Kumayambiriro kwa Mmawa Ndimayesetsabebe, koma Madzulo a Mayayi akhale Njira Yina
Ngati muli ndi mankhwala otsekemera a mahomoni, malangizo anu amalangiza kuti mutenge mapiritsi anu choyambirira m'mawa ndi madzi, mumatumbo opanda kanthu, ndipo dikirani ola limodzi musanadye kapena kumwa khofi.
Komanso, muyenera kuyembekezera maola atatu kapena anai musanayambe kumwa mankhwala ena omwe amalepheretsa kuyamwa, monga mapiritsi achitsulo kapena calcium carbonate.
Komabe, kafukufuku wina wafukufuku-wofalitsidwa m'magazini ya Journal of Clinical Endocrinology ndi Metabolism ndi mayesero akuluakulu omwe akutsatiridwa mu Archives of Internal Medicine- kutanthauza kuti kutenga mlingo womwewo wa levothyroxine (monga Synthroid kapena Levoxyl) Nthawi yogona, poyerekezera ndi chinthu choyamba mmawa, zikhoza kukhala bwino.
Kafukufuku Amapereka Usiku Ukhoza Kukhala Wabwino
Phunziroli linalembedwa mu Journal of Clinical Endocrinology ndi Metabolism kuyang'ana momwe zotsatira zowonongeka kwa magazi zimakhudzira nthawi yomwe levothyroxine imatengedwa kuyambira m'mawa mpaka kukagona. Kafukufukuyu adawonanso zotsatira za kusintha kwa nthawi imeneyi pa mlingo wachizungu wa hormone yachithokomiro (TSH).
Phunziroli, ngakhale kuti laling'ono, linali lokhazikika pa zomwe anapeza, zomwe ochita kafukufuku adanena kuti "zimapha" ndipo "zomwe zimakhala zovuta kwa odwala mamiliyoni ambiri omwe amatenga l-thyroxine tsiku ndi tsiku."
Zotsatira Zophunzira
Kwa odwala onse, TSH inachepa ndipo ufulu wanu wa thyroxine (T4) unasintha mwa kusintha thyroxine ingestion kuyambira m'mawa mpaka kukagona. Miyendo ya Triiodothyronine (T3) idawuka mwa zonse koma phunziro limodzi.
Chochititsa chidwi, TSH idatsika mosasamala kanthu koyambira TSH, kutanthauza kuti bwino kumwa mankhwala a chithokomiro mukatenga madzulo.
Potsirizira pake, ofufuza adapeza kuti chiwerengero cha TSH chachizungu-zomwe zimachitika tsiku ndi tsiku za TSH zomwe zimapezeka pa maora 24-sizinasinthe.
Kuphunzira Phunziro
Ofufuzawa anafotokoza zambiri za zotsatira zake:
- Ngakhale podikirira osachepera mphindi 30 kuti adye, chakudya cham'mawa chingakhale chosokoneza m'mimba kuchepetsa matumbo a levothyroxine.
- "Bowel motility amachedwa pang'onopang'ono," kutanthauza kuti pamafunika nthawi yaitali kuti levothyroxine ipange kudzera m'matumbo, zomwe zimachititsa kuti matumbo asatenge nthawi yaitali, motero, kuyamwa bwino ndi kumwa mankhwala.
- Kutembenuka kwa T4 mpaka T3 kungakhale koyenera madzulo.
Ochita kafukufukuwa akupereka kuti zotsatira za phunziroli, pulogalamu yaikulu yopangidwa ndi makina awiri omwe anachititsidwa khungu pofuna kuthandizira zotsatira zawo-ndipo iyi inali phunziro lomwe linalembedwa mu Archives of Internal Medicine .
Chachiwiri Chimachititsa Kuti Usiku Ukhale Wabwino
Phunziro ili, odwala 90 anamaliza mayeserowa, omwe amatha kutenga miyezi isanu ndi umodzi kutenga capsule m'mawa ndi kapu imodzi pogona (limodzi ndi capsule yogwira ntchito levothyroxine, inayo ndi malo otchedwa placebo, ndi kusintha kwa miyezi itatu) .
