Xa i-hypothyroidism isetyenziselwa ukulandela i-thyroidectomy okanye emva kwonyango nge-iodine ye-radioactive (RAI), okanye xa ufumanisa ukuba unesifo se -thyroid esingasebenzi phantsi kwe-Hashimoto's thyroiditis, kuya kuba nemibuzo ebalulekileyo yokubuza ugqirha wakho. Nazi ezintandathu zezona ziqhelekileyo kwaye zibalulekileyo.
1. Yiyiphi i-hormone ye-thyroid-stimulation hormone (TSH) ekhoyo kwibhan yakho?
Uvavanyo lwe- TSH luvavanyo oluqhelekileyo olusetyenziswayo lokuxilongwa nokuphathwa kwe- hypothyroidism e-United States.
Kodwa iilabhu ezahlukileyo zihlala zinexabiso elincinane kwizinto ezibizwa ngokuba yi "TSH reference reference range". Lo mlinganiselo uluhlu lwamaxabiso ovavanyo olubonwa ukubonisa abantu abaqhelekileyo.
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 (i- thyroid engasebenzi ), ngelixa ixabiso le- TSH elingaphezu kwe-4.5 libhekwa njenge- hypothyroid (i-thyroid engasebenzi). 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 ofunyenweyo ngayo.
QAPHELA: Ukususela ekupheleni kuka-2002, i- American Association of Clinical Endocrinologists (AACE) kunye namanye amaqela eengcali baye baphinda baphuma malunga neengcebiso zokunciphisa uluhlu lwe-TSH, ngoko-0.3 ukuya ku-3.0.
Kodwa oogqirha abazange bavumelane. Ngoko oogqirha bajonga amanqanaba angaphantsi .3 nangaphezulu kwama-3.0 njengobungqina bentsholongwane ye-thyroid. Abanye baqhubeka besebenzisa imigangatho emidala, leyo iyaqhubeka inokubaluleka kwiiLbs ezininzi.
2. Yiyiphi inqanaba leTSH ozisebenzisayo njengenjongo kum?
Lo ngumbuzo olayishiwe kodwa obalulekileyo.
Impendulo yonyango yakho iya kumtyhila okanye ifilosofi malunga nento emele "inqanaba" leTSH. Abanye oogqirha bakholelwa ukuba ukufumana isigulane kwi-top of the standard range kuyinto injongo ye-hypothyroidism unyango . Ngokomzekelo, usebenzisa i-4.5 TSH ngokuqhelekileyo, abanye oogqirha bakholelwa ukuba umyalelo weyeza we-hormone ye-thyroid ukuze ufumane i-TSH yesigulane ukuya ngaphantsi kwe-4.5 (mhlawumbi mhlawumbi ukuya ku-4.4) iya kuba yinyango epheleleyo. Abanye oogqirha bavakalelwa kukuba amanqanaba angaphantsi kwe-10.0 "angama-subclinical hypothyroidism" kwaye awamvumeli unyango.
Oogqirha bahlula kwizinga le-TSH ngaphakathi kwinqanaba eliqhelekileyo elikholelwa ukuba lijolise ekujoliswe kuyo. Abanye oogqirha, ngokomzekelo, banokujolisa kwizinga le-TSH phakathi kwe-1.0 ne-2.0 ngokusekelwe kumava abo okubonisa ukuba izigulana zivakalelwa kukuba zilungelelanisa kula mazinga.
Abanye oogqirha basilandela ngokulandela izikhokelo ezixoxwe ngaphambili, kwaye bakholelwa ukuba unyango lwe-hormone yokutshintshwa kufuneka lujolise kwizinga le- TSH elingaphezu kwama-3.0 kwizigulane ze-hypothyroid .
3. Yiyiphi imithi oyalela yona?
Ekubeni mhlawumbi awukwazi ukufunda ukubhala ngesandla, kuya kufuneka ucele! Umbuzo apha kukuthi ukuba ugqirha wakho ukhetha igama legama okanye imithi yonyango.
Ukuba igama lomnxeba limiselwe, uya kufuna ukwazi ukuba ugqirha wakho uchaze "akukho ndawo yokufakelwa indawo" okanye "ukuhambisa njengoko kubhaliweyo (DAW)." EUnited States, igama legama legama le-hormone ye-hormone yokutshintsha iquka:
- Levothyroxine (i-thyroxine / T4) yokwenziwa komsebenzi: i-Synthroid, i-Levoxyl, iTirosint, i-Unithroid, okanye i-generic
- I-Liothyronine (i-synthetic triiodothyronine / T3): i-Cytomel, okanye i-generic
- I-thyroid yemvelo: Inkqoke, i-Nature-throid, i-Thyroid WP, okanye i-NP ye-Thyroid
Uninzi lwezigulane lunqunywe i-levothyroxine. Iingcali zeChroid ziye zalumkisa izigulane nge- levothyroxine . Ngenxa yezinto ezinokuthi zitshintshwe phakathi kwegama lomenzi wezonyango kunye neentlobo zendalo kunye neziganeko ezinokuthi izigulane zifumane iimpawu ezahlukeneyo xa zizalisa imimiselo, i-ATA ne-AACE bacebisa ukuba oogqirha kufuneka -
1) Izigulane ezilumkileyo ukuba ukulungiselela kwabo i- levothyroxine ingatshintshwa kwi-pharmacy
2) Khuthaza izigulana ukuba zihlale zikulungiselele ukulungiswa kwazo kwe-levothyroxine xa kunokwenzeka
3) Qinisekisa ukuba izigulane ziyakwazi ukuba zifumana ukulungiswa okutsha kwe-levothyroxine eziza kufuneka ziphindwe i-hormone ye-thyroid-stimulating test (TSH) yegazi emva kweeveki ezintandathu ukuya kwee-sixhenxe ukuqinisekisa ukuba ngaba kufuneka
4. Kwenzeka ngokukhawuleza ukuba silindele ukuphuhliswa kweempawu, kunye nokuphuculwa kweemvavanyo zegazi lwami, wanikezwa umyinge obekiweyo?
