Ese tiroyide yawe isa nkaho ikora cyane? Reka tuvuge kuri Subclinical Hyperthyroidism!

Ese muganga wawe yavuze ko urugero rwa TSH yawe ruri hasi gato mu isuzuma ry'amaraso riherutse? Cyangwa hari ibimenyetso bidasanzwe kandi bigoye kumva? Ushobora kuba ufite indwara yitwa Subclinical Hyperthyroidism. Ntugahangayike, akenshi ntabwo ari ikibazo gikomeye. Reka tubiganireho mu buryo bworoshye kandi busobanutse.

Subclinical Hyperthyroidism ni iki?

Mu magambo make, `Subclinical Hyperthyroidism` ni indwara aho tiroyide yawe ikora cyane kurusha uko bisanzwe. Ariko ntabwo ikabije nka `overt hyperthyroidism` .

Ingirabuzimafatizo ya pituitari mu bwonko bwacu ikora imisemburo yitwa `TSH` (Hormone itera imbaraga za Thyroid). Iyi `TSH` ibwira ingirabuzimafatizo ya tiroyide iri mu ijosi ryacu gukora imisemburo ibiri yitwa thyroxine (`T4` - `thyroxine`) na triiodothyronine (`T3` - `triiodothyronine`). Iyi misemburo ya `T3` ​​na `T4` niyo ifasha imikorere y'umubiri wacu, ni ukuvuga guhindura ibiryo turya mo ingufu no kuzikoresha mu mubiri wacu.

Muri `Subclinical Hyperthyroidism`, urugero rwa `TSH` mu maraso yawe ruri hasi, ariko urugero rwa `T3` ​​​​na `T4` rwawe ni ibisanzwe. Ibyo bivuze ko tiroyide ikora cyane, bityo pituitary gland iravuga iti: "Sawa, sinkeneye `TSH` muri iki gihe, tiroyide yanjye ikora neza," kandi bigabanya umusaruro wa `TSH`. Ariko imisemburo ya tiroyide (`T3`, `T4`) ntabwo irazamuka cyane. Ibyo nibyo `subclinical` bivuze - indwara idagaragaza ibimenyetso bigaragara.

Iyi ndwara rimwe na rimwe ishobora kuba iy'igihe gito , bivuze ko ishobora gukira ubwayo mu minsi mike. Ariko, kuri bamwe ishobora kuba iy'igihe kirekire. Si buri wese ukeneye kuvurwa.

Ni nde ufite amahirwe menshi yo kurwara iyi ndwara?

Umuntu wese ashobora kurwara `Subclinical Hyperthyroidism`, ariko abantu bakurikira bafite ibyago byinshi byo kurwara:

• Abantu bafata imiti yo gusimbuza imisemburo ya tiroyide (urugero, levothyroxine) kugira ngo barwanye hypothyroidism. Hari igihe ibi bishobora kubaho iyo ingano y'umuti yongereweho gato.
• Ku bantu barengeje imyaka 65.

Iyi ndwara ikunze kugaragara gute?

Ibi si ibintu bikunze kubaho mu bihugu nka Amerika.

Hafi 0.7% by'abaturage bafite `Subclinical Hyperthyroidism`, aho urugero rwa TSH ruri munsi ya 0.1 mIU/L. Abandi 1.8% bafite urugero rwa `TSH` ruri munsi ya 0.4 mIU/L.

Ariko, mu bihugu bifite ikibazo cyo kubura iyode , cyane cyane ku bantu barengeje imyaka 70, iyi ndwara ishobora kugera kuri 15%. Muri Sri Lanka, iyi ngaruka ni nke kuko dukunze gukoresha umunyu urimo iyode , ariko ni byiza kubimenya.

Ibimenyetso ni ibihe?

Akenshi, abantu barwaye `Subclinical Hyperthyroidism` ntibagaragaza ibimenyetso . Niyo mpamvu yitwa "subclinical".

