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6 blodprøver kan løse mysteriet om dit helbred

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Skærmbillede 2015-07-27 kl. 13.50.52

 

Skrevet af Læge Aviva Romm MD, oversat af Anett Kromann – bragt på www.stofskiftesupport.dk

 

Desværre hører Læge Aviva Romm MD fra mange af sine patienter, at deres læger ikke ønsker at tage følgende blodprøver. Virkeligheden for mange stofskiftesyge er, at vi skal være fortalere for os selv.

 

For nylig kom en patient ind i mit praksis med følgende symptomer:

  • Træthed
  • Humørsyge
  • Kraftige menstruationer
  • Ingen libido
  • Forstoppelse
  • Hun kunne ikke sove ordentligt, vågnede for tidligt om morgenen og var ude af stand til at falde i søvn igen, og hun havde taget 14 kilo på, på blot et par måneder, selv om hun ikke havde ændret sine spisevaner.

 

Alle er tegn på Hypothyreoidisme (lavt stofskifte)

Hun følte ikke, at stress var årsagen til hendes symptomer, da intet i hendes liv tydede på stress. Hun var ret sikker på, at der var noget galt med hendes skjoldbruskkirtel, så hun havde bedt sin praktiserende læge om at tjekke hendes blodprøver, før hun opsøgte mig. Lægen havde kontrolleret hendes TSH blodprøve og fortalte hende, at da prøven stadig var i det normale område, selv om det var i den forkerte ende af normalen, havde hun ikke et stofskifteproblem. Han sendte hende fra konsultationen med ordene:

 

Det tyder på, at måske et antidepressiv ville være godt at overveje.

 

Men hendes blodprøver var ikke normale. De var et skridt over en meget tynd linje, problemet var: Hypothyroidisme. Det var, hvad jeg diagnosticerede. Hun startede op på en passende behandling og hendes energi og symptomer begyndte hurtigt at blive bedre

 

Dette er en typisk historie.

 

Blodprøverne for stofskifteproblemer

Selv om ikke alle hypothyreose symptomer viser sig at være et problem med skjoldbruskkirtlen eller skjoldbruskkirtelhormonerne, ved vi, statistisk set, at hypothyroidisme er en underdiagnosticeret tilstand.

Hypothyroidisme er det mest almindelige stofskifteproblem, og Hashimotos; en autoimmun form for Hypothyroidisme; er den mest almindelige form af autoimmune sygdomme. Hypothyroidisme kan vise sig når som helst.

Alligevel er så mange læger tilbageholdende med en passende diagnosticering af skjoldbruskkirtelfunktionen.

Nogle vil endda afvise dig, hvis du kommer ind med førnævnte symptomer. Dette forekommer mærkeligt i betragtning af hvor udbredt stofskifteproblemer er, og alligevel er lægerne meget hurtige til at ordinere antidepressive. Min patients læge gjorde bare, hvad vi alle har fået fortalt under lægestudiet.

Tjek TSH og hvis det er inden for, hvad vi får at vide, af det normale område, er der ikke et problem. Men der er meget mere kompleksitet til skjoldbruskkirtelblodprøverne end det.

Desværre er så mange kvinder tilbøjelige til at tro, at deres symptomer på depression, træthed, ledsmerter, svaghed, vægtøgning og flere andre symptomer, alle er i deres hoved, og går derfor ikke til lægen. Måske er det endda sket for dig.

 

Hvad er skjoldbruskkirtlen?

Skjoldbruskkirtlen er en sommerfugleformet kirtel, der sidder på forsiden af ​​halsen. Den styrer din vægt, uanset om du føler dig træg eller energisk, mentalt skarp eller tåget, munter eller ked af det, er den involveret i kontrollen af ​​alt fra dit kolesterol til dine kønshormoner.

Når din skjoldbruskkirtel ikke fungerer optimalt, kan du føle dig ked af det, træt, have forstoppelse, tage på i vægt, få tør hud, dit hår kan blive tørt og kan endda falde af, dine muskler og led kan gøre ondt, dine menstruation bliver uregelmæssig, du kan have fertilitetsproblemer, hjerne tåge, sukkertrang (fordi din krop er i desperat af mangel på energi), højt kolesteroltal, selvom din kost er fantastisk, og et væld af andre store og små symptomer.

