Ingabe i-thyroid yakho ibonakala isebenza ngokweqile? Ake sixoxe nge-Subclinical Hyperthyroidism!

Ingabe udokotela wakho uthe izinga lakho le-TSH liphansi kancane ekuhlolweni kwegazi kwakamuva? Noma unezimpawu ezithile ezingavamile, okunzima ukuziqonda? Ungase ube nesimo esibizwa ngokuthi i-Subclinical Hyperthyroidism. Ungakhathazeki, ngokuvamile asibi kakhulu. Ake sixoxe ngalokhu kalula nangokucacile.

Kuyini i-Subclinical Hyperthyroidism?

Kalula nje, i-'Subclinical Hyperthyroidism' yisimo lapho i-thyroid gland yakho isebenza khona kancane kunokujwayelekile. Kodwa ayinzima njenge-'overt hyperthyroidism' .

I-pituitary gland ebuchosheni bethu ikhiqiza i-hormone ebizwa ngokuthi i-`TSH` (i-Thyroid-Stimulating Hormone). Le `TSH` itshela i-thyroid gland entanyeni yethu ukuthi yenze ama-hormone amabili abizwa ngokuthi i-thyroxine (`T4` - `thyroxine`) kanye ne-triiodothyronine (`T3` - `triiodothyronine`). La ma-hormone e-`T3` ​​kanye ne-`T4` yiwo asiza i-metabolism yomzimba wethu, okungukuthi, ukuguqula ukudla esikudlayo kube amandla futhi sikusebenzisele imizimba yethu.

Ku-'Subclinical Hyperthyroidism', izinga le-'TSH' egazini lakho liphansi, kodwa amazinga akho e-'T3' ​​kanye ne-'T4' ajwayelekile. Lokho kusho ukuthi i-thyroid isebenza ngokweqile, ngakho-ke i-pituitary gland ithi, "Kulungile, angidingi i-'TSH' njengamanje, i-thyroid yami isebenza kahle," futhi inciphisa ukukhiqizwa kwe-'TSH'. Kodwa ama-hormone e-thyroid ('T3', 'T4') awakakhuphuki kakhulu. Yilokho okushiwo yi-'subclinical' - isimo esingaphansi esingabonakali izimpawu ezisobala.

Lesi simo ngezinye izikhathi singaba sesikhashana , okusho ukuthi singaba ngcono ngokwaso ezinsukwini ezimbalwa. Kodwa-ke, kwabanye abantu singaba ngunaphakade. Akuwona wonke umuntu odinga ukwelashwa.

Ubani okungenzeka kakhulu ukuthi athole lesi simo?

Noma ubani angaba ne-'Subclinical Hyperthyroidism', kodwa abantu abalandelayo basengozini enkulu kancane:

• Abantu abathatha ukwelashwa kokushintsha ama-hormone e-thyroid (isibonelo, i-levothyroxine) ngenxa ye-hypothyroidism. Ngezinye izikhathi lokhu kungenzeka uma umthamo womuthi ukhushulwa kancane.
• Kulabo abaneminyaka engaphezu kwengu-65 ubudala.

Sivame kangakanani lesi simo?

Lesi akusona isimo esivamile kakhulu emazweni afana neMelika.

Cishe u-0.7% wabantu bane-'Subclinical Hyperthyroidism', lapho amazinga e-TSH engaphansi kuka-0.1 mIU/L. Abanye abangu-1.8% banamazinga 'e-TSH' angaphansi kuka-0.4 mIU/L.

Kodwa-ke, emazweni anokuntuleka kwe-iodine , ikakhulukazi phakathi kwabantu abangaphezu kweminyaka engu-70, lesi simo singafinyelela ku-15%. ESri Lanka, le ngozi iphansi ngoba sivame ukusebenzisa usawoti one-iodine , kodwa kuhle ukuqaphela.

Ziyini izimpawu?

Esikhathini esiningi, abantu abane-'Subclinical Hyperthyroidism' ababonisi zimpawu . Yingakho ibizwa ngokuthi "subclinical".

