Ngati simukudziŵa bwino chithokomiro chokonzedwera, apa pali msanga wambiri. Chithokomiro chodetsedwa (chithokomiro) ndi chithokomiro cha mankhwala a chithokomiro chomwe chimapangidwa kuchokera ku chithokomiro kuchokera ku nkhumba, chomwe chimatchedwanso "chithokomiro cha porcine." Ena mwa mayina awo monga Armor Thyroid , Chithokomiro Chachilengedwe, ndi WP Chithokomiro.
Chithokomiro chodziwika ndi mankhwala osokoneza bongo, ndipo amalamulidwa ndi FDA.
Zakhala pamsika ndikugwiritsa ntchito bwino kwa zaka zoposa 100.
Mpaka kupanga mankhwala otchedwa thyroxine (omwe amadziwikanso monga levothyroxine, omwe ali ndi mayina a chizindikiro monga Synthroid, Levoxyl, ndi Tirosint) adayambitsidwa m'ma 1950, kutuluka kwa chithokomiro ndi mankhwala okhaokha omwe amachititsa mankhwala.
Pamene mankhwala anu thyroxine adayambitsidwa, panali chisangalalo chochuluka pa momwe zinalili zamakono, poyerekeza ndi chithokomiro chodetsedwa, chomwe chinkaonedwa kuti chinali chakale. Panthawiyo, madokotala ambiri anasintha odwala kupita kuchipatala ndipo sanayang'ane konse. Pakalipano, chithokomiro-chomwe ndi Synthroid-chinapindulitsa kwambiri kwa makampani osiyanasiyana osokoneza bongo omwe ali ndi ufulu wa Synthroid pa zaka zomwe zaphatikizapo Boots, BASF, ndipo tsopano AbbVie, wopukutira Abbott Labs.
Nthawi zonse, monga makampani akuluakulu osokoneza bongo, opanga Synthroid adathandizira misonkhano yachipatala, maulendo a gofu, masewera olimbitsa thupi, zopereka zafukufuku, ndi malipiro a oyankhula, ndipo amapereka zolemba zaufulu, zolembera, mapepala, maks, ndi zina zotere .
Tsopano tili ndi madokotala ambirimbiri omwe adaphunzitsidwa ku sukulu ya zachipatala kuti amvetsetse kuti mankhwalawa amathandiza kuti athandizidwe, ndipo ambiri amadziŵa dzina lakuti Synthroid makamaka chifukwa cha malonda ambiri.
Madokotala ambiri sazindikira kuti chithokomiro chodziwika bwino chikadalipo, kapena kuti chingagwiritsidwe ntchito mosamala pofuna kuchiza odwala ena a hypothyroid.
Ena amakhulupirira kuti kutulutsa chithokomiro chodziwika bwino n'kovuta. Malingaliro awa ali mwatsatanetsatane akulimbikitsidwa ndi malingaliro olakwika kuchokera kwa oimira levothyroxine ogulitsa malonda, zabodza zopanda pake zomwe zatulutsa chithokomiro zimachoka pamsika , ndi zina zambiri zodziwika.
Ngakhale kuti amakonda makina a levothyroxine, kuyambira zaka za m'ma 1990, mankhwala a chithokomiro amayamba kuyambiranso, chifukwa chidwi cha mankhwala ochiritsira chinakula. Panthawi imeneyo, odwala omwe sanamve bwino mankhwala opangidwa ndi chithokomiro amakhalanso amphamvu komanso ozindikira, chifukwa cha mbali ina pa intaneti. Odwala adamva kuti pali njira zina-pakati pawo, omwe amawotcha mankhwala a chithokomiro monga Zida ndi Zachilengedwe.
Tiyeni tiwone bwino: Malemba mamiliyoni ambiri pachaka amalembedwa kuti apange chithokomiro, poyerekeza ndi malamulo oposa 30 million pachaka a levothyroxine. Koma amakhumudwitsa odwala omwe samamva bwino omwe akubwera kumalo ngati awa, kuwerenga mabuku, ndi kulankhula ndi odwala ena. Chifukwa chake, akudziŵa bwino kuti pali njira zambiri kuposa levothyroxine, ndipo , kuti odwala ena amamva bwino pakamwa mankhwala a chithokomiro.
