Kuyaphawuleka ukuthi inani elibalulekile labantu abayizigidi ezingu-27 eziphethe i-hypothyroidism liphela futhi litholakala nge-fibromyalgia. Zombili lezi zimo zinezimpawu eziningi ezifanayo, kuhlanganise ukukhathala, ukukhathala, ukucindezeleka, ubuchopho bubuchopho , kanye nobunzima obuhlukahlukene bokuhlupheka nobuhlungu obuhlangene .
Ezinye izazi zisho ukuthi lokhu kufana nezimo eziningi ze-hypothyroidism e-United States, i-fibromyalgia nayo isifo esizimele.
Abanye bathi iqembu lezimpawu ze-fibromyalgia empeleni izimpawu ze-hypothyroidism ngokwayo. Kodwa akukho mbuzo ukuthi kukhona okuningi kokuwela phakathi kwezimo ezimbili.
Ukuqonda i-Fibromyalgia
I-fibromyalgia ibizwa nangokuthi i-fibromyalgia syndrome (i-FMS), i-fibromyositis, i-fibrositis, ne-myofibrositis. I-Fibromyalgia ibonakala ngobuhlungu obuningi obuhlangene nobunamahloni nobubele, ukukhathala, nokukhathala emva kokulala nangemva kokwenza umzamo womzimba.
I-Fibromyalgia ithinta abantu abayizigidi eziyisishiyagalombili e-US, okwenzeka ikakhulukazi besifazane abaneminyaka yobudala. Ngokuvamile, i-fibromyalgia ishaya abesifazane izikhathi eziphindwe kasikhombisa kaningi kunamadoda. Izifo ngokuvamile zivela phakathi kweminyaka engama-20 kuya ku-55, kodwa isimo singase sitholakale ebuntwaneni. Phakathi kwabo bonke abantu, kulinganiselwa ukuthi abaningi abangamaphesenti angu-3 kuya kwangu-6 abantu abaningi, kuhlanganise nezingane, bahlangabezana nezinqubo ezisemthethweni zokuxilongwa okusemthethweni kwe-fibromyalgia.
Lokhu kuzokwenza i-fibromyalgia ibe yinto ejwayelekile kabili njenge- rheumatoid arthritis .
Izimpawu ze-Fibromyalgia
Ezinye izimpawu ze-fibromyalgia zifaka:
- Ukuzwa ubuhlungu , ukushisa, ukugula, nokwesaba emzimbeni
- Izikhwehlela, ubuhlungu be-scalp, ubuhlungu ngemuva kwe-skull
- Ubuhlungu entanyeni, emahlombe, emahlombe kanye nasezindlini
- Ubuhlungu ezinqulwini, phezulu kwezintambo, ngaphandle kwe-hip ephansi, ngezansi izintambo, kanye nekhanda
- Ubuhlungu emadolweni nasendaweni ye-kneecap
- Ukukhathala, ukuphumula okungaqabuki , ukuvusa ukhathele, ukuqina kosuku
- Ukungalali, ukuvuka njalo, ubunzima bokulala, noma ukulala ngokushesha
- Isimo sikaRaynaud (lapho izandla zakho zizwa zibandayo, ziphazamise, noma ziphenduka okwesibhakabhaka, uma zivezwa izinguquko zokushisa)
- I-syndrome ye-british irritable, isifo sohudo, ukuqothulwa, ukubhuqa, ukuchoboza
Ukuxilongwa kwe-Fibromyalgia
Ukuxilongwa okusemthethweni kuqinisekiswa ngokusebenzisa i-American College of Rheumatology criteria ye fibromyalgia:
____ Ubuhlungu obubanzi okungenani izinyanga ezintathu. Ubuhlungu kumele bube ngakwesobunxele bomzimba ohlangothini lwesokudla kanye nohlangothi olufanele, nobuhlungu bobabili ngenhla nangaphansi kwesinqe. Umgogodla womlomo wesibeletho, isifuba sangaphambili, umgogodla we-thoracic noma ubuhlungu obuphansi be-back back kufanele bube khona.
