Ingxoxo no-Elizabeth "Lily" Conrad, MD
U-Elizabeth Conrad, MD - owaziwa iziguli zakhe ngokuthi "uDkt Lily" - ungumhlengikazi ohlangene ekusebenzeni eMcLean, eVirginia. UDkt. Lily unolwazi olulandelayo lweziguli ezimbona ngokungalingani kwe-thyroid ne-hormonal. Wavuma ukwabelana ngemicabango yakhe mayelana nendlela yakhe yokuthola nokuphatha iziguli kule ngxoxo ye-Q & A.
UMary Shomon: Wake waqala ngenhloso yokuba nomuthi ovamile / wendabuko bese ushintshela ekuhlanganiseni / okuphelele, noma uhlale uhlose ukuba yi MD?
Yini eyashukumisela noma ikuphefumulele?
UDkt. Lily: Ngiye ngazi ukuthi ngingaba udokotela ohlangene njalo. Singaphezu kwalokho esingakubona, thinta noma ulinganise ekuvivinyweni kwebhu. Ikhono lethu lokuthuthukisa injabulo nempilo yethu landa kakhulu lapho sikhuthaza ingqondo, umzimba, nomoya. Nginenhlanhla ukuthi udokotela ohlinzayo owaba nengxoxo yami ye-Columbia University College of Physicians & Surgeons wayevulekile kakhulu futhi unentshisekelo yokuzwa mayelana nomkhuba kanye nezinzuzo zokuzindla. Sichitha okuningi kwengxoxo ekhuluma ngokuphefumula kanye nokufana okuphakathi kokuzindla nokuzivocavoca umzimba.
Izinkinga zamaHormonal
UMary Shomon: Umkhuba wakho, Well Being-Well, usebenza neziguli eziningi ezinokungalingani kwe-hormonal. Yiziphi izinkinga ezivamile kakhulu ze-hormonal ozibona ezigulini zakho zesifazane?
UDkt. Lily: Sibona abesifazane abaningi abanenkinga ephathelene ne- Premenstrual Syndrome (PMS), i-Polycystic Ovarian Syndrome (i-PCOS), i- hypothyroidism , i- perimenopause, kanye nokunqamuka kwesikhashana .
Sibona neziguli ezicabanga ngokukhulelwa, abesifazane abane- insulin ukumelana, isifo se-metabolic syndrome, kanye nesandulela-sikashukela .
UMary Shomon: Ucabanga ukuthi kunzima kangakanani iziguli eziningi ezibona odokotela abavamile ukuba bathole kahle ukuthi bane-thyroid, adrenal, noma ezinye izinkinga zokungalingani kwe-hormonal?
UDkt. Lily: Kuthatha isikhathi, okungenzeka kunciphise kakhulu ekuboneni iziguli ezingu-20 noma ngaphezulu ngosuku. Futhi, okuningi kwalokhu kungalingani kuyizinto ezicashile futhi akutholakali kalula ngokusebenzisa ukuhlolwa okujwayelekile. Abantu bangaba nezinkinga zempilo yangempela kanye namanani welebhu angase abe nemingcele evamile. Isibonelo, uhla olujwayelekile lwe-cortisol lukhulu kakhulu, ngaphezu kwalokho, yini evamile ebhodini akuyona into ehle kakhulu. Kubalulekile ukubhekana nomuntu wonke, ngokubambisana, nokubheka izici eziningi: ukudla okunomsoco, ukuphathwa kokucindezeleka, ukwehliswa kwemvelo njll ukusiza ukusekela impilo enhle.
Ukuqeqeshwa kwethu emithi yokwelapha ikakhulukazi kusekelwe esibhedlela futhi kuhle kakhulu ekuhloleni nasekutholeni izifo ezinzima. Ukuhlaselwa yinhliziyo, ukushaya isisu, nokufakwa kwesisindo konke kusetshenziswe kangcono ngendlela evamile. Odokotela abaqeqeshwe ngokujwayelekile bayaqaphela ukuthi isistimu ngayinye ithinta abanye. Isibonelo, izikhathi ezinzima nezingajwayelekile zithuthukisa lapho i-thyroid ihlelwe kahle. Noma kunjalo, indlela evamile ingasiza kakhulu ezifweni ezingapheliyo nokungalingani.
