Cilmi-baadhis la helo Bukaan-socodka badankoodu way fiicnaadeen iyadoo la raacayo T3
Febraayo 11, 1999 - Bishii Febraayo 11, 1999 ee wargayska New England Journal of Medicine ee ku saabsan natiijooyinka cilmi-baarista taasoo lagu ogaaday in "daaweynta thyroxine iyo triiodotyronin ay hagaajisay tayada nolosha dadka badankood [hypothyroid].
Maqaalka ayaa cinwaankeedu yahay:
"Saamaynta Thyroxine ee la barbar dhigta Thyroxine iyo Triiodotyronine ee Bukaanka qaba Hypothyroidism"
by Robertas Bunevicius, Gintautas Kazanavicius, Rimas Zalinkevicius, Arthur J Prange, Jr.
Cilmi-baaris ayaa waxaa sameeyay machadka Endocrinology, Jaamacadda Kaunas Medical, Kaunas, Lithuania oo ay weheliso Waaxda Dhimirka, Iskuulka Daawada, Jaamacadda North Carolina, Chapel Hill.
Sidee loo daraaseeyay
Dhab ahaantii, waxay qaateen koox 33 qof ah oo loo yaqaan hypothyroid, ama sababo la xiriira cudurka tayroodhka ee "autoimmune thyroid disease", ama ka saarista qanjirada ay sabab u tahay kansarka qanjirka 'thyroid'. Dhammaan bukaanka waxaa la baray laba jeer shan toddobaad. Inta lagu jiro mudo shan todobaad ah, bukaanku wuxuu qaatey qiyaasta caadiga ah ee levothyroxine oo kali ah. (Levothyroxine waa magaca guud ee magacyada calaamadaha sida Euthyrox, Levoxyl, Levothroid, Levothroid iyo Synthroid.) Muddada shan toddobaad oo kale, bukaanku wuxuu helay levothyroxine PLUS triiodotyronine (T3.) (Fiiro Gaar ah: Maraykanka, magaca calaamadda T3 waa "Cytomel") Marka la eego T4 ee T3 iyo T3, 50 μg ee qiyaasta daawada levothyroxine ee caadiga ah ayaa lagu beddelay 12.5 μg of triiodotyronine (T3).
Tijaabo badan oo dhiig ah, baaritaan, niyad jimicsi iyo jireed ayaa lagu sameeyay dhowr marxaladood oo tijaabo ah.
Natiijooyinka
Laga soo bilaabo dhinaca saameynta physiological, farqiga u dhexeeya garaaca wadnaha, cadaadiska dhiigga, fal-celinta iyo howlaha kale ee T4 oo keliya, T4 iyo T3, waxay ahaayeen kuwo aad u yar. Cadaadiska dhiigga iyo kolestaroolka xaqiiqda ayaa hoos u dhacay T4 iyo T3.
Halka natiijooyinka ay ahaayeen kuwo aad u xoogan waxay ku shaqaynayeen maskaxda. Bukaanku waxay ku fiicnaadeen hawlo kala duwan oo ka mid ah hawlaha nöropsychological ee T4 iyo T3. Bukaanada 'dhimirku waxay kaloo muujiyeen horumarinta T4 iyo T3.
Dhamaadka daraasadda, bukaanka ayaa la weydiiyay haddii ay doorbidaan daaweynta koowaad ama labaad. 20 bukaan ah ayaa sheegay in ay door bideen daaweynta T4 iyo T3, 11 ma lahan wax doorasho ah, kaliya 2 ayaa doorbiday T4 kaliya. 20 bukaanno oo doorbiday T4 iyo T3 waxay soo sheegeen inay heystaan tamar badan, fayo qabka oo fiicnaaday, oo keliya ayaa dareemay guud ahaan guud ahaan.
Cilmi-baadhayaashu waxay go'aamiyeen in "daaweynta tayriska iyo triiodotyronin ay wanaajisay tayada nolosha bukaanka badankood."
Cilmi baarayaashu waxay sidoo kale ku taliyeen in barnaamijka beddelidda thyroid hormone ee loogu talagalay qof aan lahayn qanjirka thyroid, ama qanjidhka qanjidhka uu ku dhow yahay mid aan shaqeyn, wuxuu noqon doonaa "10 μg oo ah triodotyronin maalin kasta oo qaab maalinle ah oo la sii deynayo oo ay weheliso tyroxin ku filan si loo hubiyo ficil-celinta. "
Saameynaha Daaweyntaada
Daraasadani waxay leedahay saameyn weyn oo loogu talagalay dadka aan u fiicnayn beddelka hormoonka tayroodhka ee hadda jira.
