Imicabango evela kuRichard Shames, MD
Ngivame ukufaka ulwazi oluvela kuDkt. Richard Shames, umbhali ohlangene nomkakhe uKarilee Shames, RN, Ph.D., wezincwadi eziningana ngesifo segciwane, kanye nodokotela ohlangene osebenze ngeziguli ze-thyroid iminyaka eminengi. UDkt. Shames ulokhu ethembela ekuhlolweni kwamakhemikhali e-capillary fingerprick / blood spot, esikhundleni sokuhlolwa kwegazi le-thyroid kanye nokuhlaziywa okwenziwe ama-laboratories amaningi.
Le-Q & A ibheka imibono kaDkt Shames mayelana nale ndlela yokuhlola, okubhekwa njengengxabano emkhakheni wezokwelapha ojwayelekile.
Q: Kungani uthanda ukuhlolwa kwegazi ngenxa yokuhlolwa kwe-thyroid, kunokuba uhlole izivivinyo zebhodi zegazi?
URichard Shames, MD: Engikhuluma kubo bobabili iziguli nabalingani ukuthi isizathu esilula. Ngesikhathi ukuhlolwa okuvamile kwenziwa umsebenzi omuhle kubantu abaningi kakhulu, abanye (ikakhulukazi amacala azinzima kakhulu-ukuxilongwa), lezi zivivinyo ezintsha futhi ezingcono, ezimweni eziningi zitholakala ngaphandle komyalelo kadokotela, ezihlola lezi hormone izinhlelo ngokuphumelelayo nangaphezulu ngokuphelele emibonweni yami.
Ngemuva kokuhlola i-thyroid ngegazi elivame ukuguqula igazi leminyaka engu-25 yokugcina ye-hormone practice, ngize ngibone ukuphakama kobuchwepheshe obusha obonakala eminyakeni eyishumi edlule. Ama-osteopaths, izondlo zokudla, izidakamizwa kanye nodokotela be-naturopathic basebenzisa ubuchwepheshe obusha futhi baseluleka ngesikhathi samanye ama-hormone seminars ukuze sizame.
Lokho engangikuthole, njengodokotela wezokwelapha, ukuthi ukuhlolwa kwesifo segazi kusuka kwikhompiyutha ye-capillary kwanikeza imiphumela engaphezulu eqondile yamacala amabi kakhulu e -roid.
Isibonelo, lapho isiguli esinezivivinyo zelabhu ezivamile zegazi sasingakakhululeki ngaphandle kwemiphumela evamile, ngingenza ukuhlaziywa kwegazi lomunwe wegazi.
(Ngisebenzisa izivivinyo ezivela ku-Laboratory ZRT.) Lokhu kuhlola okusha ngezinye izikhathi kubonisa ukuthi lesi siguli "esivamile" sasiphezulu kakhulu noma sincane kakhulu kwihomoni yegciwane . Lapho ngilandela isiqondiso esichazwe yizivivinyo ezintsha ngokushintsha ushintsho, isiguli ngokuvamile sagcina sizizwa singcono.
Futhi, lapho nginesiguli esake sibona abanye odokotela abaningi ngaphambili, kuhlanganise ne-endocrinologists, futhi bebikwa ngokuphindaphindiwe ukuthi babengenayo inkinga ye -roid ngoba ukuhlolwa kwegazi kwakungokwemvelo, ngabanika laba bantu ukuhlolwa okusha kweminwe yegazi ukuhlaziywa kwendawo. Ngokuvamile ngibona amasosha omzimba we-thyroid lapho bekungekho khona ngaphambili, noma ngibone amanani angavamile eTSH ekuhlolweni okusha ukuthi ukuhlolwa kwegazi okuvamile kwakuboniswa njengokwejwayelekile, ngisho nokusebenzisa uhla olusha oluvamile .
Lokhu kuhlolwa okusha kwakubonakala kuyasiza kakhulu iziguli zami ezilukhuni kangangokuba ngaqala ukusebenzisa lezi zivivinyo ezigulini eziningi, ukuze ngizuze kahle. Ngangifuna ukuqonda ukuthi kungani lokhu kuvivinywa kwakuphakeme.