Ngaphezu kwalokho, ubuhlungu okungenani okungu-11 kwezingu-18 zezindawo zendawo zethenda , ezifaka:
____ Indawo lapho imisipha yentamo ifaka khona phansi kwegazi, amahlangothi angakwesokunxele nangakwesokudla (Occiput)
____ Midway phakathi kwentamo nehlombe, izinhlangothi zangakwesokunxele nezingakwesokudla (Trapezius)
____ Imisipha ngaphezulu kwesokunxele nangakwesokudla phezulu kwehlombe langaphakathi, amahlangothi angakwesokunxele nangakwesokudla (Supraspinatus)
____ 2 amasentimitha ngaphansi kwethambo elihlangene emgqeni wesandla sesobunxele nesokudla (i-episode epicondyle)
____ Izintambo zangaphandle ezingakwesokunxele nangakwesokudla (Ukuziqhenya)
__________________ ___________ Amathambo we-hip kwesokunxele nesokudla (i-Greater trochanter)
____ Ngaphezulu nje kwamadolo angakwesokunxele nangakwesokudla ngaphakathi
____ Intamo encane phambi, izinhlangothi zangakwesokunxele nezingakwesokudla (Umlomo wesibeletho ophansi)
____ Ukuphakama kwethambo lesifuba elingenhla, izinhlangothi zangakwesokunxele nezingakwesokudla (isibambo sesibili)
I-Fibromyalgia kanye nokukhathala okungapheli uJacob Teitelbaum , MD, umbhali we- From Fatigued to Fantastic , uthatha incazelo ekhululekile. Ukholelwa ukuthi uma umuntu ngokuvamile evumelana nencazelo ye-fibromyalgia, enezimpawu ezihlanganisa ukukhathala okungacacisiwe, kanye nanoma yiziphi izimpawu ezimbili ezivela emkhunjini webuchopho, ukuphazamiseka kokulala, ukoma okwedlulele, ukungasebenzi kwamathumba, kanye / noma ukutheleleka okuqhubekayo noma okuqhubekayo noma imizwa efana noketshezi, khona-ke kufanele kucatshangelwe ukuxilongwa okuhle.
I-Hypothalamic Connection
UDkt. Teitelbaum ukholelwa ukuthi engxenyeni ye-dysfunction ye-thyroid kanye ne-fibromyalgia kuyinkinga ngokukhubazeka noma ukucindezelwa kwekhanda elihle ebuchosheni obubizwa nge-hypothalamus.
UDkt Teitelbaum ...
Le gland ilawula ukulala, isimiso sakho se-hormonal, isimiso sokushisa, kanye nesistimu ye-neon autonomic (isib. - ukucindezelwa kwegazi, ukugeleza kwegazi, kanye nokuhamba kokudla ngokusebenzisa isilwane sakho). Yingakho ungeke ulale, unezinga lokushisa eliphansi, uthola isisindo, futhi (ngoba ukulala okungakahle kubangelwa ukuzivikela komzimba) ujwayele ukutheleleka okuphindaphindiwe nokuphindaphindiwe. Ngakho-ke, ukukhubazeka kwe-hypothalamic ngokwayo kungabangela izibalo eziningi! Ngicabanga ukuthi izinkinga "ze-energy fur" emasethini akho (okuthiwa i-mitochondria) zivame ukubangela ukucindezelwa kwe-hypothalamic.
Isixhumanisi se-Thyroid ne-T3
Uma unesifo se- thyroid esinezibonakaliso nezimpawu ze-fibromyalgia, kufanele ucabange ukuhlolwa ngudokotela onolwazi esimweni, kungakhathaliseki ukuthi i-MD ephelele noma ehambisanayo, i-internist noma i-rheumatologist.
Futhi, uma unesiguli se-fibromyalgia, kufanelekile ukumba ngokujulile ukucacisa ukuthi unenkinga encane ye -roid engase ibe negalelo-noma ngisho ebangela-izimpawu zakho ze-fibromyalgia.
Ngokuvamile abantu banesifo se-TSH se- thyroid ukuze banqume ukuthi banokungalingani kwe -roid, kodwa isazi se-fibromyalgia sekwephuzile uDkt. John Lowe, owahola i-Fibromyalgia Research Foundation futhi wabhala i-Metabolic Treatment of Fibromyalgia , wababuza ukuthi ubiza yini "ezinezimiso ezivamile zokugcina i-endocrinology . "
- Okuwukuphela kwezimbangela ze-thyroid ye-hormone ukuntula izimpawu yi-hypothyroidism
- kuphela iziguli ezine-hypothyroidism "ngokusho kwemiphumela yebhu" kufanele kuvunyelwe ukusebenzisa i- hormone ye-thyroid
- isiguli se-hypothyroid kufanele sivumeleke kuphela ukusebenzisa i-T4 (levothyroxine) futhi
- umthamo wesiguli akufanele ukuvimbela izinga le- hormone (TSH) le -roid elikhuthazayo .
