Kana iwe uri pane utachiona hwemishonga yemishonga yemishonga (kureva, generic levothyroxine, kana Synthroid, Levoxyl, kana Tirosint marina) uye vachiri kusanzwa zvakanaka, imwe ingangodaro ndeyokuti iwe unogona kubatsirwa nekuwedzera T3, kana kuchinja mushonga wekemikari unosanganisira T3.
T3 / Triiodothyronine
Levothyroxine yakagadzira maitiro ehomoni thyroxine, yakafukidzwa seT4.
T4 ndiyo hormone yekuchengetedza uye inofanira kushandurwa nemuviri kuT3 kuti ishandiswe nemasero.
T3 yakapfupika kune triiodothyronine. T3 ndiyo utachiona hunoshandiswa hunoshandiswa pamasero emasero kuti ubatsire nekutakura oksijeni nemasimba kune masero, maviri, uye glands mumuviri wose.
Kunyange zvazvo chirwere chetachiona chinogadzira zvose T4 uye T3, T4 haina kushanda. Kuti uve wekushandisa kumutumbi, T4 inoshandurwa kuT3.
Levothyroxine-chete kurapwa inofungidzirwa kuti ndiyo yekuchengetwa kwechiremba anowanikwa. Kune humwe huri huchikura huchapupu hwezvesayenzi, zvisinei, izvo zvinoratidza nhamba dzinoverengeka dzinoisa pfungwa paT3 therapy. Semuyenzaniso:
- Kutsvakurudza kutsva ndiko kujekesa genetic kasingazivikanwi inozivikanwa se deiodinase polymorphisms iyo inogadzirisa chikamu chevarwere zvishoma kushanda pakuchinja T4 muT3. Izvi zvidzidzo zvinoratidza kuti levothyroxine chete haikwaniki nevarwere ava.
- Zvikwi gumi nemashanu zvenguva ichangobva kuongorora vakaongorora levothyroxine pamwe neionrononine kurapa kwe hypothyroidism. Chimwe chezviongorori zvakawana mafungiro akavandudzwa, hupenyu hwehupenyu, uye hutano hunoonekwa nevarwere vanotora chirwere chekubatanidza, vachienzanisa nevothyroxine chete.
- Zvimwe zvidzidzo zvakaratidza kuti kushandiswa kwekuwedzera T3 kunokonzera kuderedza cholesterol mazinga, kuderedza kukuru kwehutano hwemuviri, nekugadziriswa kwakanyanya kwezviratidzo, pasina chero njodzi dzinowanzoenzanisa kana levothyroxine oga.
Chidzidzo cheDanish chinoshamisa , chakataurwa pamusoro peEuropean Journal of Endocrinology , yakadzidza zviratidzo zvehutano zvinokonzerwa ne levothyroxine-chete chirwere, zvichienderana nevothyroxine pamwe neT3 (munyaya iyi, muyero we microgram 20 dzeT3 zuva rimwe nerimwe wakashandiswa).
Miedzo yehutano hwehupenyu uye kuora mwoyo kwakaitwa pakutanga kwekudzidza, uye zvakare mushure memakore gumi nemaviri ekurapa nguva. Munguva imwe neimwe yemaawa gumi nemaviri-masvondo, hurukuro dzakapiwa levothyroxine pamwe neT3, kana levothyroxine pamwe ne placebo ndokuzoshandura kwevhiki 12 inotevera. Vatori vechikamu vaiva "bofu" pakuti havana kuziva kana vari kutora T3 kana kuti placebo.
Unhu hwehupenyu nemafungiro epfungwa dzinoongororwa zvakabatanidzwa, pakati pezvimwe zvikonzero: hutano huzhinji, hutano hwehutano, hutano hwepfungwa, hutano, unhu, kuora mwoyo, nekuzvidya mwoyo. Chidzidzo chacho chakaratidza kuti pakati pevarwere, vazhinji vavo vaiva vakadzi, 49% yevarwere vaida kusanganiswa, uye 15% chete vaida levothyroxine-chete kurapa.
