Ngaba i-thyroid yakho ibonakala isebenza kakhulu? Masithethe nge-Subclinical Hyperthyroidism!

Ngaba ugqirha wakho uthe izinga lakho le-TSH liphantsi kancinci kuvavanyo lwegazi lwakutshanje? Okanye ngaba uneempawu ezingaqhelekanga nezinzima ukuziqonda? Usenokuba unemeko ebizwa ngokuba yi-Subclinical Hyperthyroidism. Ungakhathazeki, ayisiyonto imbi kangako. Masithethe ngale nto ngokulula nangokucacileyo.

Yintoni i-Subclinical Hyperthyroidism?

Ngamafutshane, i-'Subclinical Hyperthyroidism' yimeko apho i-thyroid gland yakho isebenza ngaphezu kwesiqhelo. Kodwa ayinzima njenge-'overt hyperthyroidism' .

I-pituitary gland esebuchotsheni bethu ivelisa i-hormone ebizwa ngokuba yi-`TSH` (i-Thyroid-Stimulating Hormone). Le `TSH` ixelela i-thyroid gland entanyeni yethu ukuba yenze ii-hormone ezimbini ezibizwa ngokuba yi-thyroxine (`T4` - `thyroxine`) kunye ne-triiodothyronine (`T3` - `triiodothyronine`). Ezi hormone ze-`T3` kunye ne-`T4` zezona zinceda imetabolism yomzimba wethu, oko kukuthi, ukuguqula ukutya esikutyayo kube ngamandla size sikusebenzisele umzimba wethu.

Kwi-'Subclinical Hyperthyroidism', inqanaba le-'TSH' egazini lakho liphantsi, kodwa amanqanaba akho e-'T3' kunye ne-'T4' aqhelekile. Oko kuthetha ukuba i-thyroid isebenza kakhulu, ngoko ke i-pituitary gland ithi, "Kulungile, andiyidingi i-'TSH' okwangoku, i-thyroid yam isebenza kakuhle," kwaye inciphisa ukuveliswa kwe-'TSH'. Kodwa iihomoni ze-thyroid ('T3', 'T4') azikakhuphuki kakhulu. Yiloo nto ithethwa yi-'subclinical' - imeko engaphantsi engabonakalisi zimpawu zicacileyo.

Le meko ngamanye amaxesha inokuba yeyokwexeshana , oko kuthetha ukuba inokuphila ngokwayo kwiintsuku ezimbalwa. Nangona kunjalo, kwabanye abantu inokuba yeyokusisigxina. Asinguye wonke umntu ofuna unyango.

Ngubani onokuthi abe nale meko?

Nabani na unokuba ne-'Subclinical Hyperthyroidism', kodwa aba bantu balandelayo basengozini enkulu kancinci:

• Abantu abasebenzisa unyango lokutshintshwa kweehomoni ze-thyroid (umzekelo, i-levothyroxine) ngenxa ye-hypothyroidism. Ngamanye amaxesha oku kunokwenzeka ukuba idosi yeyeza inyuswe kancinci.
• Kwabo baneminyaka engaphezu kwama-65 ubudala.

Ixhaphake kangakanani le meko?

Le ayiqhelekanga kakhulu kumazwe afana neMelika.

Malunga ne -0.7% yabemi bane-'Subclinical Hyperthyroidism', apho amanqanaba e-TSH angaphantsi kwe-0.1 mIU/L. Abanye abayi-1.8% banamanqanaba e-'TSH' angaphantsi kwe-0.4 mIU/L.

Nangona kunjalo, kumazwe anengxaki yokungabikho kwe-iodine , ingakumbi kubantu abangaphezu kweminyaka engama-70 ubudala, le meko inokuba phezulu ukuya kwi-15%. ESri Lanka, le ngozi iphantsi kuba sihlala sisebenzisa ityuwa ene-iodine , kodwa kulungile ukuqaphela.

Zithini iimpawu?

Ixesha elininzi, abantu abane-'Subclinical Hyperthyroidism' ababonisi zimpawu . Yiyo loo nto ibizwa ngokuba yi-'subclinical'.