 

Hvad er Hypothyroidisme

Hypothyroidisme er en betegnelse for en nedsat metabolisk tilstand, der skyldes utilstrækkelige mængder af skjoldbruskkirtelhormoner. 95 procent af alle tilfælde skyldes det, der kaldes primær Hypothyreose. Det betyder, at skjoldbruskkirtlen er træg, eller undertiden ikke reagerer overhovedet. Dette kan skyldes en række årsager, der spænder fra utæt tarm til autoimmun sygdom.

Alternativt kan det være, at vi producerer skjoldbruskkirtelhormonerne effektivt nok, men vi kan have “thyreoideahormon resistens”; det svarer til den måde, vi kan have insulinresistens på. Problemet kan også være, at vores celler ikke optager hormonerne effektivt nok, selv om de er til rådighed. Kroppen kan også have nok af den inaktive form af skjoldbruskkirtel hormon (T4), men vi kan ikke omdanne til den aktive form (T3 = konverteringsproblemer).

Hypothyroidisme kan også skyldes mere alvorlige problemer i Hypothalamus og Hypofysen i hjernen. Kronisk eller væsentlig stress kan undertrykke hypofysen nok til at forstyrre hormonproduktionen.

 

Symptomer på hypothyroidisme kan omfatte:

  • Træthed
  • Øget følsomhed over for kulde
  • Forstoppelse
  • Tør hud
  • Uforklarlig vægtøgning
  • Trang til sukker og kulhydrater
  • Opsvulmet ansigt
  • Muskelsvaghed
  • Forhøjet kolesterol i blodet
  • Muskelsmerter, ømhed og stivhed
  • Smerter, stivhed eller hævelser i dine led
  • Tungere end normale eller uregelmæssige menstruationer
  • Tyndere hår
  • Langsommere puls
  • Depression

 

Nedsat hukommelse

Fordi disse symptomer er fælles for så mange mennesker, bliver Hypothyroidisme ofte afvist som “normale symptomer” eller depression. En af mine patienter blev beskyldt for overspisning af hendes læge, som årsagen til hendes vægtproblemer, men hvor det viste sig, at hun havde faktisk et stofskifteproblem.

 

De 6 vigtige blodprøver

Der er 6 vigtige blodprøver, der kan løse mysteriet om din skjoldbruskkirtel funktion, og dem bør din læge se på. Blodprøverne bør være lette at få fra din læge. Imidlertid kan tolkning af blodprøverne kræve nogle færdigheder, afhængigt af resultaterne, og det er ikke sikkert, at din læge er villig til at bestille mere end den gængse TSH blodprøven.

 

Det er her en fordomsfri endokrinolog eller en dygtig læge kan være til hjælp.

 

I min praksis, hvis mine patientens symptomer tyder på Hypothyroidisme, vil jeg køre hele stofskiftepanelet beskrevet nedenfor helt igennem. Hvis der er andre diagnoser, der er lige så sandsynlige, vil jeg bare tage de første 3 blodprøver (Panel 1, se nedenfor), og hvis disse kommer tilbage på grænsen eller er positive for stofskiftet og hormonproblemer, vil jeg derefter tilføje den resterende del af testpanelet. Jeg vil også nogle gange tjekke testresultaterne igen for TSH, Frit T3 og Frit T4, hvis de er normale hos en nyligt symptomatisk patient, 6-12 uger efter, fordi jeg lejlighedsvis har set første prøve være normal, for derefter kort tid efter, voila: Blodprøverne kommer tilbage og bekræfter problemet.

 

Hypofysehormonet (TSH)

Hormonet (TSH) fremstilles i den del af din hjerne, som kaldes hypofysen. TSH’s job er at fortælle skjoldbruskkirtlen, at det er tid til at få travlt med at producere mere skjoldbruskkirtel hormon. Når den sunde skjoldbruskkirtel får dette kemiske budskab, vil den producere to hormoner: Triiodothyronin (T3) og Thyroxin (T4).

