Kufunsana ndi Elizabetha "Lily" Conrad, MD
Elizabeth Conrad, MD - wodziwika kwa odwala ake monga "Dr. Lily" - ndi dokotala wothandizira ku McLean, Virginia. Dr. Lily ali wotsatira wodzipereka odwala omwe amamuwona chifukwa cha kusamvana kwa chithokomiro ndi mahomoni. Iye anavomera kufotokozera maganizo ake ponena za momwe angayankhire ndi kupeza odwala mu zokambirana za Q & A.
Mary Shomon: Kodi munayambira ndi cholinga chokhala ndi mankhwala ochiritsira / achikhalidwe ndi kusinthana kuti mugwirizanitse / mwakukhalapo, kapena munayamba mukuganiza kuti mukugwirizana nawo?
Nchiyani chakulimbikitsani kapena chakulimbikitsani?
Dr. Lily: Ndakhala ndikudziwa kuti ndidzakhala dokotala wothandizira. Tili ndi zochuluka kuposa zomwe tingathe kuziwona, kukhudza kapena kuyeza muyeso la labata. Zomwe tingachite kuti tikhale ndi chimwemwe ndi thanzi labwino zimakula kwambiri tikaganizira, thupi, ndi mzimu. Ndinali wodala kwambiri kuti dokotala wa opaleshoni wa ana yemwe anachititsa mafunso anga ku College University of Physicians & Surgeons ya Columbia University anali wouza mtima kwambiri ndipo anali wokhutira kumva za kuchita ndi phindu la kusinkhasinkha. Tinagwiritsa ntchito zokambirana zambiri za kupuma komanso kufanana pakati pa kusinkhasinkha ndi masewera olimbitsa thupi.
Matenda a Hormonal
Mary Shomon: Kachitidwe kanu , Kukhala Munthu-Kukhala bwino, kumagwira ntchito ndi odwala ambiri omwe ali ndi kusamvana kwa mahomoni. Kodi ndizifukwa ziti zomwe zimawonedwa ndi mahomoni?
Dr. Lily: Timawona amayi ambiri omwe ali ndi nkhawa zokhudza Premenstrual Syndrome (PMS), Polycystic Ovarian Syndrome (PCOS), hypothyroidism , nthawi yopuma, ndi kusamba .
Timaonanso odwala omwe akuganiza za mimba, amayi omwe ali ndi matenda a shuga, matenda a shuga, komanso matenda a shuga .
Mary Shomon: Mukuganiza kuti ndichifukwa chiyani ovuta ambiri omwe akuwona madokotala ochiritsidwa akupeza kuti ali ndi chithokomiro, adrenal, kapena zina zotere?
Dr. Lily: Zimatengera nthawi, zomwe zingakhale zochepa kwambiri pazowona odwala 20 kapena kuposa pamenepo tsiku. Komanso, zambiri za kusalinganizi ndizobisika ndipo sizikupezeka mosavuta pogwiritsa ntchito mayesero ofanana. Anthu akhoza kukhala ndi zokhudzana ndi thanzi labwino komanso ma labu omwe angakhale oyenera. Mwachitsanzo, mtundu wochuluka wa cortisol ndi wochuluka kwambiri, kuphatikizapo, zomwe zilizonse pa labu sizomwe zili zoyenera. Ndikofunika kukambirana ndi munthu aliyense, mu mgwirizano, ndikuyang'ana zinthu zambiri: zakudya, kuperewera kwa nkhawa, kuwonetsetsa zachilengedwe ndi zina zotero kuti zithandizire kukhala ndi thanzi labwino.
