Utachiona hunokonzera hormone (TSH) kuongororwa ropa kunoonekwa nevamwe vanachiremba kuti vave ivo vekutanga-uye mune dzimwe nguva chete-muedzo unofanirwa kuongorora nekutarisa utachiona husina simba kana husina kupindira, hunonzi hypothyroidism kana hyperthyroidism . Chiyero cheTSH dzimwe nguva chinoshandiswa nevanowanzogumira endocrinologists se "yegoridhe" muedzo wokuongorora nekurapa mamiriro ehutano.
Chiiko cheTSH Chichiyera?
Chiyero chinoyera mazinga ako eTSH, hormone inogadzirwa uye yakasunungurwa nepiriti yako yepituitary. Zvaunofunga kuti iwe une hutoni yakakwana yehutachiwana muropa rako, uye kana ichiona kuti hauna kukwana, mauto ako anosunungura TSH kuti awedzere utachiona hwako kuti ubudise hutoni yakawanda. Ichi ndicho chikonzero TSH yako inomuka apo utachiona hwako husingaiti . A high TSH zvinoreva kuti planditary gland iri kusunungura hormone yayo kuedza kuita kuti utachiona hwako hupindure nekubudisa hutori hwehutori.
Pamugumo wakatarisana, kana gland yako yepituitary inonzwa kuti kune utachiona hwakawanda hwehutachiona hunopararira, zvino inononoka kana kutomira kusunungura TSH. Kuderera kweTSH kunoreva kuti thyroid yako haisati yatora shoko rekusunungura hormone, uye utachiona hwehutachiona huchaperera.
ITSH Reference Range
Kubva muna 2017, pane ma laboratories akawanda muUnited States mazita ehurumende anotaridzirwa kweTSH muedzo anotangira kubva munenge 0.5 kusvika ku4,5 kana 5.0 (mIU / L).
Murwere ane TSH ari mukati memutambo wekutaridzirwa inonzi "euthyroid," uye inofungidzirwa kuva nehutano hwemazuva ose.
Nhamba yekutarisa-dzimwe nguva inonzi "yakarongeka" -chikamu chinokosha chehutachiona hwehutano hwehutano uye chirongwa chekurapa, nokuti nyika inowanzogadzirisa endocrinology inofunga kuti ndiyo inokosha yekuongororwa uye kutarisira utachiona hwebasa.
Ko TSH Reference Range Yakagadziriswa sei?
A TSH reference reference inowanikwa nokutora boka revanhu muhuwandu, kuenzanisa maTSH awo, uye kuverenga hutano hunofanirwa kuratidza huwandu hwaTSH mazinga muhupenyu hwakanaka.
Kushandisa iyo inofanirwa kutarisa, iyo TSH iri pasi pe 0.5 (yakadzika TSH) inogona kuratidzira hyperthyroidism (inotapira yekrisiti), uye TSH kupfuura 4.5 / 5.0 (yakakwirira TSH) inogona kuratidza hypothyroidism (iyo yakagadziriswa yehutachiona.)
Iyo TSH Refer Range Controversy
Chimwe chezvinhu zvinokakavadzana zvakange chiri nyaya yekuchinja "chimiro" chinongororwa pane chetachiedza cheTSH. Mukupera kwegore ra2002, National Academy of Clinical Biochemistry (NACB) yakabudisa mazano matsva ekuongororwa uye kutarisa chirwere chetachiona.
Mune mirayiridzo, NACB yakarondedzera kuti urongwa hweTSH hwekutsvaga hwaive hwakawandisa uye chaizvoizvo hwaisanganisira vanhu vane chirwere chetachiona. Apo mamwe maitiro ekufungisisa akaitwa, ayo asina kubvisa vanhu vane chirwere chetachiona, 95 muzana yevanhu vakaedzwa vakave neTSH iri pakati pe 0,4 ne2,5. Somugumisiro, iyo NACB yakakurudzira kuderedza mararamiro ekutaura kune mazinga aya.
