Pamene hypothyroidism ikutsatira chithokomiro kapena katemera wothandizira ma ARV (RAI), kapena ngati mutapezeka kuti muli ndi chithokomiro chopanda mphamvu chifukwa cha Hashimoto's thyroiditis, pali mafunso ambiri ofunika kufunsa dokotala wanu. Nazi asanu ndi limodzi mwa ofunika kwambiri ndi ofunikira.
1. Kodi ndi ma ARV otani omwe amachititsa kuti tizilombo toyambitsa matenda (TSH) mu labata yanu?
Mayeso a TSH ndi mayeso omwe amagwiritsidwa ntchito kwambiri kuti azindikire ndi kusamalira hypothyroidism ku United States.
Koma mabala osiyanasiyana nthawi zambiri amakhala ndi mfundo zosiyana ndi zomwe zimatchedwa "TSH reference range." Izi ndizoyeso zamtengo wapatali zomwe zimayesedwa kuti zikuwonetsera chiwerengero cha anthu.
Pa mabala ambiri, bukhuli la TSH limayenda kuyambira 0.5 mpaka 4.5. Mtengo wa TSH wosachepera 0.5 umatengedwa ngati hyperthyroid ( chithokomiro chopitirira muyeso ), pamene mtengo wa TSH wa zoposa 4.5 umatengedwa kukhala hypothyroid (chithokomiro chopanda mphamvu). Mabala osiyanasiyana angagwiritse ntchito malire amtundu uliwonse kuchokera ku 0.35 mpaka 0.6, ndi kumtunda kwina kulikonse kuyambira 4.0 mpaka 6.0. Mulimonsemo, nkofunika kuti muzindikire za zolembera pa labbu kumene magazi anu akutumizidwira, kotero mumadziwa zomwe mukuzipeza.
ZOYENERA: Kuchokera kumapeto kwa 2002, American Association of Clinical Endocrinologists (AACE) ndi magulu ena ogwira ntchito akhala akubwereza potsata ndondomeko kuti achepetse mtundu wa TSH, choncho 0,3 mpaka 3.0.
Koma madokotala sagwirizana. Kotero madotolo ena amalingalira zochitika pansipa .3 ndi pamwamba pa 3.0 ngati umboni wa vuto la chithokomiro. Ena akupitiriza kugwiritsa ntchito miyezo yakale, yomwe ikupitirizabe kugwira ntchito m'malabu ambiri.
2. Ndi chikhalidwe chiti cha TSH chomwe mungachigwiritse ntchito ngati chandichitikira?
Ili ndi funso lolemetsa koma lofunika.
Yankho la dokotala lanu lidzamuululira iye kapena malingaliro ake pa zomwe zimaimira "chikhalidwe" cha TSH. Madokotala ena amakhulupirira kuti kupeza wodwalayo kumtundu wapamwamba kwambiri ndi cholinga cha mankhwala a hypothyroidism . Mwachitsanzo, pogwiritsa ntchito 4.5 TSH, madokotala ena amakhulupirira kuti kuika mankhwala a chithokomiro m'malo mwa mankhwalawa kuti athandizidwe ndi TSH pansi pa 4.5 (mwina mpaka kufika 4.4). Madokotala ena amawona kuti m'munsimu 10.0 ndi "subclinical hypothyroidism" ndipo musati mutenge mankhwala oyenera.
Madokotala amasiyana m'lingaliro la TSH m'maganizo omwe amakhulupirira kuti amapanga zolinga zabwino. Mwachitsanzo, akatswiri ena amatha kukhala ndi chiwerengero cha TSH pakati pa 1.0 ndi 2.0 pogwiritsa ntchito zochitika zawo zomwe zimasonyeza kuti odwala angamve bwino pamagulu awa.
Madokotala ena amatsata ndondomeko zomwe takambirana kale, ndipo amakhulupirira kuti chithandizo cha mankhwala a chithokomiro chotsitsimutsa chithokomiro chiyenera kulumikiza TSH mlingo wosaposa 3.0 mu odwala hypothyroid .
3. Ndi mankhwala ati omwe mukuwafotokozera?
Popeza simungathe kuwerenga lembalo, muyenera kufunsa! Funso ili ndilo ngati dokotala wanu amasankha dzina la mankhwala kapena mankhwala ochiritsira.