Kodwa-ke, ngezinye izikhathi ungase ube nezimpawu ezincane ezihlobene ne-hyperthyroidism. Ngezikhathi ezinjalo, ungase ube nezinto ezifana nalezi:

• Ukuzizwa sengathi inhliziyo yakho ishaya ngokushesha (ukushaya kwenhliziyo).
• Kunjengokungathi umzimba wami uyathuthumela, ngizizwa nginovalo nje.
• Ukwehlisa isisindo (naphezu kwesifiso sokudla).
• Ukwanda kwesifiso sokudla.
• Uhudo noma ukuhamba kwamathumbu njalo.
• Isikhumba sizizwa sincane, sifudumele futhi simanzi.
• Izinguquko emjikelezweni wokuya esikhathini kwabesifazane (`Izinguquko zokuya esikhathini`).

Okubalulekile: Ukuba nalezi zimpawu akusho ukuthi une-'Subclinical Hyperthyroidism'. Kodwa-ke, uma lezi zimpawu ziqhubeka, kuwukuhlakanipha ukubona udokotela.

Kungani lokhu kwenzeka? Yiziphi izizathu?

Ngokuvamile, uhlelo lwethu lwe-endocrine lusebenza njengeqembu. Cabanga ngakho njengenkampani enkulu.

I-hypothalamus, etholakala phansi kobuchopho, ikhipha i-hormone ebizwa ngokuthi i-TRH (i-Thyroid-Releasing Hormone). Lokhu kutshela i-pituitary gland ukuthi ikhiqize i-TSH.

Ngemuva kwalokho i-'TSH' iyahamba iyotshela i-thyroid gland ukuthi yenze i-'T3' ​​(cishe i-20%) kanye ne-'T4' (cishe i-80%). Lapho le 'T3' kanye ne-'T4' zanda egazini, ithumela futhi isignali ku-pituitary gland ithi, "Kulungile, yeka ukwenza i-'TSH' manje, kune-hormone eyanele." Lokhu kubizwa ngokuthi i- 'feedback loop' . Lapho i-'T3' kanye ne-'T4' zehla, lo mjikelezo uqala futhi kusukela ekuqaleni.

Kodwa-ke, ku-'Subclinical Hyperthyroidism', ngenxa yenkinga ethile endlaleni ye-thyroid, yize izinga le-'TSH' liphansi, ukukhiqizwa kwama-hormone e-thyroid akwehli njengoba kulindelekile. Yingakho i-'TSH' iphansi, kodwa i-'T3' ​​kanye ne-'T4' zisezingeni elijwayelekile.

Izimbangela ze-"Subclinical Hyperthyroidism" zifana kakhulu nalezo ezibangela i-hyperthyroidism esobala. Nazi ezinye zezimbangela eziyinhloko:

• Ukwandisa umthamo wokwelashwa ngama-hormone (i-levothyroxine) onikezwa i-hypothyroidism (i-thyroid engasebenzi kahle). Lena yimbangela evame kakhulu.
• I-goiter enobuthi ene-multinodular. Lesi yisimo lapho kuvela khona amaqhubu (amaqhubu) angewona umdlavuza endlaleni ye-thyroid, okubangela ukuthi ikhiqize i-hormone ye-thyroid eningi kakhulu.
• Isifo sikaGraves. Lesi yisimo sokuzivikela komzimba. Lokhu kusho ukuthi amasosha omzimba wethu ahlasela i-thyroid gland, ayikhuthaze ukuthi ikhiqize ama-hormone engeziwe.
• I-Thyroiditis: Lapho i-thyroid gland ivuvukala, amazinga ama-hormone anganda okwesikhashana.

Ukubona kanjani lokhu?

Ukuhlolwa kokusebenza kwe-thyroid kuyindlela kuphela yokwazi ngokuqinisekile ukuthi une-'Subclinical Hyperthyroidism' noma cha.(Ukuhlolwa kokusebenza kwe-thyroid kuphela. Lokhu ukuhlolwa kwegazi okuvamile.

Izinga elijwayelekile lamazinga e-TSH (abizwa nangokuthi i-thyrotropin) kumuntu omdala ongakhulelwe liphakathi kwamayunithi angama-0.4 nama-4.5 milli-international ngelitha (mIU/L).

