Maphunziro a NIH Othandiza Pogwiritsira Ntchito Hormone Chifukwa cha Matenda Okalamba
Pamene amuna amakula, ma testosterone m'magazi awo amasiya. Kugwa kwa testosterone kwadodometsedwa kutsogolera ku zinthu zosiyanasiyana, monga kuchepa kwa ntchito yogonana, kuperewera kwa magazi, ndi kupuma kwa mafupa.
Testosterone supplementation amagwiritsidwa ntchito ndi madokotala ena kuthandiza ndi nkhani zoterezi. M'zaka zaposachedwapa, chidwi chawonjezeka cha testosterone supplementation mwa amuna akuluakulu.
Komabe, kufufuza kwakukulu kwa nthawi yaitali sikunayambe kuchitidwa kuti aone ngati mankhwala a testosterone amathandiziradi ndi zikhalidwe zoterezi.
Mu 2003, bungwe la Institute of Medicine linanena kuti panalibe umboni wokwanira wothandizira kupindula kwa testosterone mwa amuna achikulire ndipo analimbikitsa kufufuza kwina. Chifukwa chaichi, mu 2010, National Institute of Aging, yomwe ili mbali ya NIH, inayambitsa Testosterone Mayesero (T Mayesero) kuti aone ngati testosterone ingathandize ndi zizindikiro zochepa za testosterone yachiwiri ndi zaka zakubadwa (ie, symptomatic hypogonadism ).
Mayesero a T adzakhala ngati chithunzithunzi cha mayesero aakulu komanso okhwima m'tsogolomu. Zotsatira zambiri za mayesero a T zilipo tsopano ndipo zotsatira zake zonse zinasakanizidwa, ndipo m'malo mwa testosterone mumakhala ndi zotsatira zina komanso zoopsa zina. Kafufuzidwe kafukufuku amafunika kuchitidwa kuti apeze momwe angapindulitsire ndi zoopsa zomwe zingakhalepo komanso chithandizo choyenera cha mankhwala a testosterone.
Zoyesera Zowona
Mayesero a T ali ndi mayesero asanu ndi awiri omwe amapezeka m'madera 12 kuzungulira dziko. Pafupipafupi, amuna 790 a zaka 65 kapena kuposera omwe ali ndi matenda otsika a testosterone ndi zizindikiro zogwirizana nawo. Choyamba, ophunzira adayenera kuyesedwa ku mayesero atatu akuluakulu: Kuyezetsa Mchitidwe Wogonana, Kuyezetsa Thupi, kapena Kuyesedwa kwachilengedwe.
Kenaka, ophunzira angathe kutenga nawo mbali pa mayesero ena omwe iwo akuyenerera.
Zowonjezereka, ophunzira adayenera kudandaula za kusokonezeka kwa kugonana, kutayika thupi, kapena kuchepetsa mphamvu kuti poyamba ayambe kuyesedwa mu mayesero a T. Kuwonjezera apo, anthu omwe adagwira nawo ntchito anali osasamala omwe anali ndi zikhalidwe zina, monga kansa ya prostate, mavuto a mtima, mavuto a impso, ndi zina zotero.
M'mayesero onse, ophunzira adapatsidwa mwayi wopita ku gulu la experimental kapena placebo. Amuna mu gulu la kuyesera ankagwiritsa ntchito gel testosterone tsiku ndi tsiku (AndroGel) kwa miyezi 12; pamene gulu la placebo linalandira geliti ya placebo (popanda testosterone). Ophunzirawo anayesedwa nthawi zonse.
Chofunika kwambiri, mayeserowa anachititsidwa khungu kawiri, kutanthauza kuti ochita kafukufuku ndi ophunzira sanadziwe kuti gel anaperekedwa.
Ntchito Yogonana, Kugwira Ntchito, ndi Kuyesedwa
Zotsatira za mayesero atatu oyambirira zinafotokozedwa mu February 2016 mu New England Journal of Medicine .
Kuwongolera mu Ntchito Yogonana Kuyesera kuti ophunzira athe kuchepetsedwa ndi libido limodzi ndi wogonana naye wokonzeka kuchita zogonana kawiri pa mwezi.
Kuyikidwa mu Ntchito Yogwiritsa Ntchito Thupi limafunikanso kuti ophunzira athe kuyenda mofulumira, kuyenda movutikira, komanso kuvutika kukwera masitepe.
Amuna omwe sakanatha kuyenda, anali ndi nyamakazi yambiri, kapena anali ndi matenda aakulu a neuromuscular.
Kuphatikizidwa mu Kuyesedwa kwachidziwitso kumafuna kuti ophunzira akhale ndi mphamvu zochepa komanso kutopa.
Kukula msinkhu wa testosterone kuchokera kumunsi kupita kuntchito yabwino yogonana ikugwira ntchito modzichepetsa (mwachitsanzo, kugonana, chilakolako chogonana, ndi erectile function) komanso maganizo ndi zizindikiro zowawa. Komabe, testosterone supplementation sizinapangitse kuyenda kuyenda kapena mphamvu.