Imithi ihlala ishintsha futhi iqhubeka. Njengodokotela, sifuna okungcono kakhulu iziguli zethu. Odokotela abahlanganisayo bahlelwe ngokukhethekile ngamathuluzi engeziwe okubhekana nokungalingani okucashile; ezifana namakhambi, ukudla okunomsoco, nokugcoba ukuhlinzeka ukunakekelwa ngokwezifiso ngesiguli ngasinye.
Imithi yaseMpumalanga ihlanganisa ukubaluleka kokulinganisela, futhi lokhu kuyenezela okuningi ekubukeni kwethu kokuphulukiswa. Umzimba ufana nensimu okumele ihlaziywe, ikhuthaze ukuvumelana nobungqabavu. Umbono ojwayelekile ukubuka izifo njengento esilwa noma yokucindezela izidakamizwa.
Njengabafundi bezokwelapha, asivame ukuba nokutholakala okuningi kwamakhambi, ukudla okunomsoco kanye nama-supplements, amasu omzimba nokusebenza kwengqondo. Ngenhlanhla, lokhu kuyashintsha futhi izikole ziqala ukufaka iMithi Ephelele (Alternative Medicine (CAM). Kuyakhuthaza ukubona amaphayona afana noDkt Jim Gordon, we-Center for Mind-Body Medicine kanye neGeorgetown University eWashington, DC, akhuthaza le nguquko yokunakekelwa kwezempilo, njengoba sisuka ekugxilweni kwezidakamizwa nokuhlinzwa emgodini ngokuzikhathalela kanye namasu we-CAM ngasendleleni ekugxileni ekuzinakekeleni, ngokuvimbela kanye nokuhlala kahle njengokugxila futhi ngaleyo ndlela isidingo esincane semithi nokuhlinzwa.
Yenza umqondo omkhulu.
Izinkinga ze-Thyroid
UMary Shomon: Yiziphi izivivinyo nezinkinga ozicabangayo lapho uhlola owesifazane ngenkinga engaba khona ye-thyroid ?
UDkt. Lily: Nginomlando emlandweni wakhe nalokho akuhlangenwe nakho, uma kukhona umlando wezindaba ze-thyroid emndenini wakhe. Ngizobukeza ezinye izimpawu bese ngenza ukuhlolwa ngokomzimba. Ukuhlola kuvame ukufaka i-TSH, i-Free T3, i-Free T4, i-Reverse T3, i-Antibodies ye-Thyroid, i-anti-thyroglobulin ne-anti-peroxidase antibody. Ngokuvamile ukuhlolwa kwe-adrenal kwenziwa kanye nanoma yiziphi ezinye izivivinyo ezingase zidingeke.
UMary Shomon: I- American Thyroid Association ka-2014 Hypothyroidism Guidelines ithi iziguli ze-hypothyroid kufanele zichazwe i-levothyroxine kuphela, futhi lokho okuchaza ukuthi i-T3 kanye / noma imithi yemvelo ekhishwe yizinto ezingokwemvelo ayikho emthethweni odokotela. Uyini umbono endaweni ka-ATA?
UDkt. Lily: Kukhona ukungqubuzana mayelana nokusetshenziswa kwamalungiselelo e-T3 .
Ezinye iziguli ziphendula kahle ku-T4 futhi zingaguqula i-T4 kuya ku-T3 ngaphandle kwezinkinga. Nokho, akuzona zonke iziguli ezingakwenza lokhu kahle. Ngithola i-Free T3 ne-Reverse T3 ukuba ibaluleke kakhulu ekuqondeni ukungabi namandla kwe-T4 kwezinye iziguli. Ucwaningo oluningi luye lwabonisa ukuthi ukwaneliseka ngesiguli kunomthelela wokwelapha we-T4 / T3 . Ngenhlanhla, i-ATA ibona isidingo sokuqhubekela phambili ucwaningo kule ndawo. Ngiyajabula ukuthi okwamanje ukuhlolwa kwe-Slow Release T3 kuqhutshwa. Ukulungiswa okuncane okukhulunywe kahle kuvame ukubekezelela kangcono kunokukhululwa ngokushesha T3.
