Uma ngabe usebenzisa izidakamizwa ezithathelwanayo ze-hormone (ie, levothyroxine, noma i-Synthroid, i-Levoxyl, noma i- Tirosint brand) futhi engakapheli kahle, kungenzeka ukuthi ungazuza ngokufaka i-T3, noma ukushintsha imithi ye-thyroid efaka phakathi T3.
T3 / Triiodothyronine
I-Levothyroxine iyindlela yokwenza i-hormone thyroxine, efingqiwe njenge-T4.
I-T4 yi-hormone yokugcina futhi kumele iguqulwe ngumzimba ibe ngu-T3 ukuze isetshenziswe ngamaseli.
I-T3 ifushane ku-triiodothyronine. I-T3 yi-thyroid esebenzayo esebenza ezingeni lamaselula ukusiza ukulethwa kwe-oksijini namandla kumaseli, izicubu, nama-glands kuwo wonke umzimba.
Nakuba i-gland yegciwane ikhiqiza kokubili i-T4 ne-T3, i-T4 ayisasebenzi. Ukuze ube nokusetshenziswa emzimbeni, i-T4 iguqulwa ibe yi-T3.
Ukwelashwa kwe-Levothyroxine kuphela kubhekwa njengendlela yokunakekela odokotela abavamile. Kunomzimba okhulayo wobuchwepheshe besayensi, kodwa, okhomba izinkinga eziningana ezigxila ekuthelekeni kwe-T3. Ngokwesibonelo:
- Ucwaningo olusha luveza izifo ezithinta izakhi zofuzo ezibizwa ngokuthi i-deiodinase polymorphisms eyenza i-subset yeziguli zingasebenzi kahle ekuguquleni i-T4 ibe yi-T3. Lezi zifundo zibonisa ukuthi i-levothyroxine yodwa ayifaneleli lezi ziguli.
- Ucwaningo lweshumi nantathu luye lwahlola i-levothyroxine kanye nokwelashwa kwe-liothyronine ye-hypothyroidism. Izifundo eziningi zathola isimo sengqondo esithuthukisiwe, ikhwalithi yokuphila, nezici zokucatshangelwa ezigulini ezithatha ukwelashwa okuhlangene, uma kuqhathaniswa nevothyroxine yedwa.
- Ezinye izifundo zibonise ukuthi ukusebenzisa ama-T3 eminye emazingeni aphansi e-cholesterol, ukunciphisa okukhulu kwesisindo somzimba, nokuxazulula okungcono izimpawu, ngaphandle kwezinkinga ezengeziwe uma kuqhathaniswa nevothyroxine yedwa.
Ucwaningo lwesiDanishi oluphawulekayo , olubikwe kwi- European Journal ye-Endocrinology ehloniphekile, lwafunda izimpawu ze -roid umthelela we-levothyroxine-kuphela ukwelashwa, ngokumelene nevothyroxine kanye ne-T3 (kulokhu, umthamo wama-micrograms angu-20 we-T3 nsuku zonke wasetshenziswa).
Izivivinyo zekhwalithi yokuphila nokucindezeleka zenziwa ekuqaleni kokucwaninga, futhi emva kwezinsuku ezingu-12 zonyango. Ngesikhathi ngasinye sezinyanga ezingu-12-amasonto, izihloko zanikezwa i-levothyroxine kanye ne-T3, noma i-levothyroxine kanye ne-placebo bese ishintsha isikhathi seviki elizayo. Ababambiqhaza "babeyimpumputhe" ngoba babengazi ukuthi babethatha i-T3 noma i-placebo esebenzayo.
Ikhwalithi yokuphila nezici zengqondo ezihlolwe zifakiwe, phakathi kwezinye izici: impilo ejwayelekile, ukusebenza komphakathi, impilo yengqondo, ubungqabavu, ukuzwela, ukucindezeleka nokukhathazeka. Ucwaningo lwabonisa ukuthi phakathi kweziguli, iningi lalabo besifazane, ama-49% weziguli ayekhetha ukwelashwa okuhlangene, futhi kuphela u-15% okhethwe ukwelashwa kuphela kwe-levothyroxine kuphela.
