Izigulane ezineengxaki ze-bipolar zivame ukutshatyalaliswa xa zifumanisa ukuba iingxaki ze-thyroid ziyimpembelelo eqhelekileyo yokuthatha i-lithium yeyeza. I-lithium yinto eqhelekileyo isetyenziselwa ukuphatha ingxaki ye-bipolar, ngezinye izihlandlo ekuthiwa yixinzelelo lomntu.
I-lithium ineempembelelo ezininzi kwi-thyroid:
- kunciphisa ikhono lakho le-thyroid ukuvelisa i-thyroxine (T4)
- iphazamisa ukuguqulwa kweT4 ukuya kwi-T3
- inokunyusa ukwanda kwinqanaba leTSH
- kungonakalisa isifo se-thyroid
I-lithium iyaziwa ngokubangela i- goiter (i-thyroid eyandisiweyo), kwakunye ne-hypothyroidism (i-thyroid engasebenzi), kunye ne-autoimmune thyroiditis engapheliyo, isifo somzimba we-thyroid. Kukho ikhonkco phakathi kwe-lithium kunye ne-hyperthyroidism kwezinye izigulane.
Iimiphumo zecala ezihlobene ne-Lithium
I-Goiter: I- Goiter , i-thyroid ye-thyroid, iyona nto ifana ne-lithium, kwaye iyaqikelelwa ukuba ifikelele kwisiqingatha sazo zonke izigulane eziphathwe nge-lithium. I-Goiter isoloko ikhula ngaphakathi kwiminyaka emibini yokuqala yokuqala yonyango lwe-lithium. Nge-goiter eyenzelwe i-lithium, i-thyroid yakho inokwandisa ngokuphindwe kabini ubukhulu bayo obuqhelekileyo.
I-Hypothyroidism: I- Hypothyroidism- ukungabi nakwi-hormone ye-thyroid-kuqikelelwa ukuba ifikelele kwisiqingatha sazo zonke izigulane ezithatha i-lithium.
Ngokuqhelekileyo kwenzeka rhoqo kwiminyaka emibili yokuqala yokuqala yonyango lwakho lwe-lithium. Abasetyhini abangaphezu kwama-45 basengozini enkulu ye-lithium -ducedduced hypothyroidism, kwaye ingozi enkulu ye-hypothyroidism kwizigulane eziphathwe nge-lithium zanda ngokukhula.
I-hypothyroidism ingaba yincinci-nge-high-grade ye-hormone (TSH) yezinga eliphezulu, kunye neendawo eziqhelekileyo ze-T4 kunye ne-T3-ezineempawu okanye iimpawu ezimbalwa.
Kwezinye iimeko, i-hypothyroidism inomoya omnene, kwaye ibonakalisa kwiinyanga ezimbalwa zokuqala zonyango lwe-lithium, kodwa ixesha elidlulileyo, kwaye umsebenzi we-thyroid ubuyela kwisiqhelo. Noko ke, ipesenti yezigulane ziza kuphuhlisa i- hypothyroidism , kunye nemiqondiso kunye neempawu zayo . Ezi gulane kufuneka ziphathwe nge-lithium -ducedduced hypothyroidism .
I-Thyroiditis ngokuzenzekelayo: Izigulana ezithatha i-lithium zisengozini yokuhlakulela i-thyroiditis engapheliyo-i-inflammation ye-thyroiditis. Ukuba uqala nje ukwelapha i-lithium, ubukho be- antithyroid ( antibodies peroxidase antibodies) (ngisho ne-thyroid). Kukho kubonakala nokuba kukho ubungqina bokuba i-lithium ngokwayo ingabangela izikhusela eziphezulu kunye nokuqala kwesifo se- thyroid kwisigulane.
Ukwelashwa kwe-lithium kubonakala kudibene nomngcipheko ophezulu we- hyperthyroidism -ngaphezulu kwe-hormone ye-thyroid. Ucwaningo oluninzi luye lwabonisa ukuba i-hyperthyroidism iphindwe kabini kwizihlandlo eziphindwe kathathu kwizigulane eziphathwe nge-lithium, ngokumalunga nokuxhaphaka kwabantu bonke.
Ziziphi Iziguli Ezifanele Ziyenze?
I-UpToDate inecebiso elithile ekuncedeni izigulana ezithatha i-lithium ziqonda iziphumo ezinxulumene ne-thyroid:
Ngenxa yeziganeko eziphezulu ze-goiter kunye ne-hypothyroidism eyenzeka ngexesha lokwelashwa kwe-lithium, izigulana kufuneka zihlolwe ngokucophelela nge-thyroid kunye nokuzimisela kwe-TSH kunye ne-antithyroid-antibody titers ngaphambi kokuba unyango lwe-lithium luqalwe. Iziguli ezinomsebenzi oqhelekileyo we-thyroid ngeli xesha kufuneka zihlaziywe rhoqo emva kweenyanga ezintandathu ukuya kwezi-12 iminyaka emininzi. Ukuba umsebenzi we-thyroid awuqhelekanga ekuqaleni kovandlakanyo, i-lithium inokunikwa xa kunesidingo kodwa ukukhubazeka kwe-thyroid kufuneka kuphathwe.
Kuthetha ukuthini ukuba ukuba unikwe i-lithium, kuya kufuneka uqiniseke ukuba unobomi be-thyroid echanekileyo kunye nokuhlolwa kwegazi ukulinganisa i-TSH kunye ne-antithyroid yamanqanaba omntu , ngaphambi kokuba uqale unyango lwakho lwe-lithium. Ezinye iingcali zincoma ukuba uvavanyo lwe-thyroid emva kweeveki ezintandathu emva kokuba uqale unyango lwe-lithium. Ngethuba nje uthabatha i-lithium, ugqirha wakho kufuneka aphinde ahlolisise umsebenzi wakho we-thyroid, kubandakanywa uvavanyo olubanzi lwegazi kunye nokuhlolwa kweeklinikhi, zonke iinyanga ezintandathu ukuya kwezi-12 okanye ngaphambili, ukuba uqala ukubonisa iimpawu ezibonisa ukuba unobungozi be-thyroid.
I-lithium-induced hypothyroidism iyakwazi ukuguqulwa xa uyeka ukuthatha i-lithium. Ukuba uhlakulela ingxaki ye-thyroid ngelixa unyango lwe-lithium, iingcali azicebisi ukuyeka unyango lwakho lwe-lithium. Esikhundleni saloo nto, kubalulekile ukuba usebenze nogqirha wakho ukuqinisekisa ukuba ufumana unyango olufanelekileyo kwiimeko zakho ze-thyroid . Ugqirha wakho uzakufuna ukujonga i-thyroid yakho kunye nempendulo yakho kwindlela yokwelashwa kwe-thyroid ukuqinisekisa ukuba uphathwa ngokupheleleyo, kwaye ukuvavanya ngezikhathi ezithile ukuba ukuqhubeka kunye neyeza le-lithium kuyona ndlela ingcono kakhulu kwimpilo yakho.
Umthombo:
> Goldberg, uJoseph, MD. "Ulawulo lwe-Hypothyroidism kwizigulane kwiLithium Prophylaxis ye-Bipolar Disorder." Medscape. Oktobha 31, 2008. I-Intanethi: http://www.medscape.com/viewarticle/581200
> Ii-Surks, uMartin. "I-lithium kunye ne-thyroid." Isemgangathweno. Kufumaneka: Matshi 2009.