Ukuba unesifo se-hormone ye-hormone esikhundleni (ie, levothyroxine, okanye i-Synthroid, i-Levoxyl, okanye i- Tirosint brand) kwaye ungasayi kuziva kakuhle, unokufumana inzuzo yokongeza iT3 okanye ukuguqula unyango lwe-thyroid olubandakanya T3.
T3 / Triiodothyronine
U-Levothyroxine luhlobo lwe-hormone thyroxine, olufakwe njenge-T4.
I-T4 yi-hormone yokugcina kwaye kufuneka iguqulwe ngumzimba kwi-T3 ukuze isetyenziswe ngamaseli.
I-T3 ifutshane kwi-triiodothyronine. I-T3 i-thyroid esebenzayo esebenza kumgangatho wamaselula ukunceda ukunikezwa kwe-oksijini kunye namandla kumaseli, izicubu kunye nezigulane kuwo wonke umzimba.
Ngoxa i-thyroid yegland ikhiqiza i-T4 ne-T3, i-T4 ayisebenzi. Ukuze usebenzise umzimba, i-T4 iya guqulwa ibe yi-T3.
Ukwelashwa kwe-Levothyroxine kuphela kuthethwa njengomgangatho wokunyamekela oogqirha abaqhelekileyo. Kukho umzimba okhulayo wobungqina benzululwazi, nangona kunjalo, ochonga imiba enemiba ijolise ingqalelo kwiT3. Umzekelo:
- Uphando olutsha luchonga iziphene ze-genetic ezibizwa ngokuba yi-deiodinase polymorphisms ezenza i-subset yezigulane zingasebenzi kakuhle ekuguquleleni i-T4 ibe yi-T3. Ezi zifundo zibonisa ukuba i-levothyroxine yodwa ayinelanga ngokwezi gulane.
- Izifundo ezilishumi elinesibini zivavanya i-levothyroxine kunye ne-liothyronine unyango lwe-hypothyroidism. Ininzi yezifundo ezifumene umgangatho ophuculweyo, umgangatho wobomi, kunye nezinto ezinokwenzululwazi kwizigulane ezithatha inyango yokuxuba, xa kuthelekiswa ne-levothyroxine yedwa.
- Ezinye iziphumo zibonise ukuba ukusebenzisa i-T3 iziphumo ezisezantsi kumanqanaba e-cholesterol, ukunciphisa kakhulu ubunzima bomzimba, kunye nesisombululo esiphezulu sempawu, ngaphandle kweengozi ezongeziweyo xa kuthelekiswa ne-levothyroxine yedwa.
Ucwaningo lwesiDanmark oluphawulekayo , oluxeliweyo kwi- European Journal ye-Endocrinology , lwafunda iimpawu ze-thyroid zempembelelo ye-levothyroxine-kuphela yonyango, ngokubhekiselele ku-levothyroxine kunye ne-T3 (kulo mzekelo, i-micrograms ye-T3 ngosuku yayisetyenziswe).
Uvavanyo lwekhwalithi yobomi kunye nokuxinezeleka kwenziwa ekuqaleni kokufunda, kwaye emva koko emva kweeyure ezingama-12 zonyango. Ngexesha ngalinye leeveki ezimbini zee-12, izifundo zanikwa i-levothyroxine kunye ne-T3, okanye i-levothyroxine kunye ne-placebo kwaye yatshintshela ixesha elilandelayo leveki ezili-12. Abathathi-nxaxheba "babeyimfama" kuba bebengayazi ukuba ngaba bathabatha i-T3 okanye indawo ye-placebo.
Umgangatho wobomi kunye nemeko yengqondo ehlolwe iquka, phakathi kwezinye izinto: impilo jikelele, ukusebenza kwezenhlalakahle, impilo yengqondo, ubunzima, ukuqonda, ukuxinezeleka kunye nokuxhalabisa. Olu pho nonongo lubonisa ukuba phakathi kwezigulane, ininzi kubo babengabesifazana, i-49% yezigulane zikhetha ukonyango oludibeneyo, kwaye kuphela i-15% ekhetha ukwelashwa kuphela kwe-levothyroxine.