Nangona kunjalo, ngamanye amaxesha unokufumana iimpawu ezincinci ezinxulumene ne-hyperthyroidism. Ngamaxesha anjalo, unokufumana izinto ezifana nezi:

• Ukuziva ngathi intliziyo yakho ibetha ngokukhawuleza (ukubetha kwentliziyo).
• Kungathi umzimba wam uyangcangcazela, ndiziva ndinexhala nje.
• Ukunciphisa umzimba (nangona unomdla wokutya).
• Ukwanda komnqweno wokutya.
• Urhudo okanye ukuhamba rhoqo kwamathumbu.
• Ulusu luvakala luncinci, lufudumele, kwaye lufumile.
• Utshintsho kumjikelo wexesha lokuya exesheni kwabasetyhini (`Utshintsho lokuya exesheni`).

Kubalulekile: Ukuba nezi mpawu akuthethi ukuba une-'Subclinical Hyperthyroidism'. Nangona kunjalo, ukuba ezi mpawu ziyaqhubeka, kububulumko ukubona ugqirha.

Kutheni oku kusenzeka? Zithini izizathu?

Ngokwesiqhelo, inkqubo yethu ye-endocrine isebenza njengeqela. Cinga ngayo njengenkampani enkulu.

I-hypothalamus, ekwisiseko sobuchopho, ikhupha i-hormone ebizwa ngokuba yi-TRH (i-Thyroid-Releasing Hormone). Oku kuxelela i-pituitary gland ukuba ivelise i-TSH.

Emva koko i-'TSH' iyahamba iye kuxelela i-thyroid gland ukuba yenze i-'T3' ​​(malunga ne-20%) kunye ne-'T4' (malunga ne-80%). Xa ezi 'T3' kunye ne-'T4' zisanda egazini, ithumela kwakhona isignali kwi-pituitary gland isithi, "Kulungile, yeka ukwenza i-'TSH' ngoku, kukho i-hormone eyaneleyo." Oku kubizwa ngokuba yi- 'feedback loop' . Xa i-'T3' kunye ne-'T4' zincipha, lo mjikelo uqala kwakhona kwasekuqaleni.

Nangona kunjalo, kwi-'Subclinical Hyperthyroidism', ngenxa yengxaki ethile kwi-thyroid gland, nangona inqanaba le-'TSH' liphantsi, ukuveliswa kweehomoni ze-thyroid akuyehli njengoko bekulindelwe. Yiyo loo nto i-'TSH' iphantsi, kodwa i-'T3' kunye ne-'T4' zikwinqanaba eliqhelekileyo.

Izizathu ze-"Subclinical Hyperthyroidism" ziyafana kakhulu nezo zibangela i-hyperthyroidism ecacileyo. Nazi ezinye zezizathu eziphambili:

• Ukunyusa umthamo wonyango lwehomoni (levothyroxine) olunikwa i-hypothyroidism (i-thyroid engasebenzi kakuhle). Le yeyona nto ixhaphakileyo.
• I-Multinodular toxic goiter. Le yimeko apho kuvela khona amaqhuma angengomhlaza (ii-nodules) kwi-thyroid gland, nto leyo ebangela ukuba ivelise i-thyroid hormone eninzi kakhulu.
• Isifo sikaGraves. Esi sisifo esibangelwa kukuzikhusela komzimba. Oku kuthetha ukuba amajoni omzimba wethu ahlasela i-thyroid gland, ayikhuthaze ukuba ivelise iihomoni ezingaphezulu.
• I-Thyroiditis: Xa i-thyroid gland ivuvukala, amanqanaba e-hormone anokunyuka okwethutyana.

Uyibona njani le nto?

Uvavanyo lomsebenzi we-thyroid yeyona ndlela yokwazi ngokuqinisekileyo ukuba unayo i-'Subclinical Hyperthyroidism' okanye akunjalo.(Uvavanyo lokusebenza kwe-thyroid kuphela. Olu luvavanyo lwegazi oluqhelekileyo.

Uluhlu oluqhelekileyo lwamanqanaba e-TSH (akwabizwa ngokuba yi-thyrotropin) kumntu omdala ongakhulelwanga luphakathi kwe-0.4 kunye ne-4.5 milli-international units ngelitha (mIU/L).

