Ukuxilongwa kweNtsholongwane Kuxhomekeka kakhulu kwiimvavanyo zeGazi
Ukuba wena okanye umntu obathandayo unempawu okanye iimpawu ze-thyroid gland (engama-hypothyroidism), kubalulekile ukubona ugqirha wakho ukuvavanya ngokupheleleyo. Ukuze uhlolisise ingxaki ye-thyroid, ugqirha uya kukubuza imibuzo malunga nembali yakho yonyango kunye neyonyango, wenze uvavanyo olusemzimbeni, kwaye uqhube iimvavanyo zegazi (ngokugqithiseleyo, i-hormone ye-thyroid-stimulation, okanye iTSH test).
Ukuba ugqirha wakho ufumanisa nge-hypothyroidism, uya kufuna ukwazi isizathu sokungasebenzi kwakho kwe-thyroid, njengoko oku kuya kutyhola isicwangciso sakho soonyango. Ukutyhila ukuba "kutheni" emva koxilongo lwakho lwe-hypothyroid, ungadinga ukuba uhlolwe ngakumbi, njenge-test anti-blood test.
Fumana ugqirha
Abantu abaninzi banokufumanisa ukuba bane-hypothyroidism ngugqirha wabo okanye kwi-internist. Nangona kunjalo, oogqirha bokunakekelwa kweprayimari banamava ahlukeneyo ekulawuleni izifo ze-thyroid.
Umsebenzi wakho wokuqala kufuneka ukuba ufunde ukuba okanye ugqirha wakho wokunakekelwa ngokuyinhloko uziva ukhululekile kukuphatha, okanye ukuba ufanele uthintane ne-endocrinologist (ugqirha ogxile ekuphatheni izifo ze-hormone).
Ekugqibeleni, usenokubona i-endocrinologist kanye, kwaye ube nogqirha wakho oyintloko ugqirha ukulawula isifo sakho se-thyroid. Ngaphandle koko, i-endocrinologist yakho ingenza yonke inonyango yakho ye-thyroid emva konyaka ukuba kunjalo.
Ngaphantsi koviwo
Xa ubona ugqirha ngethuba lokuqala kunye neempawu okanye iimpawu ezisolisayo kwi-hypothyroidism, unokulindela ukuba uphumelele kwimbali yonyango kunye nokuhlolwa komzimba.
Emva kokuqwalasela nayiphi na impawu emitsha ebonisa ukuba umzimba wakho unokwehla (umzekelo, isikhumba esiqhekezayo, ukhathaza ngokulula, ukunganyamezeli, okanye ukutyikitya), ugqirha uya kubuza imibuzo ethile malunga nembali yakho yezobugqirha, njenge:
- Ngaba unesifo esisodwa sokuzimela (umzekelo, i-rheumatoid arthritis okanye uhlobo lwesifo sikashukela?)
- Ngaba unamalungu entsapho aphethe i-hypothyroidism?
- Ngaba uye wakha utyando lwe-thyroid?
- Ngaba uthatha nayiphina imithi eyenza i-hypothyroidism njenge-amiodarone okanye i-lithium?
- Ngaba uthatha nayiphi na i-supplementary i-iodine?
- Ngaba uke wafumana imisebe entanyeni yakho, ukuphatha i-lymphoma okanye ikhanda lomhlaza nomhlaza?
Ukongeza kwimbali yonyango, ugqirha wakho uya kuhlola i-thyroid yakho yokwandisa (ebizwa ngokuba yi-goiter) kunye neziqhumane (iigununu). Ugqirha wakho uya kukhangela kwakhona iimpawu ze-hypothyroidism njengengcinezelo yegazi ephantsi, i-pulse ephantsi, isikhumba esomileyo, ukuvuvukala kunye neengcamango ezilukhuni.
IiLabs kunye novavanyo
Ukuxilongwa kwe-hypothyroidism kuncike kakhulu kwiimvavanyo zegazi.
IHormone evuselela i-Thyroid (TSH)
Uvavanyo lwe- TSH luvavanyo oluphambili olusetyenziswa ukuxilongwa nokuphathwa kwe- hypothyroidism . Kodwa iilabhu ezahlukileyo zihlala zinexabiso elincinane kwizinto ezibizwa ngokuba yi "TSH reference reference range".
Kwiibhanki ezininzi, uhla lwe - TSH lwesalathisi luhamba ukusuka kwi-0.5 ukuya ku-4.5. Ixabiso le-TSH elingaphantsi kwe-0.5 libhekwa njenge- hyperthyroid, ngoxa ixabiso le- TSH elingaphezu kwe-4.5 libhekwa njengelinye i- hypothyroid.
AmaLbs ahlukeneyo angasebenzisa umda ophantsi we-0.35 ukuya kwi-0.6, kunye nomyinge ophezulu we-4.0 ukuya ku-6.0.