Ngati dzina lanu likuyankhidwa, mungafune kudziwa ngati dokotala wanu akunena kuti "palibe choyimira" kapena "kugawanika monga malemba (DAW)." Ku United States, mankhwala otchedwa hormone a mankhwala a chithokomiro amatengera:
- Levothyroxine (synthetic thyroxine / T4): Synthroid, Levoxyl, Tirosint, Unithroid, kapena generic
- Liothyronine (synthetic triiodothyronine / T3): Cytomel, kapena generic
- Chithokomiro chachilengedwe chodziwika: Zida, Chilengedwe, Chithokomiro WP, kapena NP yachithokomiro
Odwala ambiri amapatsidwa levothyroxine. Akatswiri a chithokomiro akhala akuchenjeza odwala za levothyroxine . Chifukwa cha kusinthika pakati pa mankhwala a mankhwala ndi ma generics komanso zomwe odwala angalandire malonda osiyana akamalemba, ATA ndi AACE adalangiza kuti madokotala ayenera -
1) Odziwitsa odwala kuti mavitamini awo a levothyroxine asinthidwe pa mankhwala
2) Limbikitsani odwala kuti apitirize kukonzekera levothyroxine pomwe angathe
3) Onetsetsani kuti odwala amamvetsa ngati akulandira kukonzekera kwa levothyroxine kuti athe kubwereza ma ARV (stimulating hormone) (TSH).
4. Kodi tingayembekezere mwamsanga bwanji mpumulo wa zizindikiro, ndi kukhathamiritsa mayeso a magazi a chithokomiro, kupatsidwa mlingo woyenera?
Funso lofunika kwambiri apa ndilo ngati dokotala akukupatsani chiwerengero cha chithokomiro chaching'ono ndipo akukonzekera kusintha ndondomeko yanu pang'onopang'ono, kapena ngati akuyesera kukuyenderani mofulumira momwe mungathere. Pali zifukwa zomveka zoyendetsera njira ziwirizi, koma monga wodwalayo ndikofunika kudziwa zomwe mungayembekezere.
Madokotala ena akhoza kukupatsani mlingo wotsika kwambiri ndikukuuzani kuti mumakhala bwino mu masabata awiri. Ngati pakatha milungu iwiri ndikupita ndipo simukumverera bwino, mukhoza kuganiza kuti mankhwalawa sakugwira ntchito. Koma mankhwala amatha kutenga nthawi ndithu kuti agwire ntchito.
Ngati ndinu wamkulu, kapena ngati muli ndi mbiri ya mavuto a mtima, madokotala amayamba kukuyambitsani mankhwala otsika kwambiri a ma chithokomiro kuti muzindikire yankho lanu komanso kuti musawononge vuto lanu la mtima.
5. Kodi ndi nthawi zingati zomwe mumayesa kuyesa chithokomiro mpaka titabwerere mmbuyo mndandanda wa zolembera ndi zabwino?
Momwemo, dokotala wanu akhala pamwamba pa kukufikitsani inu mwapadera. Nthawi zambiri, izi zikutanthawuza kukuwonani masabata asanu ndi limodzi kapena asanu ndi atatu kuti muyesedwe magazi ndikutsatila kusintha kwa mlingo wanu mpaka mutakhala bwino komanso m'magulu anu ali abwino.
6. Nditakhala ndi mulingo woyenera, ndifupipafupi mumati ndikubwereranso kuti ndikayesedwe magazi kuti nditsimikizire kuti zosowa zanga sizinasinthe?
Ngati dokotala akukuuzani kuti simukuyenera kubwera kamodzi pachaka, ndi nthawi yoti muyambe kudzifunsa ngati mukuwona dokotala woyenera. Akatswiri ambiri amalimbikitsa kuti odwala ayesedwe kamodzi pa miyezi sikisi iliyonse chaka choyamba kapena ziwiri, kenako kamodzi pachaka pambuyo pake.
Mawu Ochokera
Pali funso limodzi lofunikanso kufunsa: "Ngati ndili ndi mafunso pakati pa osankhidwa, ndingatani kuti ndiyankhule ndi inu? Kodi mumabwereranso nokha, kapena kodi anamwino anu akubwezerani mafoni? ndi odwala? "
Funsoli lidzakuthandizani kudziwa momwe dokotala wanu akufunira kukhalira. Ngati muli ndi mwayi wofufuza dokotala wina, yankho la dokotala wanu ku funso limeneli lingakuthandizeni kusankha chomwe mungachite. Madokotala ena amabwereranso okha ndipo adzayankha imelo. Ena amasankha kufotokoza mafunso onse kwa anamwino (omwe angapereke uthenga wabwino kapena wabwino). Koma ngati mukufuna munthu wokhazikika, kugwira ntchito, mvetserani mwatsatanetsatane zomwe dokotala wanu akunena apa. Mudzapeza lingaliro la zomwe muyenera kuyembekezera.
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.