Ke ʻano hana nui nei paha kou thyroid? E kamaʻilio kākou e pili ana i ka Subclinical Hyperthyroidism!

Ua ʻōlelo anei kāu kauka ua haʻahaʻa iki kāu pae TSH i kahi hoʻāʻo koko i hala koke nei? A i ʻole ke loaʻa nei iā ʻoe kekahi mau hōʻailona ʻē a paʻakikī ke hoʻomaopopo? Loaʻa paha iā ʻoe kahi maʻi i kapa ʻia ʻo Subclinical Hyperthyroidism. Mai hopohopo, ʻaʻole ia he mea koʻikoʻi. E kamaʻilio kākou e pili ana i kēia me ka maʻalahi a me ka maopopo.

He aha ka Subclinical Hyperthyroidism?

I ka ʻōlelo maʻalahi, ʻo ka 'Subclinical Hyperthyroidism' kahi kūlana kahi e hana iki ai kou kelepa thyroid ma mua o ka maʻamau. Akā, ʻaʻole ia e like me ka 'overt hyperthyroidism' .

Hoʻopuka ka ʻōpū pituitary i loko o ko kākou lolo i kahi hormone i kapa ʻia ʻo `TSH` (Honore Hoʻoulu Thyroid). Ke haʻi aku nei kēia `TSH` i ka ʻōpū thyroid i loko o ko kākou ʻāʻī e hana i ʻelua mau hormones i kapa ʻia ʻo thyroxine (`T4` - `thyroxine`) a me triiodothyronine (`T3` - `triiodothyronine`). ʻO kēia mau hormones `T3` ​​a me `T4` nā mea e kōkua ai i ka metabolism o ko kākou kino, ʻo ia hoʻi, e hoʻololi i ka meaʻai a kākou e ʻai ai i ikehu a hoʻohana no ko kākou kino.

I loko o ka `Subclinical Hyperthyroidism`, haʻahaʻa kou pae `TSH` koko, akā maʻamau kou mau pae `T3` ​​a me `T4`. ʻO ia hoʻi, ua hana nui iki ka thyroid, no laila ʻōlelo ka pituitary gland, "ʻAe, ʻaʻole pono iaʻu `TSH` i kēia manawa, ke hana maikaʻi nei koʻu thyroid," a hoʻemi ia i ka hana ʻana o `TSH`. Akā, ʻaʻole i piʻi nui nā hormones thyroid (`T3`, `T4`). ʻO ia ke ʻano o `subclinical` - he maʻi kumu i hōʻike ʻole ʻia nā hōʻailona maopopo.

Hiki i kēia maʻi ke lilo i mea manawa pōkole , ʻo ia hoʻi hiki ke hoʻōla iā ia iho i loko o kekahi mau lā. Eia nō naʻe, no kekahi poʻe hiki ke mau loa. ʻAʻole pono nā kānaka a pau i ka mālama ʻia.

ʻO wai ka mea i loaʻa pinepine i kēia maʻi?

Hiki i kekahi ke loaʻa i ka 'Subclinical Hyperthyroidism', akā ʻoi aku ka nui o ka pilikia o kēia poʻe:

• ʻO ka poʻe e lawe ana i ka lāʻau hoʻololi hormone thyroid (no ka laʻana, levothyroxine) no ka hypothyroidism. I kekahi manawa hiki ke hana ʻia kēia inā hoʻonui iki ʻia ka nui o ka lāʻau.
• No nā poʻe ma luna o 65 mau makahiki.

Pehea ka maʻamau o kēia ʻano?

ʻAʻole kēia he kūlana maʻamau loa ma nā ʻāina e like me ʻAmelika.

Ma kahi o 0.7% o ka heluna kanaka i loaʻa i ka `Subclinical Hyperthyroidism`, kahi i emi ai nā pae TSH ma mua o 0.1 mIU/L. ʻO kekahi 1.8% he emi nā pae `TSH` ma mua o 0.4 mIU/L.

Eia nō naʻe, ma nā ʻāina me ka nele o ka iodine , ʻoi aku hoʻi i waena o ka poʻe ma luna o 70 mau makahiki, hiki i kēia kūlana ke piʻi a hiki i ka 15%. Ma Sri Lanka, hoʻohana pinepine mākou i ka paʻakai iodized , no laila haʻahaʻa kēia pilikia, akā maikaʻi ke makaʻala.

He aha nā hōʻailona?

ʻO ka hapa nui o ka manawa, ʻaʻole hōʻike ka poʻe me ka 'Subclinical Hyperthyroidism' i kekahi mau hōʻailona . ʻO ia ke kumu i kapa ʻia ai ʻo "subclinical".

