Ðe wòdze abe wò lãkusi wɔa dɔ wògbɔa eme vie enea? Mina míaƒo nu tso Subclinical Hyperthyroidism ŋu!

Ðe wò ɖɔkta gblɔ be wò TSH ƒe agbɔsɔsɔ le ʋɛ vie le ʋudodokpɔ aɖe si wowɔ nyitsɔ laa mea? Alo ɖe dzesi wɔnuku aɖewo siwo gɔme sese sesẽ la le fu ɖem na wòa? Ðewohĩ dɔléle aɖe si woyɔna be Subclinical Hyperthyroidism le ŋuwò. Mègatsi dzi o, zi geɖe la, menye nu vevi aɖekee wònyena o. Mina míaƒo nu tso esia ŋu bɔbɔe eye eme nakɔ.

Nukae Nye Subclinical Hyperthyroidism?

Kpuie ko la, `Subclinical Hyperthyroidism` nye nɔnɔme si me wò thyroid gland le dɔ wɔm vie wu alesi wòle dzɔdzɔmee. Gake mesẽna abe ` ʋumenugbagbeviɣidɔ si dzena gaglãa` ene o.

Pituitary gland si le míaƒe ahɔhɔ̃ me wɔa lãmetsi aɖe si woyɔna be `TSH` (Thyroid-Stimulating Hormone). `TSH` sia gblɔna na lãkusi si le míaƒe kɔ me be wòawɔ lãmetsi eve siwo woyɔna be thyroxine (`T4` - `thyroxine`) kple triiodothyronine (`T3` - `triiodothyronine`). `T3` kple `T4` lãmetsi siawoe nye nusiwo kpena ɖe míaƒe ŋutilã ƒe lãmenugbagbeviwo ƒe dɔwɔwɔ ŋu, si fia be wotrɔa nuɖuɖu si míeɖuna wòzua ŋusẽ eye wòzãnɛ na míaƒe ŋutilã.

Le `Subclinical Hyperthyroidism` me la, wò ʋu me `TSH` ƒe agbɔsɔsɔ le sue, gake wò `T3` ​​kple `T4` ƒe agbɔsɔsɔme sɔ. Ema fia be lãkusia wɔa dɔ wògbɔa eme vie, eyata pituitary gland gblɔna be, "Enyo, nyemehiã `TSH` fifia o, nye lãkusi le dɔ wɔm nyuie," eye wòɖea `TSH` ƒe wɔwɔ dzi kpɔtɔna. Gake thyroid lãmetsiwo (`T3`, `T4`) mekɔ ɖe dzi ŋutɔ haɖe o. Emae nye nusi `subclinical` fia - nɔnɔme si le ete si meɖea dzesi siwo dze ƒã fiana o.

Nɔnɔme sia ate ŋu anɔ anyi ɣeyiɣi kpui aɖe ɣeaɖewoɣi , si fia be ate ŋu ahaya le eɖokui si le ŋkeke ʋɛ aɖewo megbe. Ke hã, le ame aɖewo gome la, ate ŋu anɔ anyi ɖaa. Menye amesiamee hiã atikewɔwɔ o.

Amekae ate ŋu axɔ dɔléle sia wu?

Ame sia ame ate ŋu axɔ `Subclinical Hyperthyroidism`, gake ame siwo gbɔna la le afɔku me vie:

• Ame siwo le atike si wozãna tsɔ ɖɔlia ʋumenugbagbeviɣidɔ (le kpɔɖeŋu me, levothyroxine) zãm le ʋumenugbagbeviɣidɔ ta. Ɣeaɖewoɣi la, esia ate ŋu adzɔ ne wodzi atikeawo ƒe agbɔsɔsɔ ɖe edzi vie.
• Le amesiwo xɔ wu ƒe 65 gome.

Aleke gbegbee nɔnɔme sia bɔe?

Esia menye nɔnɔme si bɔ ŋutɔ le dukɔwo abe Amerika ene me o.