Uma ukuhlolwa kwegazi lakho kubonisa ukuthi izinga lakho le-TSH liphansi (phakathi kuka-0.1 no-0.4 mIU/L noma ngaphansi kuka-0.1 mIU/L), kodwa amazinga akho e-T4 (thyroxine) kanye ne-T3 (triiodothyronine) angaphakathi kwesilinganiso esijwayelekile, une-Subclinical Hyperthyroidism.

I-'Subclinical Hyperthyroidism' ingahlukaniswa ngezigaba ezimbili eziyinhloko:

• Okuncane: Amazinga e-TSH aphansi, kodwa asabonakala - ngokuvamile aphakathi kuka-0.1 no-0.4 mIU/L. Leli zinga likhona kubantu abangu-65% kuya ku-75% abane-Subclinical Hyperthyroidism.
• Okubi kakhulu: Amazinga e-TSH angaphansi kuka-0.1 mIU/L. Lokhu kuthinta abantu abaphakathi kuka-25% no-35%.

Ingabe lokhu kudinga ukwelashwa?

Empeleni kunemibono ehlukene phakathi kodokotela mayelana nokuthi kufanele yini yelashwe i-'Subclinical Hyperthyroidism' noma cha, ngoba kusenocwaningo olwanele ngezinzuzo ezicacile zokwelashwa.

Odokotela bavame ukuncoma indlela "yokulinda bese ubona" ​​kubantu abane-subclinical hyperthyroidism. Okusho ukuthi, balinda isimo sithuthuke ngokwaso ngaphandle kokuqala ukwelashwa.

Kodwa-ke, ukwelashwa kunganconywa kulabo abanamazinga e-TSH angaphansi kuka-0.1 mIU/L, ikakhulukazi ezimweni ezilandelayo:

• Uma uneminyaka engu-65 noma ngaphezulu.
• Uma ungaphansi kweminyaka engama-65 ubudala, unesifo senhliziyo, i-osteoporosis, noma izimpawu ze-hyperthyroidism.
• Uma ungowesifazane osedlule esikhathini sokuya esikhathini, ungaphansi kweminyaka engama-65, futhi ungasebenzisi i-estrogen noma i-bisphosphonates (uhlobo lomuthi osetshenziselwa ukwelapha izinkinga zamathambo).

I-subclinical hyperthyroidism ngesikhathi sokukhulelwa ngokuvamile ayidingi ukwelashwa.

Uma kunikezwa ukwelashwa, kuyini?

Uma udokotela wakho enquma ukuthi ukwelashwa kuyadingeka, ukwelashwa kuzoncika embangela ye-subclinical hyperthyroidism.

• Uma une-goiter enobuthi ene-multinodular goiter (isigaxa entanyeni) noma iqhubu elilodwa ku-thyroid yakho, ukwelashwa okuvame kakhulu yi- radioactive iodine . Lona umuthi owuthatha ngomlomo. Amaseli asebenza ngokweqile ku-thyroid yakho amunca i-iodine. I-radioactive iodine ilimaza lawo maseli, okwenza i-thyroid inciphe futhi amazinga akho e-hormone ehle emavikini ambalwa.
• Uma unesifo sikaGraves, ukwelashwa okuvame kakhulu yimithi yokulwa ne-thyroid kanye ne-iodine enemisebe. Imithi yokulwa ne-thyroid efana ne-methimazole (Tapazole) kanye ne-propylthiouracil (PTU) isebenza ngokuvimbela ikhono le-thyroid lokwenza ama-hormone.

Ingabe lokhu kungavinjelwa ukuthi kwenzeke?

Ezimweni eziningi, akukho esingakwenza ukuvimbela ukuthuthukiswa kwe-'Subclinical Hyperthyroidism' noma i-'Hyperthyroidism' esobala.

Kodwa-ke, uma ungatholi i-iodine eyanele ekudleni kwakho (noma kakhulu) , ungahlakulela i-'Subclinical' noma i-'Overt Hyperthyroidism' ngenxa ye-'toxic goiter'. Nakuba lokhu kungavamile emazweni afana neSri Lanka ngoba sisebenzisa usawoti one-iodine, kungabonakala emazweni lapho ukuntuleka kwe-iodine kuvame khona.

