Kubvunzurudza naErizabheti "Lily" Conrad, MD
Elizabeth Conrad, MD - anozivikanwa nevarwere vake se "Dr. Lily" - chiremba anobatanidza mukuita mu McLean, Virginia. Dr. Lily ane anotevera akazvipira kune varwere vari kumuona nokuda kwehutano uye kusaenzana kwehomoni. Akabvumirana kugoverana pfungwa dzake pamusoro pokusvika kwake pakuongorora nekurapa varwere muhurukuro iyi ye Q & A.
Mary Shomon: Wakatanga nechinangwa chekuita mishonga yemagariro / chetsika uye kushandura pakubatanidza / kutenderera, kana wakagara uchida kuva mutori weMDC here?
Chii chakakurudzira kana kukufuridzira iwe?
Dr. Lily: Ndave ndichiziva nguva dzose kuti ndaizova chiremba. Isu takawanda kupfuura zvatinogona kuona, kubata kana kuyera mubvunzo webazi. Simba redu rekuvandudza mararamiro edu uye hutano zvinowedzera zvinoshamisa apo tine pfungwa, muviri, nemweya. Ndakanga ndine rufaro zvikuru kuti chiremba wechiremba wevana vanoita bvunzurudzo yangu kuColumbia University College ye Physicians & Surgeons aiva nemafungiro akazaruka uye anofarira kunzwa pamusoro pekuita uye kubatsira kwekufungisisa. Takapedza zvakawanda zvehurukuro pamusoro pekufema uye kufanana pakati pekufungisisa nekurovedza muviri.
Hormonal Issues
Mary Shomon: Zvaunoita, Zvakanaka Kuva-Zvakanaka, zvinoshanda nevarwere vakawanda vane kusaenzana kwehomoni. Ndezvipi zvinowanzosangana nehutachiona hunoonekwa mune varwere vakokadzi?
Dr. Lily: Tinoona vakadzi vakawanda vane zvinetso zvine chokuita nePremenstrual Syndrome (PMS), Polycystic Ovarian Syndrome (PCOS), hypothyroidism , nguva yokuguma, uye kumisa kwemwedzi .
Isu tinoonawo varwere vari kufunga nezvekudzivirira, vakadzi vane insulin yekudzivirira, masimba emagetsi, uye pre-diabetes .
Mary Shomon: Unofunga kuti nei zvakaoma kuvarwere vakawanda vanoona vanachiremba vanowanzogadziriswa kuti vawane zvakajeka vane utachiona, adrenal, kana mamwe maitiro asina kufanana ehomoni?
Dhiyabhorosi Lily: Zvinotora nguva, izvo zvinogona kunge zvisingakwanisi muitiro unoona 20 kana kupfuura varwere pazuva. Uyewo, dzakawanda zvekusaenzana kwezvinhu izvi hazvina kunyatsooneka uye hazviwanikwe nyore nyore kushandisa maitiro akaenzana. Vanhu vanogona kuva nehupenyu hwehupenyu hwehutano uye hutsika hungave huri mumiganhu yakatarwa. Semuenzaniso, mararamiro akaenzana e-cortisol akazara kwazvo, nekuwedzera, chii chinowanzoitwa pabazi hachisi chaicho chakanaka. Zvakakosha kutarisana nomunhu wose, mubatanidzwa, uye kutarisa zvinhu zvakawanda: chikafu, kushandiswa kwepfungwa, kusununguka kwezvakatipoteredza, etc. kubatsira kutsigira utano hwakanaka.
Kudzidziswa kwedu mune mishonga inowanzogadziriswa inowanzochengetwa kuchipatara uye yakanakisisa kusvika pakuona uye nekurapa zvirwere zvakakomba. Kurwiswa kwemwoyo, kurohwa, uye appendicitis zvose zvinoshandiswa zvakanakisisa nenzira inowanikwa. Vanachiremba vakarovedzwa pamagungano vanoziva kuti imwe neimwe yehutano inobata vamwe. Somuenzaniso, nzara uye nguva dzisinganzwisisi nguva dzinowanzovandudza apo utachiona hwakagadziridzwa. Zvisinei, pane zvayo, nzira inowanikwa inogona kunge isingabatsiri kune zvirwere zvisingaverengeki zvisingagumi uye kusaenzana.