Umbuzo oyintloko apha ukuba ngaba ugqirha wakho ukunika i-dose encinci yokutshintshwa kwe-thyroid kwaye uzimisele ukulungelelanisa amanqanaba akho ngokukhawuleza, okanye ukuba uzama ukufikelela kwindawo efanelekileyo ngokukhawuleza. Kukho izizathu ezifanelekileyo zombini zombini, kodwa njengesigulane kubalulekile ukwazi ukuba ulindele ntoni.
Abanye oogqirha bangakubeka kwiqondo eliphantsi kakhulu kwaye bakuxelele ukuba uya kuziva ngcono kwiiveki ezimbini. Ukuba ngaba iiveki ezimbini ziza kwaye uziva ungcono, usenokucinga ukuba iziyobisi azisebenzi. Kodwa unyango lunokuthatha ixesha elide ukuba liqalise ukusebenza.
Ukuba ungumntu ophezulu, okanye ukuba unembali yeengxaki zentliziyo, oogqirha baya kuhlala beqala ukuhlala endaweni ephantsi kakhulu ye-hormone ye-thyroid ukuze ukwazi ukulinganisa impendulo yakho kwaye ugweme ukukhathaza ingxaki yakho yentliziyo.
5. Zingaphi ixesha eliza kuqhuba iimvavanyo ze-thyroid uze ufike kumanqanaba am emva kwinqanaba lokubhekiselele kunye neyona ndlela?
Ngokufanelekileyo, ugqirha wakho uya kuhlala ephezulu ekufikelele kwibala eliqhelekileyo. Kwiimeko ezininzi, oku kuthetha ukukubona zonke iiveki ezintandathu ukuya kweebhozo ngenxa yokuhlolwa kwegazi uze ulandele ulungelelaniso kwisilinganisi sakho uze uziva ungcono kwaye amanqanaba akho aphezulu.
6. Emva kokuba ndihlala kwinqanaba elona lifanelekileyo, ngaba ucinga ukuba ndibuya kaninzi ukuba ndibuyele ukuhlolwa kwegazi ukuqinisekisa ukuba iimfuno zam isilinganiselo azange zitshintshe?
Ukuba ugqirha wakho uthi akudingeki ukuba ungene ubuncinane kanye ngonyaka, lixesha lokuqala ukubuza ukuba ubona ugqirha ofanelekileyo. Uninzi lweengcali zincoma ukuba izigulane zivavanywe ubuncinane kwiinyanga ezintandathu kunyaka wokuqala okanye ezimbini, zilandelwa kanye kanye ngonyaka emva koko.
ILizwi
Kukhona umbuzo owodwa owongezelelweyo obalulekile ukubuza: "Ukuba ngaba ndinemibuzo phakathi kokuqeshwa, ndingayifumana njani umnxeba nawe? Uya kubuya wena, okanye ngaba oongikazi bakho babuyisela iifowuni? nezigulane? "
Lo mbuzo uza kukunceda ukuba ulinganise indlela okhoyo ngayo ukuba ugqirha lwakho lube luyilo. Ukuba unokhetho lokufuna udokotela ohlukile, impendulo yakho ugqirha yakho ingakunceda ukuba wenze isigqibo sokuba wenze ntoni. Abanye oogqirha baya kubuya iifowuni baze baphendule i-imeyile. Abanye bakhetha ukubhekisa yonke imibuzo kubahlengikazi (abanokunikela ngolwazi olufanelekileyo okanye olubhetele ngakumbi). Kodwa ukuba ufuna umntu oyedwa, inkonzo yezandla, mamela ngokukhawuleza oko ugqirha wakho akutsho apha. Uya kufumana ingcamango yento ongayilindela.
Imithombo:
Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10 Edition. WLL / Wolters Kluwer; 2012.
Garber, J, Cobin, R, Gharib, H, kunye. al. "Izikhokelo zeCliniki zoLwazi lwe-Hypothyroidism kubantu abadala: I-Cosponsored yi-American Association of Clinical Endocrinologists kunye ne-American Thyroid Association." I-Endocrine Practice. I-Vol 18 No. 6 uNovemba / Disemba 2012.