Ariko, hari igihe ushobora kugira ibimenyetso byoroheje bifitanye isano na hyperthyroidism. Muri ibyo bihe, ushobora guhura n'ibintu nk'ibi:

• Kumva umutima wawe urimo gutera cyane (gutera cyane).
• Ni nk'aho umubiri wanjye urimo kunyeganyega, numva mfite ubwoba gusa.
• Kugabanya ibiro (nubwo hari ubushake bwo kurya).
• Kwongera ubushake bwo kurya.
• Impiswi cyangwa kwimuka kenshi mu mara.
• Uruhu rusa n'urufite ubushyuhe, rushyushye kandi rutose.
• Impinduka mu kwezi k'umugore (`Impinduka mu gihe cy'imihango`).

Icy'ingenzi: Kugira ibi bimenyetso ntibivuze ko ufite `Subclinical Hyperthyroidism`. Ariko, niba ibi bimenyetso bikomeje, ni byiza kujya kwa muganga.

Kuki ibi bibaho? Impamvu ni izihe?

Ubusanzwe, sisitemu yacu y'imisemburo ikora nk'ikipe. Tekereza nk'ikigo kinini.

Hypothalamus, iherereye mu nsi y'ubwonko, irekura imisemburo yitwa TRH (Hormone irekura Thyroid). Ibi bituma ingirabuzimafatizo ya pituitary ikora TSH.

Hanyuma 'TSH' iragenda ikabwira tiroyide gukora 'T3' ​​(hafi 20%) na 'T4' (hafi 80%). Iyo izi 'T3' na 'T4' ziyongereye mu maraso, yongera kohereza ikimenyetso kuri pituitary gland iti "Sawa, hagarika gukora 'TSH' ubu ngubu, hari imisemburo ihagije." Ibi byitwa ' feedback loop' . Iyo 'T3' na 'T4' bigabanutse, uru rugendo rwongera gutangira kuva mu ntangiriro.

Ariko, muri `Subclinical Hyperthyroidism`, bitewe n'ikibazo runaka muri tiroyide, nubwo urugero rwa `TSH` ruri hasi, umusaruro w'imisemburo ya tiroyide ntugabanuka nk'uko byari byitezwe. Niyo mpamvu `TSH` iri hasi, ariko `T3` ​​na `T4` biri ku rugero rusanzwe.

Impamvu za ``Subclinical Hyperthyroidism`` ahanini ni zimwe n'izitera hyperthyroidism igaragara. Dore zimwe mu mpamvu nyamukuru:

• Kongera urugero rw'imiti ikoreshwa mu kuvura imisemburo (levothyroxine) itangwa kuri hypothyroidism (tiyode idakora neza). Iyi ni yo mpamvu ikunze kugaragara cyane.
• Indwara ya goiter ifite uburozi bwinshi. Iyi ni indwara ituma utubyimba tutari kanseri (nodules) tuvuka mu ngirabuzimafatizo ya tiroyide, bigatuma ikora imisemburo myinshi ya tiroyide.
• Indwara ya Graves. Iyi ni indwara iterwa n'ubwiyongere bw'umubiri. Ibi bivuze ko ubudahangarwa bw'umubiri wacu bwibasira ingirabuzimafatizo ya tiroyide, buyitera imbaraga zo gukora imisemburo myinshi.
• Tiroidite: Iyo tiroyide ibyimbye, urugero rw'imisemburo rushobora kwiyongera by'igihe gito.

Ubimenya ute?

Ibizamini by'imikorere ya tiroyide ni bwo buryo bwonyine bwo kumenya neza niba ufite `Subclinical Hyperthyroidism` cyangwa udafite.(Ibipimo by'imikorere ya tiroyide gusa. Ibi ni ibipimo by'amaraso bisanzwe.

Igipimo gisanzwe cya TSH (cyanone cyitwa thyrotropin) ku muntu mukuru utaratwite kiri hagati ya milimetero 0.4 na 4.5 kuri litiro imwe (mIU/L).