UDkt. Lowe kwadingeka anselele lezi zindlela zangaphambili njengengxenye yomzamo wakhe omude wokufunda kabanzi mayelana ne-fibromyalgia engamelana nokwelapha. Umphumela waba yindlela yokwelapha esekelwe ekutholeni kwakhe ukuthi izimpawu ezingaxazululwa ezihlobene nokuphathwa kwe-hypothyroidism kanye ne-fibromyalgia empeleni zibufakazi bokungaphenduli noma ukungaphansi kwe-hypothyroidism , noma ukumelana namaselula okumelana ne-hormone yegciwane.
Isici esiyingqayizivele sezinkolelo zikaDkt. Lowe kwaba ukuqaphela kwakhe ukuthi isiguli esinokumelana neselula singase sibe nesisindo esijwayelekile ngokujikeleza ama-hormone we-thyroid okwamanje kunezibonakaliso nezimpawu ze-hypothyroidism. Nokho, wathola engxoxweni yakhe nabanye abacwaningi be-fibromyalgia / CFS, abaningi abangakwaziyo izindlela ezinjalo. Uthi:
Kubo, uma isiguli sinesilinganiso esijwayelekile se-TSH , futhi ikakhulukazi uma izimpawu zesiguli zingaphuthuki ngezindlela zokufaka esikhundleni se-T4 (levothyroxine), isimo sakhe asikwazi ukuhlobene nanoma iyiphi indlela yehomoni ye-thyroid. Ucwaningo lwesayensi lwakamuva, nokho, lubonise ukuthi le nkolelo iyimanga.
Uma une- hypothyroidism e-autoimmune , kuvamile ukuthuthukisa izimpawu zobuciko ze-fibromyalgia ezinjengobunzima bomzimba / ubuhlungu, ama-aches, nokuphazamiseka kokulala. Ngokusho kukaDkt. Lowe, kungenzeka ukuthi odokotela abavamile bangabheka noma yiziphi izimpawu ezintsha noma ezibi kakhulu njengobufakazi bokuthi kukhona esinye isimo ezifana ne-fibromyalgia ngaphezu kwenkinga ye-thyroid yokuzimela. UDkt. Lowe, kodwa, wachaza lokho njengobufakazi bokuthi isiguli sasibonisa ubufakazi be-hypothyroidism engaphansi kwe-undertated :
Njengoba i-hormone ye-hormone isweleke kakhulu, inani lezicubu ezihilelekile kanye nobukhulu bezimpawu eziphumela kukhula. Isiguli ngokuvamile sibona ukwehluleka okubucayi njengenani elikhulayo lezimpawu zokuqina okukhulu. Ezimweni eziningi, iziguli ezinjengalezi zivele zidinga isilinganiso esithile esifanele noma i-hormone yegciwane ukuze ilulame kuzo zonke izimpawu zazo.
UDkt. Lowe ukholelwa ukuthi ukunamathela okuqinile kulokho okubizwa ngokuthi "uhla olujwayelekile" alubonisi ukuthi isiguli sinokwanele yini ukujikeleza i-T3 (i-hormone ye-thyroid esebenzayo emkhakheni wamaselula, okhiqizwa ingxenye yingxenye ye-thyroid, futhi ngokuyingxenye ngokuguqulwa we-T4 i-hormone kuya ku-T3) ukugcina umzimba ovamile emangqamuzaneni. Ucwaningo lwakhe lubonise ukuthi ukulinganisa okuphephile kodwa okucindezelayo kwakuvame ukuphumelela kakhulu ekuqedeni izinkinga zempilo ezihambisana nokukhathazeka okukhulu. Ukuguqulwa kwe-T4 kuya ku-T3 kungaphili kahle, ngakho-ke iqiniso lokuthi isiguli sinesilinganiso esijwayelekile se-TSH asisho ukuthi izicubu zakhe zethemabolism zivamile.
Ngokusho kukaDkt. Lowe, ucwaningo oluthile lubonise ukuthi ama-hormone e-thyroid ephindaphindiwe, ama-dosage agcina i-TSH engaphakathi kwezinga elijwayelekile, wehlisa iziguli eziphezulu ze-cholesterol iziguli, kodwa ama-TSH-suppressive dosages anciphisa amazinga ngokuqhubekayo.
