Amathebulethi atholakala ukuthi angelashwa kangcono
Emhlanganweni we-2017 we-American Thyroid Association, iningi labacwaningi libike ngezifundo ezintsha ezibonisa ukuthi izinhlobo zamanzi ze-levothyroxine ziyasebenza kakhulu kunamathebulethi ekuphatheni amaqembu amaningi iziguli.
I-Levothyroxine ifomu lezokwelapha le-thyroxine (T4), i-hormone eyinhloko eyenziwa yi-thyroid. I-Levothyroxine yilona ukwelashwa okuyinhloko kwe-hypothyroidism, i-thyroid engasebenzi kakhulu evame ukuphumela ekususweni kokuhlinzwa kwe-thyroid, i-radioactive ablation of the gland, nokubhujiswa kwesigulo ngenxa yesifo esizimele esisuka ku-Hashimoto's thyroiditis.
I-generic levothyroxine, namagama omuthi ajwayelekile-njengama-Synthroid ne-Levoxyl, yizinhlobo zethebulethi zalesi sidakamizwa se-hormone esikhundleni se-thyroid . Ifomu lebhulethi ye-levothyroxine yindlela enkulu kakhulu le mithi ethathwa.
Sekuyiminyaka eminingana, uhlobo oluthile lwe-liquid, softgel capsule levothyroxine luye lwatholakala e-United States ngaphansi kwegama legama elithi Tirosint . Umkhiqizo we-Tirosint we-levothyroxine wenzelwe ngokuyinhloko njenge-hypoallergenic, uhlobo olukhethekile lwe-levothyroxine kubantu abanezinkinga zokugaya noma zamathumbu, ubunzima bokunakekelwa kwemithi ye-thyroid, noma ukuxilongwa kwezidakamizwa kanye nokubophezela ekufakweni kwezidakamizwa ze-levothyroxine izidakamizwa.
Ngo-Februwari ka-2017, i-FDA ivume levothyroxine, i-Tirosint-SOL. I-livid levothyroxine itholakale e-Italy kusukela ngo-2012. I-levothyroxine ye-liquid yayihloswe njengenye indlela yeziguli ezingenakugwinya, ezondliwa yi-tube, kanye nezingane ezine-hypothyroidism.
I-Tirosint-SOL ilindeleke ukuthi itholakale emakethe yase-US ngo-2018.
Liquid Levothyroxine vs. Amathebulethi
Ucwaningo oluthile, abacwaningi base-Italy babonisa ukuthi izinhlobo ze-levothyroxine zamanzi ziholela ekusimeni okungcono kwamazinga wegciwane uma kuqhathaniswa namathebulethi. Bahlolisisa iqembu leziguli ezithatha amaphilisi e-levothyroxine, owathi, naphezu kokulingana kwamanani, ayengenayo i- hormone yokuvuselela i-thyroid (TSH) namazinga wamahhala we-T4 ngaphakathi kwebala lokubhekisela.
Abacwaningi bashintsha lezi ziguli ziye ezilinganisweni ezifanayo zamanzi noma softgel levothyroxine futhi bavuselela amazinga abo e-thyroid. Bathole ukuthi amaphesenti angama-85 weziguli afundisiwe abonise ukuthuthuka okukhulu kokubili amazinga abo e-TSH namanqanaba abo amahhala we-T4. Emasontweni ambalwa emva kokuqala ama-liquid levothyroxine, iziguli ze-hypothyroid zakwazi ukufinyelela amazinga we -roid ngaphakathi kwezigaba ezibhekiswe kuzo.
Abacwaningi baphetha ngokuthi izinhlobo ze-levothyroxine ezinomfutho zinomphumela omuhle kakhulu uma kuqhathaniswa nokubunjwa kwethebulethi kwezinye iziguli.
Ngemuva kwe-Thyroidectomy, ama-Softgel Capsules More Effective
Kwesinye isifundo, abacwaningi baqhathanisa ukusebenza kwamaphilisi e-levothyroxine kanye ne-softgels ezigulini ezine-thyroidectomy esiphelele ye-goiter ye-multinodular. Lezi ziguli azizange zibe nezinkinga zokushaywa ngamagciwane.
