Kia ako tātou mō te Whakamātautau Whakaoho ACTH i tētahi ara māmā noa iho.

He maha ngā wā ka ngenge koe, ka ngoikore, ka ngaro rānei tō taumaha? Ina kite koe i te tākuta, ka whakatau pea ia ki te tirotiro i ō homoni. Ko te homoni cortisol te mea nui. Nō reira, ko te whakamātautau matua e mahia ana hei tirotiro mēnā he noa ō taumata cortisol ko te Whakamātautau Whakaoho ACTH. Ahakoa he ahua uaua te ingoa, he tino māmā noa iho. Me kōrero tātou mō tēnei katoa i tēnei rā.

He aha te tikanga o tēnei Whakamātautau Whakaoho ACTH?

He whakamātautau hauora tēnei. Hei whakamārama ake, ka tirohia te urupare a ō whekau e rua, arā, ko ngā repe adrenal, ki tētahi homoni e kiia nei ko te ACTH (Adrenocorticotropic hormone) e ahu mai ana i tō tātou roro. He ahua pōhēhē tēnei? Āe, me whakaaro tātou pēnei.

Whakaarohia te repe pituitary i roto i tō roro he rite ki te kaiwhakahaere o tētahi kamupene nui. Ko ngā repe adrenal iti e rua i runga ake i ō whatukuhu he rite ki ngā kaimahi e rua e mahi ana i taua kamupene.

Ina hiahia te kaiwhakahaere (te repe pituitary) ki te mahi i tētahi mea, ka tukuna he karere e kīia nei ko 'ACTH' ki ngā kaimahi (ngā repe adrenal). Ina tae mai tēnei karere, ka hangaia e ngā kaimahi (ngā repe adrenal) he homoni e kīia nei ko 'cortisol' ka tukuna ki roto i te tinana. He homoni tino nui tēnei cortisol mō tō tātou tinana. He āwhina i roto i ngā mahi maha pērā i te whakahaere i te ahotea, te whakahaere i ngā taumata huka toto, me te whakahaere i te toto toto.

Nā, ko tā te Whakamātautau Whakaoho ACTH he werowero i tētahi homoni ACTH hangai i hangaia mai i waho (e kiia nei ko te cosyntropin) ki roto i tō tinana, ā, ka tirohia mēnā ka aro atu ō repe adrenal (ngā kaimahi) ki taua homoni, ā, ka whakaputa tika i te cortisol.

Ko te tikanga o tēnei whakamātautau he kite i tētahi āhuatanga e kiia nei ko te 'korenga o te adrenal' . Ko te tikanga tēnei kāore e nui te cortisol e whakaputaina ana e ngā repe adrenal. E toru ngā momo o tēnei whakamātautau.

I roto i ngā āhuatanga hea ka kī atu te tākuta kia mahia tēnei whakamātautau?

Tērā pea he maha ngā take e taunaki ai tō tākuta i tēnei whakamātautau.

• Mena i whakaatuhia e te whakamātautau toto o mua he iti ngā taumata cortisol: Mena kua whakamātauhia tō toto mō tētahi atu take i whakaatu ai i te iti o ngā taumata cortisol, ka tonoa pea koe ki te mahi i tēnei whakamātautau hei whakaū.
• Mena kei a koe ngā tohu o te ngoikore o te adrenal: E ai ki tā mātou i kōrero ai i mua ake nei, mena kei a koe ngā tohu pēnei i te ngenge tonu, te whakaheke taumaha, te mamae o te puku, te whakapairuaki, te whanoke, me te toto toto iti, ka mahia tēnei whakamātautau hei kimi mena koinei te take.
• Mena kua roa koe e tango ana i ngā steroids: Ina roa koe e whakamahi ana i ngā rongoā glucocorticoid pēnei i te prednisone, ka mutu pea te mahi a ō repe pituitary me ō repe adrenal mō te wā poto. Nō reira, i muri i tō whakamutu i te tango i te rongoā, ka mahia hoki tēnei whakamātautau hei tirotiro mena kei te mahi tika anō ngā repe.

Me pēhea te whakarite i mua i te whakamātautau?

He mea tino nui tēnei. Me whai koe i ngā tohutohu a tō tākuta kia tika. I te nuinga o te wā, ka taea e koe te kī i ngā mea pēnei.

