Haddii aadan aqoon u lahayn tayroodhka la isku qurxiyo, halkan waa deg deg deg deg ah. Isticmaalidda (qallalan) qanjirka 'thyroid' waa daroogada bedelka hormoonada hormoonka tayroodh ee diyaarsan ee laga soo qaado qanjirka thyroid ee doofaarka, oo loo yaqaan 'porcine thyroid.' Qaar ka mid ah magacyada caanka ah oo ay ka mid yihiin Armor Thyroid , Nature-thyroid, iyo WP Thyroid.
Qaadashada daawada thyroid waa daawo dhakhtar qoro, oo waxaa maamula FDA.
Waxay ku jirtay suuqa oo si ammaan ah loo isticmaalay in ka badan 100 sano.
Ilaa inta lagu daro thyroxine synthetic (oo sidoo kale loo yaqaano sida levothyroxine, oo leh magac calaamad ah oo ay ku jiraan Synthroid, Levoxyl, iyo Tirosint) ayaa la soo saaray 1950-yadii, tayroodh la qallajiyey waxay ahayd daaweynta hormoonka hormoonka oo kaliya.
Markii la soo saaro thyroxine synthetic, waxaa jiray waxyaabo badan oo xiiso leh oo ku saabsan sida casriga ah uu ahaa, marka la barbardhigo tirtirka qallafsan, kaas oo loo tixgeliyey gaboobay. Waqtigaas, dhakhaatiir badan ayaa bukaanka u beddelay daawada synthetic weligeedna dib uma eegin. Dhanka kale, qanjirka 'synthroid-synthroid-' oo ah Synthroid-wuxuu noqday mid muhiim u ah shirkadaha kala duwan ee daroogada kuwaas oo lahaan jiray xuquuqda Synthroid sanado badan, kuwaas oo ay ku jiraan Boots, BASF, iyo hadda AbbVie, oo ah isbaaro Abbott Labs.
Dhammaantood, sida shirkado badan oo daroogo ah, kuwa samafalka ee Synthroid ayaa maalgaliyey kulanno caafimaad, bandhigyo golf, shahaadooyin, deeqo cilmi-baaris, iyo kharashka hadlaha, waxayna bixiyaan suugaanta bukaanka bilaashka ah, qalimaan, dabiicado, cajalado, .
Waxaanu hadda haysannaa dhowr jiil oo dhakhtar ah oo lagu tababaray dugsiga caafimaadka si loo fahmo in levotokoxinka synthetic ay tahay dawada beddelidda tayroodh oo kaliya, iyo in badan oo ogaanaya magaca Brandt-ga gaar ahaan, sababtoo ah suuq-geynta baaxad weyn.
Dhakhaatiir badan ayaan ogayn in dabiiciga ah ee loo yaqaan 'thyroid' oo weli la heli karo, ama waxaa loo isticmaali karaa si badbaado leh si loogu daaweeyo bukaanada qaarkood ee hypothyroid.
Qaar waxay rumaysan yihiin in qoraallada dabiiciga ah ee dabiiciga ah ay adag tahay. Fikradahaas waxaa nasiib daro ku ah fikrado xun oo ka yimid wakiilada iibka levothyroxine, warar aan caadi aheyn oo lagu tirtiray tikitka ayaa ka baxaya suuqyada , iyo macluumaadka kale ee anekdotal.
Inkasta oo uu doorbidayo levotyroxine-da synthetic, taniyo 1990-meeyadii, daawooyinka tayroodhka dabiiciga ah ayaa bilaabay inay dib u soo kabtaan, iyada oo danta daawada dabiiciga ah ay korodho. Waqtigaas, bukaannada aan fiicnayn daawooyinka dheef-shiid kiimikaadka ayaa sidoo kale noqda kuwo awood badan oo waxtar ah, oo ka mahadceliya qeyb ka mid ah internetka. Bukaan-socodka waxay barteen in ay jiraan ikhtiyaari-iyaga dhexdooda, daawada qashinka tufaaxa sida Armor iyo Nature-throid.
Aynu cadaynno: Qaar ka mid ah malaayiin daawo ah sannadkii ayaa loo qoraa qanjirada la qallajiyey, marka la barbar dhigo in ka badan 30 milyan oo daawo ah sannadkii loogu talagalay levothyroxine. Hase yeeshee bukaanno wareersan oo aan si fiican u dareemin kuwaas oo imanaya goobaha sidan oo kale ah, akhrinta buugaagta, iyo la hadlida bukaannada kale. Sidaa darteed, waxay sii kordhayaan inay ogaadaan in ay jiraan fursado ka baxsan levothyroxine, iyo , in bukaanjiifka qaarkood ay dareemaan fiicnaan daawooyinka tayroodhka ah.
