Kuyesa kwa TSH ndi chiyani ndipo zotsatira zanu zikutanthauza chiyani?

Maphunziro a Zaumoyo

Mayeso otulutsa chithokomiro (TSH) amawunika momwe chithokomiro chimagwirira ntchito komanso kuchuluka kwa timadzi ta chithokomiro. Amapangidwa ndimatenda a pituitary, omwe amauza chithokomiro chanu, chomwe chili kumapeto kwenikweni kwa khosi lanu, kuti apange ndi kutulutsa mahomoni omwe amayang'anira kutentha kwa thupi lathu, kagayidwe kake ka thupi, ndikusunga ubongo wathu, mitima, ndi ziwalo zina kugwira bwino ntchito.

American Thyroid Association (ATA) imalimbikitsa kuti achikulire ayambe kuyezetsa TSH ali ndi zaka 35 ndikubwereza mayeso zaka zisanu zilizonse ngati zotsatira zili zofananira. Dokotala wanu amathanso kuyitanitsa mayeso a TSH ngati mukukumana ndi zizindikilo za chithokomiro chosagwira ntchito kapena chopambanitsa. Zizindikiro za hypothyroidism (chithokomiro chosagwira ntchito) zimatha kuphatikizira kutopa, ubongo wa ubongo, khungu lowuma kwambiri, tsitsi, komanso kumva kuzizira. Zizindikiro a hyperthyroidism (chithokomiro chopitilira muyeso) chitha kuphatikizira thukuta, kugunda kwamtima, kufooka kwa minofu, nkhawa, ndi kukwiya. Mulimonsemo, inu-kapena wothandizira zaumoyo wanu-mungapeze kuti chithokomiro chanu chakula, chomwe chimatchedwa goiter, kapena mitsempha ya chithokomiro, yomwe ndi mabala ang'onoang'ono a chithokomiro.

Kodi kuyesa kwa TSH kumaphatikizapo chiyani?

Kuyezetsa magazi kwa TSH nthawi zambiri kumaperekedwa ngati gawo limodzi la mayeso amwazi mogwirizana ndi mayeso azaumoyo apachaka. Kuyesaku kumatsimikizira momwe chithokomiro chanu chimagwirira ntchito poyesa kuchuluka kwa timadzi tomwe timayambitsa chithokomiro m'magazi anu. Ndi kuyesa magazi kosasala, kutanthauza kuti simuyenera kuchita chilichonse chapadera kuti mukonzekere.

Madokotala ayenera kutenga mayeso a magazi a TSH kwa odwala chithokomiro pakatha milungu inayi kapena isanu ndi itayi atazindikira. Pulogalamu ya iwo amalimbikitsa kuyezetsa TSH miyezi isanu ndi umodzi kapena isanu ndi iwiri iliyonse mukamamwa mankhwala okhazikika ndipo nthawi zambiri ngati mlingo wanu wasintha.

Mulingo wanu wa TSH uyenera kukhala uti?

Ma laboratories ambiri amagawira milingo ya TSH pakati pa 0,4 ndi 4.5 milliunit pa lita (mU / L), malinga ndi Mgwirizano wa Chithokomiro waku America Zamgululi Mulingo wabwinobwino wa TSH nthawi zambiri, nthawi zambiri umawonetsa kuti mulibe vuto la chithokomiro.

Pulogalamu ya iwo akuti anthu pafupifupi 20 miliyoni aku America ali ndi matenda amtundu wa chithokomiro. Komabe oposa 60% mwa omwe ali ndi vuto la chithokomiro sakudziwa zaumoyo wawo.

Kodi zikutanthauzanji ngati TSH yanu ili yotsika?

Nthawi zambiri, kuchuluka kwa TSH kutsika kuposa 0.4 mU / L kumawonetsa hyperthyroidism, yomwe imadziwikanso kuti chithokomiro chopitilira muyeso, kutanthauza kuti, thupi lanu limapanga mahomoni ambiri a chithokomiro. Matenda a Graves ndimatenda amthupi omwe nthawi zina amachititsa hyperthyroidism.

