanga kunye nomnqweno wokuzama ezi zonyango ezikhoyo ngoku zifunyenwe ngcono. Kunyaka ophelileyo, umfundi wewebhusayithi wabhala kuye ukuba amxelele ukuba ukungabikho kwe-Synthroid emva kweentsuku ezintathu ukuya kwezine kuye kwamkhulula ukukhwehlela okuqhubekayo okwakunyamezela iminyaka engamashumi amabini (okanye ngaphezulu) edluleyo. Wayexelela ukuba wayitshintshile kwiSigqeba. Wabhala kuye: "fumana ubomi! I-synthroid ayikho imbangela yeengxaki zakho." Kunyaka ophelileyo, uGuttler wandiqhayisa ngegama lakhe elincinane "lokulala komgca" (ukungabikho kolwazi olufanelekileyo kunye neziphumlisi zakhe):
"Ndiyathokoza yonke" imiphetho "egcwalisa i-imeyile yakho, kungekhona yam. yenza ukuba ubomi bam bube lula lula kuphela kwizigulane ze-thyroid eziqhelekileyo ezingenakuze zicinge ngokuthatha izixhobo okanye i-combo thyrolar okanye i-cytomel. ntoni xa ekugqibeleni baya kuthatha i-thyrolar emakethi?
Ukuqikelela ukuba zonke izigulane zihamba ngokukhawuleza njengoko zinako ukuya kuma-dinosaurs afana ne "dr. G" ziya kusebenza kwinani elandayo "leengqimba" - oogqirha abanezakhono, abaphulaphule izigulane, bazicingela, baxakeka phambili nangona oontanga uxinzelelo kunye nenkampani yokuthengisa imveliso yokuthengisa, yonke imihla ekusebenziseni ngokolwazi lwabo ukuba izidakamizwa ze-T3 zisebenza kangcono kuninzi lwethu.
Kwaye abo oogqirha abafanayo bebegwetyelwe "kwiimfestile" ngokude baqinisekiswa ngokufanelekileyo ngenye yezona ziseko zonyango, iNew England Journal of Medicine