Imibiko eminingi eshicilelwe kanye nezifundo zethu ibonisa ukuthi izinga le-TSH alihambisani nezivivinyo ezihlukahlukene ze-tisab. UDkt. Lowe uzizwa lokhu kubalulekile ngoba ukwenza izicubu zomzimba ezijwayelekile kufanele kube umgomo wawo wonke ukwelashwa ngeziguli ze-hypothyroid. Lapho isiguli se-hypothyroid sinqunywe umthamo we-T4 ogcina i- TSH ngaphakathi kobubanzi obujwayelekile , ukuhlolwa kuzothengisa ubufakazi bokuthi umzimba ungavamile ngokwezakhi eziningi.
Abanye abacwaningi baxosha i-hormone ye-thyroid njengendlela yokwelashwa kwezimpawu ze-fibromyalgia noma i-CFS. Ngokusho kukaDkt. Lowe, "ukushintshwa" njengoba kuchazwe abacwaningi ngokuvamile akusebenzi ngoba ukufaka esikhundleni kusho ukusetshenziswa kwe-T4 kuphela ukugcina i- TSH ngaphakathi kobubanzi obujwayelekile . Wazizwa ukuthi akwanele ukukhulula iziguli eziningi ze-hypothyroid ezivela ezingqondweni zabo.
Wayekholelwa ukuthi ukucabanga ukuthi ama-dosage e-T4 okushintshwa yiwona kuphela ukwelashwa okwamukelekayo okuvimbela abanye abacwaningi ukuba babone imbangela ye-fibromyalgia yeziguli eziningi ayengeneli isimiso se-hormone yegciwane lesishukela. UDkt. Lowed ukholelwa ukuthi inhlanganisela ye- T4 ne-T3 ngokuvamile isebenza kangcono kune-T4 yedwa neziguli ze-hypothyroid , futhi kwezinye izimo uT3 wedwa usebenza kahle. UDkt. Lowe wathola ukuthi uma iziguli ze-hypothyroid ziphathwa nge-T4 okokuqala, kancane kancane zandisa umthamo, uma zingakunikeli inzuzo enkulu noma nhlobo, iziguli zashintshwa ku-T3.
I-T4 yedwa yindlela empofu yeziguli eziningi ze-hypothyroid fibromyalgia, futhi akusizi ngalutho iziguli ze-fibromyalgia ezinokumelana namaselula ehomoni ye-thyroid. Iningi lalezi ziguli, ezakha cishe amaphesenti angu-44 wegciwane lesiguli se-fibromyalgia ngokusho kwezifundo zethu, zizuza kuphela emithini enkulu kakhulu ye-T3. I-minority kuphela yeziguli ze-hypothyroid fibromyalgia ezithuthukisiwe ngokunethezeka nokusetshenziswa kwe-T4 yodwa.
Izwi kusuka
Uma une-hypothyroidism enezimpawu ezibonisa ukuthi i-fibromyalgia, noma une fibromyalgia, ungase uthande ukucabangela ukubona udokotela enezobuchwepheshe kuzo zombili izimo, ozibheka njengezixhumanisi ezingaphansi. Isiqalo esihle sokuthola udokotela ofanelekile kumawebhusayithi e-National Fibromyalgia Association kanye ne-National Fibromyalgia & Chronic Pain Association
Imithombo:
> Haliloglu S et al. "I-Fibromyalgia kwiziguli ezine-autoimmunity ye-thyroid: ukusabalalisa nobuhlobo nomsebenzi wesifo." I-Clin Rheumatol. 2017 Jul; 36 (7): 1617-1621. i-doi: 10.1007 / s10067-017-3556-2. I-Epub 2017 Feb 7.
> Lowe, uJohn. "Ukwelashwa Kwama-Metabolic of Fibromyalgia." Inkampani ye-McDowell Publishing; 2000.
> Nishioka K, et al. "Ukukhula okuphezulu kwe-anti-TSH receptor antibody ku-fibromyalgia syndrome." Int J Rheum Dis. 2017 Jun; 20 (6): 685-690. i-doi: 10.1111 / 1756-185X.12964. I-Epub 2016 Nov 30.
> Selmi C et al. "Umhlangano waminyaka yonke we-ACR we-2014: iso lezinyoni libheke ngokuzimela ngo-2015." I-autoimmun uMsindisi 2015 Jul; 14 (7): 622-32. doi: 10.1016 / j.autrev.2015.03.003. Epub 2015