Amewo ƒe 0.7% lɔƒo le `Subclinical Hyperthyroidism`, afisi TSH ƒe agbɔsɔsɔ mede 0.1 mIU/L o. 1.8% bubuwo ƒe `TSH` ƒe agbɔsɔsɔ mede 0.4 mIU/L o.

Gake le dukɔ siwo me iodine mede o me , vevietɔ le amesiwo xɔ wu ƒe 70 dome la, nɔnɔme sia ate ŋu asɔ gbɔ va ɖo 15%. Le Sri Lanka la, zi geɖe la, míezãa dze si me iod le , eyata afɔku sia mebɔ o, gake anyo be míanya.

Nukawoe nye dzesiawo?

Zi geɖe la, amesiwo ŋu `Subclinical Hyperthyroidism` le la meɖea dzesi aɖeke fiana o . Esia tae woyɔnɛ be "subclinical".

Gake ɣeaɖewoɣi la, àte ŋu akpɔ dzesi fafɛ siwo do ƒome kple ʋumenugbagbeviɣidɔ si gbɔ eme. Le ɣeyiɣi mawo me la, àte ŋu akpɔ nu siwo gbɔna:

• Sese le ɖokuiwò me be yeƒe dzi le ƒoƒom kabakaba (pulpitations).
• Ðeko wòle abe nye ŋutilã le ʋuʋum ene, ɖeko mele vɔvɔ̃m.
• Lolo dzi ɖeɖe kpɔtɔ (togbɔ be nuɖuɖu dzroa ame hã).
• Nuɖuɖudzroame ƒe dzidziɖedzi.
• Aɖuɖɔtoe alo dɔgbo ƒe ʋuʋu enuenu.
• Ŋutilãa senɛ le eɖokui me be yeƒe ŋutigbalẽ le sue, exɔ dzo, eye wòxɔ dzo.
• Tɔtrɔ le nyɔnuwo ƒe dzinukpɔkpɔ me (`Dzinukpɔkpɔ ƒe tɔtrɔ`).

Vevietɔ: Dzesi siawo ƒe amesinɔnɔ mefia kokoko be `Subclinical Hyperthyroidism` le ŋuwò o. Gake ne dzesi siawo gakpɔtɔ li la, nunya anɔ eme be nàyi ɖɔkta gbɔ.

Nukatae esia le dzɔdzɔm? Nukawoe nye susu siwo tae?

Zi geɖe la, míaƒe lãmenugbagbeviwo ƒe dɔwɔwɔ wɔa dɔ abe ƒuƒoƒo ene. Bu eŋu abe dɔwɔƒe gã aɖe ene.

Hypothalamus si le ahɔhɔ̃a ƒe gɔme la ɖea lãmetsi aɖe si woyɔna be TRH (Thyroid-Releasing Hormone) doa goe. Esia gblɔna na pituitary gland be wòawɔ TSH.

Emegbe `TSH` yi ɖagblɔ na thyroid gland be wòawɔ `T3` ​​(anɔ abe 20%) kple `T4` (anɔ abe 80%). Ne `T3` ​​kple `T4` siawo dzi ɖe edzi le ʋua me la, egaɖoa dzesi ɖe pituitary gland be, "Enyo, dzudzɔ `TSH` wɔwɔ fifia, lãmetsiŋusẽ sɔ gbɔ." Woyɔa esia be ` nyaŋuɖoɖo ƒe ʋuƒo` . Ne `T3` ​​kple `T4` dzi ɖe kpɔtɔ la, tsatsam sia gadzea egɔme tso gɔmedzedzea me.

Ke hã, le `Subclinical Hyperthyroidism` me la, le kuxi aɖewo le lãkusi me ta la, togbɔ be `TSH` ƒe agbɔsɔsɔ le sue hã la, lãkusi me lãmetsiwo ƒe wɔwɔme dzi ɖena kpɔtɔna abe alesi wokpɔ mɔe ene o. Esia tae `TSH` le sue, gake `T3` ​​kple `T4` le agbɔsɔsɔ si sɔ me.