Vatsvakurudzi uye endocrinologist vave vachifamba nekudzoka kwemaminitsi anenge makumi maviri pamusoro pekukosha kweT3 . Kubva pazviitiko zvavo pachavo zvinobatsira nevarwere, uye panyaya inokura yekutsvakurudza humwe uchapupu, vamwe vanachiremba vanowanzogadzirwa, uye vanyori vakawanda uye vanobatanidza vari kuwedzera kuwedzerwa kuwedzera t3 sechigadziro chekubatsira kukwanisa kurapa utachiona kune vamwe varwere. Vanowedzera T3 nenzira dzinoverengeka:
- Kuwedzera T3 kune levothyroxine kurapwa, kuburikidza nekuwedzerwa kwechirongwa chechigadzirwa T3 chigadzirwa chemishonga chemishonga Cytomel, kana kuti generic liothyronine (yakagadzirwa T3)
- Kuwedzera maitiro T3 kuburikidza nemishonga inowanikwa nguva-yakasunungurwa / yakasunungurwa-kusunungurwa T3 kuwedzera ku levothyroxine
- Kuwedzera kuwedzerwa kwehutachiona hwehutachiona hwakarongeka, zvakadai semishonga inoshandiswa mishonga Chirwere chechimiro, Chirwere cheTyroid, kana utachiona hwemazuva ose (iyo inogadzirwa neU.S. Acella) kumushonga we levothyroxine
- Kushandura varwere kuenda kune zvakasikwa zvinoratidzirwa nehutachiona-nzira chete yekurapa
- Kuisa murwere paT3 chete kurapa (izvi hazvisi zvisiri nyore.)
Zvakakosha kucherechedza, zvisinei, nokuti T3 ndiyo hormone inoshanda, inogona kuva nehuwandu hwekuvhiringidza kushaya mwoyo uye kupisa kune vamwe vanhu, kunyanya avo vane nhoroondo yezvirwere zvepfungwa, vakwegura, nevaya vane mwoyo usina kukwana mitral valve prolapse.
Vanachiremba veT3-savvy vanoongorora kuchengetedzwa kweT3 kana vachienzaniswa nezvinobatsira kune imwe nyaya-ne-kesi.
Kunyangwe mune avo varwere vasina mwoyo kana yehutano hunoita kuti T3 ive nedambudziko, vamwe varwere vanongotarisa zvinokonzera zvinokonzerwa neT3. Mwoyo unonyanya kurwisa utachiona hwetachiona huzhinji, uye kune vamwe vanhu, kunyange kuderera kweionronine, kana kuti zvishoma zveT3 muzvinhu zvakasikwa zvinoshandiswa nehutachiona zvinodhaka zvinogona kukonzera kuwedzera kwemhepo kana maperembudzi.
Kune varwere ivavo, vamwe vanachiremba vanokurudzira nguva-yakasunungurwa / yakasununguka-kusunungurwa / kuregererwa-kusununguka mafomu eT3, inowanikwa nemishonga inobva pakugadzira pharmacy.
Vamwe vanobatanidza vanachiremba, chaizvoizvo, vanodavira kuti kusununguka-kusununguka T3 ndiyo chaiyo yakakosha yekuti tibatsire T3, sezvo inonyanya kufanana nemutumbi wekutendeuka uye kusunungurwa kweT3, uye nokuti fomu yakasununguka-yakasununguka haigoni kuita chero zvikanganiso.
Zvinhu Zvakasikwa Zvinoratidzirwa Utachiona
Vamwe vashandi vakaona kuti chigarire chevarwere vavo vane chisarudzo chekuchengetedza kwezviratidzo zvavo pavanotora mishonga yemararamiro yakarongerwa utachiona, akafuridzirwa seNATT. NDT inozivikanwawo seprotein thyroid, chibage chetachiona, utachiona hwepanyama kana kuti "yenguruve yenguruve." Iyo FDA-inotarisirwa mishonga yemishonga inogadzirwa, yakagadzirwa kubva muhutano hwakasvibiswa hwekorosi yenguruve. Mishonga iyi iri muzvikamu inosanganisira Armor Thyroid, Nature-throid, uye WP Thyroid muUnited States, Canada Erfa Thyroid, uye chimiro chakasikwa chetachiona chakakonzerwa neUnited States yakabudiswa naAcella.