Ofufuzawa anafufuza mahomoni a chithokomiro, komanso magulu a creatinine, miyendo ya lipid, chiwerengero cha thupi, kuthamanga kwa mtima, ndi khalidwe la moyo.
Zotsatira Zophunzira
Ofufuzawa adapeza kuti odwala atatenga levothyroxine usiku ndikutaya TSH wa 1.25 mU / L, kusintha kwakukulu. The thyroxine yaulere ( yaulere T4 ) yakwera ndi 0.07 ng / dL, ndipo totali triiodothyronine (okwana T3) inapita ndi 6.5 ng / dL. Panalibe kusintha kwakukulu pazifukwa zinanso.
Kuphunzira Phunziro
Akatswiriwa anapeza kuti, chifukwa cha kuchuluka kwa mahomoni a chithokomiro, madokotala ayenera kulingalira kuti levothyroxine ikhale yotenga nthawi yogona.
Zomwe Zimakukhudzani Kapena Wokondedwa ndi Hypothyroidism
Kugwiritsa ntchito mankhwala pa nthawi yogona mmalo mwa m'mawa kungapereke upamwamba:
- Choyamba, ndi zophweka, popeza simukudandaula za nthawi yoti mudye chakudya cham'mawa.
- Chachiwiri, ndizosavuta kupeĊµa mankhwala, zakudya zowonjezera, ndi zakudya, monga calcium, chitsulo, ndi zakudya zapamwamba zomwe zingayambitse mankhwala a chithokomiro .
- Chachitatu, omwa khofi safunikira kuyembekezera mpaka ola limodzi pambuyo poti mankhwala awo akusangalala ndi kapu yawo yoyamba .
- Chachinayi, chikhoza kukupatsani zizindikiro zina ngati simukupeza bwino mwakumwa mankhwala a chithokomiro patsiku.
Maphunzirowa amatsimikizira zomwe odwala ambiri akhala akunena kwa zaka zambiri-amamva bwino ngati amamwa mankhwala a chithokomiro madzulo, osati m'mawa.
Pamapeto pake, ndi kofunika kulankhula ndi adokotala za kusintha nthawi kuti mutenge levothyroxine kapena dzina lakuti levothyroxine (mwachitsanzo, Synthroid). Ngati inu ndi dokotala mukuganiza kuti muperekeni mankhwalawa ndipo muzitenga mankhwala anu a chithokomiro madzulo, onetsetsani kuti muli ndi ma chithokomiro anu (masabata asanu ndi limodzi kapena asanu ndi atatu ndi nthawi yokwanira) mutatha kusintha.
Zotsatira za kuyezetsa magazi, pamodzi ndi kusintha kulikonse kapena zizindikiro zowonjezereka, zingakuthandizeni inu ndi dokotala wanu kudziwa ngati mukufuna kusintha mlingo kapena kubwereranso kuti mutenge mankhwala anu m'mawa kwambiri
Mfundo Yofunika Kukumbukira: Zofufuza Zokha Zinayesa Levothyroxine
Maphunzirowa anachitidwa ndi levothyroxine, mawonekedwe a machitidwe otalikitsa T4 / thyroxine thyroid. Fomu iyi ya ma hormone iyenera kutembenuzidwa poyamba m'thupi kuti ikhale yogwira ntchito (T3), ndipo izi zingatenge masiku.
Mankhwala a chithokomiro omwe ali ndi T3-monga Cytomel, ndi mankhwala omwe amadziwika ndi chibadwa monga chithokomiro ndi zida zankhondo-amagwiritsidwa ntchito mwachindunji ndi thupi mkati mwa maora. Mankhwalawa sanawerengedwe mu phunziroli, ndipo sakudziwika ngati mankhwala omwe ali ndi T3, kapena mankhwala omwe amadziwika ndi chithokomiro angakhale abwino kwambiri usiku.
