Ukubheka izimangalo eziphikisanayo mayelana nokukhathala kwe-Adrenal
I-Hormone Foundation (ingxenye ye-Endocrine Society) ikhishwe "uchungechunge lweqiniso," olubizwa ngokuthi "Inganekwane neqiniso." Elinye lamashidi abo elibizwa ngokuthi "Ukukhathala Kwe-Adrenal" futhi lihlasele ubukhona baleso simo, okusho ukuthi, "Ukukhathala kwama-adrenal akuyona isimo sangempela sezokwelapha. Azikho amaqiniso esayense okusekela inkolelo yokuthi ingqondo yesikhathi eside, ngokomzwelo, noma ngokomzimba ukucindezeleka kudonsa izigulane eziyingozi futhi kubangele uphawu oluvamile. " (Ungafunda lonke "i-fact sheet" njenge-PDF: Inganekwane V: I-Adrenal Ukhathala.)
Uma une-flash-backs ekuzikhulumeni ezisemthethweni ezizimele ezivela ezinhlanganweni zezidokotela ezigcizelela ukuthi i-fibromyalgia noma isifo esingapheliyo ukukhathala akuyona "impela" izimo zezokwelashwa, noma ngisho nokukhumbula odokotela ababesanda kuphikelela ukuthi ukudla okuneziphuzo, hhayi i-H. pylori bacteria , ubangele izilonda, awusodwa.
URichard Shames, MD, owathweswa iziqu eHarvard naseYunivesithi yasePennsylvania, futhi waqeqeshwa kakhulu namaNational Institutes of Health, futhi uchwepheshe ohlonishwayo odidiyelwe nodokotela we-hormone ekusebenzeni kwangasese iminyaka engaphezu kwamashumi amathathu. Ngamcela ukuba aphawule ngale mpikiswano.
URichard Shames, MD: Angivumelani nalokho iHormone Foundation ekushoyo mayelana nokukhathala okukhulu. Iphuzu labo eliyinhloko ukuthi "ukukhathala okukhulu" akuyona ukuxilongwa kwangempela futhi akubonakaliswa yisayensi yezokwelapha. Lokhu kimi kungukuthi ngenkohliso ye-quasi-yeqiniso ngamabomu, noma isitatimende sezombusazwe esingaziwa ngemithi.
Noma yimuphi udokotela ofanele usawoti wakhe uyaqonda ukuthi igama elithi "ukukhathala okunamandla" kusho ukungakwazi ukusebenza kahle kwe-adrenal. Isitatimende seHormone Foundation sivuma ngokucacile ukuthi ukungakwazi ukutholakala kwe-adrenal ukuxilongwa kwangempela. Kuye, kubonakala sengathi bayaphika ukuthi abanye abantu bangase babe nomzimba omncane wokuxilongwa kwangempela .
Lokho kuyambalwa futhi kubonakala ngokungavamile.
Q: Enye yezimpikiswano "i-fact sheet" exoxa ngayo ukuthi akukhona ukuhlolwa okungabona ukukhathala okukhulu.
URichard Shames, MD: Uma ukuhlolwa kwegazi okwamanje kungakapheli, singase singabi nalutho. Ukuhlolwa kwegazi okwamanje kulungile ekutholeni izinhlobo ezinzima zokuntuleka komzimba, okunye okubizwa ngokuthi isifo se-Addison. Akuzona kahle ekutholeni amafomu amabi. Abantu abathile abanegunya, okwenzelwe konke okumnyama noma abamhlophe-ngaphandle kwemithunzi yegrey-ngokusobala bavivinywa ukuba basho esidlangalaleni ukuthi ukuxilongwa kokungaqiniseki kahle kwe-adrenal "akusona ukuxilongwa kwangempela."
