Ho sheba Natural Thyroid, Levothyroxine, le Innovative New Treatment Options
Mofuputsi ea tummeng Dr. Wilmar Wiersinga, khatisong ea January 2014 ea koranta ea bongaka Nature Reviews Endocrinology , o na le pono e thahasellisang ea liphetoho tse ling tsa paradigm ho li-hormone ea phetoho ea phekolo ea hypothyroidism lilemong tsa morao tjena. Ke kakaretse likarolo tse thahasellisang ka ho fetisisa tsa sehlooho sena.
Liphetoho Tse 'Nè Tsa Paradigm
Dr. Wiersinga o khetholla liphetoho tse 'nè tsa paradigm.
- Paradigm Shift ea pele: Hysproidroidism e ne e sa phekolehe ho fihlela ka 1891 London, Dr. George Murray o ile a fetola hypothyroidism e matla mokuli ka ho fana ka ente ea nku ea qoqotho ea nku. Ka mor'a moo, thyroid e entsoeng ka mobu kapa e omeletsoeng kapa matlapa a liphatsa tsa qoqotho tse omeletseng li ile tsa qala ho sebelisoa e le phekolo ea pele e sebetsang bakeng sa hypothyroidism.
- Paradigm Shift ea Bobeli: Ho tloha ka 1960 ho fihlela ka 1988, tšebeliso ea lithethefatsi tsa tlhaho tse hlahisitsoeng ke qoqotho e ile ea theoha butle-butle, kaha tšebeliso ea levothyroxine e ile ea eketseha. Ka 1978, litekanyetso tsa levothyroxine li feta litekanyetso tsa tlhaho tse khethiloeng. Ka 1988, 84% ea bakuli bohle ba ne ba nka levothyroxine.
- Tsela ea boraro ea Paradigm Shift: Dr. Wiersinga o hlalosa kamoo liteko tsa liphoofolo tse tsoang lilemong tsa bo-1990 li bontšitseng hore euthyroidism - ho finyella maemo a tloaelehileng a T4 le a T3 meleng ea 'mele - ka mor'a hore ho ntšoa ho tsoa ha qoqotho ea qoqotho ho ne ho ke ke ha fumanoa ka levothyroxine feela, empa hape ho ne ho hlokahala liothyronine (T3) . Bakuli le litsebi ba tlalehile bakuli ba ntse ba ntlafatsa ka ho eketsa T3, kapa ka thero ea tlhaho ea tlhaho , empa boholo ba liteko le lipatlisiso tse entsoeng nakong ena ha lia ka tsa fumanoa li tiile hore mekhoa e meng ea phekolo e ne e phahametse. Dr. Wiersinga o fana ka maikutlo a hore ho na le liphatsa tsa tlhaho tsa lefutso tse etsang hore bakuli ba bang ba amohele phekolo ea meriana - 'me "haeba lithuto tse ling li ka khetholla sehlopha sena se itseng sa bakuli ba hypothyroid, phetoho ea boraro ea phekolo ea hypothyroidism e ka etsahala-mohlomong tšebeliso ea meriana e ikemetseng ka mokhoa ona. "
- Palo ea bone ea Paradigm Shift : Phuputso ea lipatlisiso ea 2012 e hlalositsoeng ka lekhetlo la pele e sebetsang ka lisele tsa qoqotho e ka hlahisoa ke li-cell stem. Dr. Wiersinga o hlalosa hore "qetellong mosebetsi ona o ka lebisa phetoho ea bone ea paradigm, moo bakuli ba hypothyroid ba ka phekoloang ka lisele tsa stem tse hlahisang qoqotho."
Levothyroxine Phekolo Feela
Ha a bua ka liphetoho tsa paradigm, Dr. Wiersinga o ile a sheba ka ho teba ho sebelisoa ha levothyroxine (T4) kalafo feela . O ile a bontša hore ho na le lithuto tse 'maloa tse bontšang hore phekolo ea levothyroxine e amahanngoa le mekhoa e mengata bakeng sa bakuli, ho akarelletsa:
- khatello ea kelello e eketsehileng
- ho kula hantle
- e fokotsehile boleng ba bophelo bo amanang le bophelo bo botle
- ho senyeha ha kelello ea kelello, ho ela hloko, ho ithuta le ho hopola
- ho ata ha matšoenyeho
- ho sebetsa ka kelello e futsanehileng, ho hopola le ho ithuta
Ka ho khetheha, ho ea ka Dr. Wiersinga, "Ho ba le khatello ea maikutlo kelellong, ho tepella maikutlong kapa ho tšoenyeha ho hlokomeloa ka 5-10% ea bakuli ba hypothyroid ba fumanang levothyroxine, ho sa tsotellehe maemo a tloaelehileng a TSH ."
Dr. Wiersinga o boetse o tlaleha ka thuto e thahasellisang ea Scottish e ileng ea fumana hore likotsi tsa lipelo tsa pelo, arrhythmias le bone bone thickness li eketsehile ho bakuli ba nang le litekanyetso tsa TSH tse fokolang (tlase ho003), le bakuli ba nang le maemo a phahameng a TSH (ka holimo ho 4.0) empa ho ne ho se kotsi e eketsehileng e amanang le li-TSH tse "tlase" (.04 ho ea ho4).