Maphunziro athu m'magulu ochiritsira amakhala ochiritsira kuchipatala komanso abwino kwambiri pofufuza ndi kuthana ndi matenda aakulu. Matenda a mtima, kupwetekedwa, ndi kupatsirana kwabwino ndizofunikira kwambiri ndi njira yachizolowezi. Madokotala ophunzitsidwa pafupipafupi amadziwa kuti njira iliyonse imakhudza ena. Mwachitsanzo, nthawi zovuta komanso zosavuta nthawi zambiri zimawongolera pamene chithokomiro chimakonzedwa bwino. Komabe, njira yowonongeka ingakhale yopanda phindu kwa matenda osadziwika omwe ali ndi matenda osagwirizana.
Mankhwala amasintha ndi kusintha. Monga madokotala, timafuna odwala athu zabwino. Madokotala ogwirizana ndi malo apadera ndi zida zina zowonetsera kusamvetsetseka kosaonekera; monga zitsamba, zakudya, ndi mankhwala okhwimitsa thupi kuti apereke chisamaliro chosamalidwa kwa wodwala aliyense.
Mankhwala akum'maŵa amaphatikizapo kufunika kwa kulingalira, ndipo izi zimaphatikizapo kuwona machiritso athu. Thupi limafanana ndi munda woti ukhale wokonzedwa, kulimbikitsa mgwirizano ndi mphamvu. Njira yowonongeka yakhala kuyang'ana matenda monga chinthu chomwe timamenyana kapena kuponderezera ndi mankhwala osokoneza bongo.
Monga ophunzira a zachipatala, nthawi zambiri sitidziwa zambiri zitsamba, zakudya zopatsa thanzi, mavitamini, ndi thupi. Mwamwayi, izi zikusintha ndipo sukulu ikuyamba kuphatikiza Kuwonjezera / Njira Zothandizira Mankhwala (CAM). Zimalimbikitsa kuona apainiya ngati Dr. Jim Gordon, a Center of Mind-Body Medicine ndi University of Georgetown ku Washington, DC, akulimbikitsa kusintha kwa chisamaliro, pamene tikuchoka pambali pa mankhwala osokoneza bongo ndi opaleshoni pachimake ndi kudzidalira komanso njira za CAM pokhapokha pokhapokha palipakati pazinthu zodziyang'anira, ndikupewa ndi kuwonetsetsa monga zofunikira ndikusowa zosowa za mankhwala ndi opaleshoni.
Zimakhala zomveka kwambiri.
Matenda a Chithokomiro
Mary Shomon: Ndi zovuta ziti ndi zochitika zomwe mukuganiziranso pofufuza mkazi kuti athane ndi vuto la chithokomiro ?
Dr. Lily: Ndili ndi chidwi ndi mbiri yake komanso zomwe akukumana nazo, ngati pali mbiri ya mavuto a chithokomiro m'banja lake. Ndidzawunika zizindikiro zina ndikuyesera thupi. Kuyesera kawirikawiri kumaphatikizapo TSH, Free T3, Free T4, Reverse T3, Matenda a Chithokomiro, anti-thyroglobulin ndi antirose peroxidase antibody. Kawirikawiri kuyesedwa kwa adrenal kumachitidwa komanso mayesero ena omwe angafunike.
Mary Shomon: The American Thyroid Association ya 2014 Hypothyroidism Guidelines amanena kuti odwala hypothyroid ayenera kulamulidwa levothyroxine, ndipo kuti kupereka T3 ndi / kapena mankhwala ochizira a chilengedwe ndi osayenera kwa madokotala. Kodi mukuganiza chiyani pa malo a ATA?
Dr. Lily: Pali kutsutsana pankhani ya kukonzekera kwa T3 .
Odwala ena amavomereza bwino T4 ndipo angathe kusintha T4 mpaka T3 popanda mavuto. Komabe, si odwala onse omwe angachite bwino izi. Ndimapeza Free T3 ndikusintha T3 kukhala ofunika kumvetsa kupanda mphamvu kwa T4 mwa odwala ena. Kafukufuku wambiri wasonyeza kuti kukhutira ndi odwala ndi T4 / T3 mankhwala othandizira . Mwamwayi, ATA akuzindikira kufunika kopitiliza kafukufuku m'dera lino. Ndine wokondwa kuti kafukufuku wamakono pa T3 Yowonjezereka akuchitidwa. Kuloledwa kochepa pang'ono kumakhala bwinoko kusiyana ndi kumasulidwa mwamsanga T3.