Mishonga inogara ichichinja uye ichivandudza. Sechiremba, tinoda zvakanakisisa kuvarwere vedu. Vanachiremba vanobatanidza vakagadzirirwa zvakasiyana nezvimwe zvishandiso zvekugadzirisa kusaenzana kusinganzwisisiki; zvakadai semishonga, kudya, uye kugadziriswa kuitira kupa mutano mumwe nomumwe murwere.
Mishonga yekumabvazuva inobatanidza kukosha kwekuenzanisa, uye izvi zvinowedzera zvakanyanya pakurapa kwedu maonero. Muviri wakaita sebindu raunofungidzirwa, kukurudzira kubatana uye simba. Maonero ezvakaitika ndeyekutarisa zvirwere sechimwe chinhu chatinorwisa kana kudzvinyirira nemishonga.
Sevadzidzi vezvokurapa, isu hatiwanzove nehuwandu hwemishonga yemishonga, kudya kunovaka muviri uye kuwedzera, maitiro ekugadzirisa muviri uye maitiro emagariro. Nenzira inofadza, izvi zviri kuchinja uye zvikoro zvinotanga kusanganisira Complementary / Alternative Medicine (CAM). Zvinokurudzira kuona mapiyona akaita saDkt Jim Gordon, weCent for Mind-Body Medicine neGeorgetown University kuWashington, DC, anokurudzira kushanduka kwehutano hwakanaka, sezvo isu tichibva kure nechinangwa chemishonga uye kuvhiyiwa panheyo nokuzvitarisira uye maitiro eCAM panharaunda kusvika pakuisa pfungwa pakuzvitarisira, nekudzivirira uye hukama hwakanaka sekutarisa uye naizvozvo kuderera kuduku kwezvinodhaka nekuvhiya.
Zvinonzwisisa zvikuru.
Thyroid Issues
Mary Shomon: Ndeapi miedzo uye nyaya dzinoita kuti iwe uzvifungidzire kana uchitarisa mukadzi nokuda kwedambudziko rehutachiona ?
Dr. Lily: Ndiri kufarira munhoroondo yaro uye zvaari kuwana, kana pane nhoroondo yehutano mumhuri yake. Ini ndichaongorora dzimwe zviratidzo uye ndinozoongorora muviri. Kuedza kunowanzosanganisira TSH, Free T3, Free T4, Inoshandura T3, Thyroid Antibodies, anti-thyroglobulin uye thyroid peroxidase antibody. Kakawanda test adrenal inoitwa pamwe chete nedzimwe mimwe miedzo inogona kudiwa.
Mary Shomon: IAmerican Thyroid Association ya2014 Hypothyroidism Guidelines inoti hypothyroid varwere vanofanira kungorongedzerwa levothyroxine, uye izvo zvinorayira T3 uye / kana zvakasikwa zvinoshandiswa nehutachiona zvinodhaka hazvina musoro kune vanachiremba. Iwe unofungei pane nzvimbo yeATA?
Dr. Lily: Pane gakava pamusoro pekushandisa kweT3 kugadzirira .
Vamwe varwere vanoita zvakanaka kune T4 uye vanogona kuchinja T4 kusvika kuT3 pasina matambudziko. Zvisinei, havasi varwere vose vanogona kuita izvi zvakanaka. Ndinowana Free T3 uye Shandura T3 kuti ive yakakosha pakunzwisisa kusakwanisa kweT4 mune vamwe varwere. Ongororo dzakawanda dzakaratidza kuti kugutsikana kwechigarire kwakakura neT4 / T3 therapy pamwe chete . Nenzira yakanaka, ATA inoziva kukosha kwekuenderera mberi tsvakurudzo munzvimbo ino. Ndinofara kuti ikozvino zvidzidzo paSlow Release T3 zviri kuitwa. Kunonoka kusunungurwa kugadzirira kunowanzomiririra zviri nani kudarika kusunungurwa pakarepo T3.