Cishe isigamu seziguli ezifundwayo zanikezwa amaphilisi, kanti esinye isigamu sathola amaphilisi e-softgel ngesifo esifanayo, kuqala ngokushesha ngemva kokuhlinzwa kwe-thyroid. I-TSH yeziguli, i-thyroxine yamahhala (FT4), namazinga wamahhala we-triiodothyronine (FT3) ahlolwe ngemuva kwamaviki ayisithupha ngemuva kwemaviki angu-12.
Kumaviki angu-6 no-12, iziguli ezithatha amathissile we-softgel zinezinga eliphansi kakhulu le-TSH.
Kuzo zombili amaphuzu wokulinganisa, inani leziguli eziye laphakamisa amazinga e-TSH ngaphezu kwe-3.5 mcU / ml-ethathwa njenge-hypothyroid yalolu cwaningo-laliphakeme kakhulu kwiziguli ezithola amaphilisi. Abacwaningi baphetha ngokuthi ngisho nasezigulini ezazingenayo i-malabsorption noma izinkinga zokugaya ukudla, i-levothyroxine softgel capsules yayisebenza kahle.
I-TSH Yokulawula I-TSH Engcono Ngemuva Komdlavuza
Esinye isifundo sase-Italy sibheka iziguli ezine-cancer ye-thyroid (DTC) ezithatha i-levothyroxine. Ngokusho kwe-American Thyroid Association, lezi ziguli kufanele zibe nezinga le-TSH phakathi kuka-0.1 no-0.5 mU / L-ngezansi kokuphela kwe-reference reference-ukusiza ukuvimbela ukuphindaphinda komdlavuza wegciwane.
Ngoba lokhu kuyindwangu elincane kakhulu, kubalulekile ukuthi ukwelashwa kwe-levothyroxine kube njalo ekugcineni izinga le-TSH.
Abacwaningi baqhathanisa ukuhluka kwezinga le-TSH ezigulini eziphathwe nge-levothyroxine ye-liquid, ngokubhebhethekisa amaphilisi. Isigamu seziguli zathola i-levothyroxine ye-liquid, kanti isigamu sathola ithebhulethi, futhi bonke babe nesilinganiso se-hormone yokushintshwa kwe-thyroid efanayo. Izilinganiso eziningana zamazinga we-TSH zenziwe.
Abacwaningi babona ukwanda okukhulu kwamazinga e-TSH kuziguli ezithatha amaphilisi, uma kuqhathaniswa nalabo abathwala i-levothyroxine. Ngokuqondile, amaphesenti angaba ngu-16 weziguli ezibhebheni azange afinyelele ububanzi be-TSH, uma kuqhathaniswa nabangu-4% kuphela kulabo abakhona ku-levothyroxine ye-liquid. Abacwaningi baphetha ngokuthi ukusetshenziswa kwe-LT4 levothyroxine kuqhathaniswa namathebulethi kwabangele inani eliphakeme kakhulu labalimi bomdlavuza abalondoloza izindinganiso ze-TSH ebangeni elihlosiwe lokunciphisa ingozi yokuphindaphinda umdlavuza.
Mayelana ne-Liquid Levothyroxine
Njengoba kuphawuliwe, e-US, i-levothyroxine ye-liquid eyenziwe ngezebhizinisi itholakala ku-Tirosint brand softgel capsules, naku-Tirosint-SOL liquid. I-Tirosint ayinawo ushukela, amatala, utshwala, isitashi sikakolweni (gluten), i- lactose, i-acacia , noma yiziphi ezinye izithasiselo noma izitsha ezivame ukusetshenziselwa ukwenza amaphilisi e-levothyroxine. Izithako kuphela kule capsules kukhona i-levothyroxine, i-gelatin, i-glycerin, namanzi, okungenakwenzeka ukuphazamisa ukumuncwa noma ukudala imithi. I-Tirosint-SOL iqukethe i-levothyroxine kuphela.
I-Tirosint igcinwe ikakhulukazi ezigulini ezinezimo ezinjengesifo sikaCrohn noma isifo sofuba esiyingozi esaziwa ukuthi sithinte ukugaya noma ukumuncwa. Ngenxa yokuthi i-hypoallergenic, isetshenziselwa iziguli ezinemizimba eyaziwayo ekugcwaliseni izithako noma izithako ezisetshenziselwa ukwakha igama lomkhiqizo kanye namaphilisi e-generic levothyroxine.