Mary Shomon: The American Thyroid Association ya 2014 Hypothyroidism Guidelines amati odwala hypothyroid omwe samamva bwino atapatsidwa levothyroxine ndi kubwezeretsedwa ku "euthyroid" mazinga ayenera kutumizidwa kukayezetsa magazi. Kodi mukuganiza chiyani pa malo a ATA?
Dr. Lily: Pali deta yomwe imasonyeza kuti magulu a T4 a odwala angakhale okwanira koma ma T3 nthawi zambiri amagwa pamene amapatsidwa T4 okha. Makhalidwe abwino ndi ubwino angakhudzidwe ndi kugwirizana kwa T3-serotonin.
Ndikuganiza kuti ndibwino kuti iwo awone dokotala wa banja kapena internist kuti atsimikizire kuti zonse zatsimikizidwa. Odwala omwe ali ndi zizindikiro zoyenera amayenera kufufuza bwinobwino, mwinamwake chinthu china chikuchitika ... monga matenda a Lyme kapena Lupus . Matenda ambiri angabwere ndi kutopa. Ngati pali vuto linalake limene angapindule nalo powona wodwalayo wodwalayo.
Mary Shomon: Kodi mumamva bwanji ndi odwala hypothyroid ? Kodi mukusankha chiyani kwa odwala anu: levothyroxine, T4 / T3 yokha, T3 yokha, chilengedwe chokhazikika, mankhwala owonjezera?
Dr. Lily: Ndimapereka izi pazochitika panthawiyi. Odwala amawoneka okondwa kwambiri ndi mankhwala ophatikizana komanso chilengedwe chochitidwa ndi chithokomiro bwino. Amapezekanso kudzera m'ma pharmacies ambiri.
Kusamvetseka kwa Adrenal
Mary Shomon: Pali kutsutsana kwakukulu ponena za kukhalapo kwa "kutopa kwambiri" kapena kusakwanira . Dziko lachidziwitso lachipatala limati tili ndi Cushing's Disease kapena Addison's Disease , ndipo mwinamwake, palibe mithunzi ya imvi m'ntchito ya adrenal. Kodi mukuganiza chifukwa chiyani mankhwala ochiritsira amawawona motero?
Dr. Lily: Matenda a Cushing ndi Matenda Owonjezera ndi mitundu yambiri ya cortisol yowonjezera komanso yoperewera. Ndikukhulupirira kuti kuzindikira kuti chiwerengero cha adrenal (RAI) sichikukwera. Mwachitsanzo, zimakhala zachilendo ku matenda aakulu a chiwindi. Phunziro labwino kwambiri linasindikizidwa posachedwa ku RAI kwa odwala matenda a chiwindi, (Ailment Pharmacol, Ther, 2014 Oct; 40 (7) 819-26.)
Chinthu chimodzi chomwe chimapangitsa adrenal kutayika kwambiri chovuta kuzindikira ndichoti makhalidwe abwino amakhala osiyanasiyana, mwachitsanzo, cortisol yammawa imakhala yachiwiri ya 2-20. Izi "zojambula" m'mawa mwina sizikwanira. Ndimakonda kuwerenga maulendo ambiri tsiku lonse monga kuyesedwa, Genova Adrenal test test.
Mary Shomon: Kodi mungatani kuti muzindikire ndikusamalana kwa odwala anu?