Normalområdet for TSH er noget kontroversielt. Mange eksperter mener dog, selv i konventionel endokrinologi, at den øvre ende af normalområdet faktisk mere er som 2,5 – 3.

Dette er baseret på det faktum, at når mennesker uden stofskiftesymptomer får denne test udført, ligger den mest almindeligt i det øvre område.

Min patient var et af ​​disse mennesker. Med et TSH på 4 var hun virkelig i den øvre grænse for normalen; over den foretrukne øvre grænse ifølge nogle læger. Denne strid og uoverenstemmelse mellem forskellige lægers meninger om, hvad der skal betragtes som værende den normale øvre interval for TSH, er en af ​​de mest almindelige årsager til, at kvinder bliver underdiagnosticeret for Hypothyroidisme, og lider med unødvendige symptomer, der alvorligt kan forstyrre sundhed og livskvalitet.

I de fleste tilfælde opstår Hypothyroidisme, fordi skjoldbruskkirtlen er træg, det vil sige, at der er problemer med at producere T3 og T4. Dette kan skyldes en række årsager, der spænder fra ernæringsmæssige mangler til autoimmunitet. Så TSH bliver pumpet ud i en højere fart for at forsøge at stimulere skjoldbruskkirtlen til handling.

 

Tænk på det sådan her:

Du er TSH. Din bedste vens hus er skjoldbruskkirtlen. Når du besøger din ven, banker du på hendes hoveddør. Hvis hun ikke svarer, hvad gør du så? Du banker højere for at få et svar. På samme måde vil TSH banke højere i håb om at få et svar. Det er derfor, en ikke velfungerende skjoldbruskkirtel viser sig som højt TSH i blodprøverne. Dog kan TSH være normal ved optræden af Hypothyroidisme i nogle tilfælde, og man kan stadig have symptomerne på lavt stofskifte, når TSH er normal, på grund af dårlig omdannelse af T4 til T3 (se nedenfor) eller på grund af hormonmodstand på celleniveau. Når stress undertrykker Hypofysen og blander sig i at producere TSH, kan du se lave eller normale TSH niveauer ved lav skjoldbruskkirtel hormonproduktion (T3 eller T4), og Hypothyreose symptomer.

 

Skærmbillede 2015-07-27 kl. 13.12.28

 

Skjoldbruskkirtel hormonerne T3 og T4

Triiodothyronin (T3) og Thyroxin (T4) er de hormoner, der produceres af din skjoldbruskkirtel. T4 produceres i en meget større mængde og omdannes derefter til T3; den aktive form af hormonet, som er nødvendig for at opregulere metaboliske funktioner. T3 og T4 bliver sendt ud i din blodbane, hvor de er ansvarlige for skjoldbruskkirtlens faktiske arbejde med at kontrollere dit stofskifte. Frit T3 og Frit T4 kaldes dette, fordi de ikke er bundet til proteiner i blodet, hvilket gør dem frie til at udføre deres arbejde i dine celler, at holde dit stofskifte raskt og optimalt sundt.

Målingerne Frit T3 og Frit T4 er vigtige, fordi de er indikatorer for thyroxin- og triiodothyroninaktiviteter i kroppen. En høj TSH og lav Frit T4 og Frit T3 indikerer Hypothyroidisme. En normal TSH, normal Frit T4, og lav Frit T3 kan indikere T4 til T3 konverteringsproblemer, og en normal eller høj TSH, normal Frit T4 og høj Frit T3 kan indikere cellulær resistens over for Frit T3 som stadig kan føre til Hypothyroide symptomer, fordi det aktive hormon ikke kan komme til cellen, for at gøre sit arbejde.

 

Skjoldbruskkirtlens antistoffer

Skjoldbruskkirtlens antistoftest bruges til at diagnosticere autoimmun sygdom i skjoldbruskkirtlen, Hashimotos thyroiditis og skelne det fra andre former for skjoldbruskkirtlens dysfunktion.

