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작성일 : 03-04-07 00:00
hypothyroid 핸드아웃입니다..(세션 5)
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말씀드린대로 강의중 빠진 부분을 첨가해서 올려드립니다. 도움이 되시길 바라면서..그림 화일은 올려지지 않아서 다음기회에 About the Author Dr. Ridha Arem is Associate Professor of Medicine in the Division of Endocrinology and Metabolism at Baylor College of Medicine in Houston Texas. He is also Chief of Endocrinology and Metabolism at Ben Taub General Hospital in Houston. In addition to teaching medical students and physicians-in-training he regularly speaks to primary-care physicians and specialists at various educational programs. Dr. Arem is a nationally recognized thyroid specialist. For the past ten years he has been the author and editor of Clinical Thyroidology a well respected widely read periodical publication for physicians on thyroid disorders. He also contributes to Thyroid USA the official newsletter of the American Foundation of Thyroid Patients and participates in patient education programs. hypothyroid Fatigue & lethargy 체중증가 감정변화 쉽게 운다 콜레스테롤 중성지방 증가 Bruise easily Coronary heart disease 수족냉증 hypothyroid Poor skin healing Hair loss Edema-eyelid extremities 유산 생리불순 Tender costal cartilage Unmotivated Depressed hyperthyroid Thin skin Fine features Erratic flighty behavior 식욕증가 little weight gain 다른 내분비계 질환 Tremor tachycardia heart conciousness Short breath Sensitive to heat iodine Spark cells in tissue for metabolic function and chemical reaction Iodine deficiency Cries easily Loss of eyebrow-lateral 1/3 Cracking heels Dry Costocartilage pain goitrogens Turnips Cabbage Brussel sprout Mustard Soybean:isoflavone(antithyroid agent-inhibition of thyroid peroxidase) Peanut millet Lab test T3 T4 Free T3 Free T4 TSH: 2.0-4.0/0.5-5.5/….범위 다양 TBG 갑상선기능저하의 타입 Primary hypothyroid-갑상선 자체문제(T3T4)—GTA Medi-Stim(biotics) Secondary hypothyroid-pituitary문제(TSH) --cytozyme PT/HPT thyrostim Tertiary hypothyroid-hyper cortical adrenal 문제(ASI)—ADHS phospholylated serine 스트레스로 인한 코티졸 증가-rT3증가 “Poor T4 converters” Old age Vitamine and mineral deficiency Heavy metal toxic Adrenal problem Birth control pill Synthetic estrogen Beta-blocker Need liver detox to clean up Thyroid hormone resistance www.drbrownstein.com Receptor malfunction due to vitamine and mineral deficiency heavy metal toxic and trans fat 혈액검사는 정상 증상은 갑상선저하증과 유사 American Association of Clinical Endocrinologists(AACE) New TSH range 0.3 to 3.04 Mary Shomon survey 갑상선 환자1000명중 50퍼센트가 치료에 불만족 Colorado Thyroid Prevalance Study 호르몬 치료받는 40퍼센트가 여전히 TSH가 비정상 Thyroid basal axillary temperature Normal:97.8-98.2 F 전날밤 수은체온계 침대옆에 놓고 잔다 10분간 측정(겨드랑이) Basal body temperature Thyroid AK test and treatment Muscle test-teres minor 약하면 TL teres minor NL(primary)/pituitary NV(secondary) 약하면 영양제 challenge(iodine tyrosine RNA cofactor…..) Journal:T3T4rT3 British Medical Journal TSH Above 2-high risk to develop thyroid disease 1999 New England Journal of Medicine T4 plus T3복용시에 T4 only보다 정신적 심리적 육체적 증상이 더욱 효과적 환자들도 더욱 선호 1990 Obstetrics and Gynecology 임신중에 levothyroxine증량필요 임신과 관련없이 T4만 복용한 환자는 T4 to T3 conversion이 저하 1977 Jounal of Clinical Endocrinology and Metabolism 임신과 에스트로젠이 rT3와 관련된다 Sugar and thyroid More stable sugar more stable you are More stable thyroid more stable you are 여자환자에게 질문? Stuffy nose? Sleep all the time? Easy to gain weight? Finger nail brittle? Cold hand and feet? Hair? Thyrostim(biotics) Secondary hypothyroid(anterior pituitary hypofuction)-low TSH like 2 이하 Support pituitary and thyroid GTA Meda-Stim: primary hypothyroid(TSH-4 이상) TSH가 45일간 영양제 복용후에도 지속되면 호르몬 권한다 Wilson’s syndrome: rT3(inactive form of T3)—adrenal cortical hyperfunction(ADHS) and anterior pituitary hypofunction(cytozyme-PT/HPT or thyroistim) GTA Thyroxine을 제거한 porcine thyroid Good for primary hypothyroid with Meda-Stim-- (TSH above 4) Secondary hypothyroid—thyrostim and/or cytozyme PT/HPT with flax seed oil GTA와 Meda-Stim은 primary hypothyroid에 so good! Meda-Stim Contain L-tyrosine glutamic acid aspartic acid L-glutathione sea kelp magnesium riboflavin selenium vitamin B6 thiamine zinc rubidium T4-T3 conversion에 유효(due to hyperadrenal and/or use of exogenous estrogen) Cytozyme-PT/HPT Neonatal bovine pituitary and hypothalamus Adrenal stress와 함께 TSH below 2면 ADHS and PT/HPT함께 유용 Contain high pineal—so good for insomnia epilepsy anorexia inability to gain or lose weightCHO sensitivity and neuromuscular disorder 참고)jet lag—cytozyme THY

 
   
 
 
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