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Kuyini ukuhlolwa kwe-TSH futhi imiphumela yakho isho ukuthini?

Kuyini ukuhlolwa kwe-TSH futhi imiphumela yakho isho ukuthini?Imfundo Yezempilo

Isivivinyo se-thyroid-stimulating hormone (TSH) sihlola ukusebenza kwe-thyroid namazinga e-hormone yegilo. Ikhiqizwa yi-pituitary gland, etshela i-thyroid yakho, etholakala engxenyeni engezansi entanyeni yakho, ukwenza nokukhulula ama-hormone alawula ukushisa komzimba wethu, imetabolism, nokugcina ubuchopho, izinhliziyo, nezinye izitho zethu zisebenza kahle.

I-American Thyroid Association (ATA) incoma ukuthi abantu abadala baqale ukuhlolwa kwe-TSH beneminyaka engama-35 bese bephinda izivivinyo njalo eminyakeni emihlanu uma imiphumela isezingeni elijwayelekile. Udokotela wakho angaphinde ahlele ukuhlolwa kwe-TSH uma uhlangabezana nezimpawu ze-thyroid engasebenzi noma engasebenzi ngokweqile. Izimpawu ze-hypothyroidism (i-thyroid engasebenzi) zingafaka ukukhathala, inkungu yobuchopho, isikhumba esomile ngokweqile, ukulahleka kwezinwele nokuzizwa kubanda. Izimpawu ye-hyperthyroidism (i-thyroid engasebenzi ngokweqile) ingafaka ukujuluka, ukushaya kwenhliziyo okusheshayo, ubuthakathaka bemisipha, ukukhathazeka nokucasula. Kunoma ikuphi, wena — noma umhlinzeki wakho wezokunakekelwa kwempilo — ungathola ukuthi igilo lakho likhulisiwe, elibizwa ngokuthi i-goiter, noma amaqhubu egilo, okuyizigaxa ezincane endlaleni yegilo.



Ngabe ukuhlolwa kwe-TSH kufaka ini?

Ukuhlolwa kwegazi kwe-TSH kuvame ukwenziwa njengengxenye yephaneli lokuhlolwa kwegazi ngokuhlangana nokuhlolwa kwempilo minyaka yonke. Ukuhlolwa kunquma ukuthi i-thyroid yakho isebenza kahle kangakanani ngokulinganisa inani le-hormone evuselela i-thyroid egazini lakho. Ukuhlolwa kwegazi okungazili ukudla, okusho ukuthi awudingi ukwenza noma yini ekhethekile ukulungiselela.



Odokotela kufanele bathathe isampula yegazi le-TSH ezigulini ze-thyroid njalo emavikini amane kuya kwayisishiyagalombili ngemuva kokutholakala kwabo kokuqala. I- bona uncoma ukuhlolwa kwe-TSH njalo ezinyangeni eziyisithupha kuya kwezingu-12 ngenkathi usemuthini ozinzile wemithi futhi kaningi uma umthamo wakho ushintshile.

Kufanele libe yini izinga lakho le-TSH?

Amalabhorethri amaningi ahlukanisa amazinga ejwayelekile e-TSH njengaphakathi kuka-0.4 no-4.5 milliunits ngelitha ngalinye (mU / L), ngokusho kwe I-American Thyroid Association (ATA). Izinga elijwayelekile le-TSH ezimweni eziningi, livame ukukhombisa ukuthi awunayo inkinga ye-thyroid.



I- bona ibika ukuthi abantu baseMelika abacishe babe yizigidi ezingama-20 banohlobo oluthile lwesifo segilo. Kodwa ngaphezu kuka-60% walabo abanesifo se-thyroid abasazi ngesimo sabo sezokwelapha.

Kusho ukuthini uma i-TSH yakho iphansi?

Ezimweni eziningi, amazinga we-TSH angaphansi kuka-0.4 mU / L akhombisa i-hyperthyroidism, eyaziwa nangokuthi i-thyroid engasebenzi, okusho ukuthi, umzimba wakho ukhiqiza i-hormone yegilo eningi kakhulu. Isifo seGraves yisifo sokuzilimaza komzimba kwesinye isikhathi esidala i-hyperthyroidism.

