Muddo ka badan 40 sano, habka caadiga ah ee loo daaweeyo cudurka hypothyroidism wuxuu ahaa inay bixiyaan daawada hormoonka thyroid hormone levothyroxine (ie, Synthroid, Levoxyl); iyada oo ujeedadu tahay hubinta in heerka heerka GB uu hoos u dhacayo qaybaha tixraaca. Tani waxaa loo tixgeliyey daaweyn buuxda oo ku saabsan xaaladda.
Nidaamka daaweyneed ee caadiga ah waa daaweynta la yiraahdo levothyroxine-oo ah qaabka synthetic ee thyroxine (T4) hormoonka qanjirka thyroxine-wuxuu bixin doonaa T4 ku filan, dib ugu soo celinta midabka caadiga ah ee loo yaqaan 'thyroid function' oo loo yaqaan 'Eyryroidism' calaamadaha la xiriira.
Dhakhaatiirta hormoodka ah ee badan, oo ay ku jiraan dhakhaatiirta caanka ah ee loo yaqaan 'endocrinologist Dr. Anthony Weetman , ayaa xitaa sheegay in dadka bukaanka qaba' tijaabooyinka caadiga ah ee tayroodhka 'laakiin ay ku adkaystaan in lagu daaweeyo calaamado tirakoob oo badan ama calaamadaha joogtada ah waxay heystaan' somatoform disorder '. (Xaaladaha Somatoform waxaa lagu qeexay qaamuusyada caafimaadka sida "xanuunada maskaxda ee calaamad u ah cabashooyinka jidhka, taas oo aan loo helin sharaxaad dabiici ah ama mid nafsaani ah, taas oo ay dhici karto in ay jirto xaalad nafsaani ah oo ku lug leh.")
Qanjiraha caadiga ah ee qanjirka 'thyroxine' wuxuu soo saaraa dhowr hormoon oo muhiim ah, oo ay ka mid yihiin hormoonka hormoonka thyroxine (T4) iyo hormoonka hormoonka Triiodotyronine (T3). Inta badan hormoonka soo saaro qanjiradu waa T4, laakiin T4 waa in loo bedelaa jirka si uu u hormariyo hormoonka T3 si uu u yeesho jidhkaaga. Natiijada awoodda iyo awoodda dheeriga ah waa in cudurka hypothyroidism la daaweeyo keliya levothyroxine-oo mararka qaarkood loo yaqaan 'monotherapy LT4' ama levothyroxine monotherapy - marka la qaato qiyaasta daawada loo yaqaan 'euthyroid', iyadoo heerarkaaga TSH-gaagu hoos u dhacayo.
Diinta ayaa sheeganeysa marka ay jirto T4 ku filan, jidhku had iyo goor wuxuu sameyn doonaa T3 ku filan.
Inkasta oo ay ku adagtahay caqiidadaas daawada caadiga ah, dhowr sano ka dib, qaar ka mid ah bukaannada qanjirka thyroid ayaa noqda kuwa sii kordhaya ee ku saabsan xaddiga levothyroxine ee xallinta calaamadaha. Cilmi-baareyaasha ayaa si qiyaas ah u qiyaasaya in 15% ee bukaannada ay sii wataan cilladaha laf-dhabarka ee dhibaatada leh inkastoo daaweynta levothyroxin.
Baadhitaanada bukaannada qanjirka thyroid waxay soo jeedinayaan in tirada ay ka badan tahay .
Natiijooyinka Cilmi-baarista
Si loo ogaado in dib u soo celinta heerarka tixraaca ee tixraaca tixraaca ee la adeegsanayo levothyroxine waxay ahayd mid taabogal ah, cilmi-baarayaasha Xarunta Caafimaadka Jaamacadda Rush ee Chicago waxay daraasad la barbardhigeen koox isha ku hayaan dadka caafimaadka qaba, iyada oo aan jirin caddayn ku saabsan cudurka thyroid, oo ka soo horjeeda koox dad ah waxaa lagu daaweyn jiray levothyroxine loogu talagalay hypothyroidism. Natiijooyinka waxaa la soo sheegay bishii Oktoobar 2016 ee ku saabsan Xogta Dhaqanka Xanuunka Xanuunada iyo Metabolismiska .
Natiijooyinka ayaa ahaa kuwo aad u walaac badan. Cilmi-baadhistu waxay ogaatay in:
- Kooxda levothyroxine-daweynta waxay haysaa 20 boqolkiiba heerka sare ee TSH, 10 boqolkiiba heerka T3 oo hooseeya, 15% ka hooseeya heerka T3 marka la barbardhigo kooxda xakamaynta.
- Kooxda daaweynta levothyroxine-daaweyntu waxay leedahay jaantus sare oo jirka jirka, inkasta oo ay soo sheegeen in ay cunayaan cunto yar yar maalin kasta. Waxay miisaamaan 10 rodol oo dheeri ah, inkastoo ay qiyaasaan wax yar oo kaloori ah maalintii.