De to antistoftests, som jeg bestiller, er Thyroid peroxidase antistof (TPOAb, eller Anti TPO) og Thyroglobulin Antistof (TgAb). Nogle mennesker har en autoimmun lidelse i skjoldbruskkirtlen, der ikke i første omgang testes positiv. Hvis positiv, kan antistoftesten gentages hver sjette måned, mens du måske arbejder med en læge med et holistisk syn på kroppen for at behandle eventuelle underliggende årsager.

 

Reverse T3

Når din krop ønsker at spare snarere end at brænde energi af, vil kroppen aflede det aktive T3 til en inaktiv “Reserve” form. Dette kan ske, når du er syg, under stress, eller ved underernæring. Hvis TSH og Frit T4 ser ok ud, men Frit T3 er lavt, kan det være fordi, det er ved at blive lavet om til Reverse T3, som vil blive forhøjet. Det er værd at tjekke Reverse T3, hvis der er tydelige symptomer på Hypothyroidisme, de typiske test vil ikke vise lavt TSH eller lavt Frit T4. Der er en vis uenighed blandt konventionelle læger om nytten af ​​denne test; jeg personligt finder den meget nyttig.

 

Yderligere tests

Hvis blodprøverne gentagne gange viser, at der er Hypothyroidisme, ville jeg også teste for mangler af selen, jern og zink og sørge for, at der er tilstrækkeligt kostindtag eller tilskud, hvis nødvendigt, samt se efter miljømæssige faktorer, der kan forstyrre jodudnyttelsen, f.eks., fluorid og bromid eksponeringer fra vand og flammehæmmende produkter. Jeg vil så også begynde at se nærmere efter andre underliggende årsager, for eksempel glutenallergi (Cøliaki), tungmetaleksponering, og andre miljømæssige udløsere.

 

Tal med din læge om blodprøver (eller skift læge)

Som læge kan jeg fortælle, at vi på lægestudiet lærte, at lægerne ved bedst. Men dette er ofte ikke tilfældet. Du er din krops bedste ekspert. Trods alt er du sammen med den hele tiden. Og du har ret til at bede om grundlæggende blodprøver og at modtage dem. Vi taler ikke om titusindvis af kroner i MR og CT scanninger her, vi taler om beskedne mængder blodprøver.

Når det er sagt, skal du drøfte dine symptomer med din læge, fordi der er en masse ”hype” omkring naturmedicin og naturlige produkter i verden, og din læge vil muligvis blot forsøge at beskytte dig fra det modsatte problem; at blive overdiagnosticeret eller fejldiagnosticeret ved et stofskifteproblem –  tro mig, jeg har også haft mange patienter, der blev sat på stofskiftemedicin hos alternativt praktiserende, når medicinen ikke var nødvendig.

Hvis du ikke har en ærlig samtale med din læge, hvis du føler din læge ikke lytter eller er nedladende, så er det en anden sag. Du bør være i stand til at have en gensidig respektfuld samtale med din behandler for at få de svar, du søger, og for at være i stand til at udforske dine bekymringer. Hvis du ikke kan, så find ud af, om hindringen ikke er i din favør, at du ikke er i stand til at ytre dig på grund af en opfattet autoritærtro (mange af os bliver svage i knæene, når vi står over for vores læger, især hvis vi føler os sårbare over vores sundhed) eller om din læge bare ikke kommunikerer respektfuldt.

 

Om Aviva Romm MD

Dr. Aviva Romm er mor til fire voksne børn, en Yale-uddannet læge med speciale i alternativ behandling til kvinder og børn, jordemoder, herbalist, prisbelønnet forfatter, og skaberen / ejer af WomanWise, onlinekurser dedikeret til vitalitet og optimal sundhed for kvinder og børn. Dr. Romm praktiserer alternativ og funktionel medicin på The UltraWellness center i Lenox, MA.

 

Kilder: 

http://hypothyroidmom.com/hypothyroid-testing-what-you-need-to-know-and-ask-for/

http://stofskiftesupport.dk/6-blodproever-kan-laase-mysteriet-om-dit-helbred-op

 

Hold styr på dine tal

Hvis du har behov for at skrive dine stofskiftetal/andre blodprøver ned, kan du downloade et skema, hvori du kan holde styr på alle tallene.

Hent skemaet her

 

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