Nzira dzeNACB dzakatungamirira kukurudziro munaJanuary 2003 neAmerican Association of Clinical Endocrinologists (AACE), vachikumbira vanachiremba kuti "vaongorore kurapwa kwevarwere vanoedza kunze kwemiganhu yemuganhu wakawandisa zvichienderana nechinangwa cheTSH chikamu che 0.3 kusvika ku 3.0. " Mashoko aya akatiwo: "AACE inofunga kuti hutsva huchaita kuti hutano hwakanaka hwemamiriyoni evanhu veAmerica avo vanotambura nehutano hwetachiona hwakanaka, asi vasati vashandurwa kusvikira zvino."
Mune tsvakurudzo yakabudiswa mu Journal of the American Medical Association muna 2003, Dr. Vahab Fatourechi nevamwe vatsvakurudzi vakafungidzira kuti kana huwandu hwacho hwakapeteredzwa maererano neAACE mazano, nhamba yevanhu vane chirwere chetachiona yaizowedzera kubva pa5 kubva muzana huwandu kusvika kune inofungidzirwa makumi maviri kubva muzana yevanhu, pamwe nevakawanda vehuwandu hwevarwere vakawira mu hypothyroid / underactive category.
Izvi zvaimiririra kuwedzera kunoshamisa kwehuwandu hwevarwere hwehutano munyika yose, kubva kune inofungidzirwa mamiriyoni gumi, kusvika kune mamiriyoni 60 eMamerica.
Panguva imwecheteyo, zvakadaro, musangano wekubvumirana wakaitwa nevamiririri kubva kumakambani anokosha emakambani anobatanidzwa mukurapa kwetroji-kusanganisira American Association of Clinical Endocrinologists, American Thyroid Association, uye Endocrine Society-yakabudisa zvavakawana muna 2004, vachirumbidza chiitiko chekurapa kwevarwere vane TSH mizinga ye4,5 kusvika 10.0 mIU / L. Nzira itsva yekutsvaga mabhuku yakabviswa.
Anenge makumi maviri emakore gare gare, maAmerica anoongorora mabhakato anoramba achishandisa mabhuku akare uye vanachiremba vanoramba vachiparadzaniswa. Pakati pezvipatara zvechiremba, vazhinji vanoenderera mberi kuramba kuramba kuongorora hypothyroidism kunze kwekuti mhinduro dzeTSH dzisiri kunze kwetsika yekutarisa ruzivo uye yakarongerwa sechinhu chisina kujairika ne laboratori.
Jeffrey Garber, MD, FACE, vakataura nharo pamusoro peAmerican Association of Clinical Endocrinologists (AACE). Maererano naDr. Garber, mazano haafaniri kushandiswa kuti ave shanduro yekutongwa kwechiito chechiremba wega. Kunyange zvazvo ari muzvinyorwa zvake zvakabudiswa, Dr. Garber akati haanzwi kuti kurapa subclinical hypothyroidism inowanzogadziriswa, iye akati mune zvaanoita, haazeze kubata mushandi ane TSH mukati memutsara wekutaridzirwa kana akazvitonga kuti ive inobatsira.
Said Garber:
Iyo TSH yakawanda yakatarisa inofanira kunge isingafaniri kuva nharo inokurudzira. Asi sezvinowanzoonekwa mukurapa, zviri nyore kubvumirana pane zvakanyanyisa. Paunoswedera pedyo nechepakati pemuganhu, inhare yakaoma. Tinofanira kuziva kuti iri kuenderera mberi. Kana vanhu vachiziva kuti boka iri rinowanzova nechirwere chetachiona pane boka riri pasi, hazvikuiti iwe kurapwa uye haiti kuti hazvina kukodzera, rinoti kuitevera, uye zvichida kupindira.
Dambudziko Rokurapa: "TSH Yenyu Yakanaka"
Iyo TSH reference reference issue inoita zvinetso kwauri semurwere.
