Kodi chithokomiro chanu chikuwoneka kuti chikugwira ntchito mopitirira muyeso? Tiyeni tikambirane za Subclinical Hyperthyroidism!

Kodi dokotala wanu anati mulingo wa TSH wanu ndi wotsika pang'ono poyesa magazi posachedwapa? Kapena muli ndi zizindikiro zachilendo komanso zovuta kuzimvetsa? Mwina muli ndi vuto lotchedwa Subclinical Hyperthyroidism. Musadandaule, nthawi zambiri si lalikulu. Tiyeni tikambirane izi momveka bwino komanso momveka bwino.

Kodi Subclinical Hyperthyroidism ndi chiyani?

Mwachidule, `Subclinical Hyperthyroidism` ndi vuto lomwe chithokomiro chanu chimagwira ntchito mopitirira muyeso. Koma si lalikulu ngati `overt hyperthyroidism` .

Chiwalo cha pituitary chomwe chili muubongo mwathu chimapanga mahomoni otchedwa `TSH` (Hormone Yolimbikitsa Chithokomiro). `TSH` iyi imauza chithokomiro chomwe chili m'khosi mwathu kuti chipange mahomoni awiri otchedwa thyroxine (`T4` - `thyroxine`) ndi triiodothyronine (`T3` - `triiodothyronine`). Mahomoni a `T3` ​​​​ndi `T4` awa ndi omwe amathandiza kagayidwe ka thupi m'thupi lathu, kutanthauza kuti, kusintha chakudya chomwe timadya kukhala mphamvu ndikuchigwiritsa ntchito m'thupi lathu.

Mu `Subclinical Hyperthyroidism`, mulingo wa `TSH` m'magazi mwanu ndi wotsika, koma mulingo wa `T3` ​​​​ndi `T4` wanu ndi wabwinobwino. Izi zikutanthauza kuti chithokomiro chimagwira ntchito mopitirira muyeso pang'ono, kotero pituitary gland imati, "Chabwino, sindikufuna `TSH` pakadali pano, chithokomiro changa chikugwira ntchito bwino," ndipo chimachepetsa kupanga `TSH`. Koma mahomoni a chithokomiro (`T3`, `T4`) sanafikebe pamlingo wokwera kwambiri. Ndicho chimene `subclinical` amatanthauza - vuto lomwe silikuwonetsa zizindikiro zoonekeratu.

Vutoli nthawi zina limakhala la kanthawi kochepa , zomwe zikutanthauza kuti limatha kuchira lokha m'masiku ochepa. Komabe, kwa anthu ena limatha kukhala lokhalitsa. Si aliyense amene amafunika chithandizo.

Ndani amene ali ndi mwayi waukulu wopeza vutoli?

Aliyense akhoza kukhala ndi `Subclinical Hyperthyroidism`, koma anthu otsatirawa ali pachiwopsezo chachikulu pang'ono:

• Anthu omwe akumwa mankhwala obwezeretsa mahomoni a chithokomiro (monga levothyroxine) chifukwa cha hypothyroidism. Nthawi zina izi zingachitike ngati mlingo wa mankhwalawo wawonjezeka pang'ono.
• Kwa iwo omwe ali ndi zaka zoposa 65.

Kodi vutoli ndi lofala bwanji?

Izi sizichitika kawirikawiri m'maiko ngati America.

Pafupifupi 0.7% ya anthu onse ali ndi `Subclinical Hyperthyroidism`, pomwe milingo ya TSH ndi yochepera 0.1 mIU/L. Ena 1.8% ali ndi milingo ya `TSH` yochepera 0.4 mIU/L.

Komabe, m'maiko omwe ali ndi kusowa kwa ayodini , makamaka pakati pa anthu azaka zopitilira 70, vutoli likhoza kufika pa 15%. Ku Sri Lanka, chiopsezochi n'chochepa chifukwa nthawi zambiri timagwiritsa ntchito mchere wokhala ndi ayodini , koma ndibwino kudziwa.

Kodi zizindikiro zake ndi ziti?

Nthawi zambiri, anthu omwe ali ndi `Subclinical Hyperthyroidism` sasonyeza zizindikiro zilizonse . Ndicho chifukwa chake amatchedwa "subclinical".