Q: Kungani ucabanga ukuthi ubona lokho okubheka ukuthi yimiphumela enembile ngalokhu kuhlola okusha, ngokubhekisana nokuhlolwa kwendabuko?
URichard Shames, MD: Ngikhulume noDkt. David Zava, umsunguli weZRT Labs, owachaza ukuthi igazi le-capillary liyindawo enembile kakhulu yokukala amazinga eqiniso we-hormone ye-thyroid.
Akukhona nje ukuthi ukuhlolwa komunwe okusekelwe ekhaya kunomthelela omncane, kubiza kancane, futhi kuncane kakhulu kunengozi kunokuya esiteshini sokudweba, kodwa futhi kunamandla okuba nenembile kunalokho lapho igazi likhishwa khona.
Ngaphezu kwalokho, kunenzuzo eyengeziwe yokuthatha amaconsi amancane egazi futhi ube owomile ngemizuzwana emgqeni wephepha lokuhlunga ohlotshwe ngokucophelela ohlaziywa ngemishini yesimanje (sensitive chemiluminescence). Isampuli esomile isisimeme kakhulu kunama-hormone e-thyroid ngendlela efakwe emanzini (i-tube ye-serum yegazi) njengoba kwenziwa ngama-labs avamile. Lokhu kuyiqiniso ikakhulukazi kwi-hormone ye-pshitary hormone TSH, ebhekwa njengezinga legolide lokuhlolwa kwe-thyroid.
Ama-molecule ala ma-hormone ayokwehlisa ngokushesha ngendlela ewuketshezi kunombuso owomile oqinile.
Abantu kufanele bazi ukuthi igazi elidonsa ekuseni cishe cishe wonke amashabhu ase-US awuhambisani nomshini wokuhlaziywa kuze kuhlwe. Phakathi naleso sikhathi, ama-hormone akho, ikakhulukazi i-TSH ebalulekile, angaqeda ukubonisa imiphumela ephansi kunomphumela wakho wokuhlola kunembile kuwe.
Kukhona ukukhathazeka okubalulekile ngamanani we-TSH: akuyona i-hormone ejwayelekile, i-hormone ye-pituitary ukuthi ngokwezindinganiso ezifanele kufanele zifrijiwe kahle uma zidonsa. Ama-labs amaningi amakhulu anezikhungo ze-satellite (iziteshi zokudweba) ezihambisa izampula zegazi kubo. Ingabe lezi zigcinwe ekushiseni okufanele? Ngaso sonke isikhathi. I-TSH serum ayitholakali efrijini.
Lokho kusho ukuthi ungase ube ne-low ye-thyroid nge-TSH engaphelele kodwa ekupheleni kosuku olude emgodini wokuhlola, amazinga akho e-TSH angakwazi ukulinganiswa manje ayoba uhla olujwayelekile. Uma lokho kungalungile ngokwanele, nakhu okubi nakakhulu: Uma uthola amazinga angenele okwelapha uma uthatha amaphilisi e-thyroid, lokhu kungacacile kungenza umdokotela wakho akholelwe ukuthi unomuthi okwanele noma ngisho nemithi eningi kakhulu, futhi cishe uzokwehlisa umthamo ngisho noma unzima kakhulu emthamo wamanje.
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Uma unesithakazelo ekuhlolweni kwe-capillary fingerpick / blood spot yezinga le -roid, kunezindlela ezimbili ongazithola lolu hlobo lokuhlolwa. Okokuqala, udokotela wakho angalayela lezi zivivinyo ezintsha, ngaphezu kwalokho noma esikhundleni sovivinyo lwendabuko, ngeZRT Laboratories. Lezi zivivinyo zitholakala ngaphandle kwemithi yabathengi bezempilo emazweni amaningi, ngekitshi zokuhlola ekhaya. Uma ufuna ukuzi-oda, ungahle ulandele ngqo kusuka ku-ZRT, noma ugcine imali ngokuthola ubulungu behhala eqenjini elimele lababheki lababhekene neziguli, njenge-Canary Club, lapho ungazuza khona isaphulelo sokuhlola ivolumu. Ulwazi oluthe xaxa mayelana ne-ZRT ne-Canary Club litholakala ku-athikili yami ngokuzihlola kwe-thyroid namahomoni .