Eia nō naʻe, i kekahi manawa e ʻike paha ʻoe i nā hōʻailona liʻiliʻi e pili ana i ka hyperthyroidism. I kēlā mau manawa, e ʻike paha ʻoe i nā mea e like me:

• Ke manaʻo nei e kuʻi wikiwiki ana kou puʻuwai (palpitations).
• Me he mea lā e haʻalulu ana koʻu kino, me ka hopohopo wale nō.
• Ka pohō kaumaha (ʻoiai ʻaʻohe makemake).
• Hoʻonui ʻia ka makemake.
• Ka maʻi kahe a i ʻole ka neʻe pinepine ʻana o ka ʻōpū.
• He lahilahi ka ʻili, he mehana, a he pulu hoʻi.
• Nā loli i ke kaʻina hana menstrual o nā wahine ('Nā loli menstrual').

He mea nui: ʻO ka loaʻa ʻana o kēia mau hōʻailona ʻaʻole ia he manaʻo he 'Subclinical Hyperthyroidism' kou. Eia nō naʻe, inā hoʻomau kēia mau hōʻailona, ​​​​he mea naʻauao ke ʻike i ke kauka.

No ke aha lā kēia e hana nei? He aha nā kumu?

ʻO ka maʻamau, hana kā mākou ʻōnaehana endocrine e like me kahi hui. E noʻonoʻo iā ia e like me kahi ʻoihana nui.

ʻO ka hypothalamus, aia ma ke kumu o ka lolo, hoʻokuʻu i kahi hormone i kapa ʻia ʻo TRH (Thyroid-Releasing Hormone). Ke haʻi aku nei kēia i ka pituitary gland e hana i ka TSH.

A laila hele ʻo `TSH` a haʻi aku i ka ʻōpū thyroid e hana i ka `T3` ​​​​(ma kahi o 20%) a me ka `T4` (ma kahi o 80%). Ke piʻi aʻe kēia mau `T3` ​​a me `T4` i loko o ke koko, hoʻouna hou ia i kahi hōʻailona i ka ʻōpū pituitary e ʻōlelo ana, "ʻAe, e hoʻōki i ka hana ʻana i ka `TSH` i kēia manawa, ua lawa ka hormone." Ua kapa ʻia kēia ʻo ka ` feedback loop` . Ke emi iho ʻo `T3` ​​a me `T4`, hoʻomaka hou kēia pōʻaiapuni mai ka hoʻomaka.

Eia nō naʻe, i loko o ka `Subclinical Hyperthyroidism`, ma muli o kekahi pilikia i loko o ke kelepa thyroid, ʻoiai ua haʻahaʻa ka pae `TSH`, ʻaʻole i emi ka hana ʻana o nā hormones thyroid e like me ka mea i manaʻo ʻia. ʻO ia ke kumu i haʻahaʻa ai ʻo `TSH`, akā aia ʻo `T3` ​​​​a me `T4` ma nā pae maʻamau.

ʻO nā kumu o ka "Subclinical Hyperthyroidism" ua like like me nā mea e hoʻoulu ai i ka hyperthyroidism maopopo. Eia kekahi o nā kumu nui:

• ʻO ka hoʻonui ʻana i ka nui o ka lāʻau lapaʻau hormone (levothyroxine) i hāʻawi ʻia no ka hypothyroidism (thyroid hana ʻole). ʻO kēia ke kumu maʻamau.
• ʻO ka goiter ʻawahia multinodular. He kūlana kēia e ulu ai nā puʻupuʻu ʻaʻole kanesa (nodules) i loko o ka thyroid gland, e hoʻoulu ai i ka hana ʻana i ka nui o ka hormone thyroid.
• ʻO ka maʻi Graves. He maʻi autoimmune kēia. ʻO ke ʻano kēia, hoʻouka ka ʻōnaehana pale o ko mākou kino i ka thyroid gland, e hoʻoulu ana iā ia e hana i nā hormones hou aʻe.
• Thyroiditis: Ke pehu ka ʻōpū thyroid , hiki ke hoʻonui ʻia nā pae hormone no kekahi manawa.

Pehea ʻoe e ʻike ai i kēia?

ʻO nā hoʻokolohua hana thyroid wale nō ke ala e ʻike pono ai inā he 'Subclinical Hyperthyroidism' kāu a i ʻole.(Nā hoʻāʻo hana thyroid wale nō. He mau hoʻāʻo koko maʻamau kēia.

ʻO ka pae maʻamau no ka pae TSH (i kapa ʻia hoʻi he thyrotropin) i kahi pākeke hāpai ʻole ma waena o 0.4 a me 4.5 milli-international units no ka lita (mIU/L).