Dr. Wiersinga o ile a hlahisa lipatlisiso tse bontšang hore "litekanyetso tse tloaelehileng tsa TSH ka lebaka leo ha li tiisetse euthyroidism liphateng tsohle tse nang le li-hormone tsa qoqotho." Ka mantsoe a bonolo feela: phekolo ea levothyroxine feela e ke ke ea e-ba phekolo e nepahetseng bakeng sa bakuli ba hypothyroidism. Ho e-na le hoo, tlatsetso e ling ea t3 e ka 'na ea thusa ho tloaela ho etsa mosebetsi oa qoqotho litsong tsohle.
Levothyroxine Hape Liothyroinine (T4 + T3)
Liphuputso tse 'maloa li shebileng phekolo ea levothyroxine feela, ho fapana le ho phaella ha T3 ho bontšitse hore, ho ea ka Dr. Wiersinga, "karolo e phahameng ka ho fetisisa ea bakuli (ka karolelano 48%) e rata phekolo ea motsoako ... Ho se tšoane ho serum ea ho qetela Maqheka a TSH a sitoa ho hlalosa sekhetho sena sa mokuli. "
Liphello
Dr. Wiersinga o phethela hore "phehisano e kholisang e ka etsoa hore phekolo e kopanetsoeng e ka ba le melemo haeba levothyroxine: liothyronine li-ratios tsa tekanyo li sebelisoa tse hlahisang litekanyetso tse tloaelehileng tsa TSH le T4 mahala: likhakanyo tsa T3 tsa mahala" kapa ha li fuoa bakuli ba nang le lintlha tse itseng mathata a liphatsa tsa lefutso a amang matla a bona a ho fetola T4 ho ea ho T3.
O boetse o buella hore li- endocrinologists li lokela ho sheba likhetho, ho kopanyelletsa le ho phaella ha T3, ho thusa bakuli ba hypothyroid ba nang le matšoao a tsitsitseng ho sa tsotellehe litekanyetso tse lekaneng tsa levothyroxine.
Ho ea ka Dr. Wiersinga, kgetho e 'ngoe ke ho latela litaelo tsa Europe ea Thyroid Association (ETA) bakeng sa tšebeliso e bitsoang "teko" ea T4 + T3 therapy , e leng karolelano ea levothyroxine ho liothyronine ea ka bang 17: 1 Ho ea ka sehlooho, "ka mohlala, TSH-normalizing levothyroxine tekanyo ea 100 μg, 150 μg le 200 μg nakong ea monotherapy e fetoleloa ka tekanyo ea bongaka ea 85 μg levothyroxine hammoho le 5 μg liothyronine, 125 μg levothyroxine le 7.5 μg liothyronine le 175 μg levothyroxine hammoho le 10 μg liothyronine, ka ho latellana).
Ba boetse ba khothalletsa ho arola tekanyo ea T3 letsatsi le leng le le leng (monoana o monyenyane o fanoeng hoseng le tekanyo e kholo e fanoeng nakong ea ho robala, ho lekanngoa hantle ho latela hore na ho na le litokisetso tsa liothyronine tsa moo ho sebelisoang ho sebelisoa) ho "thusa ho etsisa molumo oa circadian oa litekanyetso tsa T3 tse sa lefelloeng, tse fihlang tlhōrōng ea tsona ka hora ea boraro hoseng
ETA e boetse e buella ho lokisetsa ho lokolloa ha T3 butle-butle.
Lintlha tse ling tse thahasellisang
Tse ling tsa lintlha tse seng kae tsa moelelo tse thahasellisang ho tsoa sehloohong sena.
Litlhahiso tsa phekolo ea hypothyroidism tse ileng tsa hatisoa lilemong tsa bo-1980 le lilemong tsa bo-1990 "ka mokhoa o sa utloahaleng" li khothalletsa levothyroxine (li-synthetic T4) 'me ha li bue ka mokhoa o mong oa phekolo bakeng sa bakuli. Ho thahasellisang, mekhoa eohle ea phekolo ea hypothyroidism e hatisitsoeng lilemong tsa bo-2000 e ntse e khothalletsa levothyroxine e le phekolo e tloaelehileng, empa hape e na le likarolo tse reng ke hobane'ng ha phekolo ea levothyroxine le liothyronine (T4 + T3) e sa lokelang ho sebelisoa.
Ho na le keketseho ea phekolo ea hypothyroidism. Engelane, melaetsa ea lihomone tsa thyroid e imenne habeli ho tloha pakeng tsa 1998 le 2007. Naheng ea Netherlands, palo ea batho ba sebelisang lithethefatsi tsa qoqotho e eketsehile ka 53% pakeng tsa 2005-2011 - baahi ba Madache ba eketsehile ka 2.1% nakong eo.
Palo ea bakuli ba nang le levothyroxine feela-phekolo e fokotsehile hanyenyane ho tloha ka 2005 ho isa ho 2011 - mme ho bile le keketseho e fokolang palo ea bakuli ba kalafo ea T4 + T3.
Mohloli
Wiersinga, Wilmar. "Paradigm e fetoha li-hormone tsa thyroid bakeng sa phekolo ea phekolo ea hypothyroidism." Nature Reviews Endocrinology (2014), E hatisitsoeng ka inthaneteng 14 January 2014