Whakamātautau TSH: te awhe noa, te ingoa katoa, me te tikanga o te TSH teitei, iti hoki

Ko te TSH te thyroid-stimulating hormone, te taiaki whakaohooho i te repe tenga. Ehara i te repe tenga te kaihanga: ka puta mai i te repe pituitari (pituitary gland) i te take o te roro. Ko tāna mahi he kī atu ki te repe tenga i tō kakī te nui o te taiaki repe tenga (T4 me T3) hei hanga.

He rite ki te pūwhakarite mahana (thermostat). Ina heke te taiaki repe tenga, ka whakapikia e te repe pituitari te TSH kia kaha ake te mahi a te repe tenga. Ina nui rawa, ka whakahekea e ia te TSH. Koia i āhua huripoki ai te hua: ko te TSH teitei, i te nuinga o te wā he repe tenga māngere, ā, ko te TSH iti, he repe tenga hohe rawa.

I te mea ka urupare te TSH ki ngā panoni iti i mua i te T4, koia te whakamātautau repe tenga tuatahi, tino tairongo hoki. Ko te thyroid profile, ka tāpiri i te T4 wātea, i ētahi wā te T3 wātea, ā, ka whakaatu ngā paturopi repe tenga (thyroid antibodies, anti-TPO) mēnā kei te whakaeke te pūnaha ārai mate i te repe tenga.

Ko te TSH teitei, i te nuinga o te wā kāore te repe tenga e hanga i te taiaki kia rawaka: ko te hypothyroidism (repe tenga māngere). Ko te take e tino kitea ana puta noa i te ao ko te Hashimoto's thyroiditis, arā, ka āta tūkino te pūnaha ārai mate i te repe tenga. Ko ētahi atu take: te korenga o te iodine, he pokanga repe tenga, he iodine iraruke (radioactive iodine) rānei i mua, me ētahi rongoā (pērā i te lithium me te amiodarone).

Ko ngā tohu noa ko te ngenge, te makariri tonu, te piki o te taumaha, te kōroke (constipation), te kiri maroke, te angiangi haere o ngā makawe, te ngākau pōuri, te pōturi o te whakaaro, te nui o te rere o te mate wahine, me te pōturi o te pana o te manawa. He tokomaha kāore he tohu, inarā ina teitei paku noa te TSH. Kei tā mātou aratohu tohu repe tenga ngā taha e rua me tētahi rārangi arowhai.

Ko te TSH teitei paku (e 4 ki te 10) me te T4 wātea noa, ka kīia he subclinical hypothyroidism. He mea noa tēnei, ka hoki noa pea ki te noa, ā, i te nuinga o te wā ka whakamātautau anō i roto i te 6 ki te 12 wiki, me ngā paturopi, i mua i te whakatau. Neke atu i te 10, ka puta rānei he tohu, he hapū rānei, e whakamahere ana rānei kia hapū, ka whakaarohia te maimoatanga i te nuinga o te wā.

Ka teitei pea te TSH mō tētahi wā i muri i tētahi māuiui, ā, he teitei ake i ngā kaumātua.

Ko te TSH iti, i te nuinga o te wā kei te hanga te repe tenga i te taiaki nui rawa: ko te hyperthyroidism (repe tenga hohe rawa). Ko ngā take noa ko te Graves' disease (he mate pūnaha ārai mate), ko ngā puku repe tenga (nodules) e mahi motuhake ana, me te mumura o te repe tenga (thyroiditis), he poto noa i te nuinga o te wā.

Mēnā kei te kai koe i te rongoā repe tenga, ko te TSH iti, i te nuinga o te wā he nui ake te inenga i tō hiahia. Kaua e panoni i a koe anō; kōrero ki te rata nāna i tuhi te rongoā.

Ko ngā tohu o te repe tenga hohe rawa ko te heke o te taumaha kāore koe i whai kia heke, te tere, te pātukituki rānei o te manawa, te āwangawanga, te wiriwiri o te ringa, te wera me te werawera, te tūtae ngohengohe, te kino o te moe, me te iti o te rere o te mate wahine. Ka pā pea te repe tenga hohe rawa ki te manawataki me ngā kōiwi, nō reira me tere te tirotiro i te TSH e mārama ana te iti.

