Ukusikisela Okuphazamisayo Kusuka Esifundweni Esilahlekile
Abantu abangakhiqizi i-hormone ye-thyroid eyanele-futhi ngaleyo ndlela bangama- hypothyroid -benefit kusuka ku- levothyroxine , noma i-hormone ye-thyroid yokwenziwa. I-hormone ye-thyroid ibalulekile ekusetshenzisweni komzimba okufanele. Ngokuyinhloko, ukuphathwa kwe-hormone yegciwane kuveza imiphumela embalwa emibi, futhi ukudlula ngokweqile akuvamile. Eminye imiphumela emibi engavamile yilezi zibandakanya ama-palpitations, ukwanda kwesimo senhliziyo, ukuqhuma, ukuthuthumela nokukhathazeka.
Kodwa-ke, ucwaningo olusha luhlobanisa ukusetshenziswa okuvamile kwe-levothyroxine (Synthroid) ngomdlavuza wegciwane . Nakuba kuyithakazelisayo, lolu cwaningo oluncane alukwazi ukucaca futhi ludinga ukuphenywa okuqhubekayo.
Ucwaningo
Ku-athikili ka-July 2017 eyanyatheliswa kuyi- Journal of Clinical Pharmacology , uHung kanye nabalobi ababambisene nabo bahlola inhlangano phakathi kwe-levothyroxine nomdlavuza we-thyroid ngokusebenzisa ukuhlaziywa kwabantu-based. Ukudweba kusuka kudatha emele abantu abayi-1 million baseTaiwan, uHung kanye nozakwabo bahlonze abantu abadala abangu-1285 abathola ukuhlolwa kokuqala komdlavuza wegciwane phakathi kukaJanuwari 1, 2001 noDisemba 31, 2013.
Laba bantu abadala abanomdlavuza we-thyroid babesebenzelana nabantu abadala abangama-3855 abangenalo umdlavuza we-theroid (okungukuthi, iqembu elilawulayo) ababefana nobudala, ubulili, nokuvakasha. Kuphelele, kwakunabantu abadala abangu-5140. Phakathi kwalaba bantu abadala abangu-5140, abacwaningi bathola abantu abadala abangu-70 abaye batholakala ukuthi bane-hypothyroidism yi-endocrinologist kodwa babengenalo umlando wokuhlinzwa kwe-thyroid.
Imiphumela yalungiswa ngokuphathelene nenyanga engenayo, indawo, indawo yokuhlala emadolobheni, ukusetshenziswa kogwayi, nezifo ezihlukahlukene. Ngokwesibalo, laba bantu abangu-70 abane-hypothyroidism bahluke ngendlela eyodwa enkulu: ukuhlolwa komdlavuza wegciwane.
U-Hung kanye nozakwethu bathola abantu abadala abangu-37 abane-hypothyroidism okwathi kamuva bahlakulela umdlavuza we-thyroid.
Baphinde babhekane nabantu abadala abangama-33 abane-hypothyroidism abangazange bahlakulele umdlavuza we-thyroid. Abacwaningi base beqhathanisa la maqembu amabili ngokuqondene nezici eziningi, kuhlanganise nokusetshenziswa okuvamile kwe-levothyroxine.
Abacwaningi bathola ukuthi abantu abadala abanomdlavuza we-thyroid babengase bakwazi ukuthola ukuthi bane-hypertension, isifo sikashukela, i-osteoporosis, kanye ne-hyperlipidemia.
Okubaluleke kakhulu, uHung kanye nosebenza nabo bathola ukuthi abantu abadala abane-hypothyroidism abavame ukuthatha i-levothyroxine cishe babe nomdlavuza we -roid. Nokho, ukusetshenziswa kwe-levothyroxine okungavamile, kodwa, akuhlobene nomdlavuza wegciwane.
I-hormone ye-thyroid ne-Cancer
I-hormone ye-thyroid iyadingeka ekukhuleni okujwayelekile, ukuthuthukiswa, kanye nokusetshenziswa komzimba. Ngenxa yokuthi umdlavuza ubhekisela ekuhlukaneni kwamaselula okungalawulwa, kuye kwacatshangwa ukuthi i-hormone yegciwane ingase ibe "umdlavuza" ngandlela-thile. Kubantu, izifundo ezimbalwa nokucwaninga okulinganiselwe kusekela umbono wokuthi i-hormone ye-thyroid ifaka isandla emdlalweni.
Ngokuphawulekayo, ocwaningweni luka-2009 olubizwa ngokuthi "Umsebenzi we-Thyroid kanye neHacker Cancer: I-Study Prospective Population Study," i-Hellevik kanye nabalobi bezobambisene bathole ukuxhumana phakathi kwamazinga aphakeme wehomoni ye-thyroid nemithi ethile yomdlavuza. Balandele amaNorwegi angu-29 691 iminyaka engu-9. Ekuqaleni kwesikhathi sokubheka, akukho muntu walaba bantu oye wathola ukuthi unesifo se-thyroid.
