Udliwano-ndlebe no-Elizabeth "uLily" uConrad, MD
U-Elizabeth Conrad, owaziwa yi-MD kwizigulane zakhe ngokuthi "uDkt. Lily" - ungumgqirha odibanisayo eMacLean, eVirginia. UDkt. Lily unolwazi olulandelayo emva kwezigulane ezimbonayo ngenxa yokungalingani kwe-thyroid ne-hormonal. Wavuma ukuxelela iingcamango zakhe malunga nokujonga kwakhe kunye nokunyanga izigulane kule dilesi ye-Q & A.
UMary Shomon: Ngaba uqale ngeenjongo zokuba yinkcubeko yesintu / yemveli kwaye utshintshele ukudibanisa / ukuhlalisana, okanye ngaba uhlale unenjongo yokwenza i-MD?
Yintoni eyakhuthaza okanye iphefumlelwe?
UDkt Lily: Ndihlala ndiyazi ukuba ndiza kuba ngugqirha. Sifanele kakhulu kunokuba sibone, thintela okanye ulinganise kuvavanyo lwebhu. Amandla ethu okuphucula injabulo yethu kunye nempilo iya kwandipha ngokukhawuleza xa sikhula ingqondo, umzimba kunye nomoya. Ndine thamsanqa ukuba ugqirha wezilwanyana oqhutywe naye udliwano-ndlebe kwi-Columbia University College of Physicians & Surgeons wayevulekile kakhulu kwaye unomdla wokuva malunga nokusebenza nokuxhamla kokucamngca. Sichitha ininzi yodliwano-ndlebe exoxa ngokuphefumula kunye nokufana phakathi kokucamngca nokuzivocavoca umzimba.
Imiba yeHormonal
UMary Shomon: Ukholo lwenu, Uhlobo-Ukuphila kakuhle, lusebenza kunye nezigulane ezininzi ezinokungalingani kwemimoya. Ziziphi iimeko eziqhelekileyo zeemodemoni ozibonayo kwizigulane zakho zezilwanyana?
UDkt Lily: Siyabona abaninzi abafazi abanenkxalabo ephathelele kwi- Premenstrual Syndrome (PMS), i-Polycystic Ovarian Syndrome (i-PCOS), i- hypothyroidism , i- perimenopause, kunye nokuqeda umva .
Siphinde sibone izigulane ezicinga ngokukhulelwa, abafazi abanokuxhathisa i-insulin, i-syndrome ye-metabolic, kunye nesandulela-diabetes .
UMary Shomon: Kutheni ucinga ukuba kunzima kakhulu kwizigulane ezininzi ezibona amagqirha aqhelekileyo ukuba afumaneke ngokufanelekileyo malunga ne-thyroid, i-adrenal, okanye enye imicimbi yokungalingani kwe-hormonal?
UDkt. Lily: Kuthatha ixesha, elingaphelanga kakhulu kwiindlela zokubona izigulane ezingama-20 okanye ngaphezulu ngosuku. Kwakhona, ezininzi zezinto ezingalinganiyo zibuqili kwaye azifumaneki lula ngokusebenzisa iimvavanyo eziqhelekileyo. Abantu banokuba nemiba yempilo yempilo kunye nexabiso leebhanki zingabikho kwimida eqhelekileyo. Ngokomzekelo, uluhlu oluqhelekileyo lwe-cortisol lukhulu kakhulu, ngaphezu koko, into eqhelekileyo kwibhile ayilona nto ibaluleke kakhulu. Kubalulekile ukujongana nomntu wonke, ngentsebenziswano kunye nokujonga izinto ezininzi: ukondla, ukulawulwa kwengcinezelo, ukunyanzelisa ukusingqongileyo njl. Ukunceda ukuxhasa impilo enhle.
Uqeqesho lwethu kumachiza oqhelekileyo lusekelwe kwizibhedlele kwaye lube luhle kakhulu kuba lufumanisa kunye nokuphathwa kwezifo ezinzima. Ukuhlaselwa kwintliziyo, isifo soxilongo, kunye nesicelo se-appendicitis zisebenza ngokufanelekileyo ngendlela eqhelekileyo. Amagqirha aqeqeshelwe ngokuqhelekileyo ayaqaphela ukuba nganye inkqubo ichaphazela abanye. Ngokomzekelo, ixesha elibi kunye nelingaqhelekanga lisoloko liphucula xa i-thyroid ikhetele. Nangona kunjalo, indlela eqhelekileyo ingaba luncedo kuncinci kwizifo ezingapheliyo kunye nokungalingani.
