So ɛte sɛ nea wo thyroid no yɛ adwuma boro so kakra? Momma yɛnka Subclinical Hyperthyroidism ho asɛm!

So wo duruyɛfo kae sɛ wo TSH dodow no sua kakra wɔ mogya mu nhwehwɛmu bi a wɔyɛe nnansa yi mu? Anaasɛ worenya sɛnkyerɛnne ahorow bi a ɛyɛ nwonwa a ɛyɛ den sɛ wobɛte ase? Ebia wowɔ tebea bi a wɔfrɛ no Subclinical Hyperthyroidism. Mma ɛnhaw wo, mpɛn pii no ɛnyɛ aniberesɛm. Momma yɛnka eyi ho asɛm tiawa na emu nna hɔ.

Dɛn ne Subclinical Hyperthyroidism?

Sɛ yɛbɛka no tiawa a, `Subclinical Hyperthyroidism` yɛ tebea a wo thyroid gland no reyɛ adwuma kakra sen sɛnea ɛte daa. Nanso ɛnyɛ nea emu yɛ den te sɛ `overt hyperthyroidism` .

Pituitary gland a ɛwɔ yɛn amemene mu no yɛ hormone bi a wɔfrɛ no `TSH` (Thyroid-Stimulating Hormone). Saa `TSH` yi ka kyerɛ thyroid ntini a ɛwɔ yɛn kɔn mu no sɛ ɛnyɛ hormone abien a wɔfrɛ no thyroxine (`T4` - `thyroxine`) ne triiodothyronine (`T3` - `triiodothyronine`). Saa `T3` ​​ne `T4` hormone yi ne nea ɛboa yɛn nipadua no mu nneɛma a ɛsakra, kyerɛ sɛ, ɛdan aduan a yedi no ma ɛbɛyɛ ahoɔden na yɛde adi dwuma ma yɛn nipadua.

Wɔ `Subclinical Hyperthyroidism` mu no, wo mogya mu `TSH` dodow sua, nanso wo `T3` ​​ne `T4` dodow no yɛ nea ɛfata. Ɛno kyerɛ sɛ thyroid no yɛ adwuma boro so kakra, enti pituitary gland no ka sɛ, "Okay, enhia `TSH` mprempren, me thyroid reyɛ adwuma yiye," na ɛtew `TSH` a ɛba no so. Nanso thyroid hormone (`T3`, `T4`) no nnya nkɔ soro kɛse. Ɛno ne nea `subclinical` kyerɛ - tebea a ɛhyɛ ase a ɛnkyerɛ sɛnkyerɛnne a ɛda adi pefee.

Ɛtɔ mmere bi a saa tebea yi betumi ayɛ bere tiaa mu de , a ɛkyerɛ sɛ n’ankasa betumi ayɛ yiye wɔ nna kakraa bi mu. Nanso, wɔ nnipa binom fam no, ebetumi ayɛ nea ɛtra hɔ daa. Ɛnyɛ obiara na ohia ayaresa.

Hena na ɛda adi kɛse sɛ obenya saa tebea yi?

Obiara betumi anya `Subclinical Hyperthyroidism`, nanso nnipa a wodi so yi wɔ asiane mu kakra:

• Nnipa a wɔrenom aduru a wɔde si thyroid hormone ananmu (sɛ nhwɛso no, levothyroxine) ma hypothyroidism. Ɛtɔ mmere bi a, sɛ wɔma aduru no dodow kɔ soro kakra a, eyi betumi aba.
• Wɔn a wɔadi boro mfe 65 no fam.

Saa tebea yi abu so dɛn?

Eyi nyɛ tebea a abu so kɛse wɔ aman te sɛ Amerika mu.

Nnipa dodow bɛyɛ 0.7% na wɔwɔ `Subclinical Hyperthyroidism`, baabi a TSH dodow nnu 0.1 mIU/L. 1.8% foforo nso wɔ `TSH` dodow a ennu 0.4 mIU/L.

Nanso, wɔ aman a iodine nni mu , titiriw wɔ nnipa a wɔadi boro mfe 70 mu no, saa tebea yi betumi ayɛ kɛse akodu 15%. Wɔ Sri Lanka no, asiane yi sua efisɛ yɛtaa de nkyene a iodized wom na edi dwuma, nanso eye sɛ yɛma yɛn ani da hɔ.

Dɛn ne sɛnkyerɛnne ahorow no?

Mpɛn pii no, nnipa a wɔwɔ `Subclinical Hyperthyroidism` no nkyerɛ sɛnkyerɛnne biara . Ɛno nti na wɔfrɛ no "subclinical".

