Umlando Wokuphikisana Ngezidakamizwa Zezifo Zomzimba Wezemvelo
Akuyona imfihlo ukuthi izidakamizwa zemvelo ye-thyroid (NDT) zemvelo ziye zaphikisana amashumi eminyaka. I-NDT ifomu le-prescription ye- hormone ye- thyroid futhi ibizwa ngokuthi i- thyroid yemvelo , i-thyroid yegazi, i-porcine thyroid, "ingulube yegciwane," noma ngamagama agama njenge-Nature-throid noma i-Armor Thyroid.
I-NDT yaqala ukuvuselelwa ekuqaleni kwawo-1900 futhi yenziwe kusukela ezigulini zezilwane eziphephile (ezomisiwe), njengendlela yokwelapha i-hypothyroidism, ukuntuleka kwehomoni ye-thyroid.
Izindlela zokuqala ze-thyroid zemvelo zavela emthonjeni wezinyosi wezinyosi, kodwa ngasekuqaleni kwawo-1900, inkampani yezilwane yezilwane yangena emasimini, ithengisa isifo sayo sezinto eziphilayo ezivela emagodini, okuthiwa i-Armor Thyroid.
Ngenxa yokuthi lakhiwa ngaphambi kokuba i-FDA ikhona, imithi yayo njengemithi yokwelashwa yayiningi, futhi i-thyroid eyakhiwe yendalo, kuyilapho ilawulwa yi-FDA, ingakaze iqede inqubo " Yokusetshenziswa Kwezidakamizwa Ezintsha " (NDA) eyayidinga izidakamizwa ezintsha ezethulwa emakethe emva kokuba i-FDA yasungulwa.
I-thyroid eyakhiwe yendalo yemvelo iqukethe kokubili i-T4 (thyroxine) ne-T3 (triiodothyronine), kanye ne-calcitonin, nezinye izakhi ezitholakala emthonjeni we- thyroid . I- gland evamile yegciwane ikhiqiza ngokuyinhloko i-T4 (i-hormone yokugcina) kanye ne-T3, futhi i-T4 iguqulwa ibe yi-T3, i-hormone esebenzayo, ukuze isebenziswe ngamaseli namathishu omzimba.
Ukukhishwa kwe-Synthroid
Phakathi nekhulu leminyaka elidlule, imithi yokwelapha yokwelapha yafika emakethe.
Le nguqulo yokwenziwa kwe-hormone ye-T4 iyaziwa ngokuthi i-levothyroxine, futhi ngezinye izikhathi ibizwa ngokuthi igama legama elivamile, i-Synthroid. I-Levothyroxine yaqala ukuthandwa kakhulu, futhi phakathi nengxenye yesibili yekhulu lama-20, yaba yindlela yokwelashwa emphakathini wezokwelapha ovamile.
Odokotela bathi babezinzile futhi bezinzile kunezokwelapha eziphilayo ezikhethiwe, nokuthi umzimba wakwazi ukuguqula i-T4 ibe yi-T3 esebenzayo isidumbu esidingekayo ukuxazulula i-hypothyroidism.
Emashumini ambalwa eminyaka, iziguli eziningi ze-thyroid zazibekwe izidakamizwa ze-levothyroxine zokwelapha i-hypothyroidism. Kodwa njengoba isithakazelo sakhula emithini yemvelo ngawo-1980, odokotela abahlanganisayo nabaphelele baqala ukubeka isifo semvelo, esasihlale emakethe, nakuba sinekhwalithi encane yemakethe.
Abanye odokotela asebekhulile ababekade basebenzisa isifo segilo esinezinyosi zangasese kanye neziguli zabo, baphendule ezinye iziguli emuva kwezidakamizwa ze-thyroid ezidumile zemvelo Ezinye zalezi ziguli zazikhononda, ngemva kokuba zishintshele ku-levothyroxine, ukuthi izimpawu zabo zazinzima noma azikwazanga ukuxazululwa .
Ngesikhathi iziguli eziningi zegciwane kanye nodokotela bezingazi ukuthi kunezinketho ngaphandle kwe-levothyroxine zokwelapha i-hypothyroidism, ngawo-1990, ukuqwashisa nge-NDT njengendlela yokhetho kwanda, ngezizathu eziningana:
- ukuphakama kwe-intanethi
- ukwandisa ukufinyelela kwesiguli kwezinye iziguli
- ukwandisa ukwabelana ngolwazi phakathi kweziguli kanye nabasebenzi
Ngokuqhubekayo, iziguli zesifo se-thymothyroxine ezinomzimba nezingenelisekile zithatha i-levothyroxine zaqaphela ukuthi izidakamizwa zemvelo ezikhethiwe zemvelo zazihlukile ku-levothyroxine.
Ukusetshenziswa kwezidakamizwa kwanda, kanti ezinye iziguli zathola ukuthi izimpawu zabo kanye namazinga egazi le-thyroid , zalawulwa kangcono kwi-theroid yemvelo, uma kuqhathaniswa nevothyroxine, noma ngisho ne-levothyroxine kanye nefomu ye-T3 (igama lomkhiqizo yi-Cytomel, futhi ngokujwayelekile ibizwa ngokuthi i-liothyronine.)