Komabe, nthawi zina mungakhale ndi zizindikiro zochepa zokhudzana ndi hyperthyroidism. Nthawi zina, mungakumane ndi zinthu monga:

• Kumva ngati mtima wako ukugunda mofulumira (kugunda kwa mtima).
• Zili ngati thupi langa likunjenjemera, ndikungomva mantha.
• Kuchepetsa thupi (ngakhale kuti munthu ali ndi njala).
• Kuwonjezeka kwa njala.
• Kutsegula m'mimba kapena kuyenda m'mimba pafupipafupi.
• Khungu limaoneka lopyapyala, lofunda, komanso lonyowa.
• Kusintha kwa msambo kwa akazi (`kusintha kwa msambo`).

Chofunika: Kukhala ndi zizindikiro izi sikutanthauza kuti muli ndi `Subclinical Hyperthyroidism`. Komabe, ngati zizindikirozi zikupitirira, ndi bwino kupita kwa dokotala.

N’chifukwa chiyani izi zikuchitika? Kodi zifukwa zake ndi ziti?

Kawirikawiri, dongosolo lathu la endocrine limagwira ntchito ngati gulu. Taganizirani ngati kampani yayikulu.

Hypothalamus, yomwe ili pansi pa ubongo, imatulutsa mahomoni otchedwa TRH (Chithokomiro Chotulutsa Hormone). Izi zimauza pituitary gland kuti ipange TSH.

Kenako `TSH` imapita kukauza chithokomiro kuti chipange `T3` ​​​​(pafupifupi 20%) ndi `T4` (pafupifupi 80%). `T3` ​​​​ndi `T4` izi zikawonjezeka m'magazi, zimatumizanso chizindikiro ku chithokomiro cha pituitary kuti, "Chabwino, siyani kupanga `TSH` tsopano, pali mahomoni okwanira." Izi zimatchedwa ` feedback loop` . `T3` ​​ndi `T4` zikachepa, kuzungulira kumeneku kumayambanso kuyambira pachiyambi.

Komabe, mu `Subclinical Hyperthyroidism`, chifukwa cha vuto linalake mu chithokomiro, ngakhale kuti `TSH` ndi yochepa, kupanga mahomoni a chithokomiro sikuchepa monga momwe amayembekezeredwa. Ichi ndichifukwa chake `TSH` ndi yotsika, koma `T3` ​​​​ndi `T4` zili pamlingo wabwinobwino.

Zomwe zimayambitsa ``Subclinical Hyperthyroidism`` ndizofanana kwambiri ndi zomwe zimayambitsa hyperthyroidism yowonekera. Nazi zina mwa zifukwa zazikulu:

• Kuchulukitsa mlingo wa mankhwala a mahomoni (levothyroxine) omwe amaperekedwa kwa hypothyroidism (chithokomiro chosagwira ntchito bwino). Ichi ndiye chifukwa chofala kwambiri.
• Matenda a goiter omwe ali ndi ma nodule ambiri. Uwu ndi mkhalidwe womwe ma nodules (tizidutswa) tosakhala khansa timapangika mu chithokomiro, zomwe zimapangitsa kuti chizitulutsa mahomoni ambiri a chithokomiro.
• Matenda a Graves. Imeneyi ndi matenda omwe amayambitsa chitetezo chamthupi. Izi zikutanthauza kuti chitetezo chamthupi lathu chimaukira chithokomiro, zomwe zimapangitsa kuti chipange mahomoni ambiri.
• Matenda a Chithokomiro: Pamene chithokomiro cha thyroid chatupa, kuchuluka kwa mahomoni kumatha kuwonjezeka kwakanthawi.

Kodi mumazindikira bwanji izi?

Mayeso a ntchito ya chithokomiro ndiyo njira yokhayo yodziwira ngati muli ndi `Subclinical Hyperthyroidism` kapena ayi.(Mayeso a ntchito ya chithokomiro okha. Awa ndi mayeso a magazi achizolowezi.