UMary Shomon: I-American Thyroid Association ka-2014 Hypothyroidism Guidelines ithi iziguli ze-hypothyroid ezingazizwa kahle uma zinikezwa i-levothyroxine futhi zibuyiselwe emazingeni "euthyroid" kufanele zihanjiswe ukuhlolwa kwengqondo. Uyini umbono endaweni ka-ATA?
UDkt Lily: Kukhona idatha ephakamisa ukuthi amazinga we-T4 wesiguli anganele kodwa amazinga e-T3 awela njalo uma unikezwa i-T4 yedwa. Imodi nomqondo wokuphila kungathinteka ukuxhumana kwe-T3-serotonin.
Ngicabanga ukuthi kungcono ukuba nabo babone udokotela wabo womndeni noma i-internist ukuqinisekisa ukuthi konke kuhloliwe. Iziguli ezinezimpawu eziqhubekayo zifanelwe ukuhlolwa okuphelele, mhlawumbe kukhona okunye okuqhubekayo ... njengoLyme Disease noma uLupus . Izifo eziningi zingabonisa ngokukhathala. Uma kukhona ukucindezeleka abangase bazuze ngokubona i-psychiatrist edidiyelwe.
UMary Shomon: Uyini ulwazi lwakho ngeziguli ze-hypothyroid ? Ukhetha ukuthini izigulane zakho: i-levothyroxine, i-synthetic T4 / T3, i-T3 kuphela, i-thyroid ekhethiwe yemvelo, ihlanganiswe imithi?
UDkt. Lily: Ngiyawabeka ecaleni ngamacala. Iziguli zibonakala zijabule kakhulu nge-combination therapy futhi i-thyroid ekhishwe ngemvelo isebenza kahle. Itholakala futhi ngama pharmacy amaningi.
Ukungalingani okungekho emthethweni
UMary Shomon: Kukhona ukuphikisana okuningi phezu kokukhona "kokukhathala okunamandla" noma ukungakwazi ukusebenza kahle . Izwe lezokwelapha elivamile lithi sinesifo sikaCushing sika noma isifo sika-Addison , futhi ngenye indlela, azikho ama-shade wegrey kumsebenzi we-adrenal. Ucabangani ukuthi kungani imithi ejwayelekile ibukela ngendlela enomnyama nomhlophe?
UDkt. Lily: Izifo zeCushing kanye nezifo ze-Addisons yizinhlobo ezinzima ze-cortisol ngokweqile nokungaqiniseki. Ngikholelwa ukuthi ukuqashelwa kokungaqiniseki kwezihlobo ze-adrenal (RAI) kukhula. Isibonelo, kufana nesifo esiqandisini sesibindi. Ucwaningo oluhle kakhulu lwanyatheliswa kamuva ku-RAI kwiziguli ezinezifo zesibindi, (I-Pharmacol, Ther, 2014 Oct; 40 (7) 819-26.)
Esinye isici esenza ukukhubazeka okunamandla kunzima kakhulu ukubona ukuthi izindinganiso ezijwayelekile zinezinhlobo eziningi, isibonelo, i-cortisol yansuku zonke inezinhlobo ezijwayelekile ze-2-20. Lokhu "okufingqiwe" ngakusasa kungase kunganele. Ngithanda ukuthola ukufundwa okuningi nsuku zonke njengokungathi kunqenqemeni, ukuhlolwa kwephrofayela ye-Genova Adrenal.
UMary Shomon: Iyini indlela ongayisebenzisa ekuboneni nasekuphatheni ukungalingani okungajwayelekile ezigulini zakho ?.
