Haddii aad ku jirto daroogada hormoonka tayroodhka ah (sida, levotyroxine, generic, Levoxyl, ama Tirosint ) iyo waliba aanad fiicnayn, waxaa suurtagal ah in aad ka faa'iideysan karto inaad ku darto T3, ama aad u beddesho daawo tayroodh oo ay ku jiraan T3.
T3 / Triiodotyronin
Levothyroxine waa nooc caleenta ah oo loo yaqaan 'thyroxine hormoon', oo loo soo gaabiyo T4.
T4 waa hormoonka xajinta oo waa in lagu beddelaa jirka T3 in loo isticmaalo unugyada.
T3 waa gaaban yahay triiodotyronin. T3 waa qanjirka firfircoon ee ka shaqeeya heerkulka gacanta si uu gacan uga geysto bixinta oksijiin iyo tamar si unugyada, unugyada, iyo qanjidhada jirka oo dhan.
Inkastoo qanjirka thyroid soo saaro labada T4 iyo T3, T4 waa mid aan firfircooneyn. Si loo isticmaalo jirka, T4 waxaa loo beddelaa T3.
Daaweynta Levothyroxine-kaliya ayaa loo tixgeliyaa heerka daryeelka ee dhakhaatiirta caadiga ah. Hase yeeshee, jiritaanka ballaaran ee caddaynta sayniska, si kastaba ha ahaatee, waxay tilmaamaysaa dhowr arrimood oo diirada saaraya daaweynta T3. Tusaale ahaan:
- Cilmi-baaris cusub ayaa lagu aqoonsanayaa cilladaha hiddo-yaqaanka ee loo yaqaanno deiodinase polymorphisms taasoo ka dhigaysa qayb hoos-u-dhigaysa bukaannada aan waxtar lahayn marka lagu beddelo T4 ilaa T3. Daraasooyinkan waxay soo jeedinayaan in levothyroxin kaliya ay ku filan tahay bukaankan.
- Laba iyo toban daraasadood oo dhowaan ayaa la qiimeeyay levothyroxine iyo daaweynta liothyronin ee loogu talagalay hypothyroidism. Qaar ka mid ah daraasadaha ayaa laga helay niyadda, tayada nolosha, iyo garashada garashada ee bukaanada qaadanaya daaweynta isku dhafan, marka la barbar dhigo levothyroxine oo keliya.
- Daraasado kale ayaa muujiyay in isticmaalka natiijooyinka T3-da ee heerarka hoose ee kolestaroolka, hoos u dhiga culeyska jirka, iyo xalinta ciladaha ugu fiican, iyada oo aan wax khatar ah oo dheeraad ah marka loo barbar dhigo levothyroxine oo keliya.
Daraasad cilmibaaris oo deenish ah , ayaa lagu soo bandhigay joornaalka Yurub ee 'Endocrinology' , taas oo ka baaraandegtay astaamaha tayroodhka ee saameynta daaweynta levothyroxine-ka keliya, ladagaalanka levothyroxine iyo T3 (kiiskan, qiyaasta 20 mikrogram oo ah T3 maalin walba ayaa la isticmaalay).
Tijaabo loogu talagalay tayada nolosha iyo niyad-jabka ayaa la sameeyay bilawga daraasaddan, kadibna marxaladaha daaweynta 12-usbuuc ka dib. Muddadii labadii todobaad ee 12-usbuucba, maadooyinka waxaa la siiyey labadii levothyroxine iyo T3, ama levothyroxine oo lagu daray placebo kadibna loo beddelay muddada 12-usbuuc ee soo socota. Ka qaybqaatayaashu waxay ahaayeen "indho la '" in aanay garanaynin inay qaadanayaan T3 ama placebo firfircoon.
Tayada nolosha iyo xaaladaha maskaxeed ee la qiimeeyey waxaa ka mid ah, arrimaha kale: caafimaadka guud, shaqada bulshada, caafimaadka dhimirka, maaraynta, dareenka, niyad-jabka iyo walwalka. Daraasadan ayaa muujisay in bukaannada, kuwaas oo intooda badan ay ahaayeen haween, 49% bukaanada ayaa doorbiday daaweyn isku dhafan, keliya 15% daaweynta levothyroxine-ka keliya.
