Apo hypothyroidism inowedzera mukutevera thyroidectomy kana mushure mekurapwa ne radioacid iodine (RAI), kana kana iwe uine chirwere chetachiona chisingaitiki nekuda kweHashimoto's thyroiditis, pachava nemibvunzo yakawanda inokosha yekubvunza chiremba wako. Pano pane zvitanhatu zvezvinonyanya kukosha uye zvinokosha.
1. Chii chinowanzoita utachiona-hunokonzera hormone (TSH) iri pane lab yako?
Chiyero cheTSH ndicho chiedza chinowanzoshandiswa pakuongorora uye kutungamirirwa kwe hypothyroidism muUnited States.
Asi mabhizimusi akasiyana-siyana anowanzove nemafungiro akasiyana pane izvo zvinozivikanwa se "TSH reference range." Ichi chiyero ndeyoruzhinji rwehutano hunoonekwa hunofanirwa kuratidza huwandu huwandu hwevanhu.
Pakati pemakwenzi akawanda, tsanangudzo yeTSH inotangira kubva ku 0.5 kusvika ku4,5. A TSH kukosha kweasingasviki 0.5 inonzi hyperthyroid ( utachiona husina simba ), nepo TSH inokosha inopfuura 4,5 inonzi inogona kuitika hypothyroid (inoshandiswa nehutachiona). Kusiyanisa mabhizimusi kungashandisa muganhu wakadzika wepakati kubva kune 0,35 kusvika ku6, uye kune chikumbaridzo chepamusoro chero kupi zvako kubva pa 4.0 kusvika ku6.0. Chero mamiriro ezvinhu, zvakakosha kuti iwe uzive ruzivo rworuzhinji pabazi apo ropa rako rinotumirwa, saka iwe unoziva mitemo yauri kuongororwa.
Cherechedzai: Kubva pakupera kwegore ra2002, American Association of Clinical Endocrinologists (AACE) uye mamwe mapoka emakambani akadzoka mberi nekubuda maererano nekurudziro kuderedza tsh yeTSH, saka 0.3 kusvika ku 3.0.
Asi vanachiremba havana kuuya kuzobvumirana. Nokudaro vamwe vanachiremba vanoona maitiro pasi apa .3 uye pamusoro pe 3.0 sehuchapupu hwehutachiona husina kunaka. Vamwe vanoramba vachishandisa mitemo yekare, iyo inoramba ichinyanya kunyanya kumalabhu akawanda.
2. Ndeapi TSH yaunoshandisa iwe sechinangwa kwandiri?
Uyu mubvunzo wakatakurwa asi wekukosha.
Mhinduro yako yechiremba icharatidza iye kana mafiro ake pamusoro pezvinomirira "chimiro" cheTSH. Vamwe vanachiremba vanotenda kuti kuendesa murwere mukati memusoro wepamusoro-soro kune chinangwa che hypothyroidism kurapwa . Somuenzaniso, kushandisa 4.5 TSH yakawanda, vamwe vanachiremba vanotenda kuti kurongedza utachiona hwemishonga inotsiva mishonga yekuita kuti murwere weTSH aende pasi pasi pe4,5 (kunyange zvichida kusvika pasi kusvika ku4.4) angaita hutano hwakakwana. Vamwe vanachiremba vanonzwa sokuti mazamu ari pasi pe10.0 "subclinical hypothyroidism" uye haatongeri mushonga.
Vanachiremba vanosiyana mune izvo TSH yepamusoro mukati mehutano hwakanaka hwavanotenda hunoita chinangwa chakanaka. Vamwe vashandi, somuenzaniso, vanogona kutarisa TSH yepamusoro pakati pe 1.0 ne 2.0 zvichibva pane zvavanoziva zvinoratidza kuti varwere vanogona kunzwa vakanakisisa pamatanho aya.
Vamwe vanachiremba vanonyatsotevedzera mitemo inokurukurwa kare, uye vanodavira kuti utachiona huri kutora mushonga mushonga hunofanira kutarisa TSH yezinga risati rava 3.0 mu hypothyroid varwere .
3. Ndeupi mishonga iwe unorondedzera kwandiri?
Sezvo zvichida iwe usingakwanisi kuverenga zvakanyorwa, unofanira kubvunza! Mubvunzo apa ndewokuti chiremba wako anosarudza zita rekuda kana mishonga inogadzirwa.