Dr. Lily: Ife timapanga mbiri yakale ndi kuyesedwa kwa thupi komwe kumagwiritsidwa ntchito ngati momwekufunikira. Odwala ambiri akhoza kukhala ndi kutsika kwa magazi, ndipo tiwunika kuyendera kwawo ndi kuthamanga kwa magazi m'malo osiyanasiyana. Kawirikawiri ndimapanga mayeso a saliva kwa cortisol yomwe imatiwerengetsa mawerengedwe tsiku lonse, DHEA-S imaphatikizidwanso mu mayeserowa. Ntchito yambiri yamagazi imaphatikizidwa kuphatikizapo mbiri yambiri yamagetsi. Timayang'ana zakudya zowonjezera monga vitamini D ndi minerals monga magnesium. Malingana ndi wodwalayo, ndikhoza kuyang'ana zifukwa zina za zizindikiro zawo. Timayamba kupanga ndondomeko yothetsera zifukwa zomwe zimayambitsa zizindikiro ngati n'kotheka. Zida zochepetsera nkhaniyi zilipo, monga njira zamaganizo ndi kugwiritsa ntchito mankhwala a adaptogenic monga Aswagandha.
Kuchepetsa Kulemera
Mary Shomon: Amayi ambiri a msinkhu wa zaka zapakati, ndi zaka zapakati ndi zam'mawa zimagonjetsedwa ndi kulemera, kapena kulemedwa. Kodi muli ndi uphungu wotani kwa amayi omwe akudya bwino ndi kuchita masewera olimbitsa thupi, koma alibe kuperewera kochepa?
Dr. Lily: Choyamba, ine ndikufuna kunena, zabwino kwa inu. Kuchita masewera olimbitsa thupi komanso kudya zakudya zabwino kumakuthandizani kuti mukhale ndi thanzi labwino komanso kukhala ndi thanzi labwino kusiyana ndi kukhala chete, osadya masamba ndi zipatso zokwanira. Kenaka, ndikufuna kuonetsetsa kuti akudya mokwanira, kumwa madzi okwanira okwanira ndikupeza mpumulo wokwanira. Kawirikawiri zimatayika chifukwa chosowa chakudya chokwanira cha mapuloteni ndi ma calories kapena kupuma mokwanira. Ngati mukukumanabe ndi vuto kuti muwone munthu yemwe angagwirizane nanu kuti akuthandizeni kudziwa komwe muli, ndikukonzekeretsani kukuthandizani komwe mukufuna. Azimayi ena akukweza cortisol pochita masewera olimbitsa thupi, pamene ena amatha kutulutsa insulini. Pulogalamu yanu ikhale yoyenera kwa inu.
Maganizo-Thupi Labwino
Mary Shomon: Tayamba kuzindikira kuzindikira kufunika kokachepetsa nkhawa, kuphatikizapo zosangalatsa, ndikuyika mphamvu ya kugwirizana kwa thupi kugwirira ntchito monga gawo labwino. Kodi muli ndi malingaliro ena mwa njira zabwino kwambiri zomwe akazi angachitire izi, kupatsidwa moyo wathu wotanganidwa?
Dr. Lily: Njira imodzi yomwe ndimakonda ndikugwira ntchito nthawi zonse. Mukamayenda panja, mvetserani mapazi anu pansi, mutenge mpweya ndikuyang'ana mmwamba. Onani kumwamba, kodi mumamva dzuwa pamaso panu? Kodi pali mitambo, kodi pali mphepo? Kodi pali mbalame kapena nyama zina? Mukafika kunyumba mutenge mpweya ndikuwona mmene mumamvera mu nthawi yomweyi. Pamene mudya, tengani kamphindi kuganiza za chinthu chomwe mumayamika ndikuyamika. Kenaka tawonani kuonekera kwa chakudya, mtundu wake ndiye kununkhira kwake ndiko kapangidwe kake. Monga azimayi, nthawi zambiri timakhala ndi moyo wa banja lathu ndipo tikhoza kudzidyetsa tokha motere ndikuphunzitsanso ana athu kuti azigwirizana. Ana anga adzandikumbutsa ngati ndayiwala chisomo chathu, chomwe nthawi zambiri chimakhala chonchi: munthu aliyense amalankhula mwachidule chinthu chimodzi chomwe amayamikirira pamene tikuyendayenda patebulo. Kutenga mphindi kuti tisike ndipo kuyamikira kungasinthe maganizo athu ndi kutithandiza kukhala okonzeka kulandira.
