Iziguli ezine-bipolar disorder zivame ukumangala uma zizwa ukuthi izinkinga ze-thyroid ziwumphumela ovamile wokuthatha i-lithium yezidakamizwa. I-lithium yisidakamizwa esivamile esetshenziselwa ukwelapha ukucindezeleka kwe-bipolar, ngezinye izikhathi okubizwa ngokuthi ukucindezeleka komuntu.
I-lithiamu inezimbalwa eziningana kwi-thyroid:
- iyanciphisa amandla akho wegciwane le-thyroid ukukhiqiza i-thyroxine (T4)
- iphazamisa ukuguqulwa kwe-T4 kuya ku-T3
- kungabangela ukwanda kwezinga le-TSH
- kungase kube kubi kakhulu ngaphansi kwesifo se-autoimmune
I-lithiamu iyaziwa ngokubangela i- goiter (i-thyroid ekhulisiwe), kanye ne-hypothyroidism (i-thyroiditis engasebenzi), nesifo esingenasifo se-autoimmune thyroiditis, isimo sokuvuvukala segciwane le-thyroid. Kukhona ukuxhumana phakathi kwe-lithium ne-hyperthyroidism kwezinye iziguli.
Imiphumela Yecala Ehlobene Ne-Lithium
I-Goiter: I- Goiter , isikhumba se-thyroid esandisiwe, isisusa esibi kakhulu se-lithium, futhi kulinganiselwa ukuthi senzeka cishe cishe isigamu sazo zonke iziguli eziphathwa nge-lithium. I-goiter ngokuvamile iqala phakathi neminyaka emibili yokuqala yokuphathwa kwe-lithium. Nge-goiter eyenziwe nge-lithium, i-thyroid yakho ingakwazi ukukhulisa ngokuphindwe kabili usayizi wayo ojwayelekile.
I-Hypothyroidism: I- Hypothyroidism -ukuntuleka kwe-hormone ye-thyroid-kulinganiselwa ukuthi yenzeke phakathi kwesigamu sazo zonke iziguli ezithatha i-lithium.
Kuvame ukwenzeka phakathi neminyaka emibili yokuqala yokuphathwa kwakho kwe-lithium. Abesifazane abangaphezu kuka-45 basengozini enkulu ye-lithium-induced hypothyroidism, futhi ingozi enkulu ye-hypothyroidism ezigulini eziphathwa nge-lithium yanda ngokukhula.
I-hypothyroidism ingaba yi-subclinical-ngezinga eliphakeme le-thyroid elivuselela i-hormone (TSH), nezinga elivamile le-T4 ne-T3-enezibonakaliso ezimbalwa noma izimpawu ezimbalwa.
Kwezinye izimo, i-hypothyroidism inomoya omnene, futhi ikhombisa ezinyangeni ezimbalwa zokuqala ukwelashwa kwe-lithium, kodwa ihamba isikhathi eside, futhi umsebenzi we-thyroid ubuyela ekujwayelekile. Nokho, amaphesenti amancane weziguli azokuthuthukisa i- hypothyroidism engaphezulu, enezibonakaliso nezibonakaliso ezivamile . Lezi ziguli kufanele ziphathwe nge-lithium-induced hypothyroidism .
Yenza ngokuzenzakalelayo i-Thyroiditis: Iziguli ezithatha i-lithium nazo zisengozini yokudala i-autoimmune thyroiditis engapheli-ukuvuvukala ngokuzenzakalelayo kwegciwane le-thyroid. Uma usuqala nje ukwelashwa kwe-lithium, ukutholakala kwama- antibodies aphezulu (i-peroxidase ye-TPO antibodies) - ngisho nangaphandle kokungasebenzi kahle kwe-thyroid - ikubeka engozini ephakeme yokuthuthukisa isimo se -roid ngaphezulu ngenkathi uphathwa nge-lithium. Kubuye kubonakale kunobunye ubufakazi bokuthi i-lithium ngokwayo ingabangela imishanguzo ephezulu kanye nokuqala kwesifo se- autoimmune kwezinye iziguli.