- Kooxda daaweynta levothyroxine-daaweyntu waxay ahayd 1.6 jeer oo ay u badan tahay in ay qaataan beta-blockers, kuwaas oo inta badan loo isticmaalo daawaynta cadaadiska dhiigga.
- Kooxda loo yaqaan 'levothyroxine-treated treatment' waxay ahayd 1.5 jeer ka badan inay qaataan daawooyinka statin, oo loo isticmaalo daaweynta kolesteroolka sareeya.
- Kooxda daaweynta levothyroxine-daaweyntu waxay ahayd 1.46 jeer oo ay u badan tahay inay qaadanayaan antidepressants.
- Kooxda loo yaqaan 'levothyroxine-treated therapy' waxay sheegtey in ay tahay mid aan firfircooneyn jirka marka loo eego kooxda kantaroolka.
- Kooxda loo yaqaan 'levothyroxine-treated treated self-reported self-reported days ago bishii hore oo ay dareemeen caafimaadkooda jireed iyo maskaxeed "ma fiicna."
Sheekooyinka
Cilmi baarayaashu waxay sheegeen in ay leeyihiin laba aragti oo ku saabsan sababta ay ufudud u tahay heerarka TSH-ga ee qiyaasta tixraaca- kooxda levothyroxine-daaweyntu maaha mid caafimaad qaba sida lagu cabbiray tiro xaddidan, iyo sababta ay levothyroxin naftooda u sheegeen inayan waxba samayn ' Tareenka ugu wanaagsan ee aad uga badan tahay kooxda kantaroolka.
- Hal aragti ayaa ah in inkastoo heerka heerka caadiga ah ee caadiga ah, heerarka T3-hormoonka firfircoon - laga yaabo in aan si buuxda loo badin karin, sababtoo ah T4 si ku filan uma beddeli karo T3.
- Naqshad labaad waxay soo jeedinaysaa in heerarka T3 ee dhab ahaantii gaari karo unugyada laga yaabo inay ka muuqdaan heerarka baaritaanka dhiigga ee TSH ama T4, sababtoo ah tallaabooyinka deiodinase, oo door ka qaadaya habka isbedelka T4-ilaa-T3.
Cilmi-baadhayaashu waxay soo gabagabeeyeen maqaalkani qoraalka soo socda:
Fikradda ah in la sameeyo caddadka caadiga ah ee 'serum TSH' waxa ay qofka u sameeyaan (levothyroxine) kiliinikada daaweynta 'eyryroid' waa in dib loo eegaa tayada iyo tayada tallaabooyinka nolosha ayaa ahmiyad sare u leh cilmi-baarista hypothyroidism iyo tilmaamaha xirfadda.
Fahan Faahfaahin dheeraad ah oo laga helo Bianco Antonio, Antonio
Mid ka mid ah qorayaasha cilmibaadhista, Antonio Bianco, MD, madaxii hore ee ururada qanjirada American, iyo professor at University of Rush, ayaa wareysi siiyey MedicalResearch.com. Wareysigaas, ayuu sharxay daraasadda sii socota:
Marka la eego qiimaha daraasaddan soo socota waxay muujinaysaa in heerka caadiga ah ee heerarka TSH ee dadka bukaanka ah ee loo yaqaan 'hypothyroid' aan laga faa'iideysan karin sida loola jeedo in la kormeero daaweynta. Inkasta oo heerarka caadiga ah ee TSH-ga, bukaanadu waxay halis weyn ugu jiraan inay ku dhacaan niyad-jabka iyo dheef-shiid kiimikaad ah oo lagu garto miisaanka jidhka oo kordhay iyo heerarka sare ee kolesteroolka ... Waxaan dhihi karnaa in caadi ahaan heerka dhiigga ee dhiigga ee dhammaan calaamadaha la xidhiidha hypothyroidism waa inay tagaan . Tani waxay ubaahantahay inay isbeddesho.
War-saxaafadeed ka soo baxday daraasadda, oo ay soo saartay Rugta Jaamacadda Rush halkaas oo cilmi-baaris lagu sameeyay, Dr. Bianco ayaa sidoo kale yiri:
Inkastoo ujeeddada daaweynta ay tahay in bukaanjiintu ay dareemaan inay fiicnaanayaan, calaamadaha keligood looma isticmaali karo si loo helo garsoorka ku filan. Heerarka dhiigga dhiigga waa. Si kale haddii loo dhigo, qiyaasta daawada levothyroxine waxay ku saleysantahay heerarka kalkaaliya (TSH), mana aha in bukaanku dareemo in uu wanaagsan yahay. Waxyaabaha muhiimka ah ee lagu fahmo waa T4 ma aha hormoon firfircoon. T4 waa in loo beddelaa T3 jidhkeena oo leh enimme loo yaqaan deiodinase.