Ukuba uvavanyo lwakho lwegazi lubonisa ukuba inqanaba lakho le-TSH liphantsi (phakathi kwe-0.1 kunye ne-0.4 mIU/L okanye ngaphantsi kwe-0.1 mIU/L), kodwa amanqanaba akho e-T4 (thyroxine) kunye ne-T3 (triiodothyronine) angaphakathi koluhlu oluqhelekileyo, une-Subclinical Hyperthyroidism.

I-'Subclinical Hyperthyroidism' inokwahlulwahlulwa ibe ziindidi ezimbini eziphambili:

• Ubuncinane: Amanqanaba e-TSH aphantsi, kodwa asabonakala - ngesiqhelo phakathi kwe-0.1 kunye ne-0.4 mIU/L. Eli nqanaba lifumaneka kwi-65% ukuya kwi-75% yabantu abane-Subclinical Hyperthyroidism.
• Inzima kakhulu: Amanqanaba e-TSH angaphantsi kwe-0.1 mIU/L. Oku kuchaphazela phakathi kwama-25% nama-35% abantu.

Ngaba oku kufuna unyango?

Kukho izimvo ezahlukeneyo phakathi koogqirha malunga nokuba banyange okanye banganyanga i-'Subclinical Hyperthyroidism', kuba uphando alukabikho ngokwaneleyo malunga neenzuzo ezicacileyo zonyango.

Oogqirha badla ngokucebisa indlela "yokulinda ubone" kubantu abane-subclinical hyperthyroidism. Oko kukuthi, balinda ukuba imeko iphucuke ngokwabo ngaphandle kokuqala unyango.

Nangona kunjalo, unyango lunokucetyiswa kwabo banamanqanaba e-TSH angaphantsi kwe-0.1 mIU/L rhoqo, ingakumbi kwiimeko ezilandelayo:

• Ukuba uneminyaka engama-65 ubudala okanye ngaphezulu.
• Ukuba ungaphantsi kweminyaka engama-65 ubudala, unesifo sentliziyo, i-osteoporosis, okanye iimpawu ze-hyperthyroidism.
• Ukuba ungumfazi osele ephezile ukuya exesheni, ungaphantsi kweminyaka engama-65 ubudala, kwaye awusebenzisi i-estrogen okanye i-bisphosphonates (uhlobo lweyeza elisetyenziselwa ukunyanga iingxaki zamathambo).

I-subclinical hyperthyroidism ngexesha lokukhulelwa ayisoloko ifuna unyango.

Ukuba unyango lunikiwe, luluphi?

Ukuba ugqirha wakho ugqiba kwelokuba unyango luyimfuneko, unyango luya kuxhomekeka kwisizathu se-subclinical hyperthyroidism.

• Ukuba une-goiter enetyhefu ye-multinodular goiter (iqhubu entanyeni) okanye iqhubu elinye kwi-thyroid yakho, unyango oluqhelekileyo yi- radioactive iodine . Eli liyeza olisela ngomlomo. Iiseli ezisebenza kakhulu kwi-thyroid yakho zifunxa i-iodine. I-radioactive iodine yonakalisa ezo seli, ibangela ukuba i-thyroid inciphe kwaye amanqanaba e-hormone yakho ehle kwiiveki ezimbalwa.
• Ukuba unesifo sikaGraves, unyango oluqhelekileyo ngamayeza e-antithyroid kunye ne-radioactive iodine. Amayeza e-antithyroid afana ne-methimazole (Tapazole) kunye ne-propylthiouracil (PTU) asebenza ngokuthintela amandla e-thyroid okwenza iihomoni.

Ngaba oku kungathintelwa ukuba kwenzeke?

Kwiimeko ezininzi, akukho nto sinokuyenza ukuthintela uphuhliso lwe-'Subclinical Hyperthyroidism' okanye i-'Hyperthyroidism' ecacileyo.

Nangona kunjalo, ukuba awufumani iodine eyaneleyo ekutyeni kwakho (okanye kakhulu) , unokufumana i-'Subclinical' okanye i-'Overt Hyperthyroidism' ngenxa ye-'toxic goiter'. Nangona oku kungaqhelekanga kumazwe afana neSri Lanka kuba sisebenzisa ityuwa ene-iodine, kunokubonwa kumazwe apho ukunqongophala kwe-iodine kuxhaphakileyo.