Kwimeko nayiphi na into, kubalulekile ukuba uqaphele uluhlu lwesibheno kwibhule apho igazi lakho lithunyelwa khona, ngoko uyazi imigangatho ofunyaniswa ngayo
Ukuba uvavanyo lokuqala lwe-TSH lwegazi luphakanyisiwe, luphindaphindiwe ngokuphindaphindiweyo, kwaye uvavanyo lwe-thyroxine T4 lukhululekile kwakhona.
I-Thyroxine yamahhala (T4)
Ukuba i-TSH iphezulu kwaye i-T4 yamahhala iphantsi, ukuxilongwa kwe- primary hypothyroidism yenziwa.
Ukuba i-TSH iphezulu, kodwa i-T4 yamahhala iyinto evamile, ukuxilongwa kwe- subclinical hypothyroidism eyenziwa. Unyango lwe-subclinical hypothyroidism luxhomekeke kwizinto ezininzi.
Ngokomzekelo, ugqirha wakho unokunyanga i-hypcroidroidism yakho encinci xa unempawu ezifana nokukhathala, ukugonywa, okanye ukudandatheka, okanye unesifo esisodwa sokuzimela, umzekelo, isifo se-celiac.
Ubudala buya kudlala indima kwisigqibo sakho sobugqirha. Ngokuqhelekileyo, kukho umda ophezulu wokuqalisa imithi ye-hormone ye-thyroid endaweni yokudala kubantu abadala; oku kungenxa yokuba i-TSH yabo yesiseko isemingeni ephezulu yesiqhelo.
Ubukho be-antibodies ze-TPO (jonga ngezantsi) nendima indima kwisigqibo sakho sigqirha. Ukuba une-subclinical hypothyroidism kunye nama-antibodies ase-TPO, uogqirha wakho uya kuqalisa unyango lwe-thyroid, ukwenzela ukuthintela ukuqhubela phambili kwe-hyplinroidism kwi-hypothyroidism.
Ukuxilongwa okungaqhelekanga kwe- central or secondary hypothyroidism kuyinto enzima. I-central hypothyroidism ibonisa i-pituitary gland okanye i-hypothalamus ingxaki. Ezi zakhiwo zengqondo zilawula i-thyroid gland kwaye zingonakaliswa kwiisisu, izifo, izifo, kunye nezifo ezingenangqondo ezifana ne-sarcoidosis, phakathi kwezinye izizathu.
Ephakathi kwe-hypothyroidism, i-TSH iphantsi okanye iqhelekileyo kwaye i-T4 yamahhala ngokuqhelekileyo iphantsi okanye iphantsi.
I-TBO Antibodies
I-thyroid ye-thyroid peroxidase (TPO) i-antibodies ibonisa ukuxilongwa kwe-Hashimoto's thyroiditis, eyona nto ibangelwa yi-hypothyroidism e-United States. Ezi zikhuhlane zihlasela ngokukhawuleza i-thyroid gland, ngoko ukuphuhliswa kwe-hypothyroidism kuya kuba yinkqubo ehamba phambili, njengoko i-thyroid iya kuba yincinci kwaye ayikwazi ukuvelisa i-hormone ye-thyroid.
Oku kuthetha ukuba umntu unokukwazi "ukufumana" ama-antibodies we-TPO, kodwa umsebenzi oqhelekileyo we-thyroid ngethuba elithile; Enyanisweni, kunokuthabatha iminyaka ngomsebenzi womntu we-thyroid ukuhla ukuya kwindawo yokuba i-hypothyroid. Abanye abantu banokuba nama-antibodies ase-TPO angenakuze bathuthuke kwi-hypothyroid.
Nangona ugqirha wakho akayi kukunakekisa ngemithi ye-hormone ye-thyroid xa i-TBO yakho isifo esihle kodwa i-TSH yakho ingaphakathi kwinqanaba eliqhelekileyo lokubhekiselele, uya kubeka iliso kwi-TSH yakho ngexesha.
Ukucinga
Nangona uvavanyo lwegazi luvavanyo oluphambili lokuxilongwa kwe-hypothyroidism, ugqirha wakho unokuyalela i- thyroid ultrasound ukuba uyaphawula (okanye ufuna ukumjonga) i-goiter okanye iigununu kwiimviwo zakho zomzimba. I-ultrasound inokukunceda ugqirha ukuba anqume ubukhulu be-nodule kwaye ingaba unempawu engathandabuzayo ngomhlaza. Ngamanye amaxesha, i-biopsy yeenaliti (ebizwa ngokuba yi-aspector efanelekileyo, okanye i-FNA) eyenziwa ukuze ifumane isampuli yeeseli ngaphakathi kwinqununu. Ezi iiseli zinokuphinda zihlolwe ngokubanzi ngaphantsi kwe-microscope.
Kwimeko ye-hypothyroidism ephakathi, ukucatshulwa kwenzelwa ukuhlolisisa ingqondo kunye ne-pituitary gland. Ngokomzekelo, i- MRI ye-pituitary gland ingabonisa i-tumor, njenge-adenoma ye-pituitary.
Ukuxilongwa ngokungafani
Iimpawu ze-hypothyroidism ziyahlukahluka kwaye zingaphoswa lula okanye ziphosakele kwenye imeko yonyango.
