E aʻo kākou e pili ana i ka ACTH Stimulation Test ma ke ala maʻalahi.

Manaʻo pinepine ʻoe i ka luhi, ka palaualelo, a i ʻole ka emi ʻana o ke kaumaha? Ke ʻike ʻoe i ke kauka, hiki iā ia ke hoʻoholo e nānā i kāu mau hormones. ʻO ka hormone cortisol. No laila, ʻo ka hoʻāʻo nui i hana ʻia e nānā inā maʻamau kāu mau pae cortisol ʻo ia ka ACTH Stimulation Test. ʻOiai paha e kani iki ka inoa i kahi paʻakikī, he mea maʻalahi loa ia. E kamaʻilio kākou e pili ana i nā mea āpau i kēia lā.

I ka ʻōlelo maʻalahi, he aha kēia ACTH Stimulation Test?

He hoʻāʻo lapaʻau kēia. I ka pololei, nānā ia i ke ʻano o ka pane ʻana o kāu mau ʻōpū ʻelua i kapa ʻia ʻo nā kelepa adrenal i kahi hormone i kapa ʻia ʻo ACTH (Adrenocorticotropic hormone) e puka mai ana mai ko kākou lolo. He kani huikau iki anei kēia? ʻAe, e noʻonoʻo kākou i kēia ʻano.

E noʻonoʻo ʻoe ua like ke kelepa pituitary i loko o kou lolo me ke luna o kahi ʻoihana nui. ʻO nā kelepa adrenal liʻiliʻi ʻelua ma luna o kou mau puʻupaʻa ua like ia me ʻelua mau limahana e hana ana ma ia ʻoihana.

Ke makemake ka luna (pituitary gland) e hana i kekahi mea, hoʻouna ia i kahi leka i kapa ʻia ʻo 'ACTH' i nā limahana (adrenal glands). Ke loaʻa kēia leka, hana nā limahana (adrenal glands) i kahi hormone i kapa ʻia ʻo 'cortisol' a hoʻokuʻu iā ia i loko o ke kino. He hormone koʻikoʻi loa kēia cortisol no ko mākou kino. Kōkua ia i nā mea he nui e like me ka kaohi ʻana i ke kaumaha, ka kaohi ʻana i nā pae kō koko, a me ka kaohi ʻana i ke koko.

No laila, ʻo ka mea a ka ACTH Stimulation Test e hana ai, ʻo ia ke hoʻokomo ʻana i kahi hormone ACTH synthetic i hana ʻia ma waho (i kapa ʻia ʻo cosyntropin) i loko o kou kino a ʻike inā pane kāu mau kelepa adrenal (nā limahana) iā ia a hana pono i ka cortisol.

Hoʻohana nui ʻia kēia hoʻāʻo e ʻike i kahi maʻi i kapa ʻia ʻo 'adrenal insufficiency' . ʻO ke ʻano kēia, ʻaʻole lawa ka hana ʻana o nā kelepa adrenal i ka cortisol. Ua māhele ʻia kēia i ʻekolu ʻano.

I nā kūlana hea e haʻi aku ai ke kauka iā ʻoe e hana i kēia hoʻokolohua?

Aia paha kekahi mau kumu e paipai ai kāu kauka i kēia hoʻokolohua.

• Inā ua hōʻike kahi hoʻāʻo koko ma mua i nā pae cortisol haʻahaʻa: Inā ua loaʻa iā ʻoe kahi hoʻāʻo koko no kekahi kumu ʻē aʻe i hōʻike i nā pae cortisol haʻahaʻa, e noi ʻia paha ʻoe e hana i kēia hoʻāʻo e hōʻoia iā ia.
• Inā loaʻa iā ʻoe nā hōʻailona o ka lawa ʻole o ka adrenal: E like me kā mākou i kūkākūkā ai ma mua, inā loaʻa iā ʻoe nā hōʻailona e like me ka luhi mau, ka pohō kaumaha, ka ʻeha o ka ʻōpū, ka nausea, ka dizziness, a me ke koko haʻahaʻa, hana ʻia kēia hoʻāʻo e ʻike ai inā ʻo kēia kūlana ke kumu.
• Inā ua lōʻihi kou lawe ʻana i nā steroids: Ke hoʻohana ʻoe i nā lāʻau glucocorticoid e like me prednisone no ka manawa lōʻihi, hiki i kāu mau kelepa pituitary a me adrenal ke oki i ka hana no kekahi manawa. No laila, ma hope o kou hoʻōki ʻana i ka lawe ʻana i ka lāʻau lapaʻau, hana ʻia kēia hoʻāʻo e ʻike inā e hana pono hou ana nā kelepa.

Pehea ʻoe e hoʻomākaukau ai ma mua o ka hoʻokolohua?

He mea nui loa kēia. Pono ʻoe e hahai pololei i nā kuhikuhi a kāu kauka. ʻO ka maʻamau, hiki iā ʻoe ke ʻōlelo i nā mea e like me kēia.