Maganizo a Amagwedologist pa Chithokomiro Chodabwitsa
Pamwamba pa Endocrine Today blog, endocrinologist ndi osteopath Thomas Chakudya, DO, FACP, FACE, CDE, anachita gawo limodzi magawo atatu "Chithokomiro lotchulidwa mu kayendetsedwe ka hypothyroidism," malinga ndi momwe iye amavomereza.
- Chithokomiro chowonetsedwa mu Management of Hypothyroidism-Gawo I
- Chithokomiro chodziwika bwino mu Management of Hypothyroidism-Gawo II
- Chithokomiro chodziwika bwino mu Management of Hypothyroidism-Gawo III
Ndiko kusanthula kosangalatsa chifukwa kumapereka ndondomeko yowonekera bwino momwe ambiri omwe amachitira zinthu zakale amatha kuona zachilengedwe zowononga mankhwala a chithokomiro, ndipo chifukwa chake anthu ammudzi amatsutsana kwambiri ndi kugwiritsa ntchito mankhwalawa. (Izi zikufanizitsa ndi ma MDS onse, omwe amagwirizana nawo, omwe nthawi zambiri amasankha kugwiritsa ntchito chithokomiro chifukwa amapeza kuti zimakhala bwino kwa odwala awo ena.)
Dr. Repas akuyamba kunena kuti iye, monga anzako mu matenda otchedwa endocrinology, sagwiritsa ntchito chithokomiro choyeretsedwa, chifukwa, "Ndikhulupirira kuti chithokomiro chochotsedwa ndi mankhwala osagwiritsidwa ntchito nthawi zonse ndipo sayenera kugwiritsidwa ntchito."
Amanenanso kuti opeminologists sagwiritsira ntchito zida chifukwa cha "kusiyana kosavomerezeka kwa batch, ndipo nthawi zambiri zimakhala zosavomerezeka m'matomu otulutsa chithokomiro." Pozindikira kuti levothyroxine imakhalanso ndi kusiyana kwa mtundu wa brand mpaka mtundu, iye anati, "ngati tiona kusiyana kwakukulu pakati pa mankhwala a levothyroxine kukhala ofunika kwambiri, ndiye kuti kusiyana kwakukulu pakati pa chithandizo cha chithokomiro sikuvomerezeka."
Mu gawo lachitatu, Dr. Repas akunena kuti ngakhale kuti anthu ambiri sangafune "kuwongolera katswiri wamaganizo momwe angayambitsire matenda a mtima panthawi ya kumangidwa kwa mtima ... mwinamwake anthu ololera sangazengereze 'kundiphunzitsa' za chithokomiro." Iye akutsutsa kuti chilakolako chofuna kumvedwa ndi chidwi ndi njira zachilengedwe zimayendetsa chidwi cha chithokomiro chodziwika bwino.
Dr. Repas akunena kuti kutsutsa kwake kwa chilengedwe chongopeka kumachokera mu sayansi, koma iye akugwira. Dr. Repas sakunena kuti palibe kawiri kawiri khungu, kafukufuku wamaphunziro, kawiri-khungu komwe amafanizira levothyroxine kuti apange chithokomiro mothandizira kuthetsa zizindikiro za mliri.
Ndipotu, Dr. Repas mwiniwake akuvomereza, mu gawo la ndemanga la Gawo I:
Kwa kafukufuku wanga, nkhaŵa yanga yaikulu yokhudzana ndi chithokomiro (kapena levothyroxine kapena T3) ndi pamene adayankhula m'njira yomwe imatulutsa hyperthyroidism yanthaŵi yaitali. Ngati wodwala alibe hyperthyroid ndipo akuchita bwino pa chinthu chimodzi chotsutsana ndi wina, n'zovuta kutsutsana nazo.