Apo chiremba wako akawana mushumo wako wekudzoka shure, chinhu chipi nechipi mukati mechirongwa chekutarisa hachizogadziriswa sechinhu chisina kujairika. Izvozvo zvinoreva, kana chiremba wako achizorora pane maitiro akaiswa uye achingoita pane maitiro kunze kweropa rekutsvaga, iwe hauzone kuonekwa kana kuti mushonga wako wakagadziriswa.
Pakupedzisira, uchitaurirwa yako TSH muedzo "chimiro" hausi ruzivo ruzivo. Zvamunoda chaizvo kuziva kubva kuchiremba wako mhinduro dzemibvunzo mina inokosha:
- Ndechipi chaiyo chaiyo yeTSH yechiratidzo chekutsvaga ?
- Chii chinotaridzirwa pamusoro pebhu iyo mhinduro dzangu dzekuedza dzakagadziriswa?
- Ndezvipi zvaunofunga nezvaunotevera pakuongorora nekutarisa chirwere chetroji?
- Ndeipi chinangwa chako cheTSH chimiro chepamusoro uye yakachengeteka kusarudzwa kwezviratidzo zvangu?
Iva nechokwadi chokuti iwe unowana mhinduro chaiyo dzemibvunzo iyi usati warega chiremba wako achibvisa chinetso chetachiona, kana kukuudza kuti thyroid yako "inowanzoitika," kunyanya kana iwe uine zviratidzo .
Shoko Rinobva
Paunotarisana ne endocrinologists kana vamwe vanachiremba vanozeza kuongororwa nedzimwe nzira kunze kwekutaura kwakasimba kwemigumisiro yeTSH, inogona kunge iri nguva yekuwana pfungwa yechipiri kubva kumagariro ekupedzisira, kana kuti kuwedzera kutsvaga kwako kuisa mahedheni MD, osteopathic chiremba , kana naturopati yakarovedzwa uye ine mvumo .
Vashandi vanowanzounza zvinhu zvakawanda kunze kwekuedza kweTSH mukuongorora uye kutarisira chirwere chetachiona, kusanganisira:
- Kuwedzera kuongororwa kweropa , zvakadai sokusununguka T4 , pasina T3, uye antibody profiles
- Chipatori chekuongorora zviratidzo zvako zvinoonekwa zvechirwere chetachiona, kusanganisira kuchinja mukufungidzirwa, kuzvimba uye edema zvechiso chako uye kumativi, kukanganiswa kwebvudzi mumusoro nemuviri, kurasikirwa kwekunze kwemajisi, kuwedzera kwehutachiona, kuchinja kweziso, kushaya mwoyo, kurwisa kweropa, uye zvimwe zviratidzo zvinonzwisisika
- Kufungidzira miedzo kuongorora kuwedzera kwetroji , atrophy, uye nodules
- Nhoroondo yehutano uye yemhuri
- Chinangwa chekurapa che "zvakanakisisa" TSH mizinga nekugadzirisa zviratidzo
> Sources:
> Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. WLL / Wolters Kluwer; 2012.
> Fatourechi V, Klee GG, Grebe SK, et al. Migumisiro yekuderedza kupera kwepamusoro kwemazuva ose eTSH maonero. JAMA. 2003; 290: 3195-3196.
> Garber, J, Cobin, R, Gharib, H, et. al. "Clinical Practice Guidelines for Hypothyroidism muVakuru: Cosponsored neAmerican Association of Clinical Endocrinologists uye American Thyroid Association." Endocrine Dzidzira. Vol 18 Nha. 6 November / December 2012.
> Gursoy A, et. al. "Ndeipi mazinga ehomori-stimulating level inofanira kushandiswa mu hypothyroid varwere pasi peL-thyroxine inotsiva therapy?" Int J Clin Pract. 2006 Jun; 60 (6): 655-9