Kwenzekani lapho i-TSH yakho iphakeme?

Ngokuvamile, amazinga e-TSH aphezulu kuno-4.5 mU / L akhombisa i-hypothyroidism, noma i-thyroid engasebenzi, okusho ukuthi umzimba wakho awenzi i-hormone yegilo eyanele. I-Hashimoto's thyroiditis yisifo sokuzilimaza kwesinye isikhathi esidala i-hypothyroidism.



Ngabe usengaba nenkinga uma i-TSH yakho ingejwayelekile?

Ukuhlolwa kwe-TSH kuyinkomba ebucayi kakhulu yempilo yakho yonke yegilo, kusho uBrittany Henderson, MD, i-endocrinologist eqinisekisiwe ebhodini Isikhungo Se-Thyroid SaseCharleston eMount Pleasant, eSouth Carolina . Ukuhumusha kungaba nzima ngoba kunezinhlobonhlobo 'zokujwayelekile' esikalini se-TSH.

Imithi nezithasiselo ozithathayo njengamanje zingathinta imiphumela yokuhlolwa kwakho kwe-TSH. Isibonelo esisodwa yi-biotin, engakhombisa ngamanga amazinga aphansi we-TSH.

Okuthathwa njengokujwayelekile kuthonywe izinto eziningana:



  • Ubudala
  • Ukukhulelwa
  • Ubuhlanga

Ucwaningo kukhombisile ukuthi amazinga we-TSH athambekele ekukhuleni ngeminyaka, anciphe ngokukhulelwa, futhi ayahluka ngokobuhlanga.

Ubudala

Eyodwa funda ithole ukuthi iziguli ezingama-97.5% ezineminyaka engama-55 ubudala zinamanani we-TSH angaphansi kuka-4.0 mU / L. Ngaphezulu kwaleyo minyaka inani eliphakeme le-97.5th percentile lakhuphuka kancane kancane, lafinyelela cishe ku-4.75 mU / L phakathi kweminyaka engama-75 nengama-85 kanye no-5.0 mU / L ezigulini eziphakathi kweminyaka engama-85 nengama-90. Abantu abadala abadingi ukwelashwa.

Amazinga e-TSH nawo angahluka ezinganeni futhi ibanga lingashintsha ngokuya ngeminyaka. Kunconywa ukuthi abazali bahlole udokotela we-endocrinologist ukuthola ukuthi ngabe uhla lwe-TSH olungcono yini lwezingane zabo.



Ukukhulelwa

Kwabesifazane abakhulelwe ku-trimester yabo yokuqala, i-American Thyroid Association incoma ukuthi amazinga e-TSH agcinwe ngokuya ngesimo se-thyroid autoimmunity. Imvamisa, i-TSH igcinwa phakathi kuka-0.2-<2.5 mU/L or the upper limit of TSH ie, 4.5 mU/L based on autoimmunity. TSH is recommended to be maintained between 0.3-3 mU/L in the remaining trimesters.

Ubuhlanga

UDkt Henderson, owabhala ngokubambisana le ncwadi, Okufanele Ukwazi Ngezifo zikaHashimoto , uphawula ukuthi imiphumela ye-TSH nayo ingahluka ngokuya ngobuhlanga. Izinga le-TSH ngokwesiko liphakeme kubantu abamhlophe, liphansi kubantu abamnyama, futhi kwenye indawo liphakathi kwabantu baseSpain, uyachaza.

Uthi iziguli zingaba nemiphumela ye-TSH ebangeni 'elijwayelekile', ngenkathi zisahlangabezana nezimpawu ezisebenzayo (njengokunciphisa isisindo noma ukuzuza, ukulahleka kwezinwele, ukukhathala, ukukhathazeka nokuningi). Amazinga e-TSH akhombisa ukuthi ngabe i-thyroid yakho inenkinga, kodwa ayikhombisi ukuthi yini ebangela inkinga. Ukuthola lokho, umhlinzeki wakho wezokunakekelwa kwempilo anga-oda izivivinyo ezengeziwe.



