Odwala ambiri a chithokomiro omwe amalankhula nafe kapena omwe amalemba pa tsamba la Thandizo la Facebook, amafunsa funso lomwelo: "Ndili pa Synthroid (kapena mankhwala ena a levothyroxine monga Levoxyl) ndipo sindikumverera bwino. "
Kwa odwala chithokomiro ndi izi, chinthu choyamba kuganizira ndi ngati mungapindule ndi kuwonjezera kwa T3 .
(A brief recap: Synthroid, Levoxyl ndi mankhwala ena a levothyroxine, omwe amatchedwa l-thyroxine, ndi L-T4-ndiwo maonekedwe a hormone ya T4. T4 ndi hormone yosungirako, ndipo iyenera kukhala T3, hormone yogwira ntchito , kugwiritsa ntchito maselo anu. Cytomel mankhwala ndi mawonekedwe a T3. Pali Cytomel, ndipo akatswiri ena amagwira ntchito ndi kumasulidwa kwa T3 kwa nthawi yolembedwa kuchokera ku mankhwala osokoneza bongo. Zomwe zimachitika m'chilengedwe, Zida zoteteza Zida zimakhala ndi mitundu ya T4, T3 ndi mahomoni ena a chithokomiro .)
Tsopano, kubwereranso ku nkhani ya ngati mungapindule ndi kuwonjezera kwa T3 . Funso la ntchito ndi lakuti: dokotala wanu angakonde ngakhale kukambirana ndi inu, mochulukira kuti muwauze? Palibe yankho lomveka.
Mukauza dokotala, "Kodi ndingapindule ndi zina zina T3?" yankho likhoza kukhala lofanana ndi zochitika zinayi zomwe zingatheke ...
- A. Awonetsa momveka bwino kuti alibe chidwi chokambirana za T3.
- B. Dokotala amalemekeza mwaulemu kuti, "Sizinthu zokha zomwe ndimakhala nazo."
- C. Dokotala akuganiza za izo, ndipo akuti, "chabwino, tiyang'ane mlingo wanu waulere wa T3 kuti muwone chomwe chikuwoneka ndiyeno pangani chisankho.
- D. Dokotala akuti, "Izi ndizotheka. Tiyeni tiyese mlingo wotsika kwambiri wa T3 ndikuwone momwe mumamvera. Koma tiyeni tionetsetse kuti palibe kutsutsana kwa inu ...
Mwachiwonekere, ngati ndinu wodwala wa Dokotala A, chinthu chabwino ndicho kupeza dokotala watsopano wa chithokomiro . Kufunsa kuti akambirane za chithandizo choyenera ndilo pempho lovomerezeka, ndipo sayenera kukumana ndi kulemekeza kapena kuchotsedwa. Mitundu yambiri ya mayankho ndi umboni weniweni wakuti ndi nthawi ya dokotala watsopano.
Ngati mukugwira ntchito ndi Dokotala B, chabwino, mungafune kufunsa chomwe akuganiza kuti ndi osakhala omasuka ndi kuwonjezera T3 ku chithandizo cha chithokomiro cha levothyroxine okha. Pano, mungafune kutchula, kapena kubweretsanso kubwereza kapena kuwerengera, maphunziro a Danish omwe adafika kumapeto kwa 2009 mu European Journal of Endocrinology . Kafukufukuyu adawona nkhani yothetsera vuto ndi mankhwala T3 monga chowonjezera ku T4-yekha (levothyroxine) therapy kwa hypothyroidism .
Kafukufukuyu anafotokoza kuti 49 peresenti ya odwala anaphunzira chithandizo chomwe chinagwiritsa ntchito levothyroxine kuphatikizapo mankhwala a T3 , ndipo 15% okha ndiwo amakonda kumwa mankhwala a levothyroxine okha. (Onani m'munsimu kuti mudziwe zambiri pa phunziroli, komanso momwe mungapezereko kuti muwonetse dokotala wanu.) Ngati Dokotala B akukana kukambirana ndi T3 mwachidule ndipo sangakukhutitseni ndi kulingalira, ndi nthawi yatsopano dokotala wa chithokomiro .
Ngati mukuchita ndi Dokotala C, dzifunseni nokha mwayi. Funsani dokotala chomwe akufuna chake ndi Free T3. Ndipo pitirizani kupeza mayeso a T3, ndikumbukira kuti akatswiri ambiri a chithokomiro amakhulupirira kuti odwala amamva bwino ngati ma T3 omwe ali omasuka ali pa hafu yapamwamba kwambiri, ngakhale pa 75th percentile ndi pamwamba pa mndandanda.
Ngati ntchitoyi ikugwira ntchito, tiyeni tiyambe kuchita masewerawa. Ngati zolemba za labu likupezeka pa Free T3 ndi 2.0-4.4 pg / mL, ndiye kuti pakatikati pake pali pakati pawo, kapena 3.2, ndi 75th percentile ndi 3.8.)
Ndipo ngati ndinu wodwala wa Dokotala, ponso, dzifunseni nokha mwayi wokhala ndi dokotala woganiza bwino komanso wodziwa bwino.
Koma zotsutsana, madokotala amakhala osamala pogwiritsira ntchito T3 kwa aliyense amene ali ndi mbiri ya matenda a mtima kapena mavuto a mtima, komanso okalamba, kotero madokotala a T3-savvy adzakumbukira izi.
Zindikirani kuchokera
Ngati mukufuna kugawana chidziwitso ndi dokotala wanu pa phunziro la Danish la 2009, apa pali zina:
- Mutu: Phunziro Limasonyeza kuti Kuwonjezeka kwa T3 ndipamwamba kwa Levothyroxine / T4-Chithandizo Chakodzo Chokha cha Hypothyroidism
- Tsamba la Phunziro lachiDanishi: Birte Nygaard, Ebbe Winther Jensen, Jan Kvetny, Anne Jarløv ndi Jens Faber. "Mmene mankhwalawa amathandizira ndi thyroxine (T4) ndi 3,5,3'-triiodothyronine ndi T4 monotherapy pa odwala omwe ali ndi hypothyroidism, omwe amaphunzira mobwerezabwereza," European Journal of Endocrinology, Vol. 161, Magazini 6, 895-902, December 2009
- Phunziro: Ŵerengani Zosindikiza / Pezani Zowonjezera (Musaiwale kuti mmalo molipira pa intaneti kuti musindikizirenso, mungathe kupeza lemba laulere la nkhani yachipatala ngati muli ndi sukulu ya zachipatala, la chipatala kapena laibulale pafupi )
> Chitsime:
> Nygaard, B et. al. "Mmene mankhwalawa amathandizira ndi thyroxine (T4) ndi 3,5,3'-triiodothyronine ndi T4 monotherapy pa odwala omwe ali ndi hypothyroidism, omwe amaphunzira mobwerezabwereza," European Journal of Endocrinology, Vol. 161, Magazini 6, 895-902, December 2009