Ukwelashwa kwe-lithiamu kubonakala sengathi kuhlobene nengozi eyengeziwe ye- hyperthyroidism- noma ngaphezulu kwehomoni ye-thyroid. Ucwaningo oluthile luye lwabonisa ukuthi i-hyperthyroidism iphindwe kabili kweziguli eziphathwa nge-lithium, uma kuqhathaniswa nokwanda kwabantu abaningi.
Yini Okufanele Iziguli Zenze?
I-UpToDate inezeluleko ezithile zokusiza iziguli ezithatha i-lithium ziqonde imiphumela ehlobene ne-thyroid:
Ngenxa yezimo eziphakeme ze-goiter kanye ne-hypothyroidism eyenzeka ngesikhathi sokwelashwa kwe-lithium, iziguli kufanele zihlolwe ngokucophelela ngokomzimba we-thyroid kanye nokuzimisela kwe-serum TSH kanye ne-antithyroid anti-titanic ngaphambi kokuqala ukwelashwa kwe-lithium. Iziguli ezinomsebenzi ovamile we -roid ngaleso sikhathi kufanele zihlaziywe njalo ezinyangeni eziyisithupha kuya kwezingu-12 iminyaka eminingana. Uma umsebenzi we-thyroid ungavamile ekuhloleni kokuqala, i-lithium ingakanikezwa uma kunesidingo kodwa ukukhubazeka kwegciwane kufanele kuphulukwe.
Lokho kusho ukuthi uma umisiwe i-lithium, kuzodingeka uqiniseke ukuthi uhlolwa ngokucophelela kwe-thyroid , kanye nokuhlolwa kwegazi ukukala amazinga we-TSH ne-antithyroid antibody , ngaphambi kokuqala ukwelapha kwakho kwe-lithium. Abanye ochwepheshe bancoma ukuthi uhlole ukuhlolwa kwe-thyroid emva kwamasonto ayisithupha ngemuva kokuqala ukwelashwa kwe-lithium. Uma nje uthatha i-lithium, udokotela wakho kufanele aphinde ahlole umsebenzi wakho we-thyroid, kuhlanganise nokuhlola okuphelele kwegazi kanye nokuhlolwa kwemitholampilo, njalo ezinyangeni eziyisithupha kuya kwezingu-12, noma ekuqaleni, uma uqala ukubonisa izimpawu ezibonisa ukuthi une-dysfunction ye -roid.
I-hypothyroidism eyenziwa yi-lithiamu-ngokuvamile iyakwazi ukuguqulwa uma uyeka ukuthatha i-lithium. Uma uhlakulela inkinga ye-thyroid ngenkathi uthola ukwelapha kwe-lithium, ochwepheshe abancoma ukuyeka ukwelapha kwakho kwe-lithium. Esikhundleni salokho, ukhiye ukusebenza nodokotela wakho ukuqinisekisa ukuthi uthola ukwelashwa okuphumelelayo isimo sakho se-thyroid . Udokotela wakho uzodinga ukuqapha i-thyroid yakho kanye nempendulo yakho ekwelashweni kwe-thyroid ukuqinisekisa ukuthi uphathwa ngokugcwele, futhi ukuhlola ngezikhathi ezithile ukuthi ukuqhubeka nokwelashwa kwe-lithium kuyindlela engcono kakhulu empilweni yakho.
Umthombo:
> Goldberg, Joseph, MD. "Ukuphathwa kwe-Hypothyroidism ezigulini kuLithium Prophylaxis ye-Bipolar Disorder." I-Medscape. Okthoba 31, 2008. Online: http://www.medscape.com/viewarticle/581200
> Amaskriski, uMartin. "I-lithium ne-thyroid." Kusesikhathini. Kufinyelelwe: Mashi 2009.