Niba ibipimo by'amaraso byawe byerekanye ko urugero rwa TSH rwawe ruri hasi (hagati ya 0.1 na 0.4 mIU/L cyangwa munsi ya 0.1 mIU/L), ariko urugero rwa T4 (thyroxine) na T3 (triiodothyronine) rwawe ruri mu rugero rusanzwe, uba ufite Subclinical Hyperthyroidism.

`Subclinical Hyperthyroidism` ishobora kugabanywamo ibyiciro bibiri by'ingenzi:

• Iciriritse: Urugero rwa TSH ruri hasi, ariko ruracyagaragara - akenshi ruri hagati ya 0.1 na 0.4 mIU/L. Uru rugero ruboneka ku bantu 65% kugeza 75% bafite Subclinical Hyperthyroidism.
• Ikabije: Igipimo cya TSH kiri munsi ya 0.1 mIU/L. Ibi bigira ingaruka ku bantu bari hagati ya 25% na 35%.

Ese ibi bikenewe kuvurwa?

Mu by’ukuri hari ibitekerezo bitandukanye hagati y’abaganga ku bijyanye no kuvura cyangwa kutavura `Subclinical Hyperthyroidism`, kuko nta bushakashatsi buhagije buhari ku byiza bifatika byo kuvura.

Abaganga bakunze gutanga inama yo "gutegereza urebe" ku bantu bafite indwara ya hyperthyroidism iterwa n'indwara ya "subclinical hyperthyroidism". Ni ukuvuga ko bategereza ko iyo ndwara irushaho kuba nziza ubwabo batabanje gutangira kuvurwa.

Ariko, ubuvuzi bushobora kuba bwiza ku bantu bafite urugero rwa TSH ruri munsi ya 0.1 mIU/L, cyane cyane muri ibi bikurikira:

• Niba ufite imyaka 65 cyangwa irenga.
• Niba uri munsi y'imyaka 65, ufite indwara y'umutima, osteoporosis, cyangwa ibimenyetso bya hyperthyroidism.
• Niba uri umugore wamaze gucura, uri munsi y'imyaka 65, kandi udafata imiti ya estrogen cyangwa bisphosphonates (ubwoko bw'umuti ukoreshwa mu kuvura ibibazo by'amagufwa).

Ubusanzwe indwara ya hypothyroidism iterwa n’indwara ya subclinical mu gihe cyo gutwita ntisaba kuvurwa.

Niba hatanzwe ubuvuzi, ni ubuhe?

Mu gihe muganga wawe afashe icyemezo cy'uko ubuvuzi ari ngombwa, ubuvuzi buzaterwa n'impamvu ya hyperthyroidism iterwa n'indwara ya subclinical.

• Niba ufite indwara y’imitsi myinshi (ikibyimba mu ijosi) cyangwa agahu kamwe kuri tiroyide yawe, uburyo bukunze kuvura ni iyode ikoresha imirasire . Uyu ni umuti unywa unyoye. Uturemangingo dukora cyane muri tiroyide yawe twuma iyode. Iyode ikoresha imirasire yangiza utwo turemangingo, bigatuma tiroyide igabanuka kandi urugero rw’imisemburo yawe rukagabanuka mu byumweru bike.
• Niba urwaye indwara ya Graves, uburyo bukunze kuvura ni imiti irwanya tiroyide na iyode ikoresha imirasire. Imiti irwanya tiroyide nka methimazole (Tapazole) na propylthiouracil (PTU) ikora mu kubuza ubushobozi bwa tiroyide bwo gukora imisemburo.

Ese ibi bishobora kwirindwa ko bitabaho?

Kenshi na kenshi, nta kintu na kimwe twakora ngo tuburizemo iterambere rya `Subclinical Hyperthyroidism` cyangwa `Hyperthyroidism` igaragara.

Ariko, niba udafite iyode ihagije mu mirire yawe (cyangwa irenze urugero) , ushobora kugira `Subclinical` cyangwa `Overt Hyperthyroidism` bitewe na `toxic goiter`. Nubwo ibi bidakunze kugaragara mu bihugu nka Sri Lanka kuko dukoresha umunyu wa iyode, iyi ndwara irashobora kugaragara mu bihugu aho ibura iyode rikunze kugaragara.