Yini esingayilindela ngalesi simo? Ingabe zikhona izingozi?

I-subclinical hyperthyroidism ayivamile ukuqhubekela phambili ibe yi-hyperthyroidism esobala. Kodwa-ke, le ngozi iphakeme kancane kubantu abanamazinga aphansi kakhulu e-TSH (ngaphansi kuka-0.1 mIU/L).

Ngenxa yokuthi kunezimbangela eziningi, i-'Subclinical Hyperthyroidism' yomuntu wonke ihlukile.

Ngisho noma ingathuthuki ibe yi-'Overt Hyperthyroidism', i-'Subclinical Hyperthyroidism' ingabangela ezinye izinkinga. Ezinye zazo yilezi:

• I-fibrillation ye-atrial ( ukushaya kwenhliziyo okungajwayelekile).
• Ukwehluleka kwenhliziyo (ingozi yokuhlaselwa yinhliziyo ).
• Isifo senhliziyo (isifo semithambo yegazi ).
• Ukulahlekelwa amathambo nokuqhekeka kwawo.
• I-Dementia ( isimo sokulahlekelwa yinkumbulo okungenzeka ngokuguga).

Lezi zingozi ziphezulu kakhulu kubantu abaneminyaka engaphezu kwengu-65 kanye nalabo abane-hyperthyroidism engaphansi kwe-subclinical.

Uma ukhathazekile ngalezi zingozi, kungcono ukukhuluma nodokotela wakho ngalokhu.

Kufanele ngimbone nini udokotela?

Esikhathini esiningi, uma ukuhlolwa kwakho kubonisa ukuthi une-"Subclinical Hyperthyroidism," odokotela bazothatha indlela ethi "linda ubone".

Kodwa-ke, uma uqala ukuzwa izimpawu ze-hyperthyroidism (ukukhathazeka, ukungahlaliseki, ukushaya kwenhliziyo), qiniseka ukuthi ubona udokotela wakho. Uzobe esephinda enze olunye ukuhlolwa kwegazi le-thyroid ukuze abone ukuthi unayo yini i-'Overt Hyperthyroidism'.

Khumbula, kusenemibono eminingi ehlukene mayelana nokuthi kufanele yini welaphe i-'Subclinical Hyperthyroidism' noma cha. Wonke umuntu, isimo ngasinye sihlukile. Ngakho-ke, into engcono kakhulu ongayenza ukuxoxa ngayo yonke imibuzo yakho kanye nokwesaba kwakho nodokotela wakho. Ukulungele futhi uzimisele ukukusiza.

Umlayezo Wokuya Nawe Ekhaya

Kulungile, ngakho-ke nazi ezinye izinto okudingeka uzikhumbule kulokho esikhulume ngakho:

• I-"Subclinical Hyperthyroidism" yisimo lapho i-thyroid gland isebenza ngokweqile kancane, kodwa ingabonakali izimpawu ezinkulu.
• Lokhu kutholakala ngokuhlolwa kwegazi okubonisa izinga eliphansi le-TSH (kodwa i-T3 ne-T4 evamile).
• Njengoba ngokuvamile kungekho zimpawu, ukwelashwa kungase kungadingeki. Udokotela wakho angase athathe indlela "yokulinda bese ubona".
• Abanye abantu, ikakhulukazi abantu asebekhulile noma labo abanezinye izinkinga zempilo, bangadinga ukwelashwa.
• Uma uzwa izimpawu ze-hyperthyroidism (njengokwenyuka kwenhliziyo, ukuthuthumela, ukwehla kwesisindo), bona udokotela ngokushesha.
• Into ebaluleke kakhulu ukungesabi, ukhulume ngokukhululekile ngalokhu nodokotela wakho, bese ulandela iseluleko sakhe.

Ngithemba ukuthi lolu lwazi luwusizo. Hlala uphilile!

I- Hyperthyroidism engaphansi kwe-subclinical, i-thyroid, i-TSH, i-T3, i-T4, ama-hormone, isifo se-Graves, i-goiter