Thyroid Treatment for Hypothyroidism
Mashoko akanaka kune vane chirwere chetachiona: chidzidzo chakabudiswa mune rimwe bhuku rinoremekedzwa uye rinoremekedzwa remagazini ekupedzisira rinotaura kuti kusanganiswa kweT4 / T3 kwakakwirira kupfuura T4 chete / levothyroxine kurapa kwe hypothyroidism! Heino zvinyorwa.
Chidzidzo chevhu chinorondedzerwa pamusoro peEuropean Journal of Endocrinology chakacherechedza kukakavadzana kwehutano nehutachiona T3 sekuwedzera kune T4-chete (levothyroxine) therapy for hypothyroidism.
Zvimwe zvidzidzo zvinodzoka shure kwemakore gumi zvakaratidza hukuru hwehutano hwekubatanidza. Zvimwe zvidzidzo, zvisinei, hazvina kuwana mutsauko. Kubatana kwekutsvakurudza kwakaitwa pamusoro peT3 kwakatungamirira dzimwe nyanzvi-kunyanya, avo vanokanganisa mukurumbira we levothyroxine-chete kupedzisa kuti hapana kubatsirwa kuwedzera kweT3. (Vamwe vavo "nyanzvi" vakafanana vakagadzira kukwira kukuru, uye zvakashata zvakagumisa kuti levothyroxine / T4-chete chirwere chinopfuura T4 / T3 therapy pamwe chete.)
Chero mamiriro ezvinhu, mukutsvakurudza, vatsvakurudzi veDanish vanodzidza-kaviri-mapofu, asinganzwisisiki kudarika-kuongorora-iyo inonzi ndiyo yegoridhe yakarongeka yekutsvakurudza-yevane 59. Muboka revarwere, 50 micrograms yemutambo weT4 yakasimudzwa yakatsiviwa ne 20 mcg yeT3 kana 50 mcg yeT4 kwevhiki 12. Varwere vakazoita "kuyambuka," vachiita zvakasiyana kune mamwe mavhiki 12.
Dhiini yeT4 yakarongedzwa kana ichidiwa kuchengeta mazinga eTSH akaoma.
Miedzo yehutano hwehupenyu (QOL) uye kuora mwoyo kwakaitwa pakutanga, uye mushure memaviri evhiki gumi nemaviri kurapwa. Unhu hwehupenyu nemafungiro epfungwa dzinoongororwa zvakabatanidzwa, pakati pezvimwe zvikonzero: hutano huzhinji, hutano hwehutano, hutano hwepfungwa, hutano, unhu, kuora mwoyo, nekuzvidya mwoyo.
Zvakawanikwa nevatsvakurudzi ndezvokuti pakati pevarwere - 55 vavo vaiva vakadzi - pane zvikamu zvakasiyana-siyana mumatunhu manomwe kubva pa11 kubva kuQOL uye kuora mwoyo kwechikoro, zvichiratidza kuitika kwakanaka kwakabatana nekubatanidzwa kweT4 / T3 therapy.
Avhareji 49% evarwere vaida kusanganiswa, uye 15% chete ndivo vaida levothyroxine-chete kurapa.
Vatsvakurudzi vakagumisa kuti, mune imwe nzvimbo iyo TSH yakachengetedzwa yakasimba, T4 / T3 yehutano yekubatanidza iyo yaisanganisira 20 mcg yeT3 zuva rega rega yaive yakakwirira kupfuura levothyroxine-chete kurapwa, pakucherechedza kwehuwandu hunhu hwehupenyu hwehupenyu, kuora mwoyo uye kuzvidya mwoyo zviyero, uye kuratidza kushivirira.
Vanachiremba vanowanzotaurira njodzi yemigumisiro neT3 therapy sechikonzero chekusashandisa T3, asi chidzidzo ichi chakaratidza kuti pakanga pasina kusiyana maererano nemigumisiro. Maererano nevanyori, panguva yeT4 / T3 inorapwa, vanhu vashanu vakawana migumisiro yakaipa kusanganisira palpitations, kutuka kukuru, uye kusagadzikana kwepfungwa. Munguva yeT4-chete kurapwa, vanhu vapfumbamwe vakaratidza zvakafanana migumisiro.