Mary Shomon: IAmerican Thyroid Association ya2014 Hypothyroidism Guidelines inoti hypothyroid varwere vasinganzwi zvakanaka kana vakapa levothyroxine uye vachidzorerwa ku "euthyroid" mazinga vanofanira kutumirwa kunongororwa kwepfungwa. Iwe unofungei pane nzvimbo yeATA?
Dr. Lily: Pane dhiyabhorosi iyo inoratidza kuti mamiririri eT4 ane murwere angave akakwana asi mazinga eT3 anowanzowa apo anopiwa T4 oga. Maitiro uye manzwiro ehutano anogona kukanganiswa neT3-serotonin.
Ndinofunga kuti zviri nani kuti vaone chiremba wemhuri kana kuti mudzidzisi wavo kuti ave nechokwadi chokuti zvinhu zvose zvakatariswa. Varwere vanoramba vachiratidza zviratidzo vakakodzera kuongororwa zvakakwana, pamwe zvimwe chimwe chinhu chiri kuitika ... saRyme Disease kana Lupus . Zvirwere zvakawanda zvinogona kupa nekuneta. Kana paine kuora mwoyo vanogona kubatsirwa nekuona unyanzvi hwechirwere chepfungwa.
Mary Shomon: Chii chaunoziva ne hypothyroid varwere ? Chii chaunosarudza kurondedzera kune varwere vako: levothyroxine, yakagadzirwa T4 / T3, T3 chete, yakasikwa yakarongwa nehutachiona, yakakonzerwa nemishonga?
Dr. Lily: Ndinorayira izvi pane imwe nyaya nemhosva. Varwere vanoita sevanofara zvikuru nekusanganiswa kwechirwere uye chimiro chakasikwa chetachiona chinoshanda zvakanaka. Inowanikawo kuburikidza nemapetromasi akawanda.
Adrenal Imbalances
Mary Shomon: Pane mhirizhonga yakawanda pamusoro pehupo chaihwo hwe "adrenal fatigue" kana kuti adrenal insufficiency . Nyika inoshandiswa yezvokurapa inotaura kuti tine Cushing's Disease kana Addison's Disease , uye zvimwe, hapana misi ye gray muadrenal function. Iwe unofungei kuti nei chiremba chaiwo ichichiona nenzira yakasviba neyechena?
Dhiyabhorosi Lily: Cushing's Disease uye Addisons zvirwere ndezvipi zvakanyanya zve cortisol zvakanyanya uye kusakwana. Ndinotenda kuti kuonekwa kwechirwere chisina kukwana (RAI) chiri kuwedzera. Semuenzaniso, zvinowanzojairika mune chirwere chisingaperi chechiropa. Chidzidzo chakanaka chakabudiswa munguva ichangopfuura paRai mune varwere vane chirwere chechiropa, (Ailment Pharmacol, Ther, 2014 Oct; 40 (7) 819-26.)
Chimwe chikonzero chinoita kuti adrenal kusagadzikana zvakaoma kuziva kuti iyo tsika dzakanaka dzakasiyana zvakadai, somuenzaniso, cortisol yemangwanani ine mararamiro akaenzana a2-20. Iyi "inonongedza" mangwanani inogona kunge isina kukwana. Ndinosarudza kuwana kuverengeka kwakawanda zuva rose sezvinonzi muchero, Genova Adrenal profile test.
Mary Shomon: Ndeipi nzira yako yekuziva nekurapa kusanzwisiswa kwemazana mukati mevarwere vako ?.