Amachiza ahlala eshintsha kwaye aphucula. Njengezonyango, sifuna izigulane zethu ezilungileyo. Amagqirha ahlangeneyo afakwe ngokukhethekileyo kunye nezixhobo ezongezelelweyo zokulungisa ukungalingani okungahambi kakuhle; ezifana nezityalo, ukutya okunomsoco, kunye nokwenza i-acupuncture ukubonelela ngononophelo ngamnye.
Iyeza eliseMpuma libandakanya ukubaluleka kokulinganisela, kwaye oku kwongeza kakhulu kwimiboniso yethu yokuphilisa. Umzimba ufana nomyezo okumele ulungiswe, ukhuthaze ukuvisisana kunye nobunzima. Umbono oqhelekileyo kuye kwaba ukujonga izifo njengento esilwa okanye ukuxinzezela iziyobisi.
Njengabafundi bezonyango, asisoloko sichaza kakhulu imifuno, isondlo kunye nezongezelelo, izicwangciso ze-acupuncture kunye neengqondo zomzimba. Ngethamsanqa, oku kuya kutshintsha kwaye izikolo ziqala ukubandakanya iMicrosoft Complementary / Alternative Medicine (CAM). Kuyakhuthaza ukubona oovulindlela abanjengoDkt. Jim Gordon, weZiko leMpilo yeMpilo kunye neYunivesithi yaseGeorgetown eWashington, DC, bakhuthaza le nguqulelo lwempilo yoncedo, njengoko sisuka kwindawo ephambili ekujoliseni kweziyobisi kunye nokuhlinzwa ngundoqo kunye nokuzinyamekela kunye neendlela zeCAM kwinqanaba lokugxininisa ekuziphatheni, kunye nokukhusela kunye nokuphila kakuhle njengoko kugxininiswe kwaye ngoko kuncinci isidingo seziyobisi kunye nokuhlinzwa.
Yenza ingqiqo kakhulu.
Imiba yeTyroid
UMary Shomon: Ziziphi iimvavanyo kunye nemiba oya kuyiqwalasela xa uvavanya umfazi ngeengxaki ze-thyroid ?
UDkt Lily: Ndiyomdla kwimbali yakhe kunye nento ejongene nayo, ukuba kukho imbali yeengxaki ze-thyroid kwintsapho yakhe. Ndiza kuphonononga ezinye iimpawu kwaye ndenze uvavanyo lomzimba. Uvavanyo luvame ukuquka i-TSH, i-Free T3, i-Free T4, i-Reverse T3, i-Thyroid Antibodies, i-thyroglobulin kunye ne-thyroid-peroxidase antibody. Ngokuqhelekileyo uvavanyo lwe-adrenal lwenziwe kunye kunye nayiphi na imvavanyo efunekayo.
UMary Shomon: I- American Thyroid Association ka-2014 Hypothyroidism Guidelines ithi izigulane ze-hypothyroid kufuneka zibekwe i-levothyroxine kuphela, kwaye ukuba kulungiselelwe i-T3 kunye / okanye iziyobisi zonyango ezichongiweyo zonyango azikho mthethweni kubagqirha. Ucinga ntoni kwi-ATA?
UDkt Lily: Kukho imbambano malunga nokusetyenziswa kwamalungiselelo e-T3 .
Ezinye izigulane zisabela kakuhle kwiT4 kwaye ziyakwazi ukuguqula i-T4 ukuya kwi-T3 ngaphandle kweengxaki. Nangona kunjalo, akubona zonke izigulane ezikwazi ukwenza oku kakuhle. Ndiyifumana i-Free T3 kunye ne-T3 i-T3 ukuba ibaluleke kakhulu ekuqondeni ukungabikho kokusebenza kweT4 kwezinye izigulane. Izifundo ezininzi ziye zabonisa ukuba ukwaneliseka kwesigulane kuninzi kunye ne-T4 / T3 yonyango . Ngethamsanqa, i-ATA iyaqonda isidingo sokuqhubela phambili uphando kule ndawo. Ndiyonwabile ukuba ngoku kuqhutyelwa izifundo kwi-Slow Release T3. Amalungiselelo okukhululwa amancinci adla ngokunyamezela ngakumbi kunokukhululwa kwangoko T3.