Mlingo wabwinobwino wa TSH (womwe umatchedwanso thyrotropin) mwa munthu wamkulu wopanda pakati uli pakati pa 0.4 ndi 4.5 milli-international units pa lita (mIU/L).

Ngati mayeso anu a magazi akuwonetsa kuti mulingo wa TSH wanu ndi wotsika (pakati pa 0.1 ndi 0.4 mIU/L kapena wochepera 0.1 mIU/L), koma mulingo wanu wa T4 (thyroxine) ndi T3 (triiodothyronine) uli mkati mwa mulingo woyenera, muli ndi Subclinical Hyperthyroidism.

`Subclinical Hyperthyroidism` ikhoza kugawidwa m'magulu awiri akuluakulu:

• Wofatsa: Mlingo wa TSH ndi wotsika, koma umatha kupezekabe - nthawi zambiri pakati pa 0.1 ndi 0.4 mIU/L. Mlingo uwu umapezeka mwa anthu 65% mpaka 75% omwe ali ndi Subclinical Hyperthyroidism.
• Kuopsa: Miyezo ya TSH ndi yochepera 0.1 mIU/L. Izi zimakhudza pakati pa 25% ndi 35% ya anthu.

Kodi izi zikufunika chithandizo?

Pali maganizo osiyanasiyana pakati pa madokotala pankhani yokhudza kuchiza kapena kusachiza `Subclinical Hyperthyroidism`, chifukwa kafukufuku wokwanira sanachitikebe pa ubwino womveka bwino wa chithandizo.

Madokotala nthawi zambiri amalimbikitsa njira ya "kudikira ndikuwona" kwa anthu omwe ali ndi matenda a subclinical hyperthyroidism. Izi zikutanthauza kuti, amadikira kuti vutoli liziyenda bwino lokha popanda kuyamba kulandira chithandizo.

Komabe, chithandizo chingalimbikitsidwe kwa anthu omwe TSH yawo imakhala pansi pa 0.1 mIU/L nthawi zonse, makamaka pazochitika zotsatirazi:

• Ngati muli ndi zaka 65 kapena kuposerapo.
• Ngati muli ndi zaka zosakwana 65, muli ndi matenda a mtima, osteoporosis, kapena zizindikiro za hyperthyroidism.
• Ngati ndinu mkazi amene wafika nthawi yosiya kusamba, wosakwana zaka 65, ndipo simukumwa estrogen kapena bisphosphonates (mtundu wa mankhwala omwe amagwiritsidwa ntchito pochiza mavuto a mafupa).

Matenda a subclinical hyperthyroidism panthawi ya mimba nthawi zambiri safuna chithandizo.

Ngati chithandizo chaperekedwa, ndi chiyani?

Ngati dokotala wanu asankha kuti chithandizo chikufunika, chithandizocho chidzadalira chifukwa cha subclinical hyperthyroidism.

• Ngati muli ndi chotupa cha multinodular goiter (chotupa pakhosi) kapena chotupa chimodzi pa chithokomiro chanu, chithandizo chofala kwambiri ndi radioactive iodine . Uwu ndi mankhwala omwe mumamwa pakamwa. Maselo omwe amagwira ntchito mopitirira muyeso mu chithokomiro chanu amayamwa ayodini. Ayodini wowopsa amawononga maselo amenewo, zomwe zimapangitsa kuti chithokomiro chichepe komanso kuchuluka kwa mahomoni anu kuchepe patatha milungu ingapo.
• Ngati muli ndi matenda a Graves, mankhwala odziwika bwino ndi mankhwala oletsa chithokomiro ndi ayodini wowononga. Mankhwala oletsa chithokomiro monga methimazole (Tapazole) ndi propylthiouracil (PTU) amagwira ntchito poletsa mphamvu ya chithokomiro kupanga mahomoni.

Kodi izi zingalepheretsedwe kuchitika?

Nthawi zambiri, palibe chomwe tingachite kuti tipewe kukula kwa `Subclinical Hyperthyroidism` kapena `Hyperthyroidism` yowonekera.