Haddii aad ku jirto daaweynta levothyroxine oo keliya, waxaa suurtogal ah, sida inta badan maadooyinka waxbarashada, aad adigu aad u fiicnaan kartid marka lagu daro waqtiga soo-saarka T3 ee saamiga lagu taliyey.
Haddii aad ku jirto Armor Thyroid ama Thyros, boqolleyda hadda ee T3 ee daroogooyinkaasi waxay noqon karaan qaar aad u sarreeya, marka loo eego saamiyada lagu taliyay ee lagu sharaxay daraasaddan. Natiijooyinka ugu wanaagsan waxaa laga yaabaa in la helo iyada oo wax laga beddelayo habka daweynta si loo gaaro qaas ahaan qiyaasta lagu taliyey in lagu qeexay qodobkan.
Haddii aad ku jirto bedelka hoormoonka tayroodh oo aanad fiicnayn, waxaan kugula talinayaa in aad isla markiiba u sheegto dhakhtarkaaga daraasaddan cilmibaadhista, oo aad nuqul ka qaadato buuggan.
Haddii aad la wadaagto wax macluumaad ah oo dhakhtarkaaga ah, isla mar ahaantaana, waxaad sidoo kale dooni kartaa inaad nuqul ka bixiso maqaalada "British Medical Journal" oo soo jeedinaysa in qiimaha ka sarreeya Qabka 2aad aysan ahayn "caadi", lakiin dhab ahaantii heerar aan caadi ahayn oo tilmaamaya qanjirkii horey u jiray ee geedi socodka guuldarada.
Waxaad ka dalban kartaa nuqul adiga oo wacaya Waaxda Adeegyada Macaamiisha ee New England ee 1-800-THE-NEJM
Sawirka Weyn ee loogu talagalay Bukaannada Qanjirka 'Thyroid'
Tani dhab ahaantii waa cilmi baaris ah, oo xaqiijinaya jawiga cilmi-baarista waxa badan oo bukaanjiif ah, aniga naftayda ku jira, iyo dhakhaatiirta qaarkood, waxay dalbanayeen dhowr sanadood: bedelka hoormoonka tayroodhka ee levothyroxine kaliya kama tago boqolkiiba tiro badan ee bukaanka qaba hypothyroid, iyo bukaannadani waxay dareemaan oo ay ka shaqeeyaan marka T3 lagu daro beddelidda hormoonka tayroodhkooda.
Arrinta xiisaha leh, tani waxay sharraxaad ka bixineysaa sababta ay bukaanku ugu fiicnaadeen daawooyinka kale ee tayroodhka sida dabiiciga ah ee Thyroid Thyroid, Westhroid iyo Naturethroid, oo ay ku jiraan T4 iyo T3 dabiiciga, iyo daroogada T4 / T3 Thyros, taas oo ah daroogada qaado. Xaaladaha qaarkood, bukaanka ayaa sidoo kale ku darey Cytomel (synthetic T3) ama waqti-sii-deynta T3-ga daaweynta levothyroxine-da caadiga ah iyo weliba natiijooyin wanaagsan.
Muddo sanado ah, bukaanno ayaa loo sheegay in dhammaantood ay u baahan yihiin daaweynta levothyroxin si ay u helaan "caadiga ah TSHda caadiga ah", iyo daaweynta dhirta ayaa loo tixgeliyaa dhamaystiran. Wakhti iyo wakhti marba, dadka weli wata calaamadaha - oo ay ku jiraan daal, niyad-jabka, dhibaatooyinka garashada, iyo waxyaabo kale - ayaa la sheegay in markii ay tiradoodu ay caadi ahayd, dhibaatooyinkan la xiriirin qanjirka, , walwalka, PMS, ama si fudud "madaxaaga." Bukaan-jiifkii si wanaagsan u shaqeeyay sannadkii Armor, ka dibna wuxuu u wareegay Synthroid, tusaale ahaan, wuxuuna ka cabanayay inuusan si wanaagsan u dareemin in loo sheegay inay "jirayaan."
Tixgeli hadalkii dhawaanahan ee The Bridge, wargeyska sadexdii bilood ee ka soo wareegtay Hay'ada Thyroid Foundation of America, oo ah ururku u malaynayo in uu ka mid yahay arrimaha soo jiidashada arimaha bukaanka iyo u qareemeynta:
"Baaritaanka TT waa mid aad u cad, iyo haddii ay TSHUdadu caadi tahay, marka dhibaatada qanjidhada ka baxda maaha sababta calaamadahaas."