UDkt. Lily: Senza umlando ophelele kanye nokuhlolwa komzimba okuhambisana nalokho okudingekayo. Iziguli eziningi zingaba nomfutho wegazi ophansi, futhi sizohlola ukushaywa kwegazi nokucindezelwa kwegazi ezindaweni ezihlukene. Ngokuvamile ngizokwenza ukuhlolwa kwe-saliva nge-cortisol esinika ukufundwa okuphindaphindiwe usuku lonke, i-DHEA-S ifakiwe kulokhu kuhlolwa. Umsebenzi wegazi ojwayelekile wenziwa kufaka phakathi iphrofayili ephelele ye-chemistry. Sibheka izakhi eziyinhloko ezifana ne- Vitamin D kanye namaminerali afana ne-magnesium. Kuye ngesiguli, ngingase ngibheke ezinye izimbangela zezimpawu zabo. Siqala ukuhlela uhlelo lokubhekana nezimbangela eziyinhloko zezimpawu uma kungenzeka. Amathuluzi omnene wokubhekana nalezi zinkinga ayatholakala, njengezindlela zomzimba wengqondo kanye nokusetshenziswa kwamakhambi we-adaptogenic njenge-Ashwagandha.
Ukulahlekelwa kwesisindo
UMary Shomon: Abesifazane abaningi abaneminyaka ephakathi, kanye neminyaka ye-perimenopausal kanye neyesilisaopausal bayalwela ukuzuza kwesisindo, noma kunzima ukulahlekelwa isisindo. Yiziphi izinhlobo zeluleko onayo kubantu besifazane abadla kahle nokuzivocavoca, kodwa banemiphumela encane yokulahlekelwa isisindo?
UDkt Lily: Okokuqala, ngifuna ukusho, kuhle kuwe. Ukuzivocavoca nokudla okunempilo kuzokusiza uzizwe ungcono kakhulu futhi ugcine impilo ibe ngcono kangcono kunokuhlala phansi, futhi ungadli imifino nezithelo ezanele. Ngokulandelayo, ngifuna ukuqinisekisa ukuthi udla ngokwanele, uphuza amanzi anele ahlanzekile futhi uthola ukuphumula okwanele. Ngokuvamile izisindo zokulahlekelwa isisindo ngenxa yokungena ngokwanele kwamaprotheni nama-khalori noma ukuphumula okunganele. Uma usenenkinga ubone umuntu ongakwazi ukusebenzisana nawe ukusiza ukukhomba lapho ukhona, futhi wenze uhlelo lokukusekela lapho ungathanda ukuya khona. Abanye besifazane bakhulisa i-cortisol ngokuzivocavoca, kanti abanye kungenzeka ukuthi baphakamisa i-insulin. Uhlelo lwakho kufanele luhambisane nawe.
I-Mind-Body Medicine
UMary Shomon: Siqala ukuqaphela ngokubaluleka ukubaluleka kokunciphisa ukucindezeleka, ukuhlanganisa ukuphumula, nokubeka amandla okuxhumana kwengqondo nokusebenza njengengxenye yokuphila kahle. Ingabe unezinye izindlela ezingcono kakhulu abesifazane abangakwenza lokhu, banikeze ukuphila kwethu okumatasa?
UDkt. Lily: Omunye wamasu engiwuthandayo ukusebenza ngezikhathi zokucabangisisa nsuku zonke. Uma uphuma ngaphandle, zizwe izinyawo zakho phansi, uphefumule futhi ubheke phezulu. Phawula isibhakabhaka, ingabe uzizwa ilanga ebusweni bakho? Ingabe kukhona amafu, ingabe kukhona umoya? Zikhona izinyoni noma ezinye izilwane? Uma ufika ekhaya uthathe umoya bese uqaphela indlela ozizwa ngayo ngaleso sikhathi. Uma udla, thatha isikhashana ucabange ngento oyijabulelayo futhi ubonge. Bese uqaphele ukubukeka kokudla, umbala wayo ke iphunga layo ukuthungwa nokugcoba. Njengabesifazane, sivame ukuhlala emndenini wethu futhi singazondla ngale ndlela futhi sifundise izingane zethu ukuba zihambisane nomzuzu. Izingane zami ziyongikhumbuza uma ngikhohliwe umusa wethu, ovame ukufana nalokhu: umuntu ngamunye uthi kafushane into eyodwa abayibonga ngayo njengoba sihamba azungeze itafula. Ukuthatha isikhashana ukuma isikhashana futhi ukubonga kungashintsha ingqondo yethu futhi kusize silungele ukuthola.