Abacwaningi kanye ne-endocrinologists baye bebuya emuva nangemva cishe amashumi amabili eminyaka ngokubaluleka kwe-T3 . Ngokusekelwe ekuhlangenwe nakho kwabo okusebenzayo neziguli, futhi emzimbeni okhulayo wobufakazi, ezinye odokotela abavamile, kanye nabasebenzi abaningi abengeziwe futhi behlanganisela ngokuqhubekayo banezela ukwesekwa kwe-T3 njengesixazululo sokusiza ukwandisa ukwelashwa kwegciwane kwezinye iziguli. Bangezela i-T3 ngezindlela eziningana:
- Ukwengeza ukwelashwa kwe-T3 kuya kwe-levothyroxine, ngokufaka ukwedluliswa kwemithi yokwelapha ye-T3 igama lomuthi weCytomel, noma i-liothyronine yama-generic (yokwenziwa kwe-T3)
- Ukwengeza ukuhlanganiswa kwe-T3 nge-odokotela ehlanganiswe ukukhululwa kwesikhathi-okukhishwe / okukhulunywe ngayo T3 ngaphezu kwe-levothyroxine
- Ukwengeza umthamo wesifo semvelo esihlotshisiwe, njengezidakamizwa zemithi ye-Nature-throid, i- Armor Thyroid , noma i-thyroid yemvelo yemvelo (umkhiqizi we-US u-Acella) ukwelashwa kwe-levothyroxine
- Ukuguqula iziguli ukuya endleleni yokwelapha yemvelo yokwelapha kuphela
- Ukubeka isiguli ku-T3 kuphela yokwelapha (lokhu akuvamile.)
Kubalulekile ukuthi uqaphele ukuthi ngenxa yokuthi i-T3 i-hormone esebenzayo, ingaba nomthelela okhudlwana wokuvuthwa kwenhliziyo nokushayela abanye abantu, ikakhulukazi labo abanomlando wesifo senhliziyo, asebekhulile, nalabo abanenhliziyo engafani i-mitral valve iphinde ivele.
Odokotela be-T3-savvy bahlaziya ukuphepha kwe-T3 uma kuqhathaniswa nezinzuzo ezingase zibe khona uma kwenzeka icala.
Ngisho kulabo abagulayo abangenayo izinhliziyo noma izinkinga ezihlobene nobudala ezingenza ukuthi i-T3 ihlukumezeke, ezinye iziguli zithinta kakhulu imiphumela ekhuthazayo ye-T3. Inhliziyo ibuhlungu kakhulu kwi-hormone ye-thyroid ngokuvamile, kanti kwabanye abantu, ngisho nokulinganiselwa okuncane kwe-liothyronine, noma inani elincane le-T3 emithini yemithi ekhishwe yizinto zemvelo kungabangela ukukhuphuka kwamapulpathi noma izinhliziyo zomoya.
Kulezo ziguli, odokotela abathile batusa amafomu okukhululwa okwesikhashana / okukhululwa okwesikhashana / okukhululwa kancane kwe-T3, atholakale ngogunyaziwe kusuka kuma-pharmacy ehlanganiswayo.
Abanye odokotela abahlanganisa, eqinisweni, bakholelwa ukuthi i-T3 ekhishwa kancane kancane empeleni ifomu elihle lokuxhaswa kwe-T3, njengoba lihambisana kakhulu nokuguqulwa komzimba nokukhululwa kwe-T3, futhi ngoba ifomu lokukhululwa kancane likwazi ukudala noma yimiphi imiphumela emibi.
I-Natural Desiccated Thyroid
Abanye odokotela bathole ukuthi i-subset yeziguli zabo zikwazi ukuxazulula izimpawu zabo ngokuphepha ngenkathi zithatha imithi yemithi yemvelo ekhishwe yi-NDT. I-NDT ibizwa nangokuthi i-porcine ye-thyroid, i-thyroid ye-extract, i-thyroid yemvelo noma ngisho "yegciwane lengulube." Kuyinto yemithi kadokotela elawulwa yi-FDA, eyakhiwe kusuka emgodini we-ngulube omisiwe wezingulube. Izidakamizwa zalesi sigaba zihlanganisa izikhali ze-Thyroid, i-Nature-throid, ne-WP Thyroid e-United States, i-Erfa Thyroid yaseCanada, kanye nesifo semvelo esihlotshiswe yi-Acella.