Cudurka Dabeecadda ee Endocrinologist ee Tijaabinta dabiiciga ah ee loo yaqaan 'Thyroid'
Bogga Endocrine Maanta , blog-ka, endocrinologist iyo osteopath Thomas Repas, DO, FACP, FACE, CDE, wuxuu sameyaa maqaal sadex-qaybood ah oo ku saabsan "Tijaabinta thyroid ee maaraynta hypothyroidism," oo ka muuqda muuqaalkiisa asosaar-yaqaane.
- Tijaabinta qanjirka 'Thyroid' ee Maamulida Hypothyroidism-Part I
- Qaadashada Qanjirka 'Thyroid' ee Maaraynta Hypothyroidism-Qaybta II
- Qaadashada Qanjirka 'Thyroid' ee Maaraynta Hypothyroidism-Qeybta III
Waa falanqeyn xiiso leh maxaa yeelay waxay bixisaa aragti cad oo ku saabsan sida ugu badan ee loo yaqaan 'endocrinologists' oo u eegta daawooyinka tayroodhka dabiiciga ah ee loo yaqaan 'tyroid drug desiccated', iyo sababta ay bulshadu u noqoto mid had iyo jeer ka soo horjeeda isticmaalka daroogooyinkaas. (Tani waa marka loo eego dhamaanba, MD-yada isku dhafan, kuwaas oo inta badan door bidaan in ay isticmaalaan qanjirada qallafsan ee loo yaqaan 'thyroid' sababtoo ah waxay u arkaan in ay u shaqeyneyso qaar ka mid ah bukaankooda.)
Dr. Repas wuxuu ku bilaabmaa isagoo dhahaya, sida asxaabtiisu ay ku jirto endocrinology, ma isticmaali karo qanjirka 'quotin' sababtoo ah, "Waxaan aaminsanahay in tayroodhka qallafsan yahay daaweynta dabiiciga ah oo aan mar dambe la isticmaalin."
Wuxuu sidoo kale sheeganayaa in dhakhtarka qanjirada 'Endocrinologists' uusan isticmaalin Armor sababta oo ah "heer aan la aqbali karin oo loo qaybin karo dufcado kala duwan, oo badanaa keenaya isbedel aan la aqbali karin ee hoormoonka kor u kaca." Isagoo xusaya in levothyroxine uu leeyahay isbaddal ka tarjumaya calaamada, waxa uu sheegayaa, "haddii aan tixgelinno kala duwanaansho yar oo u dhexeeya alaabooyinka kala duwan ee levotokoksin si ay u noqdaan kuwo muhiim ah, markaa wax badan oo isbeddel ballaaran oo ka yimaada diyaar garaynta tayroodhka ah waa wax aan la aqbali karin."
Qeybta III, Dr. Repas ayaa sheegaysa in inta badan dadku aysan riyooneynin in ay "u diraan dhakhtarka wadnaha sidii loo samayn lahaa dib-u-kicinta wadnaha ee wadnaha inta lagu jiro kalkaaliye wadnaha ... haddii kale dad macquul ah looma diideynin inay 'wax baraan' ku saabsan qanjirka '. Wuxuu markaas ku doodayaa in rabitaanka dhageysiga iyo xiisaha dabeecadaha dabiiciga ah ay ku dheehan tahay xiisaha dabiiciga ah ee dabiiciga ah.
Dr. Repas ayaa sheegay in mucaaradiisu tahay dabeecadda dabiiciga ah ee dabiiciga ah ay ku saleysantahay sayniska, laakiin wuxuu leeyahay xayiraad. Dr. Repas ayaa ku fashilmay inuusan jirin wax labanlaab ah, dib-u-eegis, daraasado indho-furan oo isbarbardhigaya levothyroxin si loo tirtiro tirokoobka marka la eego waxtarka lagu xaliyo calaamadaha bukaanka.
Dhab ahaan, Dr. Repas qudhiisa ayaa qirtay, qaybta faallooyinka ee Qeybta I:
Diiwaanka, waxan ugu walaacsanahay qotada tayroodhka (ama levothyroxine ama T3) waa marka ay ku qoraan qaab natiijada fog ee dheeraadka ah ee hypothyroidism. Haddii bukaanku aanu ahayn hyperthyroid oo ay ku fiicnaadaan hal shey oo kale, waa mid aad u adag in laga doodo taas.
Waxa uu sidoo kale soo gabagabeynayaa Qaybta III iyadoo faallo bixinaysa:
Ugu dambeyntii, toddobaadkii hore waxaan arkay haweeney la socotay tirtirkii tafatirka muddo tobanaan sano ah. Waxaan sharaxay in aan hadda doorbideyno levothyroxine halkii aad ka tirtiri lahayd tirokoobka. Waxaan sidoo kale si deg deg ah u tilmaamay in hormoonka kor u kaca ee hormoonada uu ahaa mid aad u fiican, intii u dhexeysay 0.7 mIU / L iyo 1.0 mIU / L dhowrkii sano ee la soo dhaafay. Waxay lahayn wax astaamo ah; way igu adagtahay in aan ku doodo guul. Kadib markaad ka hadasho oo aad waydiiso waxa ay rabto in ay sameyso, waxay ka tagtay xafiiskeyga wali qallafsan.
