T4T3 yekutapudza kuora? Kutsvakurudza Kunoratidza Combo Therapy Kubatsira
Izvo zvinowanzozivikanwa pakati pevarwere, uye vamwe vashandi vezvokurapa, kuti nhamba yakawanda yevarwere vane hypothyroidism vacharamba vachiine zvikwangwani zvakasiyana-siyana uye zviratidzo, pasinei nekurapa ne levothyroxine iyo inotsigira inonzi "inowanzo" yehutori inokurudzira hormone (TSH) mazinga.
Chimwe chidzidzo chakawana kuti, kana ichienzaniswa nemitemo, vanopfuura 13% vakanga vasina kugutsikana nehutano hwavo, vachiratidza kusagutsikana nemishonga yavo.
Iko kunyunyuta kwakange kuri kuneta, kuwedzera kuwedzera , muviri aches / kurwadziwa, uye kushungurudza.
Maererano naDr. Bente Appelhof, MD, kubva kuYunivhesiti yeAmsterdam muNetherlands uye nevamwe vavo: "Kusawirirana kunoramba kuri pamusoro pekukosha kwekubatana pamwe neL44 neL33, zvichienzaniswa neL44 chete, mumusoro we hypothyroidism. pfungwa yokuti chikamu chakanaka chevarwere vane hypothyroidism chinoramba chiine mararamiro ezvehutano, pasinei nekugadzirisa kurapa ne levothyroxine uye kugadzirisa serum TSH [thyroid-stimulating hormone] tsika. "
Zvimwe zviongorori zvemhuka zvakaratidza kuti kuparadzaniswa kwerapi ne levothyroxine (LT4) ndoga hakuiti kuti euthyroidism - hutachiona hwemazuva ose - mumatumbu ose. Pane kudaro, euthyroidism inogona kuwanikwa kuburikidza nekubatanidza kurapa kwe LT4 uye liothyronine (LT3). Zvidzidzo zvakasiyana-siyana zvakaisa pfungwa iyi panyaya iyi, kutarisa kana chirwere cheL44 chisingave chakakwanisa kudzorera euthyroidism mumatunhu evanhuwo.
Nepo varwere vachirondedzera kusarudza kwezvidzidzo zvakabatanidzwa, vatsvakurudzi havana kukwanisa kuparadzanisa humwe humwe huripo hunovandudzwa hunogona kuongororwa.
Iye zvino, vatsvakurudzi vakaona chinhu chimwe chete chinoratidzika sechichibatanidza nekubatana-kurapa-kuora kurasikirwa.
Kutsvakurudza kwakabudiswa mu Journal of Clinical Endocrinology uye Metabolism yakataura nezvekuongorora kwakawana kuti varwere vaida chirwere chetachiona chaisanganisira pamwe chete nevothyroxine (T4) uye T3, panzvimbo pekugara kwechivheroroxine (T4 chete) kurapwa, uye kusanganiswa kwacho kwakabatanidzwa ne kuora kurasikirwa.
Ichi chiongorori chikuru chemakiriniki chakatsigira zvakawanikwa kubva kuBunevicius yekudzidza, yakabudiswa muNew England Journal of Medicine, iyo yakawana mhinduro inobatsira yekubatanidza T4 / T3 therapy ye hypothyroidism.
Iko-maviri-mapofu, randomized, kutungamirirwa nekliniki yekuedzwa yakatarisa pavarwere 141 vane primary autoimmune hypothyroidism, avo vakavhuniwa mumapoka avo vaibatwa neT4 / T3 muchiyero che5: 1, 10: 1, pamwe neboka rakaenderera mberi pamwe chete nehutano hwavo hweT4-chete. Mushure memavhiki makumi maviri nemashanu, chidzidzo chacho chakaratidza zvakajeka kune chikamu chevarwere kwekubatanidzwa kwezvipembenene, uye kunyanya, kurapa kwe5: 1 ine yepamusoro yeT3, maererano neutachiona hweT4 chete.
Zvimwe zvinowanikwa zvinofadza:
- Kupera kwekukura kwemuviri - asi kwete kuderera muSerum TSH - yakabatana nekugutsikana kwakawedzerwa nemishonga yekudzidza.
- Mune mapoka maviri akabatanidzwa, pakanga paine kuyerwa kwehuremu, inowanzotaurwa mu 5: 1 chikwata cheboka, uyo aiva nechirevo chinoderera che 1,7 kg, kana 3.75 pounds. Iko 10: 1 boka raive nechirevo chinorema kuora kwe 1 pound. T4-boka rimwe chete rakanga risina shanduko pakuyera.
- Pakati pevarwere vaida kusanganisa mushonga, 44% yaive neSUM TUM pasi pe 0.11.
- Kuchinja kunogona kuitika mumanzwiro, kuneta, hukama hwakanaka, uye maitiro eurocognitive hazvigone kuonekwa kuti zvinotsanangurwa nemurwere zvinoshandiswa pakubatanidzwa.
Chimwe chinhu chakakosha pakunodzidza ndechekuti vamwe varwere vanowana kurapwa pamwe chete vaiwana kuderedza doses, iyo inofungidzirwa kuti yakawandisa. Vaiva nehutachiona hweTSH pasi pehutano hwakatarwa, uye naizvozvo huchazoonekwa se hyperthyroid.
"Varwere vachisarudza kusanganiswa kweL44 / LT3 kuchipatara kuchipatara cheL44, asi kuchinja mafungiro, kukonzera, hukama hwakanaka, uye maitiro emagetsi haagoni kugutsikana zvinonzwisisika nei chikonzero chaicho chaive chichibatsira chirongwa cheLT4 / LT3 pamwe chete," vanonyora vanonyora. "Kuderedza muviri wepanyama kwaibatanidza nekugutsikana nekudzidza mishonga."
Kunyange zvazvo vanyori vekudzidza vaisagona kuwana chero chikonzero chinotaridzika chokurudzira mushonga wekubatana, vakagumisa vachiti: "Kunyange zvakadaro, mugumisiro wekudzidza uku hakuregi kuti pane rimwe boka revarwere rinogona kubatsirwa nechirwere chakabatanidzwa LT4 / LT3."
Sources:
Appelhof BC, et. al. "Kubatanidza utachiona ne levothyroxine uye liothyronine muzvikamu zviviri, zvichienzaniswa ne levothyroxine monotherapy mu primary hypothyroidism: aviri-mapofu, anoromized, anorongedzwa kliniki yekuedzwa."
Saravanan et. al. Mafungiro ehupfungwa mukati mevarwere vane 'kukwana' maitiro e-thyroxine: Clin Endocrinol (Oxf) 57: 577-585)