Ngā tohu o te repe tenga (thyroid): i ngā wāhine me ngā tāne, me te wā kia whakamātauria koe

Ko te repe tenga (thyroid) he repe iti, he rite te āhua ki te pūrerehua, kei mua o te kakī, kei raro tata iho i te tenga (Adam's apple). E rua ōna taiaki (hormones), ko te T4 me te T3, ā, mā rāua e whakarite te tere o te nuinga o ngā mahi a te tinana: te tere o te tahu i te pūngao, te pao o te manawa, te mahana o te tinana, te keri kai, te mate wahine, te wairua, me te tupu o te kiri me ngā makawe.

Ko te TSH (thyroid-stimulating hormone) mai i te repe pituitary i te roro e ārahi ana i te repe tenga. Ka heke te taiaki repe tenga, ka piki te TSH hei akiaki i te repe tenga kia kaha ake; ka piki te taiaki repe tenga, ka heke te TSH. Koia te take ko te TSH te whakamātautau toto tuatahi a ngā rata.

He noa ngā raruraru repe tenga, ā, he nui kē atu i ngā wāhine: e ai ki te American Thyroid Association, e rima ki te waru ngā whakareanga o te tūpono o ngā wāhine ki tō ngā tāne, ā, tata ki te kotahi wahine i ia tokowaru ka pāngia e tētahi mate repe tenga i te roanga o tōna ora. I tētahi rangahau i ngā tāone e waru o Īnia, tata ki te kotahi pakeke i ia tekau he repe tenga ngoikore tōna, ā, he tokomaha kāore i mōhio.

Ki te iti rawa te taiaki e hangaia ana e te repe tenga, ka pōturi te tinana. He pōturi rawa te puta mai o ngā tohu, ka whakapae te tangata nā te pakeke, nā te āwangawanga, nā te pukumahi rānei.

Ngā tohu noa: te ngenge, te makariri, te piki o te taumaha, te uaua o te tiko, te maroke o te kiri, ngā makawe matatoru, angiangi haere rānei, te pupuhi o te kanohi, te mamae o ngā uaua, te pōuri o te ngākau, te ngoikore o te mahara, te taumaha o te mate wahine, me te reo whango. Kāore he tohu ā ētahi, ā, ka kitea noa i tētahi whakamātautau toto auau.

Ngā take noa:

• Hashimoto's thyroiditis, ka āta tūkino te pūnaha ārai mate i te repe tenga. Koinei te take nui rawa i ngā wāhi e rawaka ana te aiōtini (iodine) i te kai, ā, he mea tuku iho i roto i ngā whānau.
• Te kore e rawaka o te aiōtini (iodine), koinei tonu te take nui rawa puta noa i te ao. Nā te tote aiōtini, kua tino onge ake.
• Te maimoatanga, te pokanga rānei o te repe tenga, pērā i te aiōtini iraruke (radioactive iodine) mō te repe tenga kaha rawa.
• Ētahi rongoā, tae atu ki te lithium me te amiodarone.
• I muri i te hapūtanga (postpartum thyroiditis), he poto noa te roa i te nuinga o te wā.

Ko te maimoatanga i te nuinga o te wā he pire taiaki repe tenga ia rā (levothyroxine), mā tō rata te horopeta e whakarite, e tirotiro mā ngā whakamātautau TSH. Ka ora anō te nuinga o te tangata ina tika te taumata.

Ki te nui rawa te taiaki e hangaia ana e te repe tenga, ka tere rawa te tinana. Ko te āhua nei kei te hihiko tonu koe, kāore e mutu.

Ngā tohu noa: te heke o te taumaha ahakoa he pai te hiakai, te tere, te kore rānei e rite o te pao o te manawa, te pākuru o te manawa (palpitations), te wera me te werawera, te wiriwiri o ngā ringa, te māharahara, te pukuriri, te kino o te moe, te auau o te tiko, te ngoikore o ngā uaua, me te iti ake o te mate wahine. I te Graves' disease, ka kirikiri pea ngā karu, ka titiro mārō, ka puta rānei.

Ngā take noa:

• Graves' disease, he mate o te pūnaha ārai mate, ā, koinei te take nui rawa.
• Ngā puku iti o te repe tenga (thyroid nodules) e hanga ana i te taiaki tāpiri, mā rātou anō.
• Thyroiditis (he repe tenga kakā), tae atu ki muri i te hapūtanga, ka puta pea he wā poto kaha rawa, kātahi he wā ngoikore.
• Te nui rawa o te rongoā taiaki repe tenga e kainga ana.

Ki te kore e maimoatia te repe tenga kaha rawa, ka taumaha ki te manawa (tae atu ki te atrial fibrillation, he pao manawa kāore e rite), ā, ka ngoikore haere ngā kōiwi, nō reira he mea tika kia maimoatia. Ko ngā kōwhiringa he rongoā hei whakatau i te repe tenga, he aiōtini iraruke (radioactive iodine), he pokanga rānei; mā tō rata (he endocrinologist i te nuinga o te wā) e whakamārama ko tēhea e tika ana.

He nui kē atu te tūpono o ngā wāhine ki ngā raruraru repe tenga, ā, ko ētahi tohu he māmā noa te ngaro:

• Te mate wahine: nui ake, auau ake rānei i te repe tenga ngoikore; iti ake, ruarua ake rānei i te repe tenga kaha rawa.
• Te hapū: ka uaua ake pea te hapū i ngā mea e rua. Ka tirotiro ngā rata i te TSH ina kāore e rite te mate wahine, ina pōturi rānei te hapū.
• Te hapūtanga: i te tīmatanga, ka whakawhirinaki te pēpi ki te taiaki repe tenga a te whaea, nō reira he nui ake te take o te raruraru repe tenga kāore anō kia maimoatia i te wā hapū. Mēnā he mate repe tenga tōu, he tohu rānei, kōrero ki tō rata, kaiwhakawhānau (midwife) rānei i te wā tonu ka hapū koe, ka whakamahere rānei kia hapū.
• I muri i te whānautanga: ka pā te postpartum thyroiditis ki te 5 ki te 10% o ngā wāhine i te tau i muri i te whānau pēpi. He maha ngā wā ka pōhēhētia ko te ngenge me te pōuri o te mātua hou.
• Te menopause: he ōrite te wera ohorere, te kino o te moe, te pōuri o te ngākau me te rerekē o te taumaha ki ngā tohu repe tenga, nō reira ka āwhina te whakamātautau TSH ki te wehe.
• PCOS: ka puta pea te mate wahine kāore e rite, te piki o te taumaha me ngā rerekētanga o ngā makawe i tētahi, i tētahi, ā, i ētahi wā ka puta tahi.

Ko te repe tenga kua rahi ake, ko te tenga (goitre) tōna ingoa. Ka puta pea i te repe tenga ngoikore, kaha rawa, e pai ana rānei te mahi, ā, kāore he mamae i te nuinga o te wā. Ko te puku iti o te repe tenga (thyroid nodule) he puku i roto i te repe.

He tino noa ngā puku iti, otirā ka pakeke haere te tangata, ā, neke atu i te 90% ehara i te mate pukupuku (benign), e ai ki te American Thyroid Association. Heoi anō, me tirotiro ia puku hou i te kakī. Ko ngā hīkoi tuatahi he whakamātautau TSH me te ultrasound o te kakī; ko ētahi puku iti ka hiahiatia he tauira mā te ngira angiangi (fine-needle).

Kia hohoro ake te kite i te rata mēnā e tere tupu ana te puku, he mārō, he reo whango rānei, he uaua te horomi, he uaua te hā rānei.

Mā ngā tohu e tohu te ara, engari mā te whakamātautau toto e whakatau:

• Ko te TSH te whakamātautau tuatahi. Ka teitei ina ngoikore te repe tenga, ka iti ina kaha rawa. Mō te nuinga o ngā pakeke, ko te awhe noa tata ki te 0.4 ki te 4.0 mIU/L. Tirohia tā mātou aratohu whakamātautau TSH mō te tikanga o ia hua.
• Ko te Free T4 (ā, i ētahi wā ko te T3) e whakaatu ana i te nui o te taiaki repe tenga kei roto tonu i te toto.
• Ko ngā paturopi repe tenga (thyroid antibodies) (anti-TPO mō te Hashimoto's, TRAb mō te Graves') e whakaatu ana mēnā nā te pūnaha ārai mate te take.
• Ka tirohia te repe e te ultrasound ina he pupuhi, he puku rānei.

He mea anō ka hē ai ngā hua: ko ngā pire tāpiri biotin (kei roto i ngā hua mō ngā makawe me ngā maikuku i te nuinga o te wā) ka hē pea te pānui o ngā whakamātautau repe tenga, nō reira kōrero ki te taiwhanga mēnā e kai ana koe i aua pire. Ka nekeneke anō te TSH nā tētahi māuiui hou, nā te hapūtanga, nā ētahi rongoā rānei.

• Kia whakamātauria i mua i te maimoa. Kaua e tīmata i ngā pire repe tenga, te aiōtini (iodine), te rimurimu (kelp), ngā pire tāpiri "thyroid support" rānei mā tō ake whakatau. Mā te nui rawa o te aiōtini ka kino ake ētahi raruraru repe tenga, ā, ka huna pea e ngā pire tāpiri te āhua tūturu.
• Tuhia ō tohu, me te wā i tīmata ai, ā, kawea te rārangi (te rārangi tohu i runga ake rānei) ki tō hui ki te rata.
• Mēnā kei te maimoatia kē koe, ā, kua hoki mai ngā tohu, tonoa kia whakamātauria anō tō TSH; tērā pea me whakarerekē te horopeta. Pātai ki tō kēmihi (pharmacist) me pēhea te kai i ngā pire repe tenga me te kai, me ētahi atu rongoā.
• Whakamahia te tote aiōtini (iodised salt) i te nui noa. He pai te kai i te kāpeti, te puāwai (broccoli) me te soy i roto i te kai noa.
• Kia mataara ki te manawa me ngā kōiwi i te repe tenga kaha rawa: mā te maimoatanga e tiaki ngā mea e rua.