Zonsezi, ochita kafukufuku akuwonetsa kuti panalibe anthu okwanira omwe angatenge mfundo zenizeni m'mayesero atatu awa.
Mayendedwe a kuchepa kwa magazi
Mu February 2017, zotsatira za Mlandu wa Anemia zinasindikizidwa.
Matenda a m'mimba ndi osowa maselo ofiira a magazi kapena hemoglobin m'magazi. Pa theka la amuna achikulire omwe ali ndi magazi m'thupi, asing'anga sangathe kukhazikitsa chifukwa.
Ndi nthenda yotaya magazi, thupi silandira magazi okwanira okosijeni, omwe amapangidwa ndi hemoglobin yomwe ili m'maselo ofiira a magazi. Anemia akhoza kukhala wofatsa kapena wovuta. Anthu omwe ali ndi vuto la kuchepa kwa magazi amatha kufooka kapena kutopa. Zizindikiro zina zikuphatikizapo chizungulire, kupuma pang'ono, kapena kupweteka mutu.
Kuperewera kwa magazi kwa nthawi yaitali kungawononge mtima, ubongo, ndi ziwalo zina. Nthaŵi zina, kuchepa kwa magazi m'thupi kumabweretsa imfa.
Chiyeso cha Anemia chinachitidwa kuti aone ngati amuna akulu omwe ali ndi ziwerengero zosadziwika za kuchepa kwa magazi m'thupi ndi testosterone angapite patsogolo m'magulu awo a hemoglobin.
Zotsatira za mayesero a zachipatala zinasonyeza kuti panali kuwonjezeka kwakukulu kwa hemoglobin mwa amuna onse omwe ali ndi magazi osadziwika komanso amuna omwe ali ndi vuto la kuchepa kwa magazi omwe amapezeka chifukwa cha gelisi la testosterone. Zotsatirazi zingakhale za mtengo wapatali, ndipo mankhwala a testosterone angagwiritsidwe ntchito popititsa patsogolo ma hemoglobin mwa amuna oposa 65 omwe ali ndi matenda ochepetsa magazi m'thupi komanso otsika kwambiri a testosterone. Komabe, kufufuza kwina kuyenera kuchitidwa.
Kuyesedwa kwa mafupa
Mu February 2017, zotsatira za Bone Trial zinafalitsidwa.
Amuna akamakula, amangocheperachepera m'magulu a testosterone komanso amachepetsanso mitsempha ya mafupa, fupa la fupa, ndi mphamvu ya fupa komanso kuwonjezeka kwa mafupa.
Kafukufuku asanakhalepo wonena za zotsatira za testosterone pa fupa akhala osadziwika. Ndi kafukufuku wa mafupa, ofufuza anayesera kuti azindikire ngati kuchulukana kwa mafupa kunakula pambuyo pa mankhwala a testosterone mwa amuna achikulire omwe ali ndi ma tepi otsika a testosterone.
Kulemera kwa mafupa kunayesedwa pogwiritsa ntchito mphamvu zamagetsi x-ray absorptiometry (DEXA), ndipo mphamvu ya fupa inayesedwa pogwiritsa ntchito computed tomography (CT).
CT ndi njira yojambula yomwe amagwiritsira ntchito x-ray kuti azijambula zithunzi za thupi. DEXA akuyesa kugwiritsa ntchito mlingo wazing'ono x-ray kuti aunike fupa la mchere ndi kuwerengetsa zinthu. Mwa kuyankhula kwina, DEXA amayeza momwe calcium ndi miyala ina ilili pfupa.
Kuwonjezera pa mavitamini D owonjezera-on-counter ndi calcium supplements, amuna omwe amamwa mankhwala okhudza mafupa sanachoke pa phunzirolo. Kuonjezera apo, amuna omwe ali ndi zochepa za DEXA sanachoke ku phunziroli.
Ofufuzawa anapeza kuti amuna omwe analandira chithandizo cha mahomoni anawonjezereka m'mphamvu ndi fupa. Mphamvu zowonjezera zinali zazikulu mu msana kuposa momwe zinaliri m'chiuno. Komabe, mofanana ndi mayesero ena a T, kufufuza kwina kumafunika kuchitidwa. Kuphunzira kwakukulu kwa zaka zambiri kuyenera kuchitidwa kuti mudziwe ngati testosterone ingachepetse chiopsezo cha kupasuka kwa fupa.
Chidziwitso cha Ntchito Yoganizira
Mu February 2017, zotsatira za Zoganizira za Ntchito Yoganizira zinasindikizidwa.
Malingana ndi Kugonjetsa ndi olemba ena a phunziroli:
Kukalamba kumagwirizana ndi kuchepa kwa ntchito zina zomvetsetsa, kuphatikizapo kukumbukira mawu ndi maonekedwe, ntchito yowonjezera, komanso luso la malo. Kukalamba kwa amuna kumathandizanso kuchepetsa testosterone ya serum, kuwonetsetsa kuti kuchepa kwa testosterone kusakanikirana kungawononge kuchepa kwa chidziwitso cha zaka.