Inā hōʻike kāu mau hoʻāʻo koko ua haʻahaʻa kou pae TSH (ma waena o 0.1 a me 0.4 mIU/L a i ʻole emi ma mua o 0.1 mIU/L), akā aia kou mau pae T4 (thyroxine) a me T3 (triiodothyronine) i loko o ka pae maʻamau, he Subclinical Hyperthyroidism kou.

Hiki ke hoʻokaʻawale ʻia ka 'Subclinical Hyperthyroidism' i ʻelua mau ʻāpana nui:

• ʻAʻole nui: Haʻahaʻa nā pae TSH, akā hiki ke ʻike ʻia - ma waena o 0.1 a me 0.4 mIU/L. Loaʻa kēia pae i 65% a 75% o ka poʻe me ka Subclinical Hyperthyroidism.
• Koʻikoʻi: ʻOi aku ka liʻiliʻi o nā pae TSH ma mua o 0.1 mIU/L. Hoʻopilikia kēia ma waena o 25% a me 35% o nā kānaka.

Pono anei kēia i ka lāʻau lapaʻau?

Aia kekahi mau manaʻo like ʻole ma waena o nā kauka e pili ana i ka mālama ʻana a i ʻole ka 'Subclinical Hyperthyroidism', no ka mea, ʻaʻole lawa ka noiʻi ʻana e pili ana i nā pono maopopo o ka mālama ʻana.

Paipai pinepine nā kauka i kahi ala "e kali a ʻike" no ka poʻe me ka subclinical hyperthyroidism. ʻO ia hoʻi, ke kali nei lākou a hoʻomaikaʻi ke kūlana iā ia iho me ka ʻole o ka hoʻomaka ʻana i ka lāʻau.

Eia nō naʻe, hiki ke ʻōlelo ʻia ka lāʻau lapaʻau no ka poʻe nona nā pae TSH ma lalo mau o 0.1 mIU/L, ʻoiai ma nā hihia aʻe:

• Inā he 65 ou mau makahiki a ʻoi paha.
• Inā ʻoe ma lalo o 65 mau makahiki, he maʻi puʻuwai, osteoporosis, a i ʻole nā ​​​​hōʻailona o ka hyperthyroidism.
• Inā he wahine postmenopausal ʻoe, ma lalo o 65 mau makahiki, a ʻaʻole lawe i ka estrogen a i ʻole bisphosphonates (kahi ʻano lāʻau lapaʻau i hoʻohana ʻia e mālama i nā pilikia iwi).

ʻAʻole pono ka lāʻau lapaʻau no ka subclinical hyperthyroidism i ka wā hāpai.

Inā hāʻawi ʻia ka lāʻau lapaʻau, he aha ia?

Inā hoʻoholo kāu kauka he pono ka lāʻau lapaʻau, e hilinaʻi ka lāʻau lapaʻau i ke kumu o ka subclinical hyperthyroidism.

• Inā loaʻa iā ʻoe kahi goiter multinodular ʻawahia (he puʻupuʻu ma ka ʻāʻī) a i ʻole hoʻokahi nodule ma kou thyroid, ʻo ka lāʻau lapaʻau maʻamau ka iodine radioactive . He lāʻau lapaʻau kēia āu e lawe ai ma ka waha. Hoʻopili nā cell overactive i loko o kou thyroid i ka iodine. Hoʻopōʻino ka iodine radioactive i kēlā mau cell, e hoʻemi ana i ka thyroid a hāʻule kāu mau pae hormone i loko o kekahi mau pule.
• Inā loaʻa iā ʻoe ka maʻi Graves, ʻo nā lāʻau lapaʻau maʻamau ka lāʻau antithyroid a me ka iodine radioactive. Hana nā lāʻau antithyroid e like me methimazole (Tapazole) a me propylthiouracil (PTU) ma ke kāohi ʻana i ka hiki o ka thyroid gland ke hana i nā hormones.

Hiki ke pale ʻia kēia mai ka hana ʻana?

I ka hapanui o nā hihia, ʻaʻohe mea hiki iā mākou ke hana e pale aku ai i ka ulu ʻana o ka 'Subclinical Hyperthyroidism' a i ʻole ka 'Hyperthyroidism' ākea.

Eia nō naʻe, inā ʻaʻole lawa ka iodine i kāu meaʻai (a nui paha) , hiki iā ʻoe ke hoʻomohala i ka 'Subclinical' a i ʻole 'Overt Hyperthyroidism' ma muli o ka 'toxic goiter'. ʻOiai ʻaʻole maʻamau kēia ma nā ʻāina e like me Sri Lanka no ka mea hoʻohana mākou i ka paʻakai iodized, hiki ke ʻike ʻia kēia ʻano ma nā ʻāina kahi i maʻamau ai ka nele o ka iodine.