Nusiwo hea ``Subclinical Hyperthyroidism`` vɛ la ƒe akpa gãtɔ sɔ kple esiwo hea hyperthyroidism si dzena gaglãa vɛ. Nu vevi siwo gbɔ wòtsona dometɔ aɖewoe nye esi:

• Lãmetsiŋusẽtike (levothyroxine) si wonana na ʋumenugbagbeviɣidɔ (thyroid si mewɔa dɔ nyuie o) ƒe agbɔsɔsɔme dzi ɖeɖe kpɔtɔ. Esiae nye nusi gbɔ wòtsona wu.
• Multinodular aɖi goiter. Esia nye nɔnɔme si me ƒunukpeƒetetedɔ (nodules) siwo menye kansa o la dona le lãkusi me, si wɔnɛ be wòwɔa lãkusi me lãmetsi si sɔ gbɔ akpa.
• Graves ƒe dɔléle. Esia nye dɔléle si dɔlélenutsiŋutete ŋutɔ wɔna. Esia fia be míaƒe ŋutilã ƒe dɔlélenutsiŋutete dzea thyroid gland dzi, eye wòʋãnɛ be wòawɔ lãmetsi geɖe.
• Thyroiditis: Ne thyroid gland la xɔ abi la, lãmetsiŋusẽ ƒe agbɔsɔsɔ ate ŋu adzi ɖe edzi hena ɣeyiɣi aɖe.

Aleke nèwɔ de dzesi esia?

Thyroid ƒe dɔwɔwɔ dodokpɔ koe nye mɔ si dzi nàto anya kple kakaɖedzi nenye be `Subclinical Hyperthyroidism` le ŋuwò alo mèle eŋu o.(Thyroid ƒe dɔwɔwɔ dodokpɔwo ɖeɖeko. Esiawo nye ʋudodokpɔ siwo wowɔna edziedzi.

TSH (si woyɔna hã be thyrotropin) ƒe agbɔsɔsɔ si sɔ le ame tsitsi si mefɔ fu o me le 0.4 va ɖo 4.5 mili-dukɔwo dome units le lita ɖeka me (mIU/L).

Ne wò ʋudodokpɔwo ɖee fia be wò TSH ƒe agbɔsɔsɔ le sue (ele 0.1 kple 0.4 mIU/L dome alo mede 0.1 mIU/L o), gake wò T4 (thyroxine) kple T3 (triiodothyronine) ƒe agbɔsɔsɔ le agbɔsɔsɔ si sɔ me la, ke Subclinical Hyperthyroidism le ŋuwò.

Woate ŋu ama `Subclinical Hyperthyroidism` ɖe hatsotso vevi eve me:

• Fafɛ: TSH ƒe agbɔsɔsɔ le sue, gake woate ŋu ade dzesii kokoko - zi geɖe la, enɔa 0.1 kple 0.4 mIU/L dome. Agbɔsɔsɔ sia le amesiwo ŋu Subclinical Hyperthyroidism le ƒe 65% va ɖo 75% me.
• Sesẽ: TSH ƒe agbɔsɔsɔ mede 0.1 mIU/L o. Esia gblẽa nu le ame 25% va ɖo 35% dome.

Ðe esia hiã atikewɔwɔa?

Le nyateƒe me la, nukpɔsusu vovovowo le ɖɔktawo dome le nenye be woada `Subclinical Hyperthyroidism` alo womadae o ŋu, elabena numekuku mesɔ gbɔ haɖe le viɖe siwo dze ƒã le atikewɔwɔ me ŋu o.

Zi geɖe la, ɖɔktawo kafua "lala eye nàkpɔ" mɔnu na amesiwo ŋu subclinical hyperthyroidism le. Eyae nye be wolalana be nɔnɔmea nanyo ɖe edzi le eɖokui si evɔ womedzea atikewɔwɔ gɔme o.