Lapho ungahle udinge ukuhlolwa okwengeziwe

Kulezi zimo, odokotela bangakhetha uku-oda iphaneli ephelele yokuhlolwa kokusebenza kwe-thyroid ukukala i-thyroxine efana ne-Free T4, Total T4, Total T3, kanye namasosha omzimba wegilo, ngaphezu kwe-TSH. Ingxenye ebucayi yokuthola imiphumela engcono kakhulu yokuhlolwa kwe-TSH nokwelashwa kwe-thyroid kubandakanya ukuqinisekisa ukuthi uthola izivivinyo ezifanele zokuxilonga.

Ukuhlolwa kwe-T4

I-Free T4 ukuhlolwa kwegazi okungazili ukudla okulinganisa amazinga we-T4, i-hormone yegilo. Izinga elijwayelekile lamabanga we-Free T4 phakathi0.8 kuya ku-1.5ama-microgram nge-decilita ngayinye (ng / dL). Ingahluka ngokuya ngesilingo se-laboratory esisetshenzisiwe. Ingqikithi ye-T4 ayenziwa ngokujwayelekile ngaphandle kokukhulelwa lapho inembe kakhudlwana kunokuhlolwa kwe-Free T4.Ububanzi obujwayelekile be-T4 bungu-5-12 ug / dl. Amazinga aphansi ka-T4 zibonwa nge-hypothyroidism, kuyilapho amazinga aphezulu ebonakala nge-hyperthyroidism.

Ukuhlolwa kwe-T3

Ukuhlolwa kwegazi okungazili ukudla okungu-Total T3 kwesinye isikhathi kunconywa njengendlela yokuxilonga i-hyperthyroidism nokunquma ubukhulu besifo. Imiphumela ejwayelekile ye-T3 ilinganiselwa kusuka kuma-nanograms ayi-100 kuye kwangama-200 nge-deciliter ngayinye (ng / dl). Ukuhlolwa kwamahhala kwe-T3 akunconyiwe ngenxa yokuguquguquka kwesilingo sayo se-laboratory. Ukubuyela emuva kwe-T3 kunendima elinganiselwe ekutholeni izinkinga ze-thyroid futhi akukhuthazwa njalo.

Udinga nini ukwelashwa?

Iziguli eziningi ze-hypothyroid zizizwa zizinhle kakhulu lapho zisebenzisa imishanguzo futhi amazinga azo e-thyroid asezingeni ‘elilungile’ le-TSH elingu-0.5-2.00 (elinesikali sebhu esingu-0.45-4.5), kusho uDkt Henderson. Njengoba ukuhlolwa kwelebhu nobubanzi kuyahluka, amazinga alungiselelwe elebhu ethile yesiguli nawo angahluka. Ezigulini esezikhulile, inhloso ye-TSH ikubanga le-4.0 - 6.0.

Ingabe i-diphenhydramine hcl iyafana ne-benadryl?

Odokotela abaningi bavame ukuphatha iziguli zabo ze-hypothyroid ngomthamo wansuku zonke we-levothyroxine, uhlobo olwenziwe ngumuntu lwe-T4 hormone ye-thyroid eyenziwe ngumzimba, abanye odokotela batusa ukusebenzisa i-T4 ne-T3 njengendlela yokwelashwa.

OKUSHIWO: Izinto ezinhlanu ezingadida ngemithi yakho yegilo

Ngemithi ye-thyroid, i-dosing kufanele ilunge kahle, kusho uDkt Henderson. Umuthi omningi kakhulu noma omncane ungaholela emiphumeleni emibi ethinta impilo yesiguli.

Ezigulini ezingama- sitholwe njenge-hyperthyroid, Ukwelashwa kungafaka imithi ye-antithyroid efana ne-methimazole, esebenza ukulawula i-thyroid engasebenzi. Ezinye iziguli zinikezwa iodine enemisebe, enikezwa ifomu lamaphilisi ukuze inciphise i-thyroid kancane kancane futhi ngokuphepha.

Uma uhlangabezana nezimpawu ze-thyroid engasebenzi noma engasebenzi ngokweqile, funa izeluleko zochwepheshe bezokwelapha kudokotela wakho noma uchwepheshe we-endocrinology ngalezi zivivinyo nezindlela zokwelashwa.