Osazindikira, ena omwe ali ndi chithokomiro amavomereza kuti akuwoneka bwino pamene akudya mankhwala kapena mavitamini onse omwe amachititsa kachilombo ka T3. Koma odwala ena a chithokomiro amapezanso kuti ngati amamwa mankhwala ndi T3 patsiku kapena madzulo, mankhwala osokoneza bongo a T3 angapangitse kuti zikhale zovuta kugona.
Choncho kumbukirani kuti ngakhale zili zotheka kuti ngati maphunziro omwewo amachitidwa ndi mankhwala a T3 , zotsatira zake zidzakhala zofanana, koma pali mwayi kuti zingakhudze khalidwe la kugona kwa odwala ena. Muyenera kusintha kokha mutatha kukambirana ndi dokotala wanu.
Madokotala ena amanena kuti odwala omwe amamwa mankhwala a T3 amagwiritsa ntchito nthawi yomasula T3, kapena amagawaniza mlingo wawo ndi kumwa mankhwala awo kangapo tsiku lonse. Njirayi ikuwoneka ngati kuchepetsa kugona kwa tulo; Komabe, onetsetsani kuti mukusintha dosingyo motsogoleredwa ndi dokotala wanu.
Kachiwiri, ngati mutasintha momwe mungatengere mankhwala anu a chithokomiro, mudzafuna kuyambiranso kuyambiranso kwa magazi ndi zizindikiro pambuyo pa milungu ingapo, kuti mudziwe ngati mukuyenera kusintha mlingo kapena nthawi ya mankhwala anu.
Mawu Ochokera
Ngakhale malangizo otsogolera akusonyeza kuti chithandizo chamatenda a chithokomiro chikhale choyamba m'mawa pamimba yopanda kanthu (chifukwa cha chiopsezo cha chakudya chimene chingalepheretse kutenga), kutenga mankhwala a chithokomiro madzulo nthawi zina kungakhale kwanzeru nthawi zina.
Izi zikhoza kukhala zowona makamaka kwa anthu omwe amavutika kudikira ora asanadye m'mawa ndi / kapena omwe akumwa mankhwala ena m'mawa.
Pamapeto pake, chinsinsi chothandizira kumwa mankhwala a chithokomiro ndi mankhwala osasinthasintha, kutengera mapiritsi a chithokomiro mozungulira nthawi yomweyo tsiku ndi tsiku, komanso mofanana.
> Zotsatira:
> Bach-Huynh TG, Nayak, B. Loh J, Soldin S, Jonklaas J. Nthawi ya Levothyroxine Administration Zimakhudza Seramu Thyrotropin Kuyikira. Journal of Clinical Endocrinology ndi Metabolism . 2009 Oct; 94 (10): 3905-3912. Idasindikizidwa pa intaneti 2009 Jul 7. doi: 10.1210 / jc.2009-0860
> Bolk N, Visser TJ, Nijman J, Jongste IJ, Tijssen JG, Zonse A. Zotsatira za Madzulo ndi Mmawa Levothyroxine Chiyeso: Mlandu wa Crossover wosachita khungu kawiri. Archives of Internal Medicine . 2010; 170 (22): 1996-2003.
> Garber JR et al. Zotsatira zamakono za hypothyroidism mwa akuluakulu: > kosungidwa > ndi American Association of Clinical Endocrinologists ndi American Thyroid Association. Chitetezo cha Endocr. 2012 Nov-Dec; 18 (6): 988-1028.
> Rajput, R Chatterjee S, Rajput M. Kodi Levothyroxine Angatengedwe Monga Mdima Wamadzulo? Kuyerekeza Kuyerekeza kwa Mmawa ndi Mdima Mdima wa Levothyroxine mu Chithandizo cha Hypothyroidism. Journal of Research Zakale . 2011; 2011: 505239. lembani: 10.4061 / 2011/505239. Epub 2011 Jul 14.