Markii maktabada markii hore la daabacay, waxaa jiray faallo badan oo ay ka tageen bukaannadii kuwaas oo ay ka xanaaqeen. Dhanka kale, Dr. Repas wuxuu isku dayay inuu sharaxo sababta uusan u rumeysaneynin Armor Thyroid, isaga oo ku magacawday wax aan khabiir aheyn oo sheeganaya in taageerayaashu ay ku mashquulsan yihiin "fikirka macquulka ah." Laakiin Dr. Repas ma bixinin caddayn cilmi ah oo lagu taageerayo sheegashadiisa, waxana uu dayacday waayo-aragnimada nolosha dhabta ah ee boqollaal iyo kumanaan bukaan-socodka bukaannada qaba iyo kuwa ku takhasusay.
Isla mar ahaantaana, Dr. Repas ayaa sidoo kale qiray, in laga fikiro fikradda dhabta ah, in walaaciisa koowaad uu ka sii darayo bukaanka udub dhexaad u ah dawada tayroodhka - ma ahan kaliya qallajinta qanjirka. Waxa kale oo uu qiray in haddii bukaanka si habboon loo maareyn karo tayroodhka la qallajiyey, ka dibna ma arko sabab sababtoo ah "ku doodi guul."
Dr. Repas kuma bilaabi doonto bukaanka cusub ee qanjirada qashin-xitaa haddii ay waydiiyaan. Haddii bukaanka hadda jira ee levothyroxine uusan fiicneyn inuu weydiisto inuu u wareego qanjirada qallafsan, ma sameyn doono. Laakiin haddii bukaanku horay u socdo oo uu si fiican u shaqeynayo, waxa uu sheegi doonaa in uusan "ku doodi doonin guul" wuxuuna sii wadi doonaa inuu qoro qashinka loo tirtiro isaga ama iyada.
Siyaabaha qaarkood, Dr. Repas wuu furfuran yahay marka loo eego qaar ka mid ah dhakhtarka indhaha. Waxaa jira qaar ka mid ah kuwa aan si fudud u heli doonin wax bukaan ah oo ku jira daroogo T3 ama la tirtiro. Qaarkood xitaa dabka ka riixaan bukaankooda ku adkeysta daroogada dabiiciga ah, ama kuwa aan raacin tilmaamaha. Laakiin Dr. Repas sidoo kale waa wakiil cad oo muuqaal ah oo aynu ka dhex aragno dhakhtarka indhaha. Walaaca ugu muhiimsani waa "Qiimaha caadiga ah" ee ugu sarreeya - iyo ujeeddadeeda daaweyntu waa inay bukaanku noqdaan kuwo caadi ah. Qaraarka calaamaduhu wuxuu u muuqdaa mid aan ku habbooneyn oo wuxuu qaataa kursiga dambe ee maareynta heerarka TSH.
Ereyga ka
Haddii lagugu daaweeyo hypothyroidism oo leh Synthroid ama levothyroxine oo kali ah waxaadna leedahay calaamadaha joogtada ah ee hypothyroidism, la hadal dhakhtarkaaga wixii suurtagal ah ee isku day inaad dabiiciga ah ee dabiiciga ah ee dabiiciga ah.
Haddii dhakhtarkaagu uu diido inu ku qanco fursaddaas oo aanad ku siineynin sabab wanaagsan oo gaar ah caafimaadkaagu, waxay u adeegi kartaa dantaada ugu fiican si aad u raadsato ra'yi kale oo ka socda dhaqtar kala duwan - feker ahaan dhakhtarka isku dhafan ama dheelitiran oo raaxo leh ikhtiyaarrada dawooyinka tayroodh-ka horjeeda cilmi-baarista endocriniga.
> Ilo:
> Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10-aad. WLL / Wolters Kluwer; 2012.
> Garber, J, Cobin, R, Gharib, H, et. al. "Tilmaamaha Tababarka Caafimaadka ee loogu talagalay Hypothyroidism ee Dadka Qaan-Gaarka ah: Cosponsored by American American of Endocrinologists Clinical Association iyo Ururka Tiriida ee Maraykanka." Tababarka Indhaha. Vol. 18 No 6 Noofembar / Disembar 2012.
> Repas, T. DO, FACP, FACE, CDE. "Tijaabinta thyroid ee maamulka ee hypothyroidism: Qaybaha I, II, III." Maanta Endocrine. Janaayo 2009. Online