Abacwaningi bathola ukuthi abantu ababenamazinga aphansi e-thyrotropin ekuqaleni kokucwaninga, okuphakamisa i-hyperthyroidism, babenengozi enkulu yokukhula komdlavuza we-lung ne-prostate kamuva. (Kwakungekho ukuhlangana phakathi kwe-hyperthyroidism nomdlavuza wekoloni noma umdlavuza webele.)
Ngaphezu kwalokho, uHellevik nosebenza nabo bathola ukuthi i-hypothyroidism ayixhunyiwe engozini yomdlavuza.
Ngakolunye uhlangothi, olunye ucwaningo lubonisa ukuthi abantu abakha i-hypothyroidism ngemuva kokuthola ukuthi banomdlavuza wekhanda nentamo baphila isikhathi eside. Ngaphezu kwalokho, abantu abanomdlavuza webele abenza isifo se-auto-immune-futhi kanjalo-hypothyroidism-bangaphila isikhathi eside, futhi.
Ngamanye amazwi, ucwaningo oluthile lubonisa ukuthi kungenzeka ukuthi amazinga wegciwane aphansi angase avikele emiphumeleni yomdlavuza. Ezifundweni zezilwane, i-levothyroxine iye yaboniswa ukukhuthaza ukukhula kwesisu nokusabalala. Ngaphezu kwalokho, i-hypothyroidism iyanciphisa ukukhula kwe-tumor, inciphisa ukusabalala kwe-tumor, futhi ithuthukise ukusinda.
Indlela
I-pituitary gland ikhipha i-hormone ebizwa ngokuthi i-hormone ye- thyroid-stimulating (TSH) . Ukuphathwa kwe-hormone ye-thyroid ngendlela ye-levothyroxine igxilisa amazinga we-TSH ngempendulo engafanele. Ngaphandle kwe-TSH, i-thyroid ilahlekelwa injongo futhi iyancipha. Ngenxa yalesi sizathu, i-hormone ye-thyroid isetshenziselwa ukwelashwa okucindezelayo ama-nodules we-thyroid nama-goiters.
I-intuitively, i-thyroid ekhuphukayo kumele ibe yinto encane kakhulu yokuba ngumdlavuza. Kodwa-ke, nge-levothyroxine ukuphathwa, kuthathwa ukuthi izibalo eziphakeme zehomoni ye-thyroid zingase zithinte ngale ndlela futhi ziphendule umdlavuza.
Nakuba le ndlela ingacacile, i-levothyroxine ingase isetshenzisane noma ilinganise ukwakheka kwesisu. Ngamanye amazwi, i-levothyroxine ingadlala indima eqondile noma engacacile ekubunjweni kwesisu. Ngokusho kukaHung nabalobi ababambisene nabo:
Kuze kube manje, kubonakala kungekho zifundo ezibika izindlela ezikhona ze-carcinogenesis ephathelene ne-thyroxin. Noma kunjalo, lesi senzakalo singachazwa ngezindlela ezimbili ezingenzeka. Okokuqala, i-thyroxin ingase isebenze njenge-agent evuselelayo ezindleleni ezivamile ze-carcinogenesis .... Okwesibili, i-thyroxin ngokwayo ingashukumisa ukukhula kwamangqamuzana omdlavuza wegciwane.
Kusho ukuthini lokhu?
Kuthathwa yedwa, lolu cwaningo oluthola ukuthi ukusetshenziswa kwe-levothyroxine ejwayelekile kuhlobene nomdlavuza we -roid kamuva. Le miphumela isekelwe ekutadisheni okucishe kube yilapho encane. Ngaphezu kwalokho, kungase kube nezinkinga nomklamo wocwaningo.
Okokuqala, bambalwa abantu abathwala i-levothyroxine ye-hypothyroidism baqhubeka nomdlavuza we-thyroid noma ezinye izinhlobo zomdlavuza. Ngokuqondile, u-Hung kanye nozakwethu bathole ukuthi amaphesenti angu-2.88 kuphela wezifundo ezine-hypothyroidism zaqhubeka nomdlavuza we-thyroid. Ngaphezu kwalokho, kuphela izigaba ezingu-0.86 ezingekho ngaphandle kwe-hypothyroidism zaqhubeka nomdlavuza we-thyroid.
Okwesibili, lolu cwaningo luwukuphela kokuqala ukubonisa ubudlelwane phakathi kokusebenzisa i-levothyroxine njalo nomdlavuza we-thyroid. Khumbula ukuthi ubudlelwane buhlukile kunombangela. Abacwaningi abazange bakhombise ukuthi i-levothyroxine ibangela umdlavuza we-thyroid.
Ngokusho kukaHung nabalobi ababambisene nabo:
[A] nakuba lokho okutholakele kuphakamisa ukuhlangana phakathi komdlavuza we-thyroid nokusetshenziswa kwe-thyroxin ejwayelekile, kudingekile izifundo ezengeziwe ukuze uhlaziye futhi uqinisekise lezi zithole .... Nakuba indima yeqiniso ye-thyroxin ekuthuthukisweni komdlavuza we-thyroid isadingeka iphhenywe, odokotela bangase bacabange lokhu kubambisana lapho belapha iziguli ezine-subclinical hypothyroidism.
