A History of the Controversy Pamusoro Pemasikirwo Emishonga
Hazvisi chakavanzika chinowanzoshandiswa nemishonga yehutachiona (NDT) yakapesana kwemakumi emakore. NDT ndiyo inorwara yehutori inoshandiswa pakuchinja uye inonziwo utachiona hwepanyama , chiziviso chetachiona, porcine thyroid, "utachiona wehave," kana kuti mazita emakiti akadai seChina-throid kana Armor Thyroid.
NDT yakatanga kusimbiswa kumashure kwekutanga kwema1900 uye yakagadzirwa kubva kune yakasvibiswa (yakaomeswa) yehutachiona yezvinyorwa zvezvipfuwo, senzira yekurapa hypothyroidism, kushayikwa kwetachiona hormone.
Mhando yekutanga yehutachiona hwepanyama yakabuda kubva muhutano hwehutano hwemhou, asi pakutanga kwema1900, kambani yezvokudya zvehondo yakasvika mumunda, ichichitengesa chaiyo yakasvibiswa nehutachiona kubva munguruve, inonzi Armor Thyroid.
Nemhaka yokuti yakagadzirwa pamberi peDaviro, maitiro avo semishonga yemishonga yakave yakaberekerwa mukati, uye chimiro chetachiona chakasikwa, panguva yakarongedzwa neDFA, hachina kumbopfuura ne " New Drug Application " (NDA) yaidiwa nemishonga mitsva yakataurirwa kumusika mushure mekunge FDA yakatangwa.
Zvisikwa zvakasvibiswa zvehutano zvine zvose T4 (thyroxine) uye T3 (triiodothyronine), uyewo calcitonin, nezvimwe zvinhu zvinowanikwa muhutano hwehutano hwehupenyu . Chirwere chetachiona chinowanzoitika chinogadzira zvikuru T4 (inonzi hormone yekuchengetedza) uye imwe T3, uye T4 inoshandurwa kuva T3, hormone inoshanda, kushandiswa nemasero uye masukisi emuviri.
The Rise of Synthroid
Pakati pepakati pezana remakore rapfuura, mishonga yakakonzerwa nehutachiona yakauya pamusika.
Ichi chigadzirwa cheT4 hormone chinowanzozivikanwa seLevothyroxine, uye dzimwe nguva chinoshandiswa nezita rinowanzozivikanwa, Synthroid. Levothyroxine yakawedzera kuve yakakurumbira, uye mukati mehafu yechipiri yezana remakore rechi20, rakava kurapwa kwekusarudzwa kwevanhu vezvechirongwa chekurapa.
Vanachiremba vanoti vaive vakagadzikana uye vakasagadzikana pane zvakasikwa zvevasikirini, uye kuti muviri wakakwanisa kutendeudza T4 muH3 yakashanda muviri waidiwa kugadzirisa hypothyroidism.
Kwemakumi emakumi emakore, huwandu hwevatachiona hwehutori hwakanyorerwa levothyroxine zvinodhaka kurwisa hypothyroidism. Asi sezvo chido chakakura mumishonga chaiyo muma1980, vanachiremba uye vanoita zvekugarisa vakatanga zvakare kuronga chimiro chechirwere chetachiona, chakange chichiri pamusika, kunyange zvazvo chiri nechikamu chiduku chemusika.
Vamwe vechiremba vakwegura avo vakamboshandisa chimiro chechirwere chechirwere pamwe nevarwere vavo zvakare, vakashandura vamwe varwere kudzokera kune zvakasikwa zvinoshandiswa nehutachiona zvinodhaka Vamwe vevarwere ava vakange vanyunyuta, mushure mokunge vashandurwa ku levothyroxine, kuti zviratidzo zvavo zvainge zvanyanya kuipa kana zvisingagoni kugadziriswa .
Kunyange zvazvo varwere vakawanda vane chirwere chetachiona uye vanachiremba vakaramba vasingazivi kuti pakanga paine chero sarudzo dzisina kunze kwevothyroxine kuti tibate hypothyroidism, mumakore ekuma1990, kuziva kweNATT sechisarudzo ichiwedzera, nekuda kwezvikonzero zvakawanda:
- kuwedzera kweInternet
- kuwedzererwa kwehutano kune vamwe varwere
- kuwedzera kugovana ruzivo pakati pevarwere nevarapi
Zvinowedzera, zviratidzo zvechirwere uye zvisina kugutsikana zvine utachiona zvinotora levothyroxine vakazoziva kuti izvo zvakasikwa zvinoshandiswa nehutachiona hwemishonga zvakange zvakasiyana kune levothyroxine.
Kushandiswa kwemishonga iyi kwakawedzera, uye vamwe varwere vakawana kuti zviratidzo zvavo uye mararamiro ehutachiona , zvakarongedzwa zviri nani pane zvakasikwa zvakasvibiswa nehutachiona, zvichienzaniswa ne levothyroxine, kana kunyange levothyroxine pamwe chete nemhando yakagadzirwa T3 (zita racho ndiro Cytomel, uye inozivikanwa seionronine.)
