Amazinga aphezulu e-Cortisol Kwabesifazane

Wake wazizwa ukhathele, ukhathazekile, noma wabona ukuzuza kwesisindo ngendlela engachazeki? Lezi kungaba izimpawu zamazinga aphezulu e-cortisol kwabesifazane. I-Cortisol, noma i-hormone yokucindezeleka, ibalulekile emisebenzini eminingi yomzimba. Kodwa-ke, lapho amazinga e-cortisol ephezulu, angaba nomthelela empilweni nempilo yowesifazane ngezindlela ezahlukahlukene.

Masiqonde izimpawu ezivamile ze-cortisol ephakeme kwabesifazane nokuthi zisho ukuthini. Sizobheka izimbangela ze-cortisol ephezulu, ukuthi odokotela bayixilonga kanjani, nezindlela zokuyelapha. 

Iyini iCortisol?

I-Cortisol iyi-hormone ye-steroid ebalulekile emzimbeni womuntu. Ivame ukubizwa ngokuthi "i-hormone yokucindezeleka" ngoba isiza ukulawula ukuphendula komzimba ekucindezelekeni. Kodwa-ke, imisebenzi ye-cortisol idlulela ngalé ukucindezeleka ukuphathwa.

Izindlala ze-adrenal, izakhiwo ezimise okonxantathu ezitholakala phezulu kwezinso ngayinye, zikhiqiza futhi zikhulule i-cortisol. I-Cortisol ithinta cishe zonke izitho nezicubu emzimbeni. Inomthelela kumetabolism, isiza ukulawula ukusetshenziswa komzimba kwamafutha, amaprothenikanye nama-carbohydrate. Le hormone iphinde icindezele ukuvuvukala, ilawule amazinga kashukela egazini kanye nomfutho wegazi, futhi ibe nomthelela emjikelezweni wokulala nokuvuka.

Amazinga e-cortisol hormone emzimbeni alandela isigqi sokujikeleza, ngokuvamile esiphezulu kakhulu ekuseni futhi esiphansi kakhulu ebusuku. Lokhu kuguquguquka kwemvelo kusiza ukulawula imisebenzi ehlukahlukene yomzimba usuku lonke.

Kubalulekile ukuqaphela ukuthi nakuba i-cortisol ibalulekile empilweni, ukulondoloza amazinga alinganiselayo kubalulekile. Amazinga e-cortisol aphezulu naphansi angathinta kabi inhlalakahle yomuntu, okungase kuholele ezimpawini ezihlukahlukene nezinkinga zempilo.

I-High Cortisol Symptom Kwabesifazane

Amazinga aphezulu e-cortisol kwabesifazane angaba nomthelela omkhulu ezicini ezihlukahlukene zempilo yabo. Okulandelayo yizimpawu ezivamile ze-cortisol ephakeme kwabesifazane:

• Izimpawu Zomzimba:
  • Ukuzuza ngokushesha kwesisindo, ikakhulukazi ebusweni, esiswini nangemuva entanyeni 
  • Ubuso bungase bube yindilinga futhi bubomvu, ngezinye izikhathi obubizwa ngokuthi "ubuso benyanga.
  • Izimpawu zokunwebeka ezinsomi esiswini, ezinqulwini, nasemabeleni
  • Isikhumba esincanyana, esintekenteke esiphuka kalula
  • Ukuphulukiswa kwesilonda
  • