Tuhinga
Te kikorangi metilīni me ngā mate tāiroiro: ngā taunakitanga me ngā pātai mō ngā rongoā
He pānga ine tō te kikorangi metilīni ki ngā tukanga koiora e pā ana ki te tāiroiro i roto i ngā pūnaha whakamātau. Kāore tēnei e whakapūmau ana i a ia hei maimoatanga mō te ngoikore tāiroiro, te mate Hashimoto, te kaha rawa rānei o te tāiroiro. Kāore i kitea i ngā rangahau kua tirohia i konei tētahi whakamātautau maimoatanga whai rōpū whakataurite ki te tangata e whakaatu ana ka whakatika haumaru te kikorangi metilīni i ēnei mate, ka whakaiti rānei i te hiahia ki ngā rongoā tāiroiro.
Nō reira, he whānui ake te pātai whaihua i te pātai mēnā ka taea e ia te whakaawe i te pākia. Ko tēhea tukanga tāiroiro ka rerekē, i roto i tēhea pūnaha whakamātau, ā, ka āwhina rānei taua rerekētanga i te tangata kua whakatauria he mate motuhake tōna? He rerekē ngā whakautu a ngā rangahau o nāianei i ngā taumata koiora rerekē. Kāore aua rangahau e whakamana ana i te whakakapi i ngā rongoā tāiroiro kua whakahaungia.
He maha ngā inenga motuhake o te mahi tāiroiro
Ko te thyroxine, arā ko T4, te taiaki matua ka whakaputaina e te tāiroiro, me tētahi rahinga iti ake o te triiodothyronine, arā ko T3. Ka huri hoki ngā kiko i te T4 hei T3. Ka tukuna e te repe pituitari te taiaki whakaongaonga tāiroiro, arā ko TSH, hei tohu ki te repe kia whakaputa taiaki. Ka whakahoki tohu ngā taiaki tāiroiro e rere ana i te toto hei whakaiti i taua tohu.
E ai ki te whakamārama a te American Thyroid Association mō ngā whakamātautau mahi tāiroiro, ka whakaurua te taiaki kua herea ki te pūmua ki ngā inenga taiaki tapeke, engari ka aromatawai ngā inenga taiaki herekore i te wāhanga kāore i herea. Mā te tiro tahi ki te TSH me te T4 herekore e āwhina te whakamārama i te āhua o te tāiroiro; ka taea e te mate o te repe pituitari te whakarerekē i te hononga noa i waenganui i ēnei. Nō reira, kāore te hekenga o te TSH anake e whakamātau ana kua pai ake te mahi tāiroiro.
E whakaatu ana te whakaahua uhi i tēnei hononga whakahoki tohu noa. Kāore e whakaatu ana i tētahi ara maimoatanga kikorangi metilīni kua whakamātauria.
Ngā mea i inea e ngā whakamātau motuhake mō te tāiroiro
I whakatauritea e tētahi rangahau o 1995 mō te kikorangi metilīni me te carbimazole ki ngā kiore ngā kararehe whakataurite, ngā kararehe i whiwhi kikorangi metilīni i roto i te kai, ngā kararehe i whiwhi i te carbimazole, he rongoā aukati tāiroiro, me ngā kararehe i whiwhi i ngā mea e rua. I ine ngā kairangahau i te T4 me te TSH e rere ana i te toto, te rahinga taiaki i roto i te tāiroiro me te repe pituitari, ngā taumaha o ngā whēkau, me te rāpoi tuku tohu cAMP.
I whakapiki te kikorangi metilīni i te T4 e rere ana i te toto, ā, i āhua whakahē i te hekenga T4 e pā ana ki te carbimazole. I ārai hoki i te pikinga nui o te TSH e rere ana i te toto e pā ana ki te carbimazole. He kiore Wistar toa ēnei, tae atu ki tētahi tauira i aukatia ai te tāiroiro mā te matū. E pā ana ngā kitenga ki ngā pānga ki te pūnaha taiaki me tētahi pāhekoheko rongoā pea, kāore ki te pai ake o ngā tohumate o te tangata whai mate tāiroiro nā te pūnaha ārai mate e whakaeke ana i te tinana ake. Kāore i te whakarāpopototanga kua whakarārangitia ngā taipitopito rawaka mō te pānga atu ki te matū hei huri i te whakamātau ki tētahi hōtaka whakamahi mā te tangata.
I whakamātauria e tētahi whakamātau motuhake o 1997 ki ngā kiore toa te kikorangi metilīni, te estradiol benzoate, me te acetylsalicylic acid, takitahi, ā, i roto hoki i ngā huinga. I whakahē te kikorangi metilīni i tētahi hekenga o te T4 i te serum e pā ana ki te aspirin, engari i puta te pānga hāngai ki te T3 i tētahi anake o ngā whakamātau e rua. I whakawhirinaki te putanga ki te taiaki i inea me te huinga i whakamahia. He tūāpapa ngoikore tēnei mō tētahi kī taurangi whānui kia “whakapiki i te mahi tāiroiro.”
He pātai kē tā ngā mahi rangahau hou ake. I kitea e tētahi rangahau tātari matū o 2021 i whakamahi i te iodotyrosine deiodinase tangata i hangaia mā te whakakotahi anō i te DNA i aukati te kikorangi metilīni i te mahi o te whākōkī i roto i tētahi whakamātautau, me te IC50 o te 3.4 micromolar. Ko te IC50 te kukūtanga e hua ai te haurua o te aukatinga mōrahi i raro i ngā tikanga o te whakamātautau. Ehara i te kukūtanga toto, i te horopeta ā-waha rānei e taunakitia ana.
Ko te iodotyrosine deiodinase, ko IYD te whakapotonga, ka hangarua i te iodide mai i ngā hua āpiti o te whakaputanga taiaki. He rerekē tēnei i ngā iodothyronine deiodinase e whai wāhi ana ki te whakahohe, ki te whakakore rānei i te hohe o ngā taiaki tāiroiro. Kāore tētahi hua aukati IYD e whakaatu ana kua pai ake te hurihanga T4 hei T3. Kāore hoki e taea e tēnei whakamātautau taratahi te matapae i te urupare taiaki whānui o tētahi tangata e whakamahi ana i te kikorangi metilīni.
Kāore ngā kitenga ki te tangata e whakapūmau i tētahi ahunga ōrite
Kotahi neke atu rānei te kitenga haumanu tōmua e tika ana kia wehewehea i ngā hua ki ngā kararehe. I roto i tētahi whakarāpopototanga o te hui American Thyroid Association o 2025, Poster 418, i whakaahua ngā kairangahau i tētahi tāne 43 tau te pakeke i whiwhi kikorangi metilīni kia pā ki te tinana whānui mō tētahi āhua ohorere o te rere toto kāore i urupare ki te maimoatanga. Nā te kitenga o tētahi tāiroiro kikorangi-pango i te wā e hangaia ana he puare ki te pūkorokoro i mahia ai ngā whakamātautau, ā, i kitea he iti te TSH me ngā taiaki tāiroiro. I pai ake te T4 herekore i te whakamahinga o te levothyroxine.
He ngoikore tāiroiro kē tō te tūroro kāore anō kia puta he tohumate haumanu, ā, i pāngia ia e te māuiuitanga taumaha o ngā whēkau maha. I whakaarohia e ngā kaituhi te huinga tohumate nā te māuiuitanga ehara nō te tāiroiro, me tētahi pānga pea o te kikorangi metilīni. Kāore e taea e tēnei take kotahi i tētahi hui te whakapūmau i te take pūtake, te auau o te putanga, te urupare rānei ki ngā hua ā-waha mō ngā kiritaki. Nā tēnei take hoki, e kore tētahi kōrero tika e āhei ki te kī e tohu ana ngā rerekētanga tāiroiro katoa kua pūrongotia ki te pikinga o ngā taumata taiaki.
Mō ētahi atu putanga, ka whai take tonu tēnei wehewehenga i waenganui i ngā tauira whakamātau me ngā tūroro i roto i te aromatawai i ngā taunakitanga ki te tangata mō ngā painga o te kikorangi metilīni.
Te ripanga taunakitanga mō ngā mate me ngā rongoā
Pānuitia ia rārangi mō te mate, te rongoā motuhake rānei. Ko te tikanga o “Kāore anō kia whakapūmautia”, kāore ngā taunakitanga kua tirohia e whakautu ana i te pātai haumanu, ehara i te mea kāore e taea tētahi pāhekoheko.
| Te mate, te rongoā rānei | Ngā taunakitanga hāngai | Te tikanga mō te whakatau |
|---|---|---|
| Te ngoikore tāiroiro tuatahi, tae atu ki te mate Hashimoto | Kāore ngā rerekētanga taiaki ki ngā kiore e whakaatu ana i te whakatikanga o te korenga taiaki ki te tangata, o te wharanga rānei nā te pūnaha ārai mate e whakaeke ana i te tinana ake. | Kāore anō kia whakapūmautia he wāhi mō te kikorangi metilīni hei whakakapi taiaki, hei whakaiti rānei i te rahinga taiaki whakakapi e hiahiatia ana. |
| Te ngoikore tāiroiro i muri i te tangohanga o te tāiroiro katoa | I whai kiko tāiroiro ngā kararehe i roto i ngā rangahau; kāore i whakamātauria te whakakapinga i muri i te tangohanga katoa o te tāiroiro. | Kāore tētahi pānga ki tētahi repe e noho tonu ana e whakaatu i te whakakapinga o te whakaputanga taiaki a tētahi repe kua kore. |
| Te mate Graves, ngā kōpuku hohe rawa rānei | Kāore i kitea he painga maimoatanga i roto i tētahi whakamātautau whai rōpū whakataurite; i kitea e ētahi whakamātau kiore he pikinga o te T4 e rere ana i te toto. | Ehara tētahi pikinga taiaki pea i te putanga maimoatanga e whāia ana. Kaua e whakatau he pai mō tēnei whakamahinga i runga i te kōrero “tautoko pākia.” |
| Te levothyroxine, te whakakapinga whai T3 rānei | Kāore i kitea he rangahau haumanu pāhekoheko e ine ana i te pānga o te tāpiri kikorangi metilīni. | Kāore he wā wehe i ngā whakamahinga, he ture whakarerekē horopeta tāiroiro rānei mō tēnei huinga e ahu mai ana i ngā taunakitanga. |
| Te carbimazole | I ngā kiore i whiwhi i ngā mea e rua, i āhua whakahēngia te hekenga T4 e pā ana ki te rongoā, ā, i āraia te pikinga TSH. | Me aro ki tēnei tohu pāhekoheko motuhake i roto i te whakamātau; kāore e ine ana i te mōrearea ki ngā tūroro. |
| Te methimazole, te propylthiouracil rānei | Kāore te whakamātau carbimazole i whakamātau tōtika i ēnei rongoā e rua. | Kaua e whakatau he ōrite te rahi o te pānga, he haumaru rānei tētahi hōtaka whakamahi ngātahi mō ētahi atu rongoā aukati tāiroiro. |
| Te mumura tāiroiro, te māuiuitanga tino taumaha rānei me ngā hua whakamātautau rerekē i te tikanga | Ka taea e te haere o te mate me te māuiuitanga taumaha te whakarerekē i ngā tauira taiaki; he nui ngā whakamārama kē mō te take o 2025. | Me whai te whakamāramatanga i te horopaki haumanu, ngā hua o mua, me te hītori o te pānga atu ki ngā matū. Kāore tētahi rerekētanga whakamātautau taiwhanga kotahi e tautohu i te pūtake. |
Ka whakakotahi te ripanga i ngā rangahau kua matapakihia i runga ake nei me te whakamārama a NIDDK mō te ngoikore tāiroiro me te whakakapi taiaki, me tāna whakaahuatanga o ngā pūtake me ngā maimoatanga o te kaha rawa o te tāiroiro. Ka whakarato te levothyroxine i te taiaki e ngaro ana. Ka whakaiti ngā rongoā aukati tāiroiro i te whakaputanga. Ka taea e te mumura tāiroiro te tuku i te taiaki kua penapenahia nā te mumura, nō reira he rerekē tōna whakahaere i tō tētahi repe e whakaputa nui rawa ana. Ka taea e ngā rongoā aukati beta te whakaiti i ngā tohumate pēnei i te wiri me te tere o te patuki manawa, me te kore e whakamutu i te whakaputanga taiaki.