Mhirizhonga yakakura sezvo varwere vakakumbira chimiro chetachiona chechirwere, uye vashandi vakawanda, kunyanya avo vane chinonyanya kukoshesa, vakaraira. Kusina zvinyorwa kwakawanda, nevamwe vanachiremba vachikanganisa vachitaura kuti zvinhu zvakasikwa zvechirwere zvinodhaka zvakange zviripo pasina mishonga kana kuti zvakagadzirwa nemombe, uye saka zvaive pangozi.
Kutungamirirwa kwepamutemo kwehutano kwakakurudzira levothyroxine uye zvakanyanya kukanganisa kushandiswa kwezvinhu zvakasikwa zvakarongwa nemishonga yehutano.
Asi zvakadaro, sekusimbisa kutsungirira uye ruzivo rwakawedzerwa, uye semishonga yakakwana uye yakasiyana-siyana yakagadziriswa zvikuru, nhamba yezvinyorwa zvemishonga yehutachiona yakasikwa yakawedzera. Bhuku rinonzi Western Research, iro rakange raita kuti zvinhu zviitike zvakasvibiswa nemishonga yehutano Maitiro-chinyorwa uye Westhroid (ikozvino WP yeTroroid), yakatengwa neRLC Labs, uye izvi zvinodhaka zviviri zvakawana hurukuro yakawanda.
Mazuva ano Clinical Practice Guidelines yeHypothyroidism muAdults , yakabudiswa neAmerican Association of Clinical Endocrinologists (AACE) uye American Thyroid Association (ATA), zvisiri izvo zvinoratidzirwa zvakasikwa zvine utachiona hwehutano. Zvinotinetsa nehurukuro yaTungamiel pamusoro pehutano hwepanyama zvakapfupikiswa munyaya ino, asi chaizvoizvo, vakaramba vachinyora zvisiri izvo kuti NDT mishonga yemishonga inobva kune mhou, uye vakaedza kuvhara nyaya yacho vachiti "Hapana humwe uchapupu hunotsigira kushandisa chesiyo yakarongwa hormone inofarira L-thyroxine monotherapy mukurapa hypothyroidism uye naizvozvo inoratidzira utachiona hwehomoni haufaniri kushandiswa pakurapa hypothyroidism. "
Vakakundikana kutaura kuti hakuna humwe uchapupu hunotsigira kushandisa levothyroxine pane zvisikwa zvakasikwa zvehutachiona. Kutsvakurudza kwakange kusati kwamboitwa nenzira ipi zvayo, saka makore emitambo, dzidziso, uye kutengeserana zvakaratidzika sechikonzero chekufambisa kwemashoko avo, kwete kutsvaga kubva kuviri-mapofu, kupfupiswa kwevezera, nyaya dzakabudiswa zvitsvakurudzo.
Kuenzanisa Levothyroxine neChechi Yakarongeka Utachiona
Imwe yongobva kuongorora, yakapofumadza, yakawanda, yekuongorora kwechikwata yakaenzanisa chizvarwa chetachiona chakakonzerwa ne levothyroxine. Chidzidzo chacho chakaongororwa varwere makumi manomwe (vane makore 18 kusvika ku65) avo vaive nehanai hypothyroidism . Varwere vaisarudzwa kuti vashandise utachiona kana levothyroxine kwemavhiki gumi nemaviri.
Achipedzisa chidzidzo, varwere vakabvunzwa kuti regimen yavakasarudza, uye inenge 49 kubva muzana yakasarudza chimiro chakasvibiswa chetachiona, zvichienderana ne19 peresenti yakasarudza levothyroxine. Inenge 33 muzana haina kutaurira zvakasarudzwa.Virwere vanotora chirwere chetachiona chakakonzerwa nehutachiona vakarashika anenge anenge mapaundi matatu, vachienzaniswa nevarwere vanotora levothyroxine , vasina kuora muviri.
Iko kutsvakurudza kwakaendeswa kune Endocrine Society ; chinhu chakakosha uye chinokosha kukurudzira varwere vetachiona . Varwere uye vashandi vane kodzero yekuraira uye kutora chero mararamiro kana rudzi rwetrosiyo hormone mishonga yemishonga inoshandiswa nekuchengeteka uye yakanakisisa kune mumwe murwere.
Shoko kubva
Kana iwe uchida kutsvaga NDT semarapirwo ako e hypothyroidism, yeuka mupfungwa:
- Iwe unogona kudiwa kushanda nechiremba chinobatanidza kana chizere, kupesana ne endocrinologist.
- Iwe unofanirwa kushanda nevarapi vane unyanzvi mukutsanangura NDT, uye kutarisira varwere paNATT.
- Haisi iyo pfungwa yakanaka kutenga mishonga yemishonga kubva kumhenderekedzo yegungwa, pasina chiremba, uye kuitora vasina kutarisira chiremba.
- Over-the-counter glandular thyroid support zvinotsigira hazvirevi chirongwa cheNATT, uye hachisi chinzvimbo chechirwere chetrodhi hormone replacement medication.
> Sources:
> Hoang TD. "Yakatsanangurwa nekodhi yekotori yakaenzaniswa nevothyroxine mukurapa hypothyroidism." American Thyroid Association (March, 2013).