Yintoni esinokuyilindela ngale meko? Ngaba kukho naziphi na iingozi?

I-subclinical hyperthyroidism ayifane ifikelele kwi-hyperthyroidism ecacileyo. Nangona kunjalo, le ngozi iphezulu kancinci kubantu abanamanqanaba aphantsi kakhulu e-TSH (ngaphantsi kwe-0.1 mIU/L).

Ngenxa yokuba zininzi izizathu, i-'Subclinical Hyperthyroidism' yomntu wonke yahlukile.

Nokuba ayiqhubeki iye kwi-'Overt Hyperthyroidism', i-'Subclinical Hyperthyroidism' inokubangela iingxaki ezithile. Ezinye zazo zezi:

• I-Atrial fibrillation ( ukubetha kwentliziyo okungahambelaniyo).
• Ukusilela kwentliziyo (umngcipheko wokuhlaselwa sisifo sentliziyo ).
• Isifo sentliziyo (isifo semithambo yegazi ).
• Ukulahlekelwa ngamathambo kunye nokuqhekeka kwawo.
• I-Dementia ( imeko yokulahlekelwa yinkumbulo enokwenzeka xa umntu ekhula).

Ezi ngozi ziphezulu kakhulu kubantu abaneminyaka engaphezu kwama-65 ubudala kunye nabo bane-hyperthyroidism enzulu engaphantsi kwe-subclinical.

Ukuba ukhathazekile ngezi ngozi, kungcono ukuthetha nogqirha wakho ngale nto.

Ndifanele ndimbone nini ugqirha?

Amaxesha amaninzi, ukuba uvavanyo lwakho lubonisa ukuba une-"Subclinical Hyperthyroidism," oogqirha baya kusebenzisa le ndlela "linda ubone".

Nangona kunjalo, ukuba uqala ukuba neempawu ze-hyperthyroidism (ukuxhalaba, ukungazinzi, ukubetha kwentliziyo), qiniseka ukuba ubona ugqirha wakho. Emva koko uza kwenza olunye uvavanyo lwegazi le-thyroid ukuze abone ukuba unayo na i-'Overt Hyperthyroidism'.

Khumbula, kusekho izimvo ezininzi ezahlukeneyo malunga nokuba kufuneka unyange okanye unganyanga i-'Subclinical Hyperthyroidism'. Wonke umntu, yonke imeko yahlukile. Ke ngoko, eyona nto ingcono onokuyenza kukuxoxa ngayo yonke imibuzo yakho kunye noloyiko lwakho nogqirha wakho. Ukulungele kwaye uzimisele ukukunceda.

Umyalezo Wokuya Ekhaya

Kulungile, nazi izinto ekufuneka uzikhumbule koko sithethe ngako:

• I-"Subclinical Hyperthyroidism" yimeko apho i-thyroid gland isebenza kakhulu, kodwa ingabonakalisi zimpawu zibalulekileyo.
• Oku kuxilongwa kuvavanyo lwegazi olubonisa inqanaba eliphantsi le-TSH (kodwa inqanaba eliqhelekileyo le-T3 kunye ne-T4).
• Ekubeni kungekho zimpawu, unyango lusenokungabi yimfuneko. Ugqirha wakho usenokuthatha indlela "yokulinda ubone".
• Abanye abantu, ingakumbi abantu abadala okanye abo banezinye iingxaki zempilo, banokufuna unyango.
• Ukuba ufumana iimpawu ze-hyperthyroidism (ezifana nokunyuka kwentliziyo, ukungcangcazela, ukwehla kobunzima), bona ugqirha ngoko nangoko.
• Eyona nto ibalulekileyo kukungaxhalabi, thetha ngokukhululekileyo ngale nto nogqirha wakho, kwaye ulandele icebiso lakhe.

Ndiyathemba ukuba olu lwazi uza kulufumana luluncedo. Hlala usempilweni!

I- Hyperthyroidism engaphantsi kweklinikhi, i-thyroid, i-TSH, i-T3, i-T4, iihomoni, isifo se-Graves, i-goiter