• Nohopuku: Tērā pea ka tonoa koe kia kaua e kai, e inu rānei i tetahi mea mō te ono hāora i mua i te whakamātautau. Ko te wai anake ka whakaaetia.
• Ngā here mahi: Tērā pea ka tonoa koe kia karo i ngā mahi pēnei i te whakakori tinana uaua mō ngā haora 12-24 i mua i te whakamātautau.
• Kai: I ētahi wā ka tonoa pea koe kia kai i ngā kai he nui te warowaihā.
• Te whakamutu i te rongoā: Ka pāngia pea ngā hua o te whakamātautau e ētahi rongoā e tangohia ana e koe (ina koa ko ngā kirīmi steroid, ngā pire, ngā inhaler rānei). Nō reira, ka tono pea tō tākuta kia mutu te tango i aua rongoā mō te wā poto. Kaua rawa e mutu te tango i tō rongoā me te kore e pātai tuatahi ki tō tākuta.

Āe, kia kite tātou he aha ngā mea ka puta i te rā o te whakamātautau.

Kāore tēnei i te whakamataku pērā i tō whakaaro. He mahi noa iho tēnei i roto i te hōhipera, i te whare rongoā rānei a te tākuta endocrinologist. Anei ngā mahi e mahia ana i ia taahiraa.

1. Te tango i te tauira toto tuatahi: Tuatahi, ka tangohia e te nēhi he tauira toto mai i tētahi uaua i tō ringa. Mā tēnei ka tirohia tō taumata cortisol taketake i mua i te tīmatanga o te whakamātautau.

2. Te werohanga: Muri iho, ka werohangahia koe e te nēhi kei roto ko te ACTH hangai (cosyntropin). I te nuinga o te wā ka tukuna tēnei ki roto i te uaua o tō ringa. Ka rite ki te werohanga a te pōpokorua iti, engari ka memeha haere i roto i ētahi hēkona.

3. Ngā tauira toto tuarua me tuatoru: Ka tangohia anō he tauira toto i muri i te 30 meneti i te werohanga. Kātahi ka tangohia anō he tauira toto i muri i te 60 meneti . Mā tēnei ka ine i te nui o te cortisol kua whakaputaina e ō repe adrenal mai i te werohanga.

4. Tukuna ki te taiwhanga: Ka tukuna ngā tauira toto i tangohia ki te taiwhanga.

Ina tangohia tō toto, ka paku noa te mamae o te kiri. Ka memeha haere i muri i tētahi wā. Tērā pea ka pā he maru iti ki te wāhi i tangohia ai te toto, he mea noa tēnā.

Āhea ka puta mai ngā hua, ā, he aha ngā kōrero mōna?

E tata ana ki te wiki te roa ka puta mai ngā hua o tēnei whakamātautau. Nā te mea ina tae mai ngā hua, ka āta tirotirohia e tō tākuta, ka whakaritea ki ō tohumate kia puta ai he whakatau.

He aha te hua noa?

Mō te tangata hauora, i muri i te werohanga ACTH, me whakaoho pai ngā repe adrenal, ā, me piki ake te taumata cortisol i roto i te toto. Ma tō tākuta e whakamārama ki a koe ngā uara i roto i tō pūrongo taiwhanga me te awhe noa.

He aha te Hua Rerekē?

• Te ngoikore o te adrenal tuatahi (mēnā he raruraru kei ngā repe adrenal): Ahakoa te werohanga ACTH, kāore te taumata cortisol e piki ake, e piki ake rānei mā te iti noa iho. Nā te mea kei ngā repe adrenal te raruraru, ā, ahakoa te nui o te whakaohooho mai i waho, kāore e taea e rātou te whakaputa cortisol.
• Te ngoikore o te adrenal tuarua (mēnā he raruraru kei te repe pituitary): Ina kore te repe pituitary e tuku i te ACTH mō te wā roa, ka mimiti haere ngā repe adrenal, ā, ka tīmata te kore mahi (atrophy). Ina werohia he ACTH ki tētahi tangata pēnei, kāore e taea e ngā repe adrenal kore mahi te urupare tonu. Nō reira, he iti noa te pikinga o ō rātou taumata cortisol, kāore rānei e piki.

I ētahi wā, mēnā he hou rawa te raru o te repe pituitary, he wāhanga noa iho rānei o te pānga, ka piki ake pea ngā taumata cortisol. Ko tō tākuta te tangata pai rawa atu hei whakatau i ēnei mea katoa.