• Hoʻokē ʻai: E noi ʻia paha ʻoe ʻaʻole e ʻai a inu paha i kekahi mea no kahi o 6 mau hola ma mua o ka hoʻāʻo. ʻO ka wai wale nō ka mea e ʻae ʻia.
• Nā kapu hana: E noi ʻia paha ʻoe e hōʻalo i nā hana e like me ka hoʻoikaika kino no 12-24 mau hola ma mua o ka hoʻāʻo.
• Meaʻai: I kekahi manawa e noi ʻia paha ʻoe e ʻai i nā meaʻai i kiʻekiʻe i nā carbohydrates.
• Ke hoʻōki ʻana i ka lāʻau lapaʻau: Hiki i kekahi mau lāʻau lapaʻau āu e lawe ai (ʻoi aku ka steroid creams, pills, a i ʻole inhalers) ke hoʻopilikia i nā hopena hoʻāʻo. No laila, e noi paha kāu kauka iā ʻoe e hoʻōki i ka lawe ʻana iā lākou no kekahi manawa. Mai hoʻōki i ka lawe ʻana i kāu lāʻau lapaʻau me ka ʻole o ka nīnau mua ʻana i kāu kauka.

ʻAe, e nānā kākou i ka mea e hana ʻia ana i ka lā o ka hoʻokolohua.

ʻAʻole kēia he mea weliweli e like me kou manaʻo. Hana pinepine ʻia ia ma ka haukapila a i ʻole ma ke keʻena lapaʻau o kahi endocrinologist. Eia ka mea e hana ʻia ma kēlā me kēia ʻanuʻu.

1. Ka lawe ʻana i ka hāpana koko mua: ʻO ka mea mua, e lawe ke kahu maʻi i kahi hāpana koko mai kahi aa koko ma kou lima. E nānā kēia i kou pae cortisol ma mua o ka hoʻomaka ʻana o ka hoʻāʻo.

2. Ke hāʻawi ʻana i ka inikini: A laila, e hāʻawi ke kahu maʻi iā ʻoe i kahi inikini e loaʻa ana ka ACTH synthetic (cosyntropin). Hāʻawi pinepine ʻia kēia i loko o ka ʻiʻo o kou lima. E like me kahi ʻanuʻu liʻiliʻi e ʻā ana iā ʻoe, akā e nalo aku ia i loko o kekahi mau kekona.

3. Nā hāpana koko ʻelua a me ke kolu: E lawe ʻia kekahi hāpana koko ʻē aʻe i 30 mau minuke ma hope o ka inikini. A laila e lawe ʻia kekahi hāpana koko ʻē aʻe i 60 mau minuke ma hope . E ana kēia i ka nui o ka cortisol i hana ʻia e kāu mau kelepa adrenal mai ka inikini.

4. Hoʻouna ʻana i ka hale hana: Hoʻouna ʻia nā hāpana koko i lawe ʻia i ka hale hana.

Ke huki ʻia kou koko, ʻike wale ʻoe i kahi ʻano ʻūlū iki. Nalo aku ia ma hope o kekahi manawa. Hiki paha iā ʻoe ke manaʻo i kahi palapū liʻiliʻi ma kahi i huki ʻia ai ke koko, he mea maʻamau ia.

Āhea e loaʻa ai nā hopena a he aha kā lākou e ʻōlelo ai?

Hiki ke hala ma kahi o hoʻokahi pule no ka hoʻi ʻana mai o nā hopena o kēia hoʻāʻo. ʻO kēia no ka mea ke loaʻa nā hopena, e nānā pono kāu kauka iā lākou a hoʻohālikelike iā lākou me kāu mau hōʻailona e hiki ai i kahi hopena.

He aha ka hopena maʻamau?

I ke kanaka olakino, ma hope o ka hoʻokomo ʻana o ka ACTH, pono e hoʻoulu maikaʻi ʻia nā kelepa adrenal a pono e piʻi nui ka pae cortisol i loko o ke koko. E wehewehe kāu kauka i nā waiwai i loko o kāu hōʻike lab a me ka pae maʻamau iā ʻoe.

He aha ka hopena maʻamau ʻole?

• ʻO ka hemahema mua o ka Adrenal (inā he pilikia me nā kelepa adrenal): I ke kanaka me kēia kūlana, ʻoiai inā hāʻawi ʻia kahi inikini ACTH, ʻaʻole e piʻi iki ka pae cortisol a i ʻole e piʻi iki. ʻO kēia no ka mea aia ka pilikia ma nā kelepa adrenal, a ʻaʻohe mea nui ka nui o ka hoʻoulu ʻana mai waho, ʻaʻole hiki iā lākou ke hana i ka cortisol.
• ʻO ka hemahema o ka adrenal lua (inā he pilikia me ka pituitary gland): Ke hoʻokuʻu ʻole ka pituitary gland iā ACTH no ka manawa lōʻihi, emi mālie nā adrenal glands a hoʻomaka e lilo i mea hana ʻole (atrophy). Ke hāʻawi ʻia kahi inikini ACTH i kēlā kanaka, ʻaʻole hiki i nā adrenal glands hana ʻole ke pane koke. No laila, ʻaʻole nui ka piʻi ʻana o kā lākou pae cortisol a ʻaʻole loa paha.

I kekahi manawa, inā he pilikia hou loa ka pilikia o ka pituitary gland a i ʻole he hapa wale nō paha i hoʻopilikia ʻia, hiki ke piʻi iki aʻe nā pae cortisol. ʻO kāu kauka ke kanaka maikaʻi loa e hoʻoholo e pili ana i kēia mau mea āpau.