Abaphandi kunye ne-endocrinologists baye bahamba ngokuphindaphindiweyo kwiminyaka engamashumi amabini malunga nexabiso le-T3 . Ngokusekelwe kumava abo asebenzayo kunye nezigulane, kunye nomzimba okhulayo ophando, abanye oogqirha abaqhelekileyo, kunye nabasebenzi abangaphezulu kunye nabanyanisiweyo banokunyusa ukongeza i-T3 njengesisombululo sokuncedisa ukwandisa i-thyroid kwizigulane ezithile. Bongeza T3 ngeendlela ezininzi:
- Ukongeza unyango lwe-T3 ukuya ku-levothyroxine, ngokusebenzisa ukongezwa kwemithi yesigqirha ye-T3 igama lomhlaza weCytomel, okanye i-liyronronine (generic T3)
- Ukongeza i-T3 yokwenziwa komnxeba ngokusebenzisa umyalelo ohlanganiswe ngokukhululeka ngexesha / ukukhululwa kwe-T3 ngokukongeza kwi-levothyroxine
- Ukongeza i-dosage ye-thyroid echongiwe yendalo, njenge-drug prescription, i- Armor Thyroid , okanye i-thyroid yezemvelo (umenzi wase-US u-Acella) unyango lwe-levothyroxine
- Ukuguqula izigulane ukuya kwindlela yokwelapha yonyango kuphela yonyango
- Ukubeka isigulane kwi-T3 kuphela yonyango (oku kuqhelekanga.)
Kubalulekile ukuba uqaphele, nangona kunjalo, ngenxa yokuba i-T3 iyimodemoni esebenzayo, inokuba nomphumo ongaphezu kwefuthe kwizinga lentliziyo kunye ne-pulse kwabanye abantu, ingakumbi abo abanembali yesifo senhliziyo, abakhulileyo kunye nabo abaneentliziyo ezinokungahambi kakuhle i-mitral valve.
Oogqirha be-T3-savvy bavavanya ukhuseleko lwe-T3 xa kuthelekiswa neenzuzo ezinokwenzeka kwiimeko ezithile ngamatyala.
Ngaphandle kwezi gulane ezingenayo nayiphi intliziyo okanye iimeko ezinxulumene neminyaka ezinokuthi zenze i-T3 ingxaki, ezinye izigulane zithinteka kakhulu kwimiphumo ekhuthazayo ye-T3. Intliziyo inomdla kakhulu kwi-hormone ye-thyroid ngokubanzi, kwaye kwabanye abantu, nokuba neqondo eliphantsi le-liothyronine, okanye inani elincinci le-T3 kwimichiza ye-thyroid echongiwe yendalo ingabangela ukunyuka kwe-pulse okanye intliziyo.
Kwala ma gulane, amanye amagqirha ancomela ukukhutshwa kwexesha / ukukhutshwa kwexesha elide lokukhutshwa kwexesha eli-T3, olutholakalayo ngumyalelo ovela kwii-pharmacy ezidibeneyo.
Amanye amagqirha adibeneyo, ngokwenene, akholelwa ukuba i-T3 yokukhululwa ngokukhawuleza ngokwenene iyona ifomu elifanelekileyo lokuncedisa i-T3, njengoko ibonakala ngokufana nokuguqulwa komzimba kunye nokukhutshwa kwe-T3, kwaye nokuba ifom ye-free-release is nayiphina imiphumo.
YeNdalo echazwe ngeTroid
Abanye oogqirha baye bafumanisa ukuba i-subset yezigulane zabo zinezigqibo ezikhuselekileyo zezibonakaliso zabo ngelixa zithatha imithi yendalo echongiweyo ye-thyroid, isicatshulwa njenge-NDT. I-NDT yaziwa nangokuthi i-porcine thyroid, i-thyroid ye-extract, i-thyroid yemvelo okanye "i-pig thyroid". Ingumuthi wegciwane olawulwa yi-FDA, owenziwe kwi-cookie eyomileyo yengulube. Amachiza kulolu hlobo abandakanya i-Armor ye-Thyroid, i-Nature-throid, ne-WP Thyroid e-United States, i-Erfa Thyroid yaseCanada, kunye ne-generic ye-nature echanekileyo ye-thyroid e-United States eveliswa ngu-Acella.