Zvinofadza kuti vaDenmark vatsvakurudzo vakaratidza matambudziko pamwe chete nedzimwe zvidzidzo zvekare zveT4 / T3 dzokurapa dzakanga dzisina kuwana chero rubatsiro kuT3 kurapa, achiti: "zvidzidzo zvakabatanidzwa mukutsvakurudza kwakaitwa musanganiswa wemapoka evarwere akasiyana, kusanganisira varwere ne kanamato yekare yehurosi, autoimmune hypothyroidism, uye subclinical pamwe nepamusoro pee hypothyroidism. "
Uye, maererano nevatsvakurudzi vechiDanish, mune imwe yezvidzidzo zvinokosha, "... [va] vanyori vakakoniwa kuchengetedza sirum TSH mazinga pazinga rakafanana mumapoka maviri ekurapa, zvinoreva serum TSH iri 3 muboka rakabatanidzwa uye 1.5 mU / l mu monotherapy boka.
Vatsvakurudzi vakati kuongorora kwavo kunoratidza kuti boka revarwere rinoratidzika kuti rinobatsirwa neT4 / T3 therapy. Kunyanya, vanoratidza kuti pangava nechikonzero che physologic chikonzero nei subgroup inopindura-kana zvinoda - T3, kunyanya, iyo:
... inonzi polymorphism inowanikwa munguva ichangobva kuwanikwa mujeni iri kunyora rudzi rwechipiri deiodinase, iyo enzyme inoshandiswa kugadziriswa kweT3 kugadziriswa kusvika kumatavi, yakagadzirirwa kuitira kubatsira kubatanidza zvikamu zvingangobatsirika neT4 / T3 therapy inobatanidza. Imwe yema polymorphism, iri muOATP1C1, utachiona hwehomori hutachiona hunotaura paropa-brain brain, yakabatanidzwa nekuneta uye kuora mwoyo.
Nzara Dutch Endocrinologist Wilmar Wiersinga Anoti Anotsigirwa T3 Ngave Wakaisvonaka, Vamwe Vanhu Vangave Vanowedzera Maitiro Okuita Zviri nani paT3
MuDutch endocrinologist Wilmar Wiersinga akanyorera chinyorwa chinotevera, chakanzi "Tinoda zvakare miedzo yakawanda paT4 uye T3 therapy in combination in hypothyroidism?"
Maererano naDkt. Wiersinga, zvimwe zvidzidzo zvekare zvakagumisa kuti hapana kubatsira kuwedzera T3. Asi, chokwadi chokuti, maererano neWudersinga, vazhinji vanodarika 10% yevatachiona ve hypothyroid havagutsikani nemanzwiro avanoita pane izvo vanachiremba vaizoti "mukana wakakwana" weevothyroxine kutungamirirwa kwakatungamirira kubudiswa kweDanish chidzidzo.
Nyaya yehurukuro, iyo inobudiswa yakazara paIndaneti, inoratidza kukanganisa mune zvidzidzo zvekare uye kuongororwa kweT4 / T3 therapy pamwe chete. Dr. Wiersinga anogumisa kuti kune zvikonzero zviviri zvakasimba zvekutungamirira mimwe miedzo yakarongedzwa yakarongedzwa kuenzanisa levothyroxine / T4 chete kurapa monotherapy, kune T4 / T3 pamwe chete therapy:
Chokutanga, miedzo kusvika ikozvino yakanga isingabudiriri mukutsvaga muviri weSerum FT4-FT3 ratios mu 24 h. Kubudirira kwekusunungurwa-kusunungurwa T3 kugadzirira kungave kwakakosha kuti uwane chinangwa che 'muviri' wekemikari hormone replacement. Chechipiri, nhamba inowedzera yemapolymorphisms mu deiodinases uye utachiona hwehomoni inotakura vatengesi inosangana nehutano hwepfungwa, kuora mwoyo, kuneta, uye kunoda kurapwa kwechirwere. Zvingave here kuti nyaya dzisingagutswi ne monotherapy dzinowanzoendesa nhengo idzi, uye dzichava nemhinduro yakanakisisa kune inorapwa here?