Dr. Lily: Tinoita nhoroondo yepamusoro uye kuongorora muviri kunoshandiswa sezvinodiwa. Varwere vazhinji vanogona kuva nehana yakasimba yeropa, uye tichaona kutora kwavo uye kuwedzera kweropa munzvimbo dzakasiyana. Kazhinji ini ndicharayira kuongorora saliva ye cortisol iyo inotipa kuverengwa kwakawandisa zuva rose, DHEA-S inowanikwa munyaya iyi zvakare. Basa rega rega rega rinowanikwa kusanganisira yakazara chemistry profile. Tinotarisa michina yakakosha yakadai seVitamin D nemaminerari akaita se magnesium. Zvichienderana nemurwere, ndinogona kutarisa zvimwe zvinokonzera zviratidzo zvavo. Isu tinozotanga kuronga hurongwa hwokutarisa zvikonzero zvinokonzera zviratidzo kana zvichibvira. Zvinyoro zvishandiso zvekugadzirisa nyaya idzi zviripo, zvakadai semafungiro emagariro-pfungwa uye kushandisa adaptogenic herbs seAshwagandha.
Kuonda
Mary Shomon: Vakadzi vazhinji vari pakati pezera remakore, uye vezera revanhu vanorwara uye vanopedzisira vari kurwisana nekurema, kana kuti kuoma kuneta. Ndezvipi mazano evamwe mauri kune vakadzi vari kudya zvakanaka uye vachirovedza, asi vane uwandu hushoma hwekurasikirwa?
Dr. Lily: Kutanga, ndinoda kutaura, zvakanaka kwauri. Kudzidzira muviri uye kudya kunopa utano kuchakubatsira kuti unzwe zvakanakisisa uye uchengetedze hutano hwakanaka kupfuura kugara, uye usingadyi miriwo nemichero yakakwana. Zvadaro, ndinoda kuve nechokwadi kuti ari kudya zvakakwana, kunwa mvura yakakwana yakakwana uye kuwana zororo rakakwana. Kazhinji kacho kurasikirwa kwemasero nekuda kwekusakwanira kudya kweprotein uye makoriyori kana kusakwana kwakakwana. Kana iwe uchiri kunetseka ona mumwe munhu anogona kukwanisa newe kuti abatsire kuziva kuti uripi, uye ita urongwa hwokukutsigira kwaunoda kuenda. Vamwe vakadzi vari kusimudza cortisol nekudarika, asi vamwe vangave vakakwirira insulini. Purogiramu yako inofanira kuenzaniswa newe.
Mind-Body Medicine
Mary Shomon: Tiri kutanga kutanga kuziva kukosha kwekuderedza kushungurudzika, kusanganisira kufara, uye kuisa simba rekufunga kwemuviri-pfungwa kushanda sechikamu chehutano hwakanaka. Iwe une dzimwe pfungwa pane dzimwe nzira dzakanakisisa dzevakadzi vanogona kuita izvi, takapiwa upenyu hwedu hwakabatikana?
Dr. Lily: Chimwe chezvinhu zvandaifarira ndezvekushanda panguva dzekufunga mazuva ese. Paunopinda panze, inzwa tsoka dzako pasi, tora mweya uye utarise kumusoro. Cherechedza denga, unonzwa zuva riri pahuma yako here? Kune makore, kune mhepo here? Kune shiri kana dzimwe mhuka here? Paunosvika kumusha tora mweya uye ona kuti uri kunzwa sei munguva iyoyo. Kana iwe uchidya, tora nguva yekufunga chimwe chinhu chaunoonga nacho uye uchipa kuvonga. Zvadaro cherechedza kuonekwa kwezvokudya, ruvara rwazvo ipapo kunhuhwirira kwayo kubwinya uye kunhu. Sevakadzi, isu tinowanzotarisa mhuri yedu uye isu tinogona kuzvidya nenzira iyi uye kudzidzisa vana vedu kutarisa munguva iyo. Vana vangu vachandiyeuchidza kana ndakakanganwa nyasha dzedu, iyo inowanzoita seyiyi: munhu mumwe nomumwe anotaura muchidimbu chinhu chimwe chavanoonga nacho patinofamba-famba patafura. Kutora nguva yekumira uye kuonga kunogona kuchinja pfungwa dzedu uye kutibatsira kuti tigadzirire kugamuchira.