Komabe, ngati simukupeza ayodini wokwanira muzakudya zanu (kapena wochuluka kwambiri) , mutha kukhala ndi `Subclinical` kapena `Overt Hyperthyroidism` chifukwa cha `toxic goiter`. Ngakhale izi sizofala m'maiko ngati Sri Lanka chifukwa timagwiritsa ntchito mchere wokhala ndi ayodini, zitha kuoneka m'maiko omwe kusowa ayodini kuli kofala.

Kodi tingayembekezere chiyani ndi vutoli? Kodi pali zoopsa zilizonse?

Matenda a subclinical hyperthyroidism nthawi zambiri sapita patsogolo kukhala hyperthyroidism yoonekera bwino. Komabe, chiopsezochi chimakhala chokwera pang'ono mwa anthu omwe ali ndi TSH yotsika kwambiri (yochepera 0.1 mIU/L).

Popeza pali zifukwa zambiri, 'Subclinical Hyperthyroidism' ya aliyense ndi yosiyana.

Ngakhale kuti sichinapite patsogolo kufika pa `Overt Hyperthyroidism`, `Subclinical Hyperthyroidism` ingayambitse mavuto ena. Ena mwa iwo ndi awa:

• Kugunda kwa mtima kosakhazikika (kugunda kwa mtima kosasinthasintha).
• Kulephera kwa mtima (chiopsezo cha kulephera kwa mtima ).
• Matenda a mtima (coronary artery disease ).
• Kutaya mafupa ndi kusweka kwa mafupa.
• Matenda amisala ( vuto la kuiwala zinthu zomwe zingachitike munthu akamakula).

Zoopsa zimenezi n’zokwera kwambiri makamaka kwa anthu azaka zopitirira 65 komanso omwe ali ndi vuto lalikulu la matenda a chithokomiro.

Ngati mukuda nkhawa ndi zoopsa izi, ndi bwino kulankhula ndi dokotala wanu za izi.

Kodi ndiyenera kupita kwa dokotala liti?

Nthawi zambiri, ngati mayeso anu akusonyeza kuti muli ndi "Subclinical Hyperthyroidism," madokotala amatenga njira ya "dikirani ndikuwona".

Komabe, ngati muyamba kuona zizindikiro za hyperthyroidism (nkhawa, kusakhazikika, ndi kugunda kwa mtima), onetsetsani kuti mwaonana ndi dokotala. Kenako adzayesanso magazi a chithokomiro kuti aone ngati muli ndi `Overt Hyperthyroidism`.

Kumbukirani, pali malingaliro osiyanasiyana okhudza ngati ayenera kuchiza kapena ayi `Subclinical Hyperthyroidism`. Aliyense, vuto lililonse ndi losiyana. Chifukwa chake, chinthu chabwino kuchita ndikukambirana mafunso ndi mantha anu onse ndi dokotala wanu. Iye ndi wokonzeka kukuthandizani.

Uthenga Wopita Nawo Kunyumba

Chabwino, nazi zinthu zina zomwe muyenera kukumbukira kuchokera pa zomwe takambirana:

• "Subclinical Hyperthyroidism" ndi vuto lomwe chithokomiro chimagwira ntchito mopitirira muyeso pang'ono, koma sichisonyeza zizindikiro zazikulu.
• Izi zimazindikirika poyesa magazi komwe kumasonyeza TSH yotsika (koma T3 ndi T4 yachibadwa).
• Popeza nthawi zambiri palibe zizindikiro, chithandizo sichingakhale chofunikira. Dokotala wanu angagwiritse ntchito njira ya "kudikira ndikuwona".
• Anthu ena, makamaka okalamba kapena omwe ali ndi mavuto ena azaumoyo, angafunike chithandizo.
• Ngati mukuona zizindikiro za hyperthyroidism (monga kugunda kwa mtima, kunjenjemera, kuchepa thupi), pitani kwa dokotala nthawi yomweyo.
• Chofunika kwambiri ndi kusachita mantha, kulankhula momasuka za izi ndi dokotala wanu, ndikutsatira malangizo ake.

Ndikukhulupirira kuti izi zikuthandizani. Khalani ndi thanzi labwino!

Matenda a Subclinical Hyperthyroidism, chithokomiro, TSH, T3, T4, mahomoni, matenda a Graves, goiter