Enye ithuluzi elilula ukudweba izinto ezintathu ozibonga nsuku zonke, mhlawumbe ngebhedi elincane etafuleni lakho lombhede. Kuyindlela enhle yokuqala noma ukuphela ngosuku.
Thola umkhuba owuthandayo, ozwayo wemvelo kuwe. I-Yoga, i-pilates, i-Tai Chi, i-Qi Gong, i-massage, ihamba ngaphandle, ukuzindla okucabangayo nemifanekiso eqondisiwe konke kungasisiza siqinise uxhumano lomzimba.
Thola okuthandayo bese uzama ukukwenza njalo. Kukhona izinhlelo zokusebenza ezinhle ezitholakalayo ezinemizuzu emifushane kodwa ephumelelayo ongayenza ngaphansi kwemizuzu engu-10.
Uma uthanda isigaba sakho se-yoga, mkhulu! Khetha indawo ekhaya lakho lapho ungakhipha khona umbhede wakho bese uchitha ama-5-10 amaminithi ngosuku wenze ukuhamba nokuphefumula. Uma ungakwazi ukwelula lokho kumaminithi angu-20, kungcono nakakhulu!
Into Enye Bonke Abagulayo Kufanele Bakwenze
UMary Shomon: Uma kukhona into eyodwa ungaqiniseka ukuthi zonke izigulane zakho zizokwenza ukuthuthukisa ubuhle, ngabe kungaba yini?
UDkt. Lily: Yiba nomusa kuwe, uthathe isikhathi sokuzinakekela, uziphathe ngendlela ongathanda ngayo umngane wakho oyigugu!
U-Elizabeth (Lily) uConrad, MD, waphumelela e-College of Physicians and Surgeons of Columbia University ngo-1991. Waqedela ukuhlala kwakhe emndenini eHlelo LaseMontgomery Family Practice Residency Programme eNorristown, PA. UDkt. Lily, njengoba aziwa iziguli zakhe, uye wafaka ibhodi eqinisekisiwe eMnyangweni WezeMpilo kusukela ngo-1994. Umsebenzi wakhe uye wazinikela ekuphulukeleni sonke isiguli ngokusebenzisana okusebenzayo okusekela impilo kanye nenhlalakahle. Ngaphandle kwesizinda sakhe somndeni wendabuko, uDkt. Lily ubelokhu efunda ukuzindla kusukela esungulweni sakhe kwezobuciko ngo-1985. Uye wafunda eziningi zengqondo / umzimba wendabuko indlela yokuphulukisa kuhlanganise Mindfulness-Based Stress Reduction nge Jon Kabat-Zinn noSaki Santorelli eNyuvesi yaseMassachusetts. Ucwaningo lwakhe lubuye lwafaka i-yoga, imithi ye-Ayurvedic, ne-homeopathy. UDkt. Lily wafunda ukukhwabanisa e-UCLA, eyaziwa njengesikole esiphezulu se-acupuncture odokotela. Waba ibhodi eqinisekisiwe kwi-Medical Acupuncture ngo-2004. Uye waqhubeka nokufunda imithi yokwelashwa kwe-acupuncture kanye ne-Chinese kanye nentshonalanga yemithi yemithi kanye nokudla okunomsoco. Usebenzisa imithi ehlanganisayo eMcLean, eVirginia, e-Well Being-Being Well, lapho futhi egxila ekwelapheni okuvamile nangokwemvelo, izinhlelo ezihlelwe ngokwezifiso zokusekela ukulinganisela kwe-hormonal nokunika amandla iziguli ngemfundo kanye namasu okuhola impilo enempilo, elinganiselayo.
Elizabeth Conrad, MD
Well Being-Kuhle, 6862 Elm Street # 720, McLean, Virginia 22101, Ph: 703-635-2158