UMary Shomon: I-American Thyroid Association yama-2014 Hypothyroidism Guidelines ithi izigulane ze-hypothyroid ezingenakuziva kakuhle xa zinikezwa i-levothyroxine kwaye zibuyiselwe kumazinga "euthyroid" kufuneka zihanjiswe ukuhlolwa kweengqondo. Ucinga ntoni kwi-ATA?
UDkt Lily: Kukho idatha ebonisa ukuba amanqanaba e-T4 yesigulane anokwaneleyo kodwa amazinga e-T3 athwala xa i-T4 yedwa. Iimoya kunye nemvakalelo yempilweni inokuchaphazeleka ngoxhumano lwe-T3-serotonin.
Ndicinga ukuba kungcono ukuba babone ugqirha okanye usapho lwabo ukuba baqiniseke ukuba yonke into ihlolwe. Izigulane ezineempawu eziqhubekayo zifanelwe ukuvavanywa ngokucokisekileyo, mhlawumbi enye into eyenziwa ... njengeLyme Disease okanye uLupus . Izifo ezininzi zingabonisa ukukhathala. Ukuba kukho uxinzelelo abanokufumana inzuzo yokubona umntu onguchwepheshe wengqondo.
UMary Shomon: Unjani amava kunye nezigulane ze-hypothyroid ? Ukhetha ukuthini izigulane zakho: i-levothyroxine, i-T4 / T3 ye-synthetic yokwenziwa, i-T3 kuphela, i-thyroid echongiwe yendalo, ifakwe imicu?
UDkt Lily: Ndiyalela oku kumatyala ngamacala. Izigulane zibonakala zivuya kakhulu kunye noxilongo lwe-thyroid olusebenzayo kakuhle. Kukwafumaneka nakwii-pharmacy ezininzi.
Ukungalingani kwe-Adrenal
UMary Shomon: Kukho imbambano enkulu malunga nobukho bokuba "ukukhathala komzimba" okanye ukungazi kakuhle . Ihlabathi lezonyango eliqhelekileyo lithetha ukuba sinesifo seCushing okanye i- Addison's Disease , kwaye ngaphandle koko, akukho mibala yegrey kwi-adrenal function. Ucinga ntoni na ukuba kutheni iyeza eliqhelekileyo lilijonga ngendlela enomnyama nomhlophe?
UDkt Lily: Izifo zeCushing kunye neziHlomelo ze-Addisons zihlobo olugqithiseleyo lwe-cortisol eyongeziweyo kunye nokungakwazi. Ndiyakholelwa ukuba ukuqaphela ukungazaliseki kwamanani (RAI) ngokunyukayo kukhula. Ngokomzekelo, kuqhelekileyo kwisifo sesibindi esingapheliyo. Ukufunda okuntle kakhulu kwanyatheliswa kutshanje kwi-RAI kwizigulane ezinezifo zesibindi, (i-Pharmacy, i-Ther, ngo-2014 Oktobha; 40 (7) 819-26.)
Enye into eyenza ukukhubazeka kwe-adrenal kunzima ukuyiqonda ukuba ixabiso eliqhelekileyo linalo lonke ububanzi, umzekelo, i-cortisol yasekuseni inomlinganiselo oqhelekileyo we-2-20. Le "fayile" kusasa ingenakwanela. Ndikhetha ukufumana ukufundwa ezininzi kwiintsuku zonke njengoko kusemgangathweni, ukuhlolwa kweprojekthi yeGenva Adrenal.
UMary Shomon: Uyintoni indlela oya kuyo ekuchongeni nasekuphatheni ukungalingani kwe-adrenal kwizigulane zakho?