Kodi chimachitika ndi chiyani TSH yanu ikakwera?

Kawirikawiri, ma TSH apamwamba kuposa 4.5 mU / L amawonetsa hypothyroidism, kapena chithokomiro chosagwira ntchito, kutanthauza kuti thupi lanu silikupanga timadzi ta chithokomiro chokwanira. Hashimoto's thyroiditis ndimatenda amthupi omwe nthawi zina amachititsa hypothyroidism.

Kodi mungakhale ndi vuto ngati TSH yanu ili yachibadwa?

Mayeso a TSH ndi chizindikiro chodziwika bwino cha thanzi lanu lonse la chithokomiro, atero a Brittany Henderson, MD, a endocrinologist Charleston Thyroid Center ku Mount Pleasant, South Carolina . Kutanthauzira kumatha kukhala kovuta chifukwa pali mitundu yambiri ya 'zachilendo' pamlingo wa TSH.

Mankhwala ndi zowonjezera zomwe mukugwiritsa ntchito pano zingakhudze zotsatira za mayeso anu a TSH. Chitsanzo chimodzi ndi biotin, yomwe imatha kuwonetsa zabodza ma TSH otsika.

Zomwe zimawoneka ngati zachilendo zimakhudzidwa ndi zinthu zingapo:

• Zaka
• Mimba
• Mtundu

Kafukufuku yawonetsa kuti kuchuluka kwa TSH kumawonjezeka ndi ukalamba, kuchepa ndi pakati, komanso kusiyanasiyana chifukwa cha mafuko.

Zaka

Chimodzi kuphunzira adapeza kuti 97.5% ya odwala mpaka azaka 55 anali ndi TSH zosakwana 4.0 mU / L. Pamwamba pa msinkhu umenewo mtengo wapamwamba wa 97.5th percentile unakwera pang'onopang'ono, kufika pafupifupi 4.75 mU / L pakati pa zaka 75 ndi 85 ndi 5.0 mU / L mwa odwala pakati pa 85 ndi 90. Kafukufukuyu adapitiliza kunena kuti kuchuluka kwa TSH pang'ono akuluakulu sikuti amafuna chithandizo.

Magawo a TSH amathanso kusiyanasiyana kwa ana ndipo mawonekedwewo amatha kusintha kutengera zaka. Ndikulimbikitsidwa kuti makolo akafunse ana endocrinologist kuti adziwe kuchuluka kwa TSH kwa mwana wawo.

Mimba

Amayi apakati pa trimester yawo yoyamba, American Thyroid Association imalimbikitsa kuti ma TSH azisungidwa potengera matenda a chithokomiro. Kawirikawiri, TSH imasungidwa pakati pa 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.

Mtundu

Dr. Henderson, yemwe adalemba nawo bukuli, Zomwe Muyenera Kudziwa Zokhudza Matenda a Hashimoto , amanenanso kuti zotsatira za TSH zimatha kusiyanasiyana kutengera mtundu. Magulu a TSH mwachikhalidwe amakhala okwera kwambiri mwa azungu, otsika mwa anthu akuda, ndipo kwinakwake pakati pa anthu aku Spain, akufotokoza.

Akuti odwala atha kukhala ndi zotsatira za TSH mumtundu wa 'wabwinobwino,' pomwe adakali ndi zizindikilo zogwira ntchito (monga kuonda kapena kupindula, kutaya tsitsi, kutopa, nkhawa ndi zina zambiri). Mulingo wa TSH umawonetsa ngati chithokomiro chanu chili ndi vuto, koma sizikuwonetsa chomwe chikuyambitsa vutoli. Kuti mudziwe, wothandizira zaumoyo wanu akhoza kuyitanitsa mayeso ena.