Q: Kubukeka sengathi kufana neziguli eziphethe i-hyplinroidism emngceleni. Isivivinyo esijwayelekile sakwa-TSH sithi "sivamile," kepha odokotela abaningi manje bayaqaphela ukuthi amazinga ngaphakathi kocingo okuthiwa "evamile" okubhekwayo angase abonakale enkingeni yekhambi.
URichard Shames, MD: Ngokuqinisekile. I-thyroid encane ephansi isifaniso esihle sokuntuleka komzimba okuncane. Ukuhlolwa kwegazi kwamanje kuvame ukungacabangi ngokwanele ukukhombisa imiphumela engavamile kubo bonke abantu abanezinhlobo ezincane ze-hypothyroidism. Eminyakeni eyishumi nesishiyagalolunye noma engu-20 eyedlule, abaningi be-endocrinologists babephika "u-hypothyroidism omnene" njenge-diagnosis yeqiniso.
Lokhu kufana ngokuphawulekayo nokuphikisana kwamanje kokungakwazi ukusebenza kahle kwe-adrenal. Kwathatha iminyaka yobufakazi obungokwesayensi obukhulayo, kodwa manje abaningi be-endocrinologists bathi, "Odokotela neziguli ngokufanayo badinga ukuba bazi kangcono ukuthi kungenzeka ngempela ukuthi kungenzeka ukuthi umuntu ongatholakali noma omngcele we-hypothyroidism angatholakali."
Q: Ingabe ukuqokwa kwezokwelapha kuzogcina kugxile kuleso siqondiso?
Richard Shames, MD: Yebo, nakanjani. I-flap yamanje yinto efanayo engeyona inkinga, ngokusekelwe okufanayo okungewona ukuphikisana. Ngakho-ke, uma ukuhlolwa kwegazi kungcono nakakhulu, futhi / noma uma ukuhlolwa kwe-hormone ye-sali kwamukelwa ngokwengeziwe ngaphakathi, ukukhathala okukhulu kuzothathwa njengokwakheka kwegazi ngempela ukuthi: "ukungasebenzi kahle kwe-adrenal.
Ngamanye amazwi, uhlobo oluthile lokuxilongwa kweqiniso, ukuthi ukuhlolwa kwegazi okujwayelekile okuvamile kuphuthelwa njalo.
Q: Kuze kube yilapho ukuxilongwa kuqondwa futhi kwamukelwa kangcono, kwenzekani?
URichard Shames, MD: Okokuqala, kungasiza ukuqala ukuyibiza ngokungenakuthola, okungukuthi, nokuthi isigaba sokuhlonza "sangempela" sesivele sikhona. (Ikhodi ejwayelekile ye-ICD-9 yalokhu ngu-255.4) Izinhlobo ezimbi zalesi simo sangempela zingakutholwa njengamanje ngomlando omuhle wezokwelapha, kanye nokuhlolwa okubonakalayo ngokomzimba, kanye nokuhlanganiswa okunengqondo kwegazi elikhethwe kahle, umchamo, nokuhlolwa kwamathe. kufanele sikwenze okwamanje.
Q: Kuthiwani ngezimangalo zikaHormone Foundation / Endocrine Society ukuthi "... ukuhlolwa kokukhathala okunamandla akusekelwe kumaqiniso esayense noma kusekelwe izifundo ezinhle zesayensi ..."
URichard Shames, MD: Kunezinombolo ezimangalisayo zezifundo zesayensi nezincwadi ezishicilelwe abacwaningi be-endocrinology nabaprofesa, abaphikisana nalezi zimpawu ezingavamile mayelana nokukhathala okukhulu. Ngamanje ngisebenza ngokubuyekezwa okungeziwe kwalolu daba, ukwabelana nabafundi bakho, okuzofingqa futhi ukukhomba ukuthi yini abanye odokotela abaningi futhi ngiyibona njengeqiniso elijulile ngalesi sihloko, ngokuphambene ne-Endocrine Society ngokungahambisani kahle nombono obalulekile .