Mu phunziro ili, amuna achikulire omwe ali ndi testosterone otsika komanso kuwonongeka kwa kukumbukira zaka amapatsidwa testosterone. Kukhumudwa kukumbukira zaka zakale kunatanthauzidwa ndi zodandaula za kukumbukira komanso kusokonekera kwa mayesero a mawu ndi mawu oyenera kukumbukira.
Phunziroli silinasonyeze kuti chithandizo cha testosterone chinathandizira kuchepa kwa kukumbukira zakale.
Mayendedwe a Mtima
Maphunziro okhudza zotsatira za testosterone pa zotsatira za mtima zimatsutsana. Matenda a mtima adapangidwa kuti atsimikizire ngati testosterone supplementation mwa amuna achikulire omwe ali ndi masewera otsika a testosterone angachepetse chitukuko cha voleti yamadzimadzi yosakanikirana.
Chombo chosakanikirana ndi mitsempha yamagetsi yakhala ikugwirizanitsidwa ndi matenda a mtima ndi mavuto amtima amtsogolo. Amayesedwa pogwiritsa ntchito chiwerengero chodziwika bwino cha ma chithunzi, zomwe zimayesedwa.
Ofufuzawa anapeza kuti mwa amuna omwe amatenga gelulo testosterone, pankakhala kuwonjezeka kwakukulu kwazomwe sizinatchulidwepo. Izi zikupeza chifukwa chakuti kuwonjezeka kwa chivomezi chocheperachepera kumachepetsanso magazi a mitsempha ya magazi, yomwe ingakhale yovulaza. Mitsempha ya Coronary imapereka mtima ndi magazi.
Apanso, monga ndi mayesero ena a T, kufufuza kwina kumafunika kuti tipeze tanthauzo lenileni la phunziro ili.
Pansi
Zotsatira za maphunzirowa zikusonyeza kuti mankhwala a testosterone mwa amuna akuluakulu omwe ali ndi testosterone otsika angapindule nawo. Komabe, mankhwala a testosterone angapangitsenso ngozi. Zovuta zogulitsa sizidziwika. Phunziro lalikulu ndi lalitali liyenera kuchitidwa kuti lifotokoze zotsatira za testosterone pa thanzi labwino, fupa la fupa, kulemala, ndi zina.
Ngati ndinu okalamba omwe muli ndi testosterone ndipo mukufunitsitsa kutenga testosterone, chisankho ichi chiyenera kusamalidwa bwino ndi dokotala wanu. Dokotala wanu adzatha kuyesa bwino momwe mungakhalire komanso ngati malo ogwiritsira ntchito mahomoni angakuike pamsangamsanga. Ndi lingaliro loipa kuti wina aliyense azitha kuwonjezera ma hormone supplementation popanda kuyang'aniridwa ndi dokotala. Chifukwa chakuti mahomoni amapezeka mwachibadwa m'thupi sakutanthauza kuti akhoza kutengedwa popanda zotsatira zoipa.
Pomaliza ndi muyeso wabwino, taganizirani malangizo awa okhudzana ndi mayesero a N:
Chifukwa chakuti mayesero a T amayendetsedwa ndi amuna akulu omwe alibe chifukwa chochepa cha testosterone kupatula kukalamba, zotsatirazi sizikugwira ntchito kwa amuna omwe ali ndi mavitamini otsika chifukwa cha zifukwa zina osati ukalamba. Mwamuna aliyense woganizira za mankhwala a hormone ayenera kukambirana za zovuta ndi zopindulitsa zomwe zimakhalapo ndi wothandizira zaumoyo.
> Zotsatira:
> Budoff, MJ, et al. Testosterone Treatment and Coronary Artery Plaque Buku la Amuna Achikulire Ndi Testosterone Wamtsika. JAMA. 2017; 317 (7): 708-716.
> Wodwala, SM, ndi al. Chithandizo cha Testosterone ndi Ntchito Yodziwa Zinthu Mwa Amuna Okalamba Ndi Testosterone Yochepa Ndiponso Kulimbana Kwambiri Kwa Zaka. JAMA. 2017; 317 (7): 717-727.
> Roy, CN, ndi al. Mgwirizano wa Testosterone Maseŵera ndi Anemia mwa Amuna Okalamba. JAMA Internal Medicine. February 21, 2017 (e-pub).
> Snyder, PJ, ndi al. Zotsatira za Chithandizo cha Testosterone pa Kuthamanga Kwambiri kwa Mnofu wa Mnofu ndi Mphamvu kwa Amuna Okalamba Ndi Ochepetsa Testosterone. JAMA Internal Medicine. February 21, 2017 (e-pub).
> Snyder, PJ, ndi al. Zotsatira za Chithandizo cha Testosterone mwa Amuna Okalamba. New England Journal of Medicine. 374 (7): 611-624.