Gake woate ŋu akafu atikewɔwɔ na amesiwo ƒe TSH ƒe agbɔsɔsɔ medea 0.1 mIU/L o ɣesiaɣi, vevietɔ le nɔnɔme siwo gbɔna me:

• Ne èxɔ ƒe 65 alo wu nenema.
• Ne mexɔ ƒe 65 haɖe o la, dzidɔ, ƒumeŋuɖui, alo ʋumenugbagbeviɣidɔ ƒe dzesiwo le ŋuwò.
• Ne ènye nyɔnu si tsi megbe, si mexɔ ƒe 65 haɖe o, eye mèle estrogen alo bisphosphonates (atike ƒomevi aɖe si wozãna tsɔ daa ƒu ƒe kuxiwo) zãm o.

Zi geɖe la, ʋumenugbagbeviɣidɔ si mebɔ o le fufɔɣi mehiã be woawɔ atike nɛ o.

Ne wowɔ atike na ame la, nukae nye ema?

Ne wò ɖɔkta tso nya me be ehiã be woawɔ atike na wò la, atikewɔwɔa anɔ te ɖe nusi gbɔ ʋumenugbagbeviɣidɔ si mebɔ o la tso dzi.

• Ne aɖi si nye multinodular goiter (ƒu si le kɔ me) alo nodule ɖeka le wò lãkusi ŋu la, atikewɔwɔ si bɔ wue nye iodine si me keklẽŋusẽ le . Esia nye atike si nènona to nu me. Lãmenugbagbevi siwo wɔa dɔ akpa le wò lãkusi me la xɔa iodine la. Iodine si me keklẽŋusẽ le la gblẽa nu le lãmenugbagbevi mawo ŋu, si wɔnɛ be lãkusia dzi ɖena kpɔtɔna eye wò lãmetsiŋusẽ dzi ɖena kpɔtɔna le kwasiɖa ʋɛ aɖewo megbe.
• Ne Graves ƒe dɔlélea le ŋuwò la, atike siwo wozãna wue nye atike siwo wua ʋumenugbagbeviɣidɔ kple iodine si me keklẽŋusẽ le. Atike siwo tsia ʋumenugbagbeviɣidɔ nu abe methimazole (Tapazole) kple propylthiouracil (PTU) ene wɔa dɔ to mɔxexe ɖe lãkusi ƒe ŋutete be wòawɔ lãmetsiŋusẽwo nu me.

Ðe woate ŋu axe mɔ ɖe esia nu be wòagadzɔ oa?

Zi geɖe la, naneke meli míate ŋu awɔ atsɔ axe mɔ ɖe `Subclinical Hyperthyroidism` alo `Hyperthyroidism` si dze gaglãa ƒe dzɔdzɔ nu o.

Ke hã, ne mèkpɔ iodine si sɔ le wò nuɖuɖu me o (alo wòsɔ gbɔ akpa) , àte ŋu axɔ `Subclinical` alo `Overt Hyperthyroidism` le `toxic goiter` ta. Togbɔ be esia mebɔ le dukɔwo abe Sri Lanka ene me o le esi míezãa dze si me iodine le ta hã la, woate ŋu akpɔ nɔnɔme sia le dukɔ siwo me iodine ƒe anyimanɔmanɔ bɔ ɖo me.

Nukae míate ŋu akpɔ mɔ na le nɔnɔme sia ŋu? Ðe afɔku aɖewo lia?

Ƒã hafi ʋumenugbagbeviɣidɔ si womekpɔna o la yia ŋgɔ va zua ʋumenugbagbeviɣidɔ si dzena gaglãa. Gake afɔku sia lolo vie le amesiwo ƒe TSH ƒe agbɔsɔsɔ le sue ŋutɔ (si mede 0.1 mIU/L o) gome.

Esi wònye be nu geɖewo gbɔe wòtso ta la, amesiame ƒe `Subclinical Hyperthyroidism` to vovo.