UDkt Lily: Senza imbali epheleleyo kunye novavanyo lomzimba olulungiswayo njengoko lufunekayo. Izigulane ezininzi zingaba nexinzelelo lwegazi eliphantsi, kwaye siza kujonga impulse yabo kunye nexinzelelo lwegazi kwizikhundla ezahlukileyo. Ngokuqhelekileyo ndiya kuluvavanya uvavanyo lwe-saliva malunga ne-cortisol esinika ukufundwa ezininzi kwixesha, i-DHEA-S ifakiwe kule mvavanyo. Umsebenzi wegazi osemgangathweni ukwenziwa kubandakanya iphrofayili epheleleyo yechemistry. Sijonge izondlo eziphambili ezifana ne- Vitamin D kunye neemaminerali ezifana ne-magnesium. Ngokuxhomekeka kwisigulane, ndinokubangela ezinye izimbangela zeempawu zabo. Emva koko siqala ukuqulunqa icebo lokujongana nezizathu eziphambili zeempawu xa kunokwenzeka. Izixhobo ezincinci zokujongana nale micimbi zikhoyo, njengendlela yokusebenza kwengqondo kunye nokusetyenziswa kwamacimbi e-adaptogenic njengeAshwagandha.
Ukuhla ukusinda
UMary Shomon: Abaninzi abasetyhini abaphakathi kweminyaka yobudala, kunye neminyaka ye-perimenopausal kunye ne-menopausal bayalwela ukufumana ubunzima, okanye ubunzima bokulahlekelwa ubunzima. Ziziphi iintlobo zengcebiso ozifumanayo kubasetyhini abadla kakuhle kunye nokusebenzisa, kodwa banokuphumelela okunciphisa umthwalo?
UDkt Lily: Okokuqala, ndifuna ukuthetha, kukulungele. Ukuzivocavoca kunye nokutya okunempilo kuya kunceda ukuba uzive kakuhle kwaye ugcine impilo ibe ngcono kunokuba uhlale uhlala, kwaye ungadli imifuno nezithelo. Emva koko, ndifuna ukuqinisekisa ukuba udla ngokwaneleyo, ukusela amanzi aneleyo acocekileyo nokufumana ukuphumla ngokwaneleyo. Ngokuqhelekileyo ukulahlekelwa isisindo sokunyuka kwesisindo ngenxa yokungenakwanela kokutya kweeprotheyini kunye neekhalori okanye ukuphumla okunganeleyo. Ukuba usenenkathazo yabona umntu onokusebenzisana nawe ukukunceda ekufumaneni apho ukhona, kwaye wenze icebo lokukuxhasa apho ungathanda ukuya khona. Amanye amabhinqa aphakamisa i-cortisol ngokugqithiseleyo, ngelixa abanye bebephakamisa i-insulin. Iprogram yakho kufuneka ilandelwe kuwe.
I-Mind-Body Medicine
UMary Shomon: Siqala ukuqaphela ngokwenene ukubaluleka kokunciphisa uxinzelelo, ukubandakanya ukuphumla, nokubeka amandla oxhumano lomzimba ukuba lusebenze njengenxalenye yokuphila kakuhle. Ngaba unayo ingcamango kwezinye iindlela ezona ndlela zingaphaya kwabasetyhini abanokwenza oku, banike ubomi bethu obuxakekile?
UDkt. Lily: Enye yam indlela endiyithandayo kukusebenza ngexesha lokukhumbula yonke imihla. Xa uhamba ngaphandle, zivale iinyawo zakho emhlabathini, uthathe umoya uze ukhangele phezulu. Phawula isibhakabhaka, ngaba uvakalelwa ilanga ebusweni bakho? Kukho amafu, ingumoya? Ngaba zikhona iintaka okanye ezinye izilwanyana? Xa ufika ekhaya uthathe umoya kwaye uqaphele indlela oziva ngayo ngaloo mzuzu. Xa udla, thatha isikhashana ukucinga into enombulelo ngayo kwaye ubulele. Emva koko phawula ukubonakala kwendawo yokutya, umbala wayo ngokobude bawo ubunqamlezo kunye nokuvumba. Njengabasetyhini, sihlala sisisiseko sentsapho yethu kwaye sinokuzondla ngale ndlela kwaye sifundise abantwana bethu ukuba badibanise. Abantwana bam baya kundikhumbuza ukuba ndilibalile ubabalo lwethu, oluqhelekileyo lufana nalolu hlobo: ngamnye umntu uthi kancinane into endiyibonga ngayo njengoko sihamba ngetafile. Ukuthatha umzuzu ukuba ume kwaye unombulelo unokutshintsha ingqondo yethu kwaye usincede silungele ukufumana.