He aha kā mākou e manaʻo ai me kēia kūlana? Aia kekahi mau pilikia?

ʻAʻole pinepine ka holomua ʻana o ka subclinical hyperthyroidism i ka hyperthyroidism maopopo. Eia nō naʻe, ʻoi aku ka kiʻekiʻe o kēia pilikia i ka poʻe me nā pae TSH haʻahaʻa loa (ʻoi aku ma mua o 0.1 mIU/L).

Ma muli o ka nui o nā kumu, ʻokoʻa nā kānaka a pau i ka 'Subclinical Hyperthyroidism'.

ʻOiai inā ʻaʻole ia e holomua i ka 'Overt Hyperthyroidism', hiki i ka 'Subclinical Hyperthyroidism' ke hana i kekahi mau pilikia. ʻO kekahi o lākou:

• ʻO ka fibrillation atrial ( ka puʻuwai puʻuwai kūpono ʻole).
• Ka hāʻule ʻana o ka puʻuwai (ka pilikia o ka hoʻomohala ʻana i ka hāʻule ʻana o ka puʻuwai ).
• Maʻi puʻuwai coronary (maʻi ʻaʻa coronary ).
• Ka pohō a me nā haki o ka iwi.
• ʻO Dementia ( kahi ʻano o ka nalowale o ka hoʻomanaʻo e hiki ke hana me ka ʻelemakule).

He kiʻekiʻe loa kēia mau pilikia no ka poʻe ma luna o 65 mau makahiki a me ka poʻe me ka hyperthyroidism subclinical koʻikoʻi.

Inā ʻoe e hopohopo nei e pili ana i kēia mau pilikia, ʻoi aku ka maikaʻi o ke kamaʻilio ʻana me kāu kauka e pili ana i kēia.

Āhea wau e ʻike ai i ke kauka?

ʻO ka hapa nui o ka manawa, inā hōʻike kāu mau hoʻokolohua he "Subclinical Hyperthyroidism" kou, e lawe nā kauka i ke ʻano "e kali a ʻike".

Eia nō naʻe, inā hoʻomaka ʻoe e ʻike i nā hōʻailona o ka hyperthyroidism (hopohopo, hoʻomaha ʻole, palpitations), e ʻike pono i kāu kauka. A laila e hana ʻo ia i kahi hoʻāʻo koko thyroid ʻē aʻe e ʻike inā he 'Overt Hyperthyroidism' kou.

E hoʻomanaʻo, he nui nā manaʻo like ʻole no ka mālama ʻana i ka 'Subclinical Hyperthyroidism'. He ʻokoʻa kēlā me kēia kanaka, kēlā me kēia kūlana. No laila, ʻo ka mea maikaʻi loa e hana ai, ʻo ia ke kūkākūkā i kāu mau nīnau a me nā makaʻu me kāu kauka. Ua mākaukau ʻo ia a makemake e kōkua iā ʻoe.

Leka Lawe-Home

ʻAe, eia kekahi mau mea e pono ai ʻoe e hoʻomanaʻo mai nā mea a mākou i kamaʻilio ai:

• ʻO ka "Subclinical Hyperthyroidism" kahi kūlana kahi e hana nui iki ai ke kelepa thyroid, akā ʻaʻole hōʻike i nā hōʻailona nui.
• Ua ʻike ʻia kēia ma o kahi hoʻāʻo koko e hōʻike ana i kahi pae TSH haʻahaʻa (akā ʻo T3 a me T4 maʻamau).
• ʻOiai ʻaʻohe pinepine nā hōʻailona, ​​ʻaʻole pono paha ka lāʻau lapaʻau. Hiki i kāu kauka ke lawe i kahi ala "kali a ʻike".
• Pono paha kekahi poʻe, ʻoi aku ka poʻe ʻelemakule a i ʻole ka poʻe me nā pilikia olakino ʻē aʻe, i ka mālama ʻia.
• Inā ʻike ʻoe i nā hōʻailona o ka hyperthyroidism (e like me ka piʻi ʻana o ka puʻuwai, ka haʻalulu, ka pohō kaumaha), e ʻike koke i ke kauka.
• ʻO ka mea nui loa, ʻaʻole ia e hopohopo, e kamaʻilio ākea e pili ana i kēia me kāu kauka, a e hahai i kāna ʻōlelo aʻo.

Manaʻolana wau he mea pono kēia ʻike nou. E ola kino!

ʻO ka Hyperthyroidism Subclinical, thyroid, TSH, T3, T4, hormones, maʻi Graves, goiter