Kutsvakurudza Kunowana Vakawanda Mwoyo Murefu Vanonzwa Vakanyanya Nekuwedzera kweT3
February 11, 1999 - Nyaya yaFebruary 11, 1999 yeNew England Journal yeMedicine inoshuma pamigumisiro yeongororo yakawana kuti "kurapa ne thyroxine uye triiodothyronine kwakagadzirisa hupenyu hwevakawanda [hypothyroid] varwere."
Nyaya yacho inonzi:
"Migumisiro ye Thyroxine Seyoenzaniswa ne Thyroxine pamwe Triiodothyronine muVachipatendi ne Hypothyroidism"
naRobertas Bunevicius, Gintautas Kazanavicius, Rimas Zalinkevicius, Arthur J Prange, Jr.
Kutsvakurudza kwakatungamirirwa neInstitute of Endocrinology, Kaunas Medical University, Kaunas, Lithuania pamwe neDhipatimendi rePsychiatry, School of Medicine, University of North Carolina, Chapel Hill.
Kuti kudzidza kwaiitwa sei
Chaizvoizvo, vakatora boka revanhu 33 vakange vari hypothyroid, zvichida nekuda kwechirwere chetachiona chega, kana kuti kubviswa kwehutachiona hwavo nekuda kwekenza yekameti. Vose varwere vakadzidziswa kwemavhiki maviri mashanu vhiki. Munguva imwe yevhiki vhiki shanu, murwere akawana muwandu wake wenguva dzose yeevothyroxine oga. (Levothyroxine ndiro zita rinowanzoreva mazita ezita eEuthyrox, Levoxyl, Levothroid uye Synthroid.) Munguva imwe nguva yevhiki vashanu, murwere akawana levothyroxine PLUS triiodothyronine (T3.) (Cherechedza: MuU.S., zita re T3 i "Cytomel.") Muchikamu cheT4 pamwe nechikamu che3, 50 μg yemuenzaniso wechirwere levothyroxine yakashandurwa ne 12.5 μg ye triiodothyronine (T3).
Zvimwe zvakasiyana-siyana zveropa, kunzwisisa, mafungiro uye maitiro epanyama zvakaitwa pamatanho akasiyana-siyana ekuedzwa.
Mhinduro
Kubva pamaonero ehupenyu, zvinopesana pakati pekupisa, ropa, mafungiro uye zvimwe zvakasiyana-siyana zveT4 chete, zvichienderana neT4 pamwe neT3, zvakanga zviduku. Ropa rega uye cholesterol zvechokwadi rakaderera zvishoma pane T4 pamwe neT3.
Ikoko migumisiro yakave yakashamisa yaiva mukushanda kwepfungwa. Varwere vanoitwa zviri nani pane zvakasiyana-siyana zvemaitiro eurouropsychological paT4 pamwe neT3. Varwere 'mupfungwa mupfungwa vakaratidzawo kubudirira paT4 pamwe neT3.
Pakupera kwekudzidza, varwere vakabvunzwa kana vachida kurapwa kwekutanga kana kwechipiri. 20 varwere vakati vaida T4 pamwe neT3 kurapwa, 11 vakanga vasingafariri chero nzira, uye 2 chete vaida T4 chete. Vachiremba makumi maviri nevatatu vakasarudza T4 pamwe neT3 vakaratidza kuti vakanga vane simba rakawanda, vakagadziriswa, uye vaingofunga zviri nani.
Vatsvakurudzi vakafunga kuti "kurapwa ne thyroxine pamwe ne triiodothyronine kwakagadzirisa hupenyu hwevamwe varwere."
Vatsvakurudzi vakatsigirawo kuti chirongwa chinoshandiswa chetachiona chekurovedza hutachiona kune mumwe munhu asina chirwere chetroroid, kana kuti chirwere chayo chine chirwere chinenge chisina kushanda, chichange chiri "10 μg ye triiodothyronine zuva rimwe nerimwe mukusununguka-kusununguka fomu pamwe chete ne thyroxine yakakwana kuti uoneke euthyroidism. "
Zvinokonzerwa neMushonga Wako
Ichi chidzidzo chinobatsira zvikuru kune vanhu vasinganzwisisi zvakanaka pahutachiona hwemaprojoni.