Chimiro chetachiona chakasvibiswa chave chiri kushandiswa kwemakore anopfuura zana. Vakawanda vanobatanidza hormone nyanzvi vanotenda kuti mishonga iyi, iyo inopa T4, T3, T2, T1, nemamwe mahomoni ehutori uye zvivako zvekudya, zvakanyanya kufanana nehutachiona hwehutori hwevanhu kupfuura hutachiona hwemishonga. Vanotaura kuti zvikamu zvizhinji zvevarwere vavo vanonzwa zviri nani pavari. Vamwe varwere vanoona kuti vanonzwa zvakanakisisa pamishonga yehutachiona hwepanyama, kana pamishonga yemishonga pamwe chete nehutachiona hwepanyama.
Shoko Rinobva
Kusununguka T3 uye kudzorera T3 kuongororwa kweropa, pamwe chete nemakiriniki zviratidzo uye zviratidzo zve hypothyroidism, zvinogona kubatsira kuziva kana iwe unowanikwa zvakakwana zveT3, kana kuti unogona kubatsirwa neT3 kurapwa. Vamwe vanachiremba vanobatanidza vanotenda kuti kuchinja kwakakwana kwehutano kuchaita kuti mahara T3 akasununguka ari pakati kusvika kune imwe yepamusoro ye laboratory reference range.
Ramba uchiyeuka kuti T3 kuedza uye kushandiswa kweT4 / T3 mishonga pamwe chete nemishonga yakasikwa yakakonzerwa nemakemikari ehutano inokakavadzana. Vakawanda vekugogotoriki uye vanogadzirira vanachiremba vanopikisa zvikuru pfungwa yekuedza T3 uye kurapa neT3 mishonga, pasinei nekuvimbiswa kutsvaga kutsvaga. Vanotaura nezvekunetseka kwekuti kutengesa zvakanyanya kweT3 kunogona kukonzera mwoyo mapapitende kana mamwe madhara.
Vakawanda vezvechiremba vanowanzoonawo maitiro ehutachiona chaiwo zvakanaka . Vanotaura kuti mishonga iyi haisati yasvika, kwete "kusagadzikana," uye vazhinji havangagoni kuiraira.
Kana iwe uchida kufungidzira kubhadhara T3 kurapwa kana masikirwo emasikirwo emishonga ehutachiona, iwe ungada kushanda nechiremba chinobatanidza kana chizere.
Uyewo, apo zvakasiyana-siyana pamusoro pe-the-counter-thyroid zvinotsigisa zvinowanikwa, uye vamwe vanoti vane "thyroid glandulars," izvi hazvirevi mishonga yekodzero yemishonga, uye haisi iyo inotsiva mishonga yemishonga yehutachiona yakasikwa.
> Sources:
> Celi FS, et al. "Maitiro ekugadzirisa maitiro e-liothyronine therapy mu hypothyroidism: maitiro asinganzwisisiki, maviri-mapofu, kuonekwa kwechionronine uye levothyroxine." J Clin Endocrinol Metab. 2011 Nov; 96 (11: 3466-74.): 10.1210 / jc.2011-1329 Epub 2011 Aug 24.
> Clinical Practice Guidelines for Hypothyroidism muVakuru : Co-inotsigirwa neAmerican Association of Clinical Endocrinologists uye American Thyroid Association.
> Escobar-Morreale HF, et al. "Kurapa kwe hypothyroidism ne levothyroxine kana kusanganisira levothyroxine pamwe neL-triiodothyronine." Best Pract Res Clin Endocrinol Metab. 2015; Jan; 29 (1): 57-75. doi: 10.1016 / j.beem.2014.10.004. Epub 2014 Nov 25. Ongororo.
> McAninch EA, Bianco AC. "The History and Future of Treatment of Hypothyroidism." Ann Intern Med. 2016 Jan 5; 164 (1): 50-6. doi: 10.7326 / M15-1799. Erratum in: Ann Intern Med. 2016 Mar 1; 164 (5): 376. PMID: 26747302
> Nygaard, B et al. "Migumisiro yekubatanidza utachiona ne thyroxine (T4) uye 3,5,30-triiodothyronine pamwe neT4 monotherapy muvarwere vane hypothyroidism, vane mapofu maviri-mapofu, akaisa ruzivo rwepamusoro." European Journal of Endocrinology (2009) 161 895-902