Ezinye zenezela izinzuzo ze-Tirosint liquid formulations: ukudla, calcium , insimbi, ikhofi , nobisi akubonakali ukuphazamisa ukumunwa kwe-levothyroxine ye-liquid, njengoba kwenza ngamaphilisi.
Ngenxa yesimo salo njengesidakamizwa esikhethekile sezethameli ezilinganiselwe, futhi ngenxa yokuthi iTirosint ibiza kakhulu kunezinye izinhlobo ze-levothyroxine noma amaphilisi ajwayelekile, kufanele kuze kube yimanje ayisetshenziselwa ukwelashwa kwe-hypothyroidism e-United States.
Izwi elivela
Ukutholakala kocwaningo kusikisela ukuthi iziguli eziningi-hhayi nje kuphela lezo ezinama-malabsorption noma izifo- ezingase zizuze ngokusuka ezinhlotsheni ze-levothyroxine ezinhlobonhlobo ze-levothyroxine. Olunye ucwaningo olwanyatheliswa encwadini ye- RD Diet lathola ukuthi phakathi kweziguli eziyi-1 ezithatha i-levothyroxine, amaphesenti angu-15 ayenamafutha kuya ezigciniweni kanye nezithasiselo ezitholakala ezibhebheni ze-levothyroxine.
Kunezinselele ezithile zokwenza ushintsho kusuka kwithebhulethi levothyroxine eya eTirosint softgel capsules noma i-Tirosint-SOL liquid, kodwa:
- Udokotela wakho angeke awazi amathissile we-Tirosint noma i-Tirosint-SOL liquid njengendlela ongakhetha kuyo.
- Umshuwalense wakho, i-HMO, noma ezinye izidingo zezempilo angeke zizimisele ukukhokhela noma ukubuyisela i-Tirosint. Kulesi simo, ungase udinga umhlinzeki wakho wokunakekelwa kwezempilo ukuze uvumele "ukunikezwa okulotshiwe" noma "ukungabi khona okufakwayo / akukho okuvamile".
- Uma kufanele ukhokhe ngaphandle kwe-pocket, ukwehlukaniswa kwezindleko-okungaba ngu-$ 50 kuya ku-100 noma ngaphezulu ngenyanga-kungenza ukuthi inkinobho ingavumeleki ngokwezimali.
Kodwa-ke, uma uthola kunzima ukufinyelela amazinga okuhlolwa akho ehlosiwe noma aphezulu futhi uxazulule izimpawu zakho eziqhubekayo ze-hypothyroidism, ungase ufune ukuxoxa nomhlinzeki wakho wezempilo mayelana nokuthi ngabe ukushintshwa kokwelashwa kunconywa yini.
> Imithombo:
> Benvanga, S. et al. "I-Thyroxine ku-Oral Liquid noma ukuFometha kwe-Softgel Iqinisekisa izinga le-Serum elijwayelekile le-Free T4." I-Thyroid. Okthoba 2017, 27 (S1): A-166-A-188.
> Fallahi, P et. al. "I-Oral L-Thyroxine e-Gel Capsule ne-Tablet Formulation in Iziguli ezithunyelwa ku-Total Thyroidectomy." I-Thyroid. Okthoba 2017, 27 (S1): A-166-A-188.
> McMillan M, Rotenberg K, et al. Ukwelashwa kwemithi, imithi ehambisanayo, kanye nokudla njengezici ezithinta ukwelashwa kwe-levothyroxine: imiphumela ye-CONTROL yokuqapha iphrojekthi. Izidakamizwa RD. 2015. Disemba 21.
> Pirola, I. et. al. "TSH Ukuhlukahluka kweziguli ezithinteka ngegciwane lesifo segijithali elibhekene ne-Levothyroxine Liquid Solution noma ithebhulethi." I-Thyroid. Okthoba 2017, 27 (S1): A-166-A-188.
> Sevilla Alsina, ME et. al. "Indlela Engcono Yokuphathwa Kwe-Hypothyroidism Ngemva Kokwehluleka Kwe-Oral Levothyroxine." I-Thyroid. Okthoba 2017, 27 (S1): A-166-A-188.