Abalobi bayavuma ukuthi lokho okufunayo kuyizinhlangano ezidinga ukukhishwa ngenxa yocwaningo olwengeziwe. Lesi sifundo sincane futhi sidinga amasampula amakhulu amampula ukuze sithinte noma iyiphi inhlangano.
Kuyathakazelisa ukuthi abalobi benza isincomo esisodwa sokuthi abahlengikazi bangakwazi ukugcina lo mhlangano engqondweni uma bebeka iziguli ze-levothyroxine ezine-subclinical hypothyroidism, noma ukwehluleka kwe-thyroid. Lesi sincomo kungenzeka kusengaphambili.
Okwesithathu, isisekelo esiyisisekelo socwaningo singase siphuthelwe. Ngokuqondile, abacwaningi abahlukanisi phakathi kwezimbangela ezihlukahlukene ze-hypothyroidism. I-hypothyroidism elula, engadinga ukusebenzisa okungaphezulu okuvamile kwe-levothyroxine, ihluke kakhulu ku-hypothyroidism eyingozi kakhulu, okungase kudingeke ukuthi kusetshenziswe i-levothyroxine, futhi lokhu umehluko wangaphakathi kungabangela ukukhula kwamazinga omdlavuza obonakala phakathi kwabasebenzisi abajwayelekile be-thyroxine. Empeleni, abacwaningi bangama-apula nama-oranges.
Okwesine, abacwaningi basebenzisa idatha yomshuwalense ukuze bachaze ukusetshenziswa okuvamile nokungajwayelekile kwe-thyroid, okuyinto indlela engabaza ngayo.
Izwi elivela
Uma ishiywe ingalashwa, i-hypothyroidism ingakhululekile futhi iyabuhlungu. Abantu abane-hypothyroidism bahlangabezana nokukhathala, ukuqothulwa, ukucindezeleka, isikhumba esomile, inzuzo yesisindo, nokuningi. I-Levothyroxine iyindlela yokwelapha ephumelelayo ye-hypothyroidism futhi ingathuthukisa izinga lokuphila. Abantu abaningi bathatha i-levothyroxine nsuku zonke ngaphandle kwezinkinga.
Uma udokotela wakho enqume ukuthi u-levothyroxine ejwayelekile ukwelashwa kwe-hypothyroidism, akufanele ukhathazeke kakhulu ngaleli mithi edala umdlavuza. Kubantu abaningi, inzuzo ye-levothyroxine ikhulu kakhulu kunoma yikuphi ukulimala okungaba khona, okubandakanya nomdlavuza ongenzeka. Ngaphezu kwalokho, lolu cwaningo oluxhumanisa i-levothyroxine njalo nomdlavuza we-thyroid luncane futhi lungase lube nezindaba ngokuklama. Ekugcineni, isixhumanisi abacwaningi abasikiselayo sidinga ngempela uphenyo olwengeziwe ngaphambi kokuba kwenziwe noma yiziphi izimangalo ezicacile ezingenziwa.
Akufanele ushintshe imithi yakho yemithi ngenxa yokwesaba umdlavuza wegciwane esekelwe kulolu daba olulodwa, okungenzeka lufundela amaphutha. Uma uhlala uthatha i-levothyroxine ngaphansi kokuqondiswa kukadokotela wakho, sicela ulandele lolu hlelo lokwelapha. Noma yiziphi izinguquko ohlelweni lwakho lwezokwelapha kumele zixoxwe nodokotela wakho.
Uma ukhathazekile ngesixhumanisi phakathi kwe-levothyroxine nomdlavuza we-thyroid-noma yini enye, ngenxa yalolu daba-sicela uxoxe ngalokhu nodokotela wakho we- endocrinologist noma udokotela oyinhloko . Ngokubuza imibuzo, awugcini nje ukugxilisa ukukhathazeka kwakho kodwa futhi ufunde kabanzi mayelana nesimo sakho. Insight yingxenye ebalulekile yokwelashwa okuphumelelayo.
> Imithombo
> Cantrell F. Isahluko 150. IHormone ye-Thyroid. Ku: Olson KR. ama-eds. Ukushisa nokudlulela kwezidakamizwa, 6e eNew York, NY: McGraw-Hill; 2012.
> Hellevik, AI, et al. Umsebenzi we-Thyroid kanye neengozi yomdlavuza: Isifundo Somphakathi Esifunayo. I-Epidemiology ye-Cancer, i-Biomarkers & Prevention. 2009; 18: 570-574.
> Hung, SH, Chung, i-SD, i-Lin, i-HC. Ukusetshenziswa kwe-Thyroxin Kuhlangene Neengozi Yokunyuka Kwegciwane Le-Thyroid Kwabeziguli Nge-Hypothyroidism. I-Journal of Clinical Pharmacology. July 19, 2017. (e-pub ngaphambi kokuphrinta)
> Stoll, SJ, et al. I-Hormone Replacement Alternative Ngemva kwe-Lobectomy ye-Thyroid. Ukuhlinzwa. 2009; 146: 554-560.