Cilmi-baareyaasha iyo endocrinologists ayaa dib-u-dhac ku yimid ilaa 20 sano oo ku saabsan qiimaha T3 . Iyadoo lagu saleynayo waayo-aragnimadooda khaaska ah ee bukaanka, iyo ciddii sii kordhaysa ee caddaynta cilmi-baarista, qaar ka mid ah dhakhaatiirta caadiga ah, iyo xirfadlayaasha guud iyo is-dhexgalayaasha ayaa sii kordhaya iyagoo raacaya T3 dhammaystiran si xal loogu helo daaweynta tayroodka bukaannada qaarkood. Waxay ku daraan T3 dhowr siyaabood:
- Daaweynta T3 ee daaweynta levothyroxin, iyada oo loo marayo ku darida daawada loo yaqaan "T3" ee daawada "Cytomel", ama laydhka (generic T3)
- Ku darista T3 dabiiciga ah daawada rijeetada oo la sii deynayo waqti-sii-deyn / sii-deyn-sii-deyn ah T3 marka lagu daro levothyroxine
- Ku darida qiyaasta dabiiciga ah ee dabiiciga ah, sida daawooyinka dhakhtarku qoro, Astaamaha Thyroid , ama qanjirada dabiiciga ah ee dabiiciga ah (soosaarka Maraykanka waa Acella) daaweynta levothyroxin
- Beddelidda bukaanada si daaweyn dabiiciga ah oo loo isticmaalo daaweynta tayroodhka
- Ka dhigista bukaanka daaweynta T3 oo kaliya (tani waa mid aan caadi ahayn.)
Waxaa muhiim ah in la ogaado, sababta oo ah T3 waa hoormoonka firfircoon, waxa uu yeelan karaa saameyn xad dhaaf ah oo ku kacaya garaaca wadnaha iyo garaaca wadnaha dadka qaarkood, gaar ahaan kuwa leh taariikhda wadnaha wadnaha, waayeelka, iyo kuwa leh cillado wadnaha sida dhoobo mitral ah.
Dhakhaatiirta T3-ka ah waxay qiimeeyaan ammaanka T3 marka la barbar dhigo faa'iidooyinka laga helo kiis-kiis.
Xitaa dadka bukaanka ah ee aan haysan wax wadnaha ah ama arimo la xidhiidha da'da oo keeni kara dhibaatooyin T3, bukaanjiifka qaar ayaa si aad ah ugu nugul saameynta dhiirrigelinta ee T3. Wadnuhu aad ayuu u nugul yahay hoormoonka tayroodh guud ahaan, dadka qaarkiisna, xitaa qiyaasta daawada liotyronin, ama qadar yar oo ah daawada T3 ee dabiiciga ah ayaa sababi kara garaaca garaaca wadnaha ama wadnaha.
Bukaannadaas, dhakhaatiirta qaarkood waxay ku taliyaan foomamka sii daaya / sii-deynsan ee sii-deynaya / sii-daynaya ee T3, oo ay ku jirto dawooyinka rijeetada lagu soo qoro farmasiyada.
Qaar ka mid ah dhakhaatiirta isku dhafan, dhab ahaantii, waxay rumaysan yihiin in T3 uu si tartiib ah u sii daayo foomka ugu wanaagsan ee T3, taasoo ah mid si aad ah u egtahay isbedelka jidhka ee u dhigma iyo sii deynta T3, iyo sababta oo ah qaabka tartiib tartiib tartiib tartiib ah waxyeello kasta.
Dabiiciga ah ee loo yaqaan "Thyroid Natural Desiccated"
Dhaqaatiirta qaarkood waxay ogaadeen in bukaannadoodu hoos u dhacaan cilladahooda cilladahooda iyagoo qaadanaya daawo dabiiciga ah oo loo yaqaan 'thyroid', oo loo soo gaabiyo NDT. NDT waxaa kale oo loo yaqaannaa "thyroid porcine", "thyroid extract", thyroid dabiiciga ama xitaa "thyroid pig." Waa daawo takhtar ah oo loo yaqaan 'FDA', oo laga soo saaro qanjidhada qallalan ee qanjidhada. Daawooyinka ku jira qeybtan waxaa ka mid ah Armor Thyroid, Nature-throid, iyo WP Thyroid ee Maraykanka, Kanada ee Erfa Thyroid, iyo guud ahaan dabiiciga ah ee tayroodhka ee Maraykanka oo ay soo saartay Acella.
Tijaabinta dabiiciga ah ee dabiiciga ah ayaa la isticmaalay muddo ka badan qarni. Khubaro badan oo hormone ah ayaa aaminsan in daawooyinkan, kuwaas oo bixiya T4, T3, T2, T1, iyo hormoonnada kale ee hormoonada ah iyo kuwa nafaqada, waxay aad ugu dhow yihiin hoormoonka tayroodhka ee dadka marka loo eego daawooyinka loo yaqaan 'synthetic'. Waxay sheegaan in boqolkiiba tiro badan oo ka mid ah bukaankooda ay ku fiicnaanayaan iyaga. Bukaanjiifka qaarkood waxay ogaadaan in ay dareemaan ugu fiicnaanta daawooyinka tayroodh dabiiciga ah, ama daawooyinka dabiiciga ah iyo waxyaabo kale oo tayroodh dabiiciga ah.