Maererano naDkt. Wiersinga, kukurudzirwa kwekusunungurwa kweT3 kusingagumi, kwakapiwa semusi weusiku umwechete (pamwe chete ne levothyroxine kamwe chete zuva nezuva) kunogona kuchengetedza zvakanakisisa zvehutano hweHinos T4 uye Free T3 mune vamwe varwere vane utachiona kwemaawa 24.
Cherechedza: Saka ngatitorei zvakare zvakare. Hafu yevarwere vaida T4 / T3 pamwe chete - 15% chete vaida levothyroxine-chete, uye, hupenyu hwehupenyu nezvimwe zvinhu zvakavandudzwa. Uye, chirwere cheT4 / T3 chakanga chisina matambudziko kune T4-chete. (Mukati, muchidzidzo ichi, chirwere cheT4-chete chinokonzera ZVIMWE zvinokonzerwa nematambudziko.) Ndinofungidzira kuti zvimwe zvakafanana zvinonzi tezivo nyanzvi - avo vanowanzowanzova mubhadharo wevashandi vaLevothyroxine - zvichida vanoenda vanozviwisira ivo pachavo vachiedza kutsanangurira zvitsva, uye zvichava zvinonakidza vachivatarisa vachiedza!
Iyo chaiyo magazini inobudiswa mukati mazvo yose inonakidza kuverenga, asi nhamo, haina kutumirwa paInternet yakazara. Iwe unogona, zvakadaro, kutenga iyo kopi paIndaneti ye $ 25 muEuropean Journal of Endocrinology website. Izvi ndizvo chaizvo izvo iwe unoda chiremba wako kuti averenge zvakare, saka iva nechokwadi chekumurega kuti azive kuti atore kopi zvakare. Kutaura chokwadi, zvingave zvakakosha kuti utenge kopi kuZIVA kuna chiremba wako, kana iye asingadi kudzidza nezvedzidziso yehutano.
Mamwe Mashoko Pamusoro peT4-Chete Vs. T4 / T3 Kusanganiswa Kwakaitwa neHyspothyroidism
- A Tarisa T4 chete vs. vs. T4 / T3 Zvinodhaka Zvinodhaka
- T3 Triiodothyronine Zvinodhaka Kuvandudza Unhu hweHupenyu hweHypothyroidism: Tsvakurudzo Inowana Vakawanda Varwere Vanonzwa Vakanyanya Nekuwedzera kweT3 / New England Journal yeMishonga Yokudzidza 1999
- Kudzidza Kunowana Varwere Vanosarudza Kusanganiswa T4 / T3 Kurapa: Ongororo Dzakaratidzwa Combo Therapy Associated with Weight Loss / 2005
> Sources:
> Birte Nygaard, Ebbe Winther Jensen, Jan Kvetny, Anne Jarløv naJens Faber. "Chiitiko cheMishonga Inobatanidza ne Thyroxine (T4) uye 3,5,3'-Triiodothyronine Versus T4 Monotherapy muVirwere neHypothyroidism, Chipiri-Chirema, Randomised Cross-over Study," European Journal of Endocrinology , Vol 161, Nyaya 6, 895-902, December 2009 Abstract, (Full text ($ 25))
> Wiersinga, Wilmar "Tinodikanwa Kunyange Tichiedzwa Zvikuru paT4 uye T3 Kurapa Kwakaitwa muHypothyroidism?" European Journal of Endocrinology , Vol. 161, Nyaya 6, 955-959. Rugwaro rwakakwana (rusununguko)