Chimwe chinhu chakareruka ndonyora zvinhu zvitatu zvaunoonga zuva rega rega, zvichida pane pati duku patafura yako yepamubhedha. Iyo inzira yakanaka yekutanga kana kupedza zuva.
Tsvaga chiito chaunoda, chinonzwa sokuti kwauri. Yoga, pilates, Tai Chi, Qi Gong, kuitisa, kubuda panze, kufungisisa kwefungwa uye kutungamirirwa nemifananidzo zvose zvinogona kutibatsira kusimbisa mutano wepfungwa.
Tsvaga chimwe chinhu chaunoda uye edza kuzviita nguva dzose. Kune mamwe mazano akanaka anowanikwa ane maitiro mashomanana asi anoshanda aunogona kuita mumaminitsi gumi.
Kana iwe uchida kirasi yako yega, yakakura! Sarudza nzvimbo mumba mako kwaunokwanisa kubvisa marara ako uye kupedza 5-10 maminitsi pazuva uchiita maitiro uye kufema. Kana iwe unogona kutambanudza izvozvo kumaminitsi makumi maviri, kunyange zviri nani!
Chimwe Chimwe Chero Mumiriri Wega Oga Anofanira Kuita
Mary Shomon: Kana pane chinhu chimwe chete iwe unogona kuva nechokwadi chokuti mumwe wevarwere vako aizodaro kuti achinatsire hutano, chii chaizove?
Dr. Lily: Iva nomutsa kwauri, tora nguva yekuzvitarisira, zvibata iwe sezvaunoda shamwari yakakosha!
Elizabeth (Lily) Conrad, MD, akapedza chikoro kubva kuChikoro cheMasikirwo neViongorori veKunivhesiti munaChitatu muna 1991. Akapedzisa kugara kwake mumhuri yemhuri paThe Montgomery Family Practice Residency Program muNorristown, PA. Dr. Lily, sezvaanozivikanwa nevarwere varo, ave mubhokisi rakagadzirirwa muMhuri Medicine kubvira muna 1994. Basa rake rakarambidzwa kuporesa murwere wose muzviito, kubatana kushanda kunotsigira hutano uye hupenyu. Mukuwedzera kune tsika yake yemitambo yemhuri, Dr. Lily ave achidzidza kufungisisa kubva pakutaurira kwake kune martial arts muna 1985. Akadzidza maitiro mazhinji emafungiro / miviri nzira yekuporesa kusanganisira Mindfulness-Based Stress Reduction naJon Kabat-Zinn naSaki Santorelli paYunivhesiti yeMassachusetts. Zvidzidzo zvake zvakanyorawo yoga, mishonga yeAyurvedic, uye homeopathy. Dr. Lily akadzidza kugadziriswa kuUCLA, inozivikanwa senyika yepamusoro yechikoro chekugadzirisa vanachiremba. Akava gwaro rakagadziriswa muAradic Acupuncture muna 2004. Akaramba achidzidza kugadziriswa uye mushonga wemishonga weChina uyewo kumadokero mishonga yemishonga uye kudya kunovaka muviri. Anoita mishonga inobatanidza mu McLean, Virginia, pa Well Being-Kuva Zvakanaka, uko iye anonyanya kutaura nezvekurapa kwechigarire uye yepanyama, zvirongwa zvakarongwa zvekutsigira hutori hwemari uye kupa simba kuvaridzi vane dzidzo uye mazano ekutungamirira hupenyu hune hutano hwakanaka.
Elizabeth Conrad, MD
Well Being-Being Well, 6862 Elm Street # 720, McLean, Virginia 22101, Ph: 703-635-2158