Nthawi yomwe mungafune mayeso ena

Zikatero, madokotala amatha kusankha kuyesera gulu lonse la mayesero a chithokomiro kuti athe kuyeza thyroxine monga Free T4, Total T4, Total T3, ndi ma antibodies a chithokomiro, kuwonjezera pa TSH. Gawo lovuta kuti mupeze zotsatira zabwino kwambiri za mayeso a TSH ndi chithandizo cha chithokomiro chimaphatikizapo kuonetsetsa kuti mukulandira mayeso oyenera.

Mayeso a T4

T4 yaulere ndi kuyesa magazi kosasala komwe kumayeza kuchuluka kwa T4, mahomoni a chithokomiro. Mulingo wabwinobwino wa Free T4 pakati pa0.8 mpaka 1.5ma micrograms pa desilita imodzi (ng / dL). Zimatha kusiyanasiyana kutengera mayesedwe a labotale omwe agwiritsidwa ntchito. Chiwerengero cha T4 sichimachitidwa kupatula pathupi pomwe chili cholondola kuposa mayeso a Free T4.Mulingo wabwinobwino wa Total T4 ndi 5-12 ug / dl. Maseŵera otsika a T4 amawoneka ndi hypothyroidism, pomwe milingo yayikulu imawoneka ndi hyperthyroidism.

Mayeso a T3

Kuyezetsa magazi kosasala kwathunthu kwa T3 nthawi zina amalimbikitsidwa ngati njira yodziwira za hyperthyroidism ndikuzindikira kukula kwa matendawa. Zotsatira Zabwinobwino za T3 zimayezedwa kuyambira 100 mpaka 200 nanograms pa deciliter (ng / dl). Kuyesa kwaulere T3 sikuvomerezeka chifukwa cha kusanthula kwake kwa labotale. Kutembenuza T3 kumakhala ndi gawo lochepa pofufuza zovuta za chithokomiro ndipo sizoyenera kutero.

Kodi mufuna chithandizo chiti?

Odwala ambiri a hypothyroid amamva bwino akamamwa mankhwala ndipo chithokomiro chawo chili mu 'mulingo woyenera' wa TSH wa 0.5-2.00 (wokhala ndi lab lab ya 0.45-4.5), Dr. Henderson akuti. Popeza kuyezetsa magazi ndi magulu amasiyanasiyana, milingo yokwanira ya labu yapadera ya wodwalayo imathanso kusiyanasiyana. Kwa okalamba, chandamale cha TSH chili mgulu la 4.0 - 6.0.

Madokotala ambiri nthawi zambiri amachiza odwala awo a hypothyroid ndi levothyroxine, mankhwala opangidwa ndi anthu a T4 hormone ya chithokomiro yopangidwa ndi thupi, madokotala ena amalimbikitsa kugwiritsa ntchito T4 ndi T3 ngati njira yothandizira.

ZOKHUDZA: Zinthu 5 zomwe zingasokoneze mankhwala anu a chithokomiro

Ndi mankhwala a chithokomiro, dosing iyenera kukhala yolondola, Dr. Henderson akuti. Mankhwala owonjezera kapena ochepa kwambiri amatha kubweretsa zovuta zomwe zimakhudza thanzi la wodwalayo.

Odwala omwe ali amapezeka kuti ndi hyperthyroid, Chithandizochi chitha kuphatikizira mankhwala a antithyroid monga methimazole, omwe amateteza ku chithokomiro chambiri. Odwala ena amapatsidwa ayodini ya radioactive, yomwe imaperekedwa m'mapiritsi kuti ichepetse chithokomiro pang'onopang'ono.

Ngati mukukumana ndi zizindikilo za chithokomiro chosakwanira kapena chomwe chimagwira ntchito mopitilira muyeso, pitani kuchipatala kuchokera kwa dokotala kapena katswiri wazachipatala za mayeserowa ndi mankhwalawa.