I-T4T3 yokuLithwa kwesisindo? Uphando lubonisa iCommbo Treatment
Ulwazi oluqhelekileyo phakathi kwezigulane kunye nabanye oogqirha bezokwelapha, ukuba inani elininzi lezigulane ezine- hypothyroidism ziya kuqhubeka nezikhalazo kunye neempawu ezahlukeneyo, nangona unyango lwe-levothyroxine egcina oko kuthiwa "okuqhelekileyo" kweyroid ye-hormone (TSH).
Olunye uphando lufumanise ukuba, xa kuthelekiswa nokulawulwa, ngaphezulu kwama-13% abazange banelisekile ngemeko yabo yempilo, babonakalisa ukunganeliseki ngonyango lwabo.
Izikhalazo eziphambili ziyikhathala, inzuzo yesisindo , i-body aches / pain, kunye ne-clumsiness.
Ngokutsho kukaDkt. Bente Appelhof, MD, evela kwiYunivesithi yase-Amsterdam eNetherlands kunye nabo basebenzelana nabo: "Ingxabano isala malunga nexabiso lokuxhatshazwa kunye ne-LT4 kunye ne-LT3, xa kuthelekiswa ne-LT4 yedwa, kwi-hypothyroidism eyintloko. Ingcamango yokuba inqanaba elifanelekileyo lezigulane ezine-hypothyroidism lihlala likhalazo zezempilo, nangona unyango lwama- levothyroxine kunye nokumiselwa kwe-serum ye-TSH [i-hormone ye-thyroid-stimulating]. "
Ezinye izifundo zezilwanyana ziye zabonisa ukuba unyango oluthathelwa yi-levothyroxine (LT4) yedwa aluqinisekisi ukuba i-euthyroidism - amanqanaba aqhelekileyo e-thyroid - kuzo zonke iifom. Kunoko, i-euthyroidism inokuphunyezwa kuphela ngonyango oluhlangeneyo lwe-LT4 kunye ne-liothyronine (LT3). Izifundo ezahlukeneyo zijolise kulo mbandela, zijonge ukuba ingabe i-LT4 unyango lingafumaneki ngokwaneleyo ukubuyisela i-euthyroidism kwizicubu zomntu ngokunjalo.
Nangona izigulane zihlala zichaza ukukhethwa kwezifundo ezidibeneyo, abaphandi abazange bakwazi ukuhlukanisa izinto ezithile eziphuculweyo.
Ngoku, abaphandi baye bachonga ubuncinane into ebonakalayo inxulumene neyeza lokudibanisa - ukulahleka kwesisindo.
Uphando olupapashwe kwi- Journal of Clinical Endocrinology kunye ne-Metabolism luchaze ngophando olwalufumene ukuba izigulane zikhetha unyango lwe-thyroid olubandakanya inhlanganisela ye-levothyroxine (T4) kunye ne-T3, kunokuba yonyango lwe-levothyroxine (T4 kuphela), kwaye loo nzo nokulahleka kwesisindo.
Olu vavanyo lweklinikhi olukhulu luqinisekisile iziphumo ezivela kwi-Bunevicius study, eyapapashwa kwi- New England Journal of Medicine, eyafumana umphumo ozuzisayo we-T4 / T3 unyango lwe-hypothyroidism.
Icandelo le-clinic eliyimpumputhe, elilandeleleneyo, elilawulwa ngokungenamsebenzi, libuke iigulane ezili-141 ezinezixhobo eziphambili ze-hypothyroidism, eziye zaphulwa ngamaqela awaphathwa nge-T4 / T3 kwisiqingatha se-5: 1, 10: 1, kunye neqela eliqhubekayo kunye neyonyango yeT4 kuphela. Emva kweeveki ezili-15, uphando lubonakalisa ukhetho olucacileyo kwiindawo zezigulane zokudibanisa unyango, kwaye ngokukodwa, unyango lwe-5: 1 obandakanya izinga eliphezulu le-T3, ngokubhekiselele kunyango lwe-T4 kuphela.
Ezinye iziphumo ezithandekayo:
- Ukunciphisa ubunzima bomzimba - kodwa kungekhona ukuhla kwe-TSH ye-serum.
- Kuzo zombini ngamaqela, kwakukho ukwehla kwesisindo, esona sichazwa kwiqela elingu-5: 1, elinexabiso elinciphile le-1.7 kg, okanye ama-3.75. Iqela le-10: 1 linomlinganiselo wokulahleka kwesisindo se-1. Iqela elilodwa le-T4 lingazange litshintshe ubunzima.
- Kwizigulane ezakhetha ukonyango, i-44% yayine-serum ye-TSH ngaphantsi kwe-0.11.
- Utshintsho olunokulinganiswa kwimiva, ukukhathala, ukuphila kakuhle, kunye nemisebenzi ye-neurocognitive ayinakuqatshelwa ukuchazela isigqibo sogulane kwinkqubo yokudibanisa unyango.
Esinye isitshixo esingazange siphumelele kwisifundo kukuba ezinye izigulane ezifumana unyango oludibeneyo zifumana amanyathelo axhasayo, okubhekwa njengongaphezulu kokubanjwa. Babenamazinga e-TSH ngaphantsi kwebala eliqhelekileyo, kwaye ngoko ke baya kuthathwa njenge-hyperthyroid.
"Izigulane zikhethiweyo zonyango lwe-LT4 / LT3 ezidibeneyo kwi-LT4 yonyango, kodwa ukutshintsha kwimizimba, ukukhathala, ukuphila kakuhle, kunye nemisebenzi yengqondo ayinakukwazi ukucacisa ukuba kutheni isiphumo esiyinhloko sathandela unyango lwe-LT4 / LT3," kubhala abalobi. "Ukunciphisa ubunzima bomzimba kwahlanganiswa kunye nokwaneliseka ngamachiza okufunda."
Ngelixa abalobi beemfundo bengakwazi ukufumana isizathu esinokulinganiswa sokuncoma ukonyango oluhlangeneyo, baphetha ngokuthi: "Nangona kunjalo, umphumo wale sifundo awukuthinteli ukuba inxalenye ethile yezigulane zinokuzuza kwi-LT4 / LT3.
Imithombo:
Appelhof BC, kunye. al. "Ulwabiwo oluhlangeneyo kunye ne-levothyroxine kunye ne-liothyronine kwizibini ezimbini, xa kuthelekiswa ne-levothyroxine monotherapy kwi-hypothyroidism ephambili: i-clinic trial, ine-double blind-randomized."
Saravanan kunye. al. Inhlalakahle yengqondo kwiigulane kwi-'yanele 'ye-l-thyroxine: I-Clin Endocrinol (Oxf) 57: 577-585)