Douglas Ross, La taliyaha Caafimaad ee Qaybta Thyroid Foundation of America
Waa arrin aan la ogaan karin in bukaannada la iska indho tiray, loo diidey, la iska indho tiray, oo ay sameeyeen illaa iyo intii ay ku sugnaayeen xarunta caafimaadka ee caadiga ah, ururada tayroodhka iyo kooxaha caafimaadka.
Dhanka kale, dhakhaatiirta daawooyinka dabiiciga ah sida Armor-ama xitaa wax-soo-saarkooda Thyros-waxay ku qoran yihiin sida xatooyo, ama masuuliyad darro, ama mararka qaarkood, xitaa ay ku soo qaadaan eedaymaha ay ku hayaan nimanka levothyroxine-keliya ee guddiyada caafimaadka ee degaanka .
Aynu rajeyneyno in macluumaadkan uu keeno bukaanka iyo ururada caafimaadka, iyo sidoo kale dhakhtarka, in uu bilaabo dhageysiga bukaan socodka - iyo in aaney shirkadaha dawooyinka.
Dhab ahaantii, waxa ay ahayd mawqifka suuqgeynta shirkadaha sida Knoll Pharmaceutical, soo saaraha Synthroid, in levothyroxine oo kaliya ay tahay qof kasta oo u baahan. Ka dib markii midigta ka dambaysa oo ereyada lagu dhajiyo erey kasta waxay aheyd hareeraha farsamoyaqaannada endocrinologists kuwaas oo si farxad leh uga faa'iideysanaya Knoll iyo ra'yigeeda 'bixinta lacagta, maalgelinta mashruuca, kharashka shirarka, iyo ciribtirka, iyo waxay diidaan inay dhagxaan doonka lacagta levothyroxine.
Hogaaminta marti-gelinta waxay ahayd sida saaxiibo Richard Guttler, oo naftiisa ku magacawday "thyroidologist" wuxuuna bukaanka ka qaadaa $ 150 ama in ka badan - "loo baahan yahay horay" - adeegiisa "Second Opinion" ee internetka. Sanadkii la soo dhaafay, wuxuu si taxadar leh u eryey bukaannada ka cabanaya calaamadaha aan la xalin iyo rabitaanka ah in ay isku dayaan daawooyinkan kale ee hadda la ogaaday inay shaqeynayaan si ka wanaagsan. Sanadkii la soo dhaafay, akhristaha bogga ayaa u qoray isaga si uu u ogaado in maqnaanshaha Synthroid ka dib markii seddex ilaa afar maalmood ay ka niyad jabtay qufac joogto ah oo ay ku jirtay muddo 20 sano ah (ama ka badan) sano. Waxay u sheegtay inay u beddeshay Armor. Wuxuu dib u soo qoray iyada: "nolol raadso synthroid maaha sababta dhibaatooyinkaaga." Sanadkii la soo dhaafay, Guttler ayaa sidoo kale iigu riday aniga oo leh magaciisa gaarka ah ee "sariirta sariirta" (oo aan lahayn xarfo waaweyn iyo xarakayn)
"Waan ku faraxsanahay" foojishooyinka "waxay soo buuxinayaan boostadaada, ma ahan miino, noloshayda ayaa fududeyneysa wax ka qabashada kaliya bukaannada qanjirada caadiga ah ee aan marnaba ka fekerin in ay qaataan hubka ama qashinka circa ama cytomel.what samee marka ay ugu dambeyntii qaadaan tirakoobka suuqyada marka xigta waxay noqon doontaa naqshadeeyaha dabiiciga ah ee bakeeriga dabiiciga ah ee qoob ka ciyaara ee ku shaqeeya boggaaga ... dr.g
Tijaabi dhamaan bukaanada si dhakhso ah u socota si ay uga fogaan karaan dinosaurs sida "dr. G" ay u soconayaan tirada sii kordheysa ee "fareemaha" - dhakhaatiirta takhasuska ah ee takhasuska leh oo dhegeystey bukaanada, iyaga oo naftooda u fakaray, cadaadiska iyo shirkadda dawooyinka ee saamileyda suuq-geynta, oo ay weheliyaan tababarro ku salaysan aqoontooda in daawooyinka T3 ay si fiican u shaqeeyaan badanaa badanaa.
Dhakhaatiirtaas oo kale muddo dheer oo la cambaareeyay "fringes" ayaa hadda lagu caddeeyay mid ka mid ah xayawaanka aadka u daran ee daawada caadiga ah, Journal of New England of Medicine