Ne meyi ŋgɔ va ɖo `Overt Hyperthyroidism` o hã la, `Subclinical Hyperthyroidism` ateŋu ahe kuxi aɖewo vɛ. Wo dometɔ aɖewoe nye:

• Atrial fibrillation ( dzi ƒe tsotso si mesɔ o).
• Dzi ƒe dɔmawɔmawɔ nyuie (afɔku si le dzidɔ ƒe dɔmawɔmawɔ nyuie me ).
• Dzitodzito me dɔléle (dzitodzito me dɔléle ).
• Ƒu ƒe gbagbã kple ƒu ƒe gbagbã.
• Dementia ( nɔnɔme si me ŋkuɖoɖonudzi ƒe gbɔdzɔgbɔdzɔ le si ate ŋu adzɔ ne ame tsi).

Afɔku siawo lolo ŋutɔ na amesiwo xɔ wu ƒe 65 kple amesiwo ŋu ʋumenugbagbeviɣidɔ sesẽ si womekpɔna o.

Ne ètsi dzi ɖe afɔku siawo ŋu la, anyo wu be nàƒo nu tso esia ŋu na wò ɖɔkta.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Zi geɖe la, ne wò dodokpɔwo ɖee fia be ``Subclinical Hyperthyroidism'' le ŋuwò la, ɖɔktawo awɔ "lala eye nàkpɔ" mɔnu.

Gake ne ʋumenugbagbeviɣidɔ ƒe dzesiwo dze egɔme (dzimaɖitsitsi, dzimaɖitsitsi, dzi ƒe tsotso) la, kpɔ egbɔ be yeyi ɖɔkta gbɔ. Emegbe awɔ thyroid ʋudodokpɔ bubu akpɔe ɖa be `Overt Hyperthyroidism` le ŋuwò hã.

Ðo ŋku edzi be nukpɔsusu vovovo geɖewo gakpɔtɔ li ku ɖe nenye be woada `Subclinical Hyperthyroidism` alo womadae o ŋu. Amesiame, nɔnɔme ɖesiaɖe to vovo. Eyata nu nyuitɔ si nàwɔe nye be nàdzro wò nyabiasewo kple vɔvɔ̃wo katã me kple wò ɖɔkta. Ele klalo eye wòlɔ̃na faa be yeakpe ɖe ŋuwò.

Gbedasi si Wotsɔ Yi Aƒeme

Enyo, eyata nu aɖewo siwo dzi wòle be nàɖo ŋkui tso nusiwo ŋu míeƒo nu tsoe me lae nye esi:

• ``Subclinical Hyperthyroidism`` nye nɔnɔme si me thyroid gland wɔa dɔ wògbɔa eme vie ko, gake meɖea dzesi gãwo fiana o.
• Wokpɔa esia to ʋudodokpɔ si ɖee fia be TSH ƒe agbɔsɔsɔ le sue (gake T3 kple T4 sɔ).
• Esi wònye be zi geɖe la, dzesi aɖeke menɔa eŋu o ta la, ɖewohĩ mahiã be woawɔ atike nɛ o. Wò ɖɔkta ateŋu awɔ "lala eye nàkpɔ" mɔnu.
• Ame aɖewo, vevietɔ ame tsitsiwo alo amesiwo ŋu lãmesẽkuxi bubuwo le, ate ŋu ahiã be woawɔ atike na wo.
• Ne èkpɔ ʋumenugbagbeviɣidɔ ƒe dzesiwo (abe dzi ƒe tsotso ƒe dzidziɖedzi, ʋuʋu, lolo dzi ɖeɖe kpɔtɔ ene) la, yi ɖɔkta gbɔ enumake.
• Nu vevitɔe nye be màgatsi dzodzodzoe o, aƒo nu tso nya sia ŋu gaglãa kple wò ɖɔkta, eye nàwɔ ɖe eƒe aɖaŋuɖoɖo dzi.

Mele mɔ kpɔm be nyatakaka sia aɖe vi na wò. Nɔ lãmesẽ me!

` Subclinical Hyperthyroidism, ʋumenugbagbeviɣidɔ, TSH, T3, T4, lãmetsiŋusẽwo, Graves ƒe dɔléle, goiter