Ereyga
T3 oo bilaash ah oo baaritaanno dhiig ah, oo ay weheliso astaamaha calaamadaha iyo astaamaha hypothyroidism, ayaa kaa caawin kara inaad ogaato in aad leedahay heerar caadi ah oo la heli karo T3, ama laga faa'iideysan karo daaweynta T3. Qaar ka mid ah dhakhaatiirta isku dhafan waxay aaminsan yihiin in bedelka beddelidda tayroodhku ku iman doono heerarka T3 ee dhexda dhexe ilaa qeybta sare ee qiyaasta tiibayda.
Maskaxda ku hay in imtixaanka T3 iyo isticmaalka daaweynta isku dhafan ee T4 / T3 iyo daawooyinka dabiiciga ah ee dabiiciga ah ee dabiiciga ah ay yihiin arrimaha muranka dhaliya. Dhakhaatiir badan oo ku takhasusay indhaha iyo dhakhaatiirta caadiga ah ayaa aad u adkaysata fikradda tijaabada T3 iyo daaweynta daawooyinka T3, inkastoo natiijooyinka cilmi-baarista ee rajada leh. Waxay qeexayaan dareenka ah in qiyaasaha xad-dhaafka ah ee T3 ay sababi karaan isbeddelka wadnaha ama saameynaha kale.
Dhakhaatiir badan oo caadiga ah sidoo kale ma daaweyn daawooyinka tayroodh dabiiciga ah . Waxay ku andacoodaan in daroogooyinkan ay ka baxeen taariikhda, "ma ahan mid joogto ah," qaar badanina ma qori doonaan.
Haddii aad doonaysid inaad tixgeliso daaweynta dheeraadka ah ee daaweynta T3 ama daawooyinka dabiiciga ah ee loo yaqaan 'thyroid', waa inaad u baahataa inaad la shaqeyso dhakhtarka is-dhexgalinta ama dheelitiran.
Sidoo kale, iyadoo la heli karo taakuleyn taakuleeyn oo kala duwan oo taakuleenta ah, oo qaar ka mid ah ay sheeganayaan inay ku jiraan "qanjidhada thyroid", kuwani maahan daawo tirtiran oo daawada loo isticmaalo, oo ma beddelayso dawooyinka tayroodhka ee daawada.
> Ilo:
> Celi FS, et al. "Saamaynta metabolis ee daaweynta liotyronin ee hypothyroidism: waa la kala soocay, laba-indhoole ah, tijaabo iskudhaf ah ee liotyronin iyo levothyroxine." J Clin Endocrinol Metab. 2011 Nov; 96 (11: 3466-74: doi: 10.1210 / jc 2011-1329.Pubub 2011 Aug 24.
> Tilmaamaha Tababarrada Daaweynta ee Hypothyroidism ee Dadka Qaan-Gaarka ah : Waxaa wada-kafaala-yareeya Ururka Asluubta Maraykanka ee Endocrinologists iyo Ururka Tirakoobyada Ameerikaanka.
> Escobar-Morreale HF, et al. "Daaweynta hypothyroidism leh levothyroxine ama isku-dar ah levothyroxine iyo L-triiodotyronine." Dhaqdhaqaaqa ugu fiican ee lagu daaweyn karo Clin Endocrinol. 2015 Jan 29 (1): 57-75. doi: 10.1016 / jbeem.2014.10.004. Epub 2014 Oct 25. Dib-u-eegid.
> McAninch EA, Bianco AC. "Taariikhda iyo mustaqbalka Daaweynta Hypothyroidism." Ann Intern Intern Med. 2016 Jan 5; 164 (1): 50-6. doi: 10.7326 / M15-1799. Erratum ee Ann Ann Med Med. 2016 Mar 1; 164 (5): 376. PMID: 26747302
> Nygaard, B et al. "Saamaynta daaweynta isku dhafan oo leh tyroxin (T4) iyo 3,5,30-teriiodotyronine oo ka soo horjeeda daaweynta T4 ee bukaanka qaba hypothyroidism, oo ah laba-indhoole, kala-sooc la'aan iskudhafan." Journal Journal of Endocrinology (2009) 161 895-902