Kana zita rezita rinorayirwa, iwe unoda kuziva kana chiremba wako achitaura "kwete maitiro echiito" kana "kuparadzira sezvakanyorwa (DAW)." MuUnited States, zita rechirwere chetrojoni rinoshandiswa zvinodhaka zvinosanganisira:
- Levothyroxine (synthetic thyroxine / T4): Synthroid, Levoxyl, Tirosint, Unithroid, kana
- Liyronronine (synthetic triiodothyronine / T3): Cytomel, kana kuti generic
- Kurondedzwa kwehutano hwepanyama: Hondo, Hupenyu-hutachiona, Utachiona WP, kana kuti NP yakakura yeTroroid
Vakawanda varwere vanorayirwa levothyroxine. Nyanzvi dzechirwere dzakagara dzakanyevera varwere nezve generic levothyroxine . Nekuda kwekugona kwekusiyana pakati pezviratidzo zvemishonga nemagetsi uye zvingaita kuti varwere vagone kugamuchira michina yakasiyana-siyana pavanenge vachizadzisa zvinyorwa, ATA neAACE vakakurudzira kuti vanachiremba vanofanira -
1) Varwere vanoziva kuti maitiro avo eLevothyroxine anogona kuchinjwa pamishonga
2) Kurudzira varwere kuti varambe vari pavanenge vachigadzirisa levothyroxine kana zvichibvira
3) Iva nechokwadi chokuti varwere vanonzwisisa kana vakagadziriswa nevevothyroxine yekugadzirira kuti vazofanira kudzokorora hormone yehutori-stimulating (TSH) yeropa revhiki kusvika kumatanhatu gare gare kuti vaone kana vachida kuwedzera kuchinja kwemazi
4. Kukurumidzira kwatingaita sei kutaridzirwa kwezviratidzo, nekugadzirisa kwehutachiona hwehutachiona hwehutachiona, hwakapiwa dhigi rinorayirwa?
Mubvunzo wakakosha pano ndewokuti chiremba wako arikupa kaduku kadiki yekutora utachiona uye chinangwa chekugadzirisa maitiro ako zvishoma nezvishoma, kana kuti iye ari kuedza kukuendesa kune imwe nzvimbo yakakwana nokukurumidza sezvinobvira. Pane zvikonzero zvakajeka zvezvinhu zviviri, asi semurwere zvinokosha kuziva zvaunotarisira.
Vamwe vanachiremba vanogona kukuisa pamwero wakaderera uye vozokuudza kuti iwe uchanzwa zviri nani mumavhiki maviri. Kana kana mavhiki maviri achiuya uye iwe usinganzwi uri nani, unogona kufunga kuti mushonga wacho hausi kushanda. Asi mishonga inogona kutora nguva yakareba kuti itange kushanda.
Kana iwe uri mukuru, kana kuti iwe une nhoroondo yezvinetso zvemwoyo, vanachiremba vachawanzotanga nehana yakaderera zvikuru yehutoriyasi yakashandurwa kuitira kuti uone kupindura kwako uye kudzivisa kukuradza chinetso chemoyo wako.
5. Unowanzoedza sei kutarisa utachiona kusvikira tawana maitiro angu kumashure mawere uye zvakanakisisa?
Zvakanaka, chiremba wako achagara ari pamusoro pekutora iwe muhutano hwakanaka. Kwenguva dzakawanda, izvi zvinogona kunge zvichireva kukuonai masvondo matanhatu kusvika masere nekuda kwekuedzwa kweropa uye nekutevera nekugadziriswa kweroji yako kusvikira wava kunzwa zviri nani uye mazinga ako akakwana.
6. Mushure mokunge ndiri mumamiriro akasiyana-siyana, unowanzoti ndinodzoka kuongororwa ropa kuti ndione kuti zvido zvangu hazvina kuchinja here?
Kana chiremba wako akati haufaniri kupinda kamwe kamwe pagore, inguva yekutanga kufunga kuti uri kuona chiremba akakodzera. Nyanzvi nyanzvi dzinokurudzira kuti varwere vanoongororwa kanenge mwedzi mitanhatu yose mugore rokutanga kana maviri, rinoteverwa kamwe chete pagore pashure pacho.
Shoko Rinobva
Pane mumwe mubvunzo wakawedzerwa unokosha kubvunza kuti: "Kana ndine mibvunzo pakati pekugadzwa, ndingakwanisa sei kusangana newe?" Unodzoka unodana iwe here, kana kuti vanamukoti vadzoka kukumbira iwe? nevarwere? "
Mubvunzo uyu uchakubatsira kuti uone kuti chiremba wako chinowanikwa sei. Kana iwe uine sarudzo yekutsvaga chiremba akasiyana, kupindura kwechiremba wako kumubvunzo uyu kunogona kukubatsira kusarudza zvokuita. Vamwe vanachiremba vachadzoka vachifonera ivo uye vachapindura kunyange email. Vamwe vanosarudza kutarisa mibvunzo yose kune vanamukoti (avo vanogona kupa mashoko akanaka kana kuti zviri nani). Asi kana iwe uchida munhu wega, maoko-ari kushanda, teerera zvakanyanya kune izvo chiremba wako anotaura pano. Iwe uchawana pfungwa yezvaunotarisira.
Sources:
Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. WLL / Wolters Kluwer; 2012.
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.