Chida china chosavuta ndi kulemba zinthu zitatu zomwe mumayamikila tsiku ndi tsiku, mwinamwake pedi pogona pogona. Ndi njira yabwino kuyamba kapena kutha tsiku.
Pezani chizolowezi chomwe mumachikonda, chomwe chimakumverera mwachibadwa. Yoga, pilates, Tai Chi, Qi Gong, kupaka minofu, kuyenda kunja, kusinkhasinkha kumaganizo ndi kutsogolera zithunzi zonse zingatithandize kulimbitsa kugwirizana kwa thupi.
Pezani chinachake chomwe mumakonda ndikuyesera kuchichita nthawi zonse. Pali mapulogalamu ena abwino amene ali ndi mafupikidwe ochepa koma ogwira mtima omwe mungachite mkati mwa maminiti khumi.
Ngati mumakonda kalasi yanu ya yoga, ndibwino! Sankhani malo m'nyumba mwako komwe mungathenso kutulutsa mphasa yanu ndipo mutenge mphindi zisanu ndi zisanu pa tsiku ndikuchita kupuma ndi kupuma. Ngati mungathe kutambasulira izo kwa mphindi 20, bwino kwambiri!
Mmodzi Mmodzi Wodwala Wonse Ayenera Kuchita
Mary Shomon: Ngati pali chinthu chimodzi mutha kuonetsetsa kuti odwala anu aliyense angachite bwino kuti akhale bwino, zikanakhala zotani?
Dr. Lily: Khalani okoma mtima, mutenge nthawi yodzikonda nokha, muzidzichitira nokha ngati mnzanu wamtengo wapatali!
Elizabeth (Lily) Conrad, MD, adamaliza maphunziro awo ku College of Physicians and Surgeons of Columbia University mu 1991. Anamaliza ntchito yake ya banja ku The Montgomery Family Practice Residency Program ku Norristown, PA. Dr. Lily, monga odwala ake amadziwira, wakhala akuvomerezedwa ku Family Medicine kuyambira 1994. Ntchito yake yakhala ikuchiritsa odwala onse mu mgwirizano wodzipereka, wogwira ntchito womwe umathandizira umoyo ndi thanzi. Kuwonjezera pa chizoloŵezi cha makolo ake, Dr. Lily wakhala akuphunzira kusinkhasinkha kuyambira pachiyambi chake ku masewera a mpikisano mu 1985. Iye waphunzira njira zambiri zamaganizo / thupi ku machiritso kuphatikizapo Maganizo Okhazikika Pochepetsa Kupanikizika ndi Jon Kabat-Zinn ndi Saki Santorelli ku yunivesite ya Massachusetts. Maphunziro ake aphatikizapo yoga, mankhwala a Ayurvedic, ndi matenda a kutupa thupi. Dr. Lily anaphunzira kudulidwa ku UCLA, akudziwika ngati sukulu yapamwamba ya acupuncture kwa madokotala. Anakhala dipatimenti yodzitetezera ku Medical Acupuncture mu 2004. Iye apitiliza kuphunzira mankhwala ochiritsira amchere ndi a Chitchaina komanso madokotala azitsamba ndi zakudya zabwino. Amagwiritsa ntchito mankhwala othandizira ku McLean, Virginia, ku Well Being-Well, komwe akugwiritsanso ntchito njira zowonongeka komanso zachilengedwe, zomwe zimakonzedwa kuti zikhale ndi mphamvu zothandizira odwala komanso kupatsa odwala maphunziro ndi njira zothandizira moyo wathanzi komanso wathanzi.
Elizabeth Conrad, MD
Kukhala Wabwino-Kukhala Wabwino, 6862 Street Elm # 720, McLean, Virginia 22101, Ph: 703-635-2158