Nanso, ɛtɔ mmere bi a wubetumi anya sɛnkyerɛnne ahorow a emu nyɛ den a ɛfa hyperthyroidism ho. Wɔ mmere a ɛtete saa mu no, ebia wubehyia nneɛma te sɛ:

• Sɛ wote nka sɛ wo koma rebɔ ntɛmntɛm (pulpitations).
• Ɛte sɛ nea me nipadua rewosow, mete ehu nka kɛkɛ.
• Mu duru a ɛso tew (ɛmfa ho sɛ aduan ho akɔnnɔ wɔ hɔ no).
• Aduan ho akɔnnɔ a ɛkɔ soro.
• Atiridiinini anaasɛ dwensɔtwaa a ɛtaa ba.
• Wora te nka sɛ ɛyɛ teateaa, ɛyɛ hyew, na ɛyɛ nwini.
• Nsakrae a ɛba mmea brayɛ mu (`Bere mu nsakrae`).

Nea ɛho hia: Sɛ wowɔ saa nsɛnkyerɛnne yi a, ɛnkyerɛ sɛ wowɔ `Subclinical Hyperthyroidism`. Nanso, sɛ saa sɛnkyerɛnne ahorow yi kɔ so a, nyansa wom sɛ wobɛkɔ oduruyɛfo nkyɛn.

Dɛn nti na eyi rekɔ so? Dɛn ne nea enti a ɛte saa?

Mpɛn pii no, yɛn endocrine nhyehyɛe no yɛ adwuma te sɛ kuw. Fa no sɛ ɛyɛ adwumakuw kɛse bi.

Hypothalamus a ɛwɔ amemene no ase no ma hormone bi a wɔfrɛ no TRH (Thyroid-Releasing Hormone) fi adi. Eyi ka kyerɛ pituitary gland no sɛ ɛnyɛ TSH.

Afei `TSH` kɔ na ɔka kyerɛ thyroid gland no sɛ wɔnyɛ `T3` ​​(bɛyɛ 20%) ne `T4` (bɛyɛ 80%). Sɛ saa `T3` ​​ne `T4` yi kɔ soro wɔ mogya no mu a, ɛsan de nsɛnkyerɛnne kɔ pituitary gland no so sɛ, "Okay, gyae `TSH` yɛ mprempren, hormone a ɛdɔɔso wɔ hɔ." Wɔfrɛ eyi ` feedback loop` . Sɛ `T3` ​​ne `T4` so tew a, saa kyinhyia yi fi ase bio fi mfiase.

Nanso, wɔ `Subclinical Hyperthyroidism` mu no, esiane ɔhaw bi a ɛwɔ thyroid gland no mu nti, ɛwom mpo sɛ `TSH` dodow no sua de, nanso thyroid hormones a wɔyɛ no so ntew sɛnea wɔhwɛɛ kwan no. Ɛno nti na `TSH` sua, nanso `T3` ​​ne `T4` wɔ dodow a ɛfata mu.

Nea ɛde ``Subclinical Hyperthyroidism`` ba no dodow no ara ne nea ɛde hyperthyroidism a ɛda adi pefee ba no yɛ pɛ. Nneɛma atitiriw a ɛde ba no bi ni:

• Hormone ayaresa (levothyroxine) dodow a wɔde ma wɔ hypothyroidism (thyroid a ɛnyɛ adwuma) ho a wɔbɛma akɔ soro. Eyi ne ade a ɛtaa de ba.
• Multinodular awuduru goiter. Eyi yɛ tebea a ɛma akisikuru (nodules) a ɛnyɛ kokoram nyin wɔ thyroid ntini no mu, na ɛma ɛyɛ thyroid hormone pii dodo.
• Graves yare no. Eyi yɛ tebea a nipadua no tumi ko tia nyarewa. Eyi kyerɛ sɛ yɛn nipadua mu tumi a ɛko tia nyarewa no tow hyɛ thyroid gland no so, na ɛkanyan no ma ɛyɛ hormone pii.
• Thyroiditis: Sɛ thyroid gland no ho yɛ hyew a, hormone dodow betumi akɔ soro bere tiaa bi.

Wobɛyɛ dɛn ahu eyi?

Thyroid dwumadie nhwehwɛmu nko ara ne ɔkwan a wobɛfa so ahu no yie sɛ wowɔ `Subclinical Hyperthyroidism` anaasɛ wonni bi.(Thyroid dwumadi ho nhwehwɛmu nkutoo. Eyinom yɛ mogya mu nhwehwɛmu a wɔyɛ daa.