I-thyroid ekhishwe imvelo isetshenziswa isikhathi esingaphezu kwekhulu leminyaka. Ochwepheshe abaningi be-hormone ehlangene bakholelwa ukuthi le mithi, ehlinzeka nge-T4, T3, T2, T1, namanye ama-hormone wegciwane kanye nezakhi zokudla okunomsoco, ngokufanayo kufana ne-hormone ye-thyroid yomuntu kunezidakamizwa zokwenziwa. Bika ukuthi amaphesenti amakhulu eziguli zabo azizwa kangcono kubo. Ezinye iziguli zithola ukuthi zizizwa zingcono emithini yemvelo ye-thyroid, noma ngezidakamizwa zokwenziwa kanye ne-thyroid yemvelo.
Izwi elivela
I-T3 yamahhala futhi ibuyele emuva ukuhlolwa kwegazi kwe-T3, kanye nezibonakaliso zemitholampilo nezimpawu ze-hypothyroidism, ingasiza ukukhomba ukuthi unamazinga avamile we-T3 etholakalayo, noma ingazuza ku-T3 yokwelapha. Abanye odokotela abathintekayo bakholelwa ukuthi indawo eyanele ye-thyroid izothatha amazinga wamahhala we-T3 phakathi naphakathi nengxenye ephezulu yesithenjwa sebhethrikhi.
Khumbula ukuthi ukuhlolwa kwe-T3 nokusetshenziswa kwe-T4 / T3 imithi yokwelapha kanye nemithi yemvelo yemithi ye-thyroid iyinkinga. Abaningi be-endocrinologists kanye nodokotela abavamile bayamelana nomqondo wokuhlola i-T3 futhi baphatha izidakamizwa ze-T3, naphezu kokuthola okuseshembisayo okucwaninga. Bachaza ukuthi ukuphakama ngokweqile kwe-T3 kungabangela izinhliziyo ezincane noma ezinye izimo ezimbi.
Odokotela abaningi abavamile ababukeli kahle izidakamizwa zemvelo ye-thyroid . Bathi lezi zidakamizwa ziphelelwe yisikhathi, hhayi "ezihambisanayo," futhi abaningi ngeke bazinqume.
Uma ufuna ukucabangela ukwelashwa kwe-T3 eyengeziwe noma izidakamizwa zemvelo yegazi, kungase kudingeke usebenze nodokotela ohlangene noma ophelele.
Futhi, ngenkathi kutholakala izithako ezihlukahlukene zokusekela kwe-thyroid, futhi ezinye zibiza ukuthi ziqukethe "izigulane ze-thyroid," lezi akuzona imishanguzo yegciwane lengculazi, futhi azilutho esikhundleni semithi yesiguli yemvelo yemithi.
> Imithombo:
> Celi FS, et al. "Imiphumela ye-metabolic ye-liothyronine therapy ku-hypothyroidism: isivivinyo esingenakulinganiswa, esiphambanisekile, esiphambanweni se-liothyronine versus levothyroxine." J Clin Endocrinol Metab. 2011 Nov; 96 (11: 3466-74.): 10.1210 / jc.2011-1329.
> Izinkombandlela Zokuzivocavoca Zomtholampilo ze-Hypothyroidism Kubantu Abadala : Baxhaswe yi-American Association of Clinical Endocrinologists kanye ne-American Thyroid Association.
> Escobar-Morreale HF, et al. "Ukwelashwa kwe-hypothyroidism nge-levothyroxine noma inhlanganisela ye-levothyroxine ne-L-triiodothyronine." I-Best Pract Res Clin Endocrinol Metab. 2015 Jan; 29 (1): 57-75. doi: 10.1016 / j.beem.2014.10.004. Epub 2014 Okthoba 25. Ukubuyekezwa.
> McAninch EA, i-Bianco AC. "Umlando nekusasa lokuphathwa kwe-Hypothyroidism." U-Ann Intern Med. 2016 Jan 5; 164 (1): 50-6. i-doi: 10.7326 / M15-1799. I-Erratum ku: Ann Intern Med. 2016 Mar 1; 164 (5): 376. I-PMID: 26747302
> Nygaard, B et al. "Umthelela we-combination combination ne-thyroxine (T4) kanye ne-3,5,30-triiodothyronine ne-T4 monotherapy ezigulini ezine-hypothyroidism, isifundo esiphambene nesiphambano esiphambanweni, esingahleliwe." I-European Journal of Endocrinology (2009) 161 895-902