Ukuphikisana kwanda njengoba iziguli eziningi zicela isifo se-nature esakhiwe emvelo, kanye nabasebenzi abaningi, ikakhulukazi labo abanokugxila kokubambisana, okubekiwe. Kwaziswa okungalungile, kanti odokotela abathile bephutha ngokusobala ukuthi izidakamizwa zemvelo ezikhishwe imvelo zazitholakala ngaphandle kwemithi noma zenziwe ngamakhambi, ngakho-ke kwakuyingozi.
Iziqondiso zokwelashwa ezisemthethweni zanconywa i-levothyroxine futhi ziqede ngokukhethekile ukusebenzisa imithi yemvelo ekhishwe imvelo.
Kodwa nokho, njengoba ukukhuthazwa kwesineke nolwazi lukhuphuka, futhi njengoba imithi ephelele futhi ehlukile yathola indawo enkulu, inani lemigomo yemithi ye-thyroid yemvelo yanda. Lebhu, Ucwaningo lwe-Western, olwenziwe imithi yemvelo yesifo se-thyroid (Nature-throid neWesthroid (manje i-WP Thyroid), yathengwa yi-RLC Labs, futhi lezi zidakamizwa ezimbili zathola isabelo esikhulu semakethe.
Imikhombandlela yakamuva ye- Clinical Practice ye-Hypothyroidism kubantu abadala , enyatheliswa yi- American Association of Clinical Endocrinologists (AACE) kanye ne- American Thyroid Association (ATA), isifo se-thyroid esicacile esingokwemvelo. Ukukhathazeka ngengxoxo yoMqondisi we-thyroid yemvelo kufingqiwe kule ngqungquthela, kodwa ngokuyinhloko baqhubeka ngokuphambene ngokuphambene ukuthi izidakamizwa ze- NDT zivela emfuyweni, futhi zizama ukuvala lesi sihloko ngokuthi "Akukho bufakazi obuzosekela ngokusebenzisa i-thyroid ekhethiwe i-hormone ngokukhetha i-L-thyroxine monotherapy ekwelapheni i-hypothyroidism ngakho-ke ukucacisa i-hormone ye-thyroid akufanele isetshenziselwe ukwelashwa kwe-hypothyroidism. "
Abahluleka ukuphawula ukuthi abukho ubufakazi bokusekela ukusebenzisa i- levothyroxine ngokukhetha isifo se-thyroid. Ucwaningo aluzange lwenzeke ngandlela-thile, ngakho-ke iminyaka yemikhuba, imfundiso, kanye nokukhangisa kubonakala sengathi yindlela yokushayela izincomo zabo, hhayi ukuthola okuvela ezinkampanini zocwaningo eziphishwe kabili, ezibukeziwe kontanga.
Ukuqhathanisa i-Levothyroxine ne-Natural Desiccated Thyroid
Ucwaningo oluthile olungakahleleki, olwenziwe ngokuphindaphindiwe, olwimpumputhe, luqhathanisa i-levothyroxine yemvelo emisiwe. Ucwaningo lwaluhlola iziguli ezingama-70 (abaneminyaka engu-18 kuya ku-65) ababene-hypothyroidism eyinhloko . Iziguli zazinikezwa ngezikhathi ezithile ukuthi zithathwe yi-thyroid noma i-levothyroxine emasontweni angu-16.
Ukuphetha isifundo, iziguli zabuzwa ukuthi yiziphi izigaba abazithandayo, kanti cishe amaphesenti angu-49 abathanda ukwelashwa kwemvelo, cishe amaphesenti angu-19 abakhetha i-levothyroxine. Amaphesenti angaba ngu-33 ayengacacisi okuthandayo.Iziguli ezithatha isifo se-thyroid zemvelo zalahlekelwa cishe ngamakhilogremu amathathu, uma kuqhathaniswa neziguli ezithatha i-levothyroxine , ezingazange zinciphise isisindo.
Lelo cwaningo lunikezwe ku- Endocrine Society ; ukuthuthukiswa okukhulu nokubalulekile kweziguli zegciwane . Iziguli kanye nabahlinzeki banelungelo lokubeka noma ukuthatha noma yiluphi uhlobo lomuthi noma uhlobo lwemithi yokwelapha i-hormone ye- thyroid isebenza ngokuphepha futhi engcono kunesiguli ngasinye.
Izwi kusuka
Uma unesithakazelo ekuhloleni i-NDT njengokwelashwa kwe-hypothyroidism yakho, khumbula engqondweni yakho:
- Kungase kudingeke usebenze nodokotela ohlangene noma ophelele, ngokumelene nodokotela we-endocrinologist.
- Kufanele usebenze nodokotela onolwazi ekudaleni i-NDT, nokuphatha iziguli ku-NDT.
- Akukaze kube yinto enhle ukuthenga izidakamizwa ezisemthethweni ngaphandle kwe-shore, ngaphandle kwemithi, futhi uthathe ngaphandle kokuqondisa odokotela.
- Izithako ezisekelwe ngaphezu kwezinto ezithintekayo ze-thyroid aziyona imithi ye-NDT, futhi ayifaki esikhundleni semithi yokwelapha ye-hormone ye-thyroid.
> Imithombo:
> Hoang TD. "Ukukhishwa kwe-thyroid kuchazwe ngokuqhathaniswa ne-levothyroxine ekwelapheni i-hypothyroidism." I-American Thyroid Association (Mashi, 2013).