Bukaanku waxay ka cabanayaan niyad-jabka, gaabis ah oo leh maskax-siga. Waxay ku adagtahay inay miisaanka khasaarto. Waxay ka cabanayaan dareemid jilicsan oo leh tamar yar. Hase yeeshe dhakhaatiirta ayaa ku adkeynaya iyaga, "Waxaan ku siinayaa qadarka saxda ah ee dawada, Qadhiina waa caadi, waa inaad dareento fiicnaan."
Natiijooyinkani waxay ku xiran yihiin waxa bukaannadu noo sheegi lahaayeen. Daraasadani waxay dukumiinti u tahay markii ugu horeysay, si aan caadi aheyn, in bukaanka ku jira levothyroxine dareemaan wax ka sii daran oo ka firfircoon kantaroolka, waxay muujinayaan isbeddelada wadnaha ee loo yaqaan 'cardiometabolic' inkastoo ay caadi yihiin heerarka caadiga ah ee TSH.
Dr. Bianco waa mid ka mid ah hoggaamiyeyaasha dhaqdhaqaaqa si loo baaro in cillado hidde ah ee bukaanjiifka qaar wax u dhimi karaan shaqada deiodinase iyo waxyeellada T4-ilaa-T3, iyo sidoo kale in dheeraad ah T3-da daaweynta monotechoxine monotherapy ay keeni karto xal wanaagsan calaamadaha, tayada bukaanka ee nolosha, iyo hagaajinta caafimaadka ee loogu talagalay dadka qaarkood lagu daaweeyo hypothyroidism.
Dr. Bianco wuxuu si cad u sheegay in uu aaminsan yahay in daawo wanaagsan loo baahan yahay si loo daaweeyo hypothyroidism. Dhanka kale, wuxuu ku talineyaa in dhakhtarradu ka baxaan dhaqanka, "si sahlan loo daaweeyo, qaadashada kiniinkan, waxaadna noqon doontaa mid qurux badan" habka daaweynta, halkii aad ka qaadan lahayd qaab kale marka ay bukaanka la-talinayaan daaweynta hypothyroidism. Sida laga soo xigtay Dr. Bianco:
Dhakhaatiirtu waa inay u sheegaan bukaankooda, "Waxaan doonayaa in aan caadi ahaado Qaaxadaada, laakiin waxaad noqon doontaa khatar sare oo ah miisaanka, inaad la kulantid niyadjab iyo daal, sidoo kale waxay u badan tahay in kolesteroolkaaga kor u kaco." Taasi waa waxa aan u baahannahay inaan u sheegno bukaanka, oo ku salaysan daraasaddeena.
Waa maxay Cilmi-baaristu?
Muddo labaatan sano ah, u doodayaasha bukaan-socodka iyo qaar ka mid ah dhakhaatiirta ayaa sheegay in daaweynta monotherapy levothyroxine aysan aheyn midka kaliya. Inkasta oo ay u shaqeyso dadka qaba hypothyroidism, bukaanku weli ma dareemayo fiicnaan, inkastoo lagu daaweynayo levothyroxine, iyo in loo arko in uu yahay "dheecaanka" caadiga ah ee TSH, sida baaritaanka dhiigga.
Dr. Bianco wuxuu ka go'an yahay in uu baaro iyo horumariyo caddayn ku saabsan baahida loo qabo daaweynta T4 / T3 ee isku-darka daaweynta bukaan-socodka hypothyroid labadaba rajo iyo muuqaal. Haa, haa, sida Dr. Bianco uu sheegay, dawo wanaagsan ayaa loo baahan yahay si loo daaweeyo cudurka hypothyroidism.
Si kastaba ha noqotee, waxaa jira fursado loogu talagalay bukaanada in Dr. Bianco uusan si cad u doodin. Waxaad heli kartaa T3-gaaga bilaashka ah, oo haddii uu yaryahay ama aaney aad u fiicneyn, waxaad la shaqeyn kartaa dhaqtar kaasoo ku daraya daawada T3 - sida Cytomel (liothyronine), ama daroogo, daawo qoris ah - daaweyntaada, ama yaa kuu qori doona daroogada dabiiciga ah ee dabiiciga ah ee loo yaqaan 'thyroid drug' oo ay ka mid yihiin Nature-throid ama Armor Thyroid adiga.
> Ilo:
> Wareysi lala yeesho Antonio Bianco, MD. MedicalResearch.com. Oktoobar, 14, 2016.
> Xarunta Caafimaadka Jaamacadda Rush. War Saxaafadeed: Calaamadaha 'Hypothyroidism' calaamadaha inkastoo ay daaweyntu isticmaasho, baaritaanka dhiigga ee caadiga ah. Oktoobar 12, 2016. Maalinta Sayniska.
> Sarah J. Peterson, Elizabeth A. McAninch, Antonio C. Bianco. Miyuu yahay caadi caadi ah oo la dhaho 'Euthyroidism' oo ku jira Levothyroxine Monotherapy? Jariidada Daaweynta Cudurrada Endokrinology iyo Metabolism, 2016; jc.2016-2660