Kāore i te pērā te auau, ka iti te TSH nā tētahi māuiui taumaha, nā ngā rongoā steroid, nā te hapūtanga tōmua (ka heke noa i taua wā), nā tētahi raru rānei o te repe pituitari, he onge tēnei.

Ka panoni te hapūtanga i ngā whakamātautau repe tenga. Ka heke noa te TSH i ngā marama tuatahi e toru (first trimester), ā, ka whakawhirinaki te pēpi ki te taiaki repe tenga a te whaea i te tīmatanga, nō reira ka whakamahi ngā taiwhanga i ngā awhe motuhake mō ia wāhanga o te hapūtanga (trimester). Ki te kore ēnā e wātea, ka tūtohu te American Thyroid Association kia kīia ko te 4.0 mIU/L te tepe o runga i te hapūtanga tōmua. Mēnā kei te hapū koe, e whakamahere ana rānei, ā, he mate repe tenga tōu, he TSH rerekē rānei, haere wawe ki tō rata; he maha ngā wā me whakarerekē wawe te rongoā repe tenga.

He teitei ake noa te TSH o ngā kaumātua. Ka noa pea te 5 ki te 7 i te hunga neke atu i te 70 tau, ā, he āta ake ngā rata ki te maimoa i te TSH teitei paku i ngā kaumātua.

• He tauira toto iti mai i tētahi ia toto (vein). Kāore he take o te nohopuku mō te TSH, ahakoa tērā pea me nohopuku mō ētahi atu whakamātautau i taua toronga anō.
• Whakamutua te biotin (vitamin B7, kei roto i te maha o ngā pire āpiti mō te makawe, te kiri me ngā matikuku) mō te 2 rā neke atu i mua, nā te mea ka hē pea te teitei, te iti rānei o ngā hua repe tenga. Mēnā nā te rata i tuhi, pātai tuatahi ki a ia.
• Mēnā kei te kai koe i te rongoā repe tenga, kia tangohia te toto i mua i tō inenga o te ata, ā, kia ōrite te wā o te rā i ia whakamātautau.
• He paku teitei ake te TSH i te atatū i te ahiahi, ā, ka neke pea i te wā o tētahi māuiui, i muri tata mai rānei.
• Ka hoki mai ngā hua i taua rā anō, i te rā e whai ake nei rānei.

• Ina tīmata, ina panoni rānei te rongoā repe tenga: e 6 ki te 8 wiki i muri, nā te mea koinā te roa kia tau te TSH.
• Ina ū te inenga: kotahi i te tau i te nuinga o te wā.
• TSH teitei paku, kāore he maimoatanga: whakamātautau anō i roto i te 6 ki te 12 wiki, kātahi ia 6 ki te 12 marama.
• Hapūtanga me tētahi mate repe tenga: tata ki ia 4 wiki i te haurua tuatahi o te hapūtanga, kia rite ki tā tō rata.
• Ngā mōrearea (mate huka momo 1, he mate repe tenga i te whānau, ētahi atu mate pūnaha ārai mate, he iraruke ki te kakī i mua, he tohu rānei): pātai ki tō rata mō te whakamātautau.

• Mā tō rata e whakatau te rongoā repe tenga me tōna inenga. Kaua rawa e tīmata, e whakamutu, e panoni rānei i a koe anō; he nui te pānga o ngā panoni iti.
• Kainga te rongoā repe tenga kia rite ki tā tō rata, tā tō kaiwhakarite rongoā (pharmacist) rānei i whakamārama ai, i te nuinga o te wā i te puku kau, ā, kia wehe i te konupūmā (calcium), i te rino (iron) me te soy, nā te mea ka ārai ēnei i te ngongotanga.
• Whakamahia te tote iodine (iodised salt) i te rahi noa; kaua e kai i ngā pire iodine inenga nui, i ngā pire kelp rānei, ki te kore tō rata e tūtohu.
• Tiakina ērā atu wāhanga: ka āwhina te moe, te korikori me te kai taurite i te kaha me te taumaha, ahakoa he aha te hua repe tenga.
• Tuhia tō TSH me tō T4 wātea i roto i te wā. He nui ake te kōrero a te ia i tētahi tau kotahi.