Kana iwe uri paine standard levothyroxine chete kurapwa, zvinogona kuti, kufanana nehuwandu hwezvidzidzo zvekudzidza, newewo unogona kunzwa zviri nani nekuwedzerwa kwekanguva-kusunungurwa mutengo T3 muhutano hwekurudzirwa hunofanirwa.
Kana iwe uri muchirongwa cheTyroid kana Thyrolar, ikozvino mazana eT3 mumishonga iyo inogona kunge yakanyanya kukwirira, ichienzaniswa nehutano hwakarondedzerwa huri kurondedzerwa munyaya ino. Zvakanakisisa zvinogona kuwanikwa kuburikidza nekugadzirisa urongwa hwemishonga kuti huenzanise zvakananga kune iyo inorumbidzwa yero inotsanangurwa munyaya ino.
Kana iwe uri pane utachiona huripo uye usinganzwi zvakanaka, ndinokurudzira kuti uzivise chiremba wako pakarepo pamusoro pekutsvakurudza kwekutsvakurudza, uye uwane kopi yenyaya ino iwe pachako zvakare.
Kana iwe uchizogovera chero ruzivo chero kupi zvako kune chiremba wako, panguva imwe chete, iwe ungadawo kugovera kopi yeBrithani Medical Journal iyo inoratidza kuti zvigaro pamusoro peTSH ye 2 zvingasave "zvisizvo," asi zvinomiririra maitiro asina kukodzera anoratidza utachiona huripo mukusakundikana.
Iwe unogona kuraira kopi nokudana New York Journal yeChipatimendi Chekuitira Vatengi pa1-800-THE-NEJM
Mufananidzo Mukuru kune Vashandi veTroji
Izvi chaizvoizvo zvinokonzera kutsvakurudza, kusimbisa munharaunda yekutsvakurudza izvo varwere vakawanda, ini pamwe chete, uye vamwe vanachiremba, vave vachitsvaka kwemakore anoverengeka: levothyroxine-chete utachiona hwemaramiro anoshandiswa hausi kusiya chikamu chikuru chevatachiona vanonzwa zvakanaka, uye varwere ava vanonzwa uye vanoshanda zviri nani apo T3 yakawedzerwa kune utachiona hwemaprojoni panzvimbo yavo.
Zvinofadza kuti izvi zvinopa tsanangudzo yekuti nei varwere vakanzwa zvakanaka nguva dzose pane mamwe maitiro ehutachiona semhando yeHoor Army, Westhroid uye Naturethroid, iyo ine T4 uye T3 zvakasikwa, uye yakagadzirirwa T4 / T3 mishonga yako Thyrolar, iyo inodhaka ini tora. Mune zvimwe zviitiko, varwere vakawedzerawo Cytomel (synthetic T3) kana nguva-kusunungurwa T3 kuenzanirana nevothyroxine therapy uyewo kune zvigumisiro zviri nani.
Kwemakore, varwere vakamboudzwa kuti zvose zvavanoda chirwere che levothyroxine kuti vazviise mu "chimiro chechidiki cheTSH," uye utachiona hunofungidzirwa hwakazara. Nguva uye nguva zvakare, vanhu avo vachiri kutambura nezviratidzo - kusanganisira kuneta, kuora mwoyo, zvinetso zvekuziva, uye zvimwe - vakaudzwa kuti kana chirwere chavo chetachiona chakanga chiri chenguva dzose, matambudziko aya akanga asingachadikanwi nehutachiona, uye panzvimbo pacho akanga ava kuora mwoyo zvino , kushungurudzika, PMS, kana kuti "mumusoro wako." Varwere vakanga vashanda zvakanaka kwemakore paArmor, saka vakashandura ku Synthroid, somuenzaniso, uye vakanyunyuta nezvekusanzwa zvakanaka vakaudzwa kuti vakanga "vachikwegura."
Chimbofunga chirevo ichi chave pfupi muThe Bridge, nhau yegore roga roga kubva ku Thyroid Foundation yeAmerica, sangano rinofanirwa kunge riri pamucheto wekutaura kwehutano nekurudzira:
"TSH miedzo yakanyatsojeka, uye kana TSH yako yakajairika, ipapo utachiona husina kunaka hausi hukonzera zviratidzo izvi."