I-thyroid ekhethiweyo yemvelo isetyenziselwe ngaphezu kwekhulu leminyaka. Iingcali ezininzi ze-hormone ezidibeneyo zikholelwa ukuba ezi zonyango, ezinika i-T4, T3, T2, T1, kunye nezinye i-hormone ze-thyroid kunye nezinto ezinomsoco, ngokufanayo zifana ne-hormone ye-thyroid yomntu kuneziyobisi. Bika ingxelo yokuba ipesenti enkulu yezigulane zabo ziziva zibhetele kubo. Ezinye izigulane zifumanisa ukuba ziziva zilungele kumachiza e-thyroid, okanye kwiziyobisi zokwenziwa kunye ne-thyroid yezinto eziphilayo.
ILizwi
I-T3 yamahhala kwaye iphendulele iimvavanyo zegazi ze-T3, kunye neempawu zekliniki kunye neempawu ze-hypothyroidism, kunokukunceda ukuba uqaphele ukuba unamanqanaba aqhelekileyo afumaneka kwi-T3, okanye unokufumana inzuzo kwi-T3 unyango. Abanye oogqirha abadibanisayo bakholelwa ukuba ukutshintshwa kwe-thyroid eyaneleyo kuya kubangela amazinga angamahhala eT3 phakathi ukuya kwisiqingatha esiphezulu sereferensi yereferensi.
Gcina ukhumbule ukuba ukuhlolwa kwe-T3 kunye nokusetyenziswa kweT4 / T3 kunye nonyango kunye neziyobisi ze-thyroid ezichongiweyo zemvelo ziyimpikiswano. Uninzi lwama-endocrinologist kunye namayeza aqhelekileyo anqabile kakhulu kwingcamango yokuvavanya i-T3 kunye nokunyanga nezidakamizwa ze-T3, nangona iziphumo zophando ezithembisayo. Bachaza ukuba iingxaki ezidityanisiweyo zeT3 zingenza iintliziyo zithinteke okanye ezinye iziphumo.
Amagqirha amaninzi aqhelekileyo awakuboni kakuhle izidakamizwa ze-thyroid . Bathi la mayeza aphelelwe ngumhla, awanakho "ahambisanayo," kwaye abaninzi banakuze bawuncede.
Ukuba ufuna ukuqwalasela unyango olongezelelweyo lwe-T3 okanye utywala lwezonyango ezidityanisiweyo, ungadinga ukusebenza kunye nodokotela ohlangeneyo okanye opheleleyo.
Kwakhona, ngelixa iindidi ezixhasayo ze-thyroid zisekhona, kwaye ezinye zibiza ukuba ziqukethe "i-thyroid glandulars," akuyiyo imishanguzo yeyeza ye-thyroid, kwaye ayifaki indawo yezilwanyana zonyango zemvelo.
> Imithombo:
> Celi FS, et al. "Impembelelo ye-liothyronine yonyango kwi-hypothyroidism: isilingo esingenasiphelo, esingaba yimpumputhe, esinama-double-blind, of crossover of liothyronine versus levothyroxine." J Clin Endocrinol Metab. 2011 Nov; 96 (11: 3466-74.): 10.1210 / jc.2011-1329.
> Izikhokelo zeeKliniki zoLwazi lwe-Hypothyroidism kubantu abadala : Uxhaswe ngu-American Association of Clinical Endocrinologists kunye ne-American Thyroid Association.
> Escobar-Morreale HF, et al. "Ukwelashwa kwe-hypothyroidism nge-levothyroxine okanye inhlanganisela ye-levothyroxine kunye ne-L-triiodothyronine." I-Best Pract Res Clin Clin Endocrinol Metab. 2015 Jan; 29 (1): 57-75. i-doi: 10.1016 / j.beem.2014.10.004. Epub 2014 Oktobha 25. Ukuphonononga.
> McAninch EA, Bianco AC. "Imbali kunye nexesha elizayo lokunyanga kwe-Hypothyroidism." Ann Intern Med. 2016 Jan 5; 164 (1): 50-6. i-doi: 10.7326 / M15-1799. I-Erratum ku: Ann Intern Med. 2016 uMar 1; 164 (5): 376. PMID: 26747302
> Nygaard, B et al. "Impembelelo yonyango oluhlangeneyo kunye ne-thyroxine (T4) kunye ne-3,5,30-triiodothyronine kunye ne-T4 monotherapy kwizigulane ezine-hypothyroidism, i-double-blind, study random." I-European Journal ye-Endocrinology (2009) 161 895-902