Ka whakautua rānei te pātai rongoā e te whakamahinga i te pokanga tāiroiro?
Kāo. Ka kitea hoki te kikorangi metilīni i roto i ngā rangahau hei waikano pokanga. Hei tauira, i tētahi rangahau anga whakamua ki ngā tūroro 56 i tangohia ai te tāiroiro, i rehutia te waikano ki te wāhi pokanga hei āwhina ki te wehewehe i ngā hanganga mā ō rātou tauira mau tae me te memeha o te tae. I pā tōna pātai ki te tautohu hanganga tinana i te wā o te pokanga.
He rerekē te āta kite i te kiko i te whakatika i te whakaputanga taiaki tāiroiro. Kāore tētahi rangahau waikano pokanga e whakapūmau ana ka maimoatia te mate tāiroiro mā te horomi kikorangi metilīni, ā, e pā ana te tautohu repe paratāiroiro ki ngā repe he rerekē te mahi taiaki. Ka whakarōpū te whare pukapuka rangahau kikorangi metilīni i ngā rangahau i runga i te wawaotanga me te putanga i inea i ia rangahau.
Ngā mea hei kawe ki tētahi kōrerorero mō ngā rongoā
Kawea mai te whakatau mate tāiroiro, te rongoā me tōna momo whakarite e whakamahia ana ināianei, ngā hua whakamātautau taiwhanga o nā tata nei, me te hua kikorangi metilīni ake, tōna rahinga, te ara whakamahi, me ngā wā whakamahi. Me whai taunakitanga mō te tikanga o te pāhekoheko tētahi kerēme ka taea noa te whakamahi i ngā hua e rua me ētahi hāora i waenganui; kāore te wehe i ngā wā horomi e ārai aunoa i tētahi pānga rongoā ki te tinana whānui.
Whakaurua hoki ngā rongoā kāore e pā ana ki te tāiroiro. E whakatūpato ana ngā mōhiohio whakahau rongoā mō PROVAYBLUE mō te huinga tohumate serotonin taumaha ina whakamahia me ngā rongoā e pā ana ki te serotonin me ngā opioid, ā, e rāhui ana i te whakamahinga ki te hunga whai korenga G6PD nā te mōrearea o te pakarutanga o ngā pūtau toto whero. Kāore taua tapanga rongoā werohanga e whakapūmau ana i tētahi hōtaka tāiroiro haumaru mō te whakamahi ā-waha mō te wā roa. Ka whakamārama te tirohanga whānui mō te haumaru o te kikorangi metilīni i ēnei mōrearea whānui ake.
Me aromatawai ngā tohumate hou pēnei i te patuki manawa rerekē, te wiri, te kore e manawanui ki te wera rānei, kaua e whakapae noa kua pai ake te pākia. Me whai āwhina hauora ohotata mēnā ka puta te kirikā me te rangirua, te ohooho nui, te mārō o ngā uaua, te tere haere rānei o te kino o te patuki manawa i muri i te pānga atu ki te matū. Ka taea e ēnei tohumate te inaki ki ngā tauhohenga rongoā taumaha me ngā mate o te pūnaha taiaki. Kaua e whakarerekē i te whakakapinga taiaki tāiroiro, te maimoatanga aukati tāiroiro, ngā rongoā whakamauru pōuritanga rānei hei whakauru i te kikorangi metilīni, ki te kore he tohutohu a te kaimātai hauora nāna ngā rongoā i whakahau.