T4T3 chifukwa cha Kutaya Kwambiri? Kafukufuku Wowonetsera Combo Therapy Zothandiza
Anthu ambiri amadziwa kuti odwala, omwe ali ndi matenda a hypothyroidism , adzapitirizabe kukhala ndi zodandaula zosiyanasiyana, ngakhale kuti mankhwalawa ndi a levothyroxine omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda (TSH).
Kafukufuku wina anapeza kuti, poyerekeza ndi maulamuliro, oposa 13% sanakhutsidwe ndi thanzi lawo, kusonyeza kusakhutira ndi mankhwala awo.
Madandaulo oyambirira anali kutopa, phindu lolemera , thupi lapweteka / ululu, ndi kupweteka.
Malingana ndi Dr. Bente Appelhof, MD, wa ku yunivesite ya Amsterdam ku Netherlands ndi anzake: "Mtsutso umatsalira za kufunika kokhala pamodzi ndi LT4 ndi LT3, poyerekeza ndi LT4 yokha, ku hypothyroidism. lingaliro lakuti chiŵerengero chokwanira cha odwala omwe ali ndi hypothyroidism amakhalabe ndi zodandaula zaumoyo, ngakhale mankhwala othandizidwa ndi levothyroxine ndi normalization ya TSH ya seramu [mahomoni otulutsa timadzi timatenda]. "
Maphunziro ena a zinyama asonyeza kuti mankhwala othandizira mankhwalawa ndi levothyroxine (LT4) okha saonetsetsa kuti euthyroidism - miyezo yambiri ya chithokomiro - m'magulu onse. M'malo mwake, euthyroidism ikhoza kupezeka pokhapokha mutagwiridwa ndi LT4 ndi liothyronine (LT3). Kafukufuku wosiyanasiyana adayang'ana pa nkhani iyi, ndikuyang'ana ngati mankhwala a LT4 sangakhale okwanira kubwezeretsa euthyroidism m'matumba a anthu.
Pamene odwala nthawi zonse amafotokoza zomwe amakonda pa maphunziro omwe aphatikizidwa, ofufuza sadatha kuthetsa chinthu china chomwe chingawonongeke.
Tsopano, ofufuza apeza chinthu chimodzi chimene chikuwoneka chikugwirizana ndi mankhwala othandizira - kutaya thupi.
Kafukufuku wofalitsidwa mu Journal of Clinical Endocrinology ndi Metabolism anafotokoza za kafukufuku amene anapeza kuti odwala ankakonda chithandizo cha chithokomiro chomwe chinaphatikizapo levothyroxine (T4) ndi T3, osati mankhwala omwe amagwiritsidwa ntchito masiku onse a levothyroxine (T4). ndi kulemera kwake.
Chiyeso chachikulu chachipatalachi chinatsimikizira zomwe zafukufuku wa Bunevicius, zofalitsidwa ku New England Journal of Medicine, zomwe zinapeza zotsatira zopindulitsa zothandizira T4 / T3 mankhwala a hypothyroidism.
Kuyesedwa kwachiwiri, kowoneka bwino, koyendetsa kachipatala kunayang'anitsitsa odwala 141 omwe ali ndi autoimmune hypothyroidism, omwe anaphwanyidwa m'magulu omwe anachitidwa ndi T4 / T3 mu chiŵerengero cha 5: 1, 10: 1, komanso gulu lomwe linapitiliza ndi mankhwala awo oyamba a T4 okha. Pambuyo pa masabata khumi ndi awiri, phunziroli linasonyeza bwino lomwe mbali ya odwala chifukwa cha mankhwala ophatikizana, makamaka mankhwalawa 5: 1 omwe ali ndi mlingo wapamwamba wa T3, pokhapokha chithandizo cha T4 okha.
Zina mwazomwe zapeza chidwi:
- Kutsika kwa kulemera kwa thupi - koma kuchepa kwa seramu TSH - kunagwirizanitsidwa ndi kukhutira kwakukulu ndi mankhwala ophunzirira.
- Mu magulu onse awiriwa, kuchepa kwachulukidwe, kotchulidwa kwambiri mu gulu la chiŵerengero cha 5: 1, amene anali ndi kuchepa kutanthauza 1.7 kg, kapena 3.75 mapaundi. Gulu la 10: 1 linali ndi kulemera kwa piritsi imodzi. Gulu la T4-lokha linalibe kusintha kwa kulemera kwake.
- Mwa odwala omwe ankakonda kuphatikiza mankhwala, 44% anali ndi TSH ya seramu yosakwana 0.11.
- Kusintha kosasinthasintha m'malingaliro, kutopa, ubwino, ndi ntchito zokhudzana ndi ubongo sizikanakhoza kudziwika kuti zifotokoze zomwe wodwala amakonda pazowonongeka.
Cholakwika chimodzi chofunika pa phunziroli chinali chakuti odwala ena omwe amalandira mankhwala ophatikizana anali kulandira mankhwala osokoneza bongo, omwe amaonedwa kuti ndi operewera kwambiri. Iwo anali ndi vidiyo TSH pansi pa zofanana, ndipo kotero zikanatengedwa ngati hyperthyroid.
"Odwala amasankha mankhwala othandizira odwala LT4 / LT3 kukhala opaleshoni ya LT4, koma kusintha kwa maganizo, kutopa, ubwino, ndi ntchito zogwira mtima sizikanakhoza kufotokoza momveka bwino chifukwa chake zotsatira zake zinali zothandizira kulumikizana kwa LT4 / LT3," olemba alemba. "Kuchepetsa kulemera kwa thupi kunkagwirizana ndi kukhutira ndi mankhwala ophunzirira."
Ngakhale olemba maphunziro sankakhoza kupeza chifukwa chilichonse cholingalira chothandizira mankhwala othandizira, iwo anatsimikiza kuti: "Komabe, zotsatira za phunziro ili sizitsutsa kuti mwina gulu lina la odwala lingapindule ndi mankhwala okhudzana ndi LT4 / LT3."
Zotsatira:
Appelhof BC, ndi. al. "Kuphatikizidwa ndi levothyroxine ndi liothyronine m'magwiridwe awiri, poyerekezera ndi levothyroxine monotherapy pachiyambi hypothyroidism: kuyesa kachipatala kamodzi khungu, kodziŵika bwino."
Saravanan et. al. Kukhala ndi maganizo abwino kwa odwala omwe ali ndi 'okwanira' mlingo wa thyroxine: Clin Endocrinol (Oxf) 57: 577-585)