Ni iki twakwitega kuri iyi ndwara? Ese hari ingaruka zishobora guterwa n'iyi ndwara?

Hyperthyroidism isanzwe idakunze gutera imbere ikaba hyperthyroidism igaragara. Ariko, iyi ngaruka iri hejuru gato ku bantu bafite urugero rwa TSH ruri hasi cyane (munsi ya 0.1 mIU/L).

Kubera ko hari impamvu nyinshi, `Subclinical Hyperthyroidism` ya buri wese iratandukanye.

Nubwo bitagenda bijya kuri `Overt Hyperthyroidism`, `Subclinical Hyperthyroidism` ishobora guteza ingorane zimwe na zimwe. Zimwe muri zo ni:

• Gutera umutima mu buryo butari bwo (atrial fibrillation ).
• Umutima unanirwa (ibyago byo kurwara umutima unanirwa ).
• Indwara z'umutima (indwara y'imitsi ifata imitsi ).
• Gutakaza amagufwa no kuvunika.
• Dementia ( indwara yo kwibagirwa ishobora kubaho uko umuntu asaza).

Izi ngaruka ni nyinshi cyane cyane ku bantu barengeje imyaka 65 ndetse n'abafite ikibazo gikomeye cya hyperthyroidism.

Niba uhangayikishijwe n'izi ngaruka, ni byiza kuvugana na muganga wawe kuri ibi.

Ni ryari ngomba kujya kwa muganga?

Akenshi, niba ibizamini byawe bigaragaza ko ufite "Subclinical Hyperthyroidism", abaganga bazajya bafata uburyo bwo "gutegereza urebe".

Ariko, niba utangiye kugira ibimenyetso bya hyperthyroidism (guhangayika, kubura amahoro, gutera ubwoba mu mutima), menya neza ko wagiye kwa muganga. Hanyuma azakora ikindi gipimo cy'amaraso ya tiroyide kugira ngo arebe niba ufite `Overt Hyperthyroidism`.

Wibuke ko hakiri ibitekerezo byinshi bitandukanye ku bijyanye no kuvura cyangwa kutavura `Subclinical Hyperthyroidism`. Buri muntu, buri kibazo kiratandukanye. Kubwibyo, ikintu cyiza cyo gukora ni ukuganira na muganga wawe ku bibazo byawe byose n'ubwoba bwawe. Yiteguye kandi yiteguye kugufasha.

Ubutumwa bwo kujyana mu rugo

Noneho rero, dore ibintu bimwe na bimwe ugomba kwibuka mu byo twavuze:

• "Subclinical Hyperthyroidism" ni indwara aho tiroyide ikora cyane, ariko ntigaragaze ibimenyetso bikomeye.
• Ibi bipimwa hakoreshejwe isuzuma ry'amaraso rigaragaza urugero rwa TSH ruri hasi (ariko T3 na T4 bisanzwe).
• Kubera ko akenshi nta bimenyetso bihari, kuvurwa bishobora kuba atari ngombwa. Muganga wawe ashobora gufata ingamba zo "gutegereza urebe".
• Hari abantu bamwe, cyane cyane abageze mu za bukuru cyangwa abafite izindi ngorane z'ubuzima, bashobora gukenera kuvurwa.
• Niba ugaragaje ibimenyetso bya hyperthyroidism (nk'umuvuduko w'umutima wiyongera, guhinda umushyitsi, kugabanya ibiro), hita ubonana na muganga.
• Igikuru ni ukudatinya, kubivuganaho na muganga wawe mu buryo bweruye, no gukurikiza inama ze.

Ndizera ko aya makuru azaba ingirakamaro. Komeza ugire ubuzima bwiza!

` Indwara ya hypothyroidism iterwa n'indwara ya hypothyroidism, tiroyide, TSH, T3, T4, imisemburo, indwara ya Graves, goiter