Douglas Ross, Mutevedzeri wezvokurapa weTyroid Foundation yeAmerica
Hazvizivikanwi zvachose kuti varwere havana kuregererwa, kuregwa, kuregererwa, uye kutarisirwa kwenguva yakareba sezvavakambove nedare rezvechiremba, masangano ehutori uye mapoka ezvehutano.
Munguva iyi, vanachiremba vakatsanangura maitiro ehutachiona ehutachiona seArmor - kana kuti iyo yakagadzirwa neshamwari yako Thyrolar - yakanyorwa sequacks, kana kusaremekedzwa, kana pane dzimwe nguva, kunyange yakakonzerwa nemhosva yeevothyroxine-chete chekushingaira mumabhodhi ekurapa avo .
Ngatitarisirei kuti ruzivo urwu runokonzera murwere nemapoka ezvokurapa, pamwe nachiremba, kutanga kuterera kune vamwe varwere - uye kwete kumakambani emishonga.
Zviri pachena, yakange iri nzvimbo yekutsvaga yemakambani akafanana naKooll Pharmaceutical, manufactuer yeSythroid, iyo levothyroxine oga ndiyo yose inoda chero. Kutevera uye kumashure mazwi ose eve mapoka evanhu vekupedzisira ekugutsikana neKonoll nekukwikwidzana kwavanoita makwikwi ekubhadhara mari, kubhadhara mari yepurogiramu, mari yemusangano, uye mari yekusununguka, uye vari kushaya simba kugona levothyroxine mari yezvikepe.
Kutungamira chikwata chaiva shamwari dzakadai saRichard Guttler, uyo anozviti "chirojekistori" uye anokweretesa varwere zvakanyanya $ 150 kana kupfuura - "inotarisirwa mberi" - nokuda kwe "Second Opinion" basa paIndaneti. Gore rakapera, akaramba achitsamwira varwere vakanyunyuta nezvechirwere chisina kugadziriswa uye chido chekuedza izvi zvinodhaka zvinowanikwa zvino kushanda zviri nani. Gore rapera, muverengi webhusaiti akanyora kwaari kuti amuudze kuti kusavapo kweSyroid shure kwemazuva matatu kana mana chete kwakamubatsira kuti agare achinyima chikwama kuti akanga atsungirira kwemakore makumi maviri (kana kupfuura) apfuura. Akamuudza kuti akashandura kuva zvombo. Akanyora zvakare kwaari: "kuwana hupenyu! Synthroid haisi iyo inokonzera matambudziko ako." Gore rakapera, Guttler akandibata nechinzvimbo chake chakasiyana-siyana che "nzira yepamubhedha" (kusava nekodzero yakakodzera uye zviratidzo zvepakati).
"Ndiri kufara" mhepo "iri kuzadza e mail yako, kwete yangu.Inoita kuti hupenyu hwangu huve nyore kubata nehutachiona hwehutachiona husingambofungi nezvekutora zvombo kana combo thyrolar kana cytomel. vanoita apo pavanotora thyrolar kubva pamusika? inotevera ichava yakasikwa muzvigadziro yehutachiona hwehutachiona hwega pachako yakabhurwa pawebsite yako ... dr.g "
Kufungidzira vose varwere vanomhanya zvakasimba sezvavanogona kubva kune dinosaurs se "dr g" ichave ichimhanya kunowedzera kuwanda kwe "makumbo" - vanachiremba vane ruzivo, vane ruzivo avo vakateerera varwere, vakafunga ivo pachavo, vakavakirwa mberi pasinei nevezera ravo kushungurudza uye kambani inoshandiswa kwekutengesa kushambadzira, nguva yose ichiita zvichienderana neruzivo rwavo kuti mishonga yeT3 inoshanda zviri nani kune vakawanda vedu.
Uye avo vanachiremba avo kwenguva refu vakatongerwa ku "mhiri" ikozvino vakaratidzwa zvakanaka neimwe yezvinyorwa zvezvokurapa, New England Journal of Medicine