TSH (a wɔsan frɛ no thyrotropin) dodow a ɛfata wɔ ɔpanyin a onni nyinsɛn mu no yɛ 0.4 kosi 4.5 mili-amanaman ntam units wɔ lita biara mu (mIU/L).

Sɛ wo mogya mu nhwehwɛmu kyerɛ sɛ wo TSH dodow sua (ɛwɔ 0.1 kosi 0.4 mIU/L ntam anaasɛ ennu 0.1 mIU/L), nanso wo T4 (thyroxine) ne T3 (triiodothyronine) dodow no wɔ nea ɛfata mu a, wowɔ Subclinical Hyperthyroidism.

Wobetumi akyekyɛ `Subclinical Hyperthyroidism` mu akuw atitiriw abien:

• Ɛnyɛ den: TSH dodow sua, nanso ɛda so ara tumi hu - mpɛn pii no ɛyɛ 0.1 ne 0.4 mIU/L ntam. Saa dodow yi wɔ nnipa a wɔwɔ Subclinical Hyperthyroidism 65% kosi 75% mu.
• Ɛyɛ den: TSH dodow nnu 0.1 mIU/L. Eyi ka nnipa 25% kosi 35%.

So eyi hia ayaresa?

Nokwarem no, adwene ahorow wɔ nnuruyɛfo mu wɔ sɛ ebia wɔbɛsa `Subclinical Hyperthyroidism` anaasɛ wɔrensa ho, efisɛ nhwehwɛmu a ɛdɔɔso da so ara wɔ mfaso a ɛda adi pefee a ɛwɔ ayaresa so no ho.

Nnuruyɛfo taa kamfo "twɛn na hwɛ" kwan ma nnipa a wɔwɔ subclinical hyperthyroidism. Ɛne sɛ, wɔtwɛn ma tebea no ankasa tu mpɔn a wonfi ayaresa ase.

Nanso, wobetumi akamfo ayaresa akyerɛ wɔn a wɔn TSH dodow sua sen 0.1 mIU/L bere nyinaa, titiriw wɔ nsɛm a edidi so yi mu:

• Sɛ woadi mfe 65 anaa nea ɛboro saa a.
• Sɛ wunnii mfe 65 a, wowɔ komayare, nnompe mu yare, anaa hyperthyroidism ho sɛnkyerɛnne.
• Sɛ woyɛ ɔbea a woagyae brayɛ, wunnii mfe 65, na wonnom estrogen anaa bisphosphonates (aduru bi a wɔde sa nnompe mu haw) a.

Mpɛn pii no, subclinical hyperthyroidism bere a nyinsɛn no nhia ayaresa.

Sɛ wɔde ayaresa ma a, ɛyɛ dɛn?

Sɛ wo duruyɛfo si gyinae sɛ ɛho hia sɛ wɔsa no a, ayaresa no begyina nea ɛde subclinical hyperthyroidism no ba no so.

• Sɛ wowɔ awuduru multinodular goiter (akuru a ɛwɔ wo kɔn mu) anaasɛ ntini biako a ɛwɔ wo thyroid so a, ayaresa a wɔtaa yɛ ne radioactive iodine . Eyi yɛ aduru a wonom fa w’ano. Nkwammoaa a ɛyɛ adwuma boro so a ɛwɔ wo thyroid mu no twetwe iodine no. Iodine a ɛyɛ radioactive no sɛe saa nkwammoaa no, na ɛma thyroid no so tew na wo hormone dodow so tew wɔ adapɛn kakraa bi mu.
• Sɛ wowɔ Graves yare a, ayaresa a wɔtaa de sa ne nnuru a ekum thyroid ne radioactive iodine. Nnuru a ekum thyroid te sɛ methimazole (Tapazole) ne propylthiouracil (PTU) yɛ adwuma denam tumi a thyroid ntini no tumi yɛ hormone a esiw ano no so.

So wobetumi asiw eyi ano na amma?

Mpɛn pii no, biribiara nni hɔ a yebetumi ayɛ de asiw `Subclinical Hyperthyroidism` anaasɛ `Hyperthyroidism` a ɛda adi pefee no ano.

Nanso, sɛ woannya iodine a ɛdɔɔso wɔ w’aduan mu (anaasɛ pii) , wubetumi anya `Subclinical` anaa `Overt Hyperthyroidism` esiane `toxic goiter` nti. Ɛwom sɛ eyi ntaa mma wɔ aman te sɛ Sri Lanka mu esiane sɛ yɛde nkyene a iodine wom na edi dwuma nti de, nanso wobetumi ahu tebea yi wɔ aman a iodine a enni nipadua mu abu so no mu.