Amatsirizitsanso gawo lachitatu ndi ndemanga yosamveka:
Pomaliza, sabata yatha ndinamuwona mkazi yemwe wakhala akudwala chithokomiro kwa zaka zambiri. Ndinafotokozera kuti tsopano timakonda levothyroxine mmalo mwa chithokomiro. Ndinayambanso kunena kuti hormone yake yotulutsa chithokomiro yakhala yabwino, pakati pa 0.7 mIU / L ndi 1.0 mIU / L pazaka zingapo zapitazo. Iye analibe zizindikiro; Zinali zovuta kuti ndikhale wotsutsa. Atatha kukambirana ndi kumufunsa chimene akufuna kuchita, anasiya ofesi yanga akadakali ndi chithokomiro.
Pamene nkhaniyi idasindikizidwa poyamba, panali ndemanga zambiri zomwe odwala omwe adawakwiyira. Dokotala Repas akuyesera kufotokozera chifukwa chake samakhulupirira zida zankhondo, kutchula kuti sizomwe zasayansi komanso kunena kuti mafanizi ake ali nawo "kuganiza zamatsenga." Koma Dr. Repas sanapereke umboni wa sayansi kuti athandizire zomwe adanena, ndipo adanyalanyaza zochitika zenizeni zokhudzana ndi chithandizo cha athropiya ndi mazana ambiri.
Panthawi imodzimodziyo, Dr. Repas akuvomerezanso, mwachindunji, kuti chidwi chake chachikulu ndichokudwalitsa wodwala kuti asamangidwe ndi mankhwala enaake a chithokomiro, osati chithokomiro chokha. Ndipo amavomereza kuti ngati wodwala angathe kuyang'aniridwa bwino pa chithokomiro, ndiye kuti sawona chifukwa chokhalira "kutsutsana ndi kupambana."
Dr. Repas sudzayambitsa odwala atsopano pa chithokomiro chochitidwa-ngakhale atapempha. Ngati wodwalayo ali ndi levothyroxine sakumva bwino akupempha kuti atsegule ku chithokomiro, sangachite. Koma ngati wodwalayo ali kale ndipo akuchita bwino, akunena kuti "satsutsana ndi kupambana" ndipo apitiriza kupereka chithokomiro chodziwika kwa iye.
Mwa njira zina, Dr. Repas ali ndi malingaliro otseguka kuposa ena okhulupirira zachipatala. Pali ena omwe sangakhale ndi odwala aliwonse pa mankhwala a T3 kapena chithokomiro chodziwika bwino. Ena amawotcha odwala awo omwe amaumirira mankhwala a chithokomiro, kapena omwe sangatsatire malangizo. Koma Dr. Repas akuwonetseranso bwino momwe timaonera pakati pa anthu odwala matendawa. Cholinga chawo chachikulu ndi "TSH yachibadwa" -ndipo cholinga chawo cha mankhwala ndikutenga odwala kukhala osiyana. Kusintha kwa chizindikiritso kumawoneka kuti sikukuthandizani ndipo kumatenga mpando wobwerera kwa oyang'anira magulu a TSH.
Mawu ochokera
Ngati mukuchiritsidwa ndi hypothyroidism ndi Synthroid kapena levothyroxine nokha ndipo muli ndi zizindikiro za chithokomiro chokhazikika, kambiranani ndi dokotala kuti mungathe kuyesa chithokomiro chodziwika bwino.
Ngati dokotala wanu sakanafuna kusangalala ndi njirayi popanda kukupatsani chifukwa chabwino kwambiri cha thanzi lanu, zingakhale zothandiza kwambiri kufunafuna lingaliro lina kuchokera kwa dokotala wina - makamaka dokotala wothandizira kapena wodalirika wokhala ndi ufulu wambiri Njira zothandizira mankhwala a chithokomiro-motsutsana ndi katswiri wa sayansi yamakono.
> Zotsatira:
> Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. WLL / Wolters Kluwer; 2012.
> Garber, J, Cobin, R, Gharib, H, et. al. Malangizo Okhudza Zipatala za Hypothyroidism M'zochitika Zakale: Ambiri amathandizidwa ndi American Association of Clinical Endocrinologists ndi American Thyroid Association. " Chitetezo cha Endocrine. Mph. 18 No. 6 Novemba / December 2012.
> Zakudya, T. DO, FACP, FACE, CDE. "Chithokomiro chodziwika bwino poyang'anira hypothyroidism: Mbali I, II, III." Endocrine Masiku ano. January 2009. Online