Esinye isixhobo esilula kukuluhlu lwezinto ezintathu ozoyibonga ngazo imihla ngemihla, mhlawumbi kwi-pad encinane kwitheyibhile lakho lokulala. Yindlela enhle yokuqalisa okanye yokuphela imini.
Fumana umkhwa owuthandayo, ovakalelwa yinto engokwemvelo kuwe. I-Yoga, i-pilates, i-Tai Chi, i-Qi Gong, i-massage, ukuhamba ngaphandle, ukucamngca ngengqondo kunye nezobugcisa ezikhokelwayo konke kunokusinceda siqinise uqhagamshelwano lomzimba.
Fumana into oyithandayo uze uzame ukwenza njalo. Kukho ezinye izinto ezintle ezinokufumaneka ezinemizuzu emifutshane kodwa efanelekileyo enokuyenza ngaphantsi kwemizuzu eyi-10.
Ukuba uthanda iklasi lakho le-yoga, likhulu! Khetha indawo kwindawo yakho apho unokukhupha umatshini wakho kwaye uchithe imizuzu emi-5 ngosuku wenze ukuhamba nokuphefumla. Ukuba unako ukululalisa loo mizuzu engama-20, nokuba bhetele!
Enye Into Yonke Isiguli Kufanele Yenze
UMary Shomon: Ukuba kukho into enye unokuqinisekisa ukuba zonke izigulane zakho ziyakwenza ukuphucula ukuphilisa, ingaba yintoni na?
UDkt Lily: Yiba nomusa kuwe, uthathe ixesha lokuzinyamekela, ziphathe njengokuba ungumhlobo oxabisekileyo!
U-Elizabeth (uLily) uConrad, MD, waphumelela kwiKholeji yamaGqirha kunye noogqirha beYunivesithi yase-Columbia ngo-1991. Wagqiba ukuhlala kwakhe kwintsapho kwenkqubo ye-Montgomery Family Practice Residency Programme e-Norristown, PA. UDkt. Lily, njengoko eyaziwa izigulane zakhe, uye wabhalwa ngokuqinisekileyo kwi-Medicine yoLuntu ukususela ngo-1994. Umsebenzi wakhe uye wazinikela ekuphulukeleni isigulane sonke ekusebenzisaneni, ekusebenzisaneni okuxhasa impilo kunye nenhlalakahle. Ukongezelela kwimvelaphi yakhe yemveli yentsapho, uDkt. ULily uye wafunda ukucamngca ukususela ekungeniseni kwakhe kwi-arts kartial ngo-1985. Ufunde iindidi zengqondo / umzimba wendlela yokuphulukisa kuquka ukuphuculwa kwengcinezelo kunye no-Jon Kabat-Zinn noSaki USanrelli kwiYunivesithi yaseMassachusetts. Uphononongo lwakhe luye lwaquka i-yoga, amayeza ase-Ayurvedic kunye ne-homeopathy. UDkt. Lily wafunda ukulungiswa kwe-UCLA, eyaziwayo njengeziko eliphezulu le-acupuncture yezilwanyana. Waba ibhodi eqinisekisiwe kwi-Medical Acupuncture ngo-2004. Uye waqhubeka nokufunda i-Acupuncture kunye neChina yemithi yamachiza kunye nentshona yeyeza kunye nokutya. Usebenzisa imichiza edibeneyo eMcLean, eVirginia, kwi-Well Being-Ekunjalo, apho ejolise kwiinkqubo eziqhelekileyo nezonyango, izicwangciso ezizimeleyo zokuxhasa ukulinganisela kwe-hormonal kunye nokuxhobisa izigulane ngemfundo kunye nezicwangciso zokuphila impilo enokulinganisela.
Elizabeth Conrad, MD
Uhlobo-Ukuba, 6862 Elm Street # 720, McLean, Virginia 22101, Ph: 703-635-2158