Dɛn na yebetumi ahwɛ kwan wɔ tebea yi ho? So asiane ahorow bi wɔ hɔ?

Subclinical hyperthyroidism ntaa nkɔ so nkɔ hyperthyroidism a ɛda adi pefee. Nanso, asiane yi dɔɔso kakra wɔ nnipa a TSH dodow sua koraa (ennu 0.1 mIU/L) mu.

Esiane sɛ nneɛma pii na ɛde ba nti, ɛsono obiara `Subclinical Hyperthyroidism`.

Sɛ mpo ɛnkɔ so nkɔ `Overt Hyperthyroidism` a, `Subclinical Hyperthyroidism` betumi de nsɛnnennen bi aba. Ebi ne:

• Atrial fibrillation ( koma a ɛbɔ a ɛnteɛ).
• Koma a entumi nyɛ adwuma yiye (asiane a ɛwɔ hɔ sɛ obi benya komayare ).
• Koma mu yare (akoma mu ntini mu yare ).
• Nnompe a ɛyera ne nea ɛpaapae.
• Dementia ( tebea a ɛma obi nkae ade a ebetumi aba bere a obi nyin no).

Saa asiane ahorow yi yɛ kɛse titiriw ma nnipa a wɔadi boro mfe 65 ne wɔn a wɔwɔ subclinical hyperthyroidism a emu yɛ den.

Sɛ asiane ahorow yi haw wo a, ɛbɛyɛ papa sɛ wo ne wo duruyɛfo bɛkasa afa eyi ho.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Mpɛn pii no, sɛ wo nhwehwɛmu kyerɛ sɛ wowɔ ``Subclinical Hyperthyroidism,'' nnuruyɛfo bɛfa "twɛn na hwɛ" kwan no so.

Nanso, sɛ wufi ase nya hyperthyroidism ho sɛnkyerɛnne (dadwen, ahomegye, koma a ɛbɔ) a, hwɛ hu sɛ wobɛkɔ wo duruyɛfo nkyɛn. Afei ɔbɛyɛ thyroid mogya mu nhwehwɛmu foforo de ahwɛ sɛ wowɔ `Overt Hyperthyroidism` anaa.

Kae sɛ, adwene ahorow pii da so ara wɔ hɔ wɔ sɛ ebia wɔbɛsa `Subclinical Hyperthyroidism` anaasɛ wɔrensa ho. Ɛsono obiara, tebea biara. Enti, ade a eye sen biara a ɛsɛ sɛ woyɛ ne sɛ wo ne wo duruyɛfo besusuw wo nsɛmmisa ne wo suro nyinaa ho. Ɔyɛ krado na ɔwɔ ɔpɛ sɛ ɔbɛboa wo.

Nkrasɛm a Wɔde Kɔ Fie

Okay, enti nneɛma bi a ɛsɛ sɛ wokae fi nea yɛaka ho asɛm no mu ni:

• ``Subclinical Hyperthyroidism`` yɛ tebea a ɛma thyroid ntini no yɛ adwuma boro so kakra, nanso ɛnkyerɛ sɛnkyerɛnne atitiriw.
• Wɔnam mogya mu nhwehwɛmu a ɛkyerɛ sɛ TSH dodow sua (nanso T3 ne T4 a ɛfata) so na ɛkyerɛ eyi.
• Esiane sɛ mpɛn pii no, yare no ho sɛnkyerɛnne biara nni hɔ nti, ebia ɛho renhia sɛ wɔde sa yare. Ebia wo duruyɛfo bɛfa "twɛn na hwɛ" kwan so.
• Ebia nnipa binom, titiriw wɔn a wɔn mfe akɔ anim anaa wɔn a wɔwɔ akwahosan ho haw afoforo, behia ayaresa.
• Sɛ wuhu hyperthyroidism ho sɛnkyerɛnne (te sɛ koma a ɛbɔ kɛse, wo ho popo, wo mu duru a ɛso tew) a, kɔ oduruyɛfo nkyɛn ntɛm ara.
• Nea ɛho hia sen biara ne sɛ woremmɔ hu, wo ne wo duruyɛfo nka eyi ho asɛm pefee, na di n’afotu akyi.

Mewɔ anidaso sɛ wubehu sɛ mfaso wɔ saa nsɛm yi so. Kɔ so nya apɔwmuden!

` Subclinical Hyperthyroidism, thyroid, TSH, T3, T4, nkwaadɔm, Graves yare, goiter