Ukuchonga ezinye iindlela ezisekelwe kwiimpawu
Ngokuxhomekeke kwiimpawu zakho ezizodwa, ugqirha uya kukuhlalutya ngezinye iimeko zonyango (ngakumbi ukuba i-TSH yakho iyinto eqhelekileyo). Ezi ziquka:
- IAnemia
- Usulelo lwe-HIV (umzekelo, i-mononucleosis okanye isifo seLyme)
- Ubunzima be-Vitamin D
- Fibromyalgia
- Ukuxinezeleka okanye uxhalabe
- Ukulala ngomoya
- Isifo okanye isifo sesifo
- Esinye isifo sokuzimela (umzekelo isifo se-celiac okanye i-rheumatoid arthritis)
Iingxaki zokuSetyenziswa ngeeNkcukacha ezisekelwe kwiZiphumo zoVavanyo lwegazi
Nangona i-hypothyroidism eyona nto iyona nto ibangelwa yi-TSH ephakamileyo, kukho ezinye izifo ogqirha wakho oza kugcina engqondweni. Ngokomzekelo, iimvavanyo zegazi le-thyroid ezixhasa ukuxilongwa kwe-hypothyroidism ephakathi zinokuba zivela kwiimeko ezingekho komzimba.
Nonthyroidal lllness
Abantu ababethelelwe esibhedlele abanesifo esibi okanye abaye bafumana umthambo we-bone, ukuhlinzwa ngokugqithiseleyo, okanye ukuhlaselwa yintliziyo kunokuba nokuhlolwa kwegazi ye-thyroid ehambisana ne-central hypothyroidism (i-TSH ephantsi kunye ne-T4 ephantsi) -ngokuba "ukugula okungenayo" ngokungekho mvume yokufumana unyango.
Kulo mzekelo, ukulinganisa iimvavanyo zegazi ezibizwa ngokuba yi-T3, i-metabolite ye-T4, inokuba luncedo ekuhlukaniseni phakathi kwenyaniso ye-hypothyroidism kunye ne-non -roidroid. I-reverse T3 iphakanyisiwe kwi-non -roidroid.
Kwi-non -roidroid yokugula, i-thyroid function test tests kufuneka ijonge ngokuqhelekileyo xa umntu ebuyisela kwisifo sakhe. Nangona, abanye abantu bahlakulela i-TSH ephakamileyo emva kokubuyiselwa. Kula bantu, ukuphinda i-TSH kwiiveki ezine ukuya ezintandathu kubonisa ukuba i-TSH evamile.
Ukungaqiniseki kwe-Adrenal
I-Hypothyroidism kunye ne-adrenal insufficiency inokuhlala, njengokuba benza kwimeko engavumelekanga ebizwa ngokuba yi-autoimmune polyglandular syndrome. Le syndrome ibangelwa kwiinkqubo ezizimeleyo ezibandakanya iintlanti ezininzi, ngakumbi i-thyroid gland (kubangela i-hypothyroidism) kunye neengqungquthela ze-adrenal (kubangele ukungakwazi ukufumana izilwanyana).
Enye yeengozi ezinkulu ezinxulumene nale syndrome iyaphatha i-hypothyroidism (ukunika i-hormone substitution substitution) ngaphambi kokunyanga u-hypoadrenalism (ofuna unyango lwe-corticosteroid), njengoko oku kungabangela ukuxhatshazwa kweengxaki ze-adrenal. Ngelishwa ngolu hlobo, i-hypoadrenalism ingaphuthelwa ngenxa ye-TSH ephakamileyo kunye neempawu ezingacacanga eziba kunye nalabo abonwa kwi-hypothyroidism.
I-TSH-producing Pituitary Adenoma
Ukuba i-TSH iphakanyisiwe, kubalulekile ukuba i-T4 yamahhala ijongwe kwakhona. Kwi-hypothyroidism ephambili, i-T4 yamahhala kufuneka iphantsi, kodwa ukuba umntu unesifo se-Tsh-secreting pituitary, i-T4 yamahhala iya kuphakanyiswa.
> Imithombo:
> I-American Thyroid Association. (2013). Incwadana yezigulane kunye neMindeni yabo .
> Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10 Edition. WLL / Wolters Kluwer; 2012.
> Garber J et al. Izikhokelo zeZikliniki zoLwazi lwe-Hypothyroidism kubantu abadala: I-Cosponsored yi-American Association of Clinical Endocrinologists kunye ne-American Thyroid Association. I-Endocrine Practice . Ngo-2012 uNgo-Dec; 18 (6): 988-1028.
> Gaitonde DY, uRowley KD, Sweeney LB. Hypothyroidism: ukuhlaziywa. I-Phys Physician. 2012 u-Agasti 1; 86 (3): 244-51.
> Upala S, Yong WC, i-Sanguanke A. Ukungabikho komsebenzi oyintloko kwi-adrenal insufficiency engacatshulwa njenge-hypothyroidism kwisigulane esinama-polyglandular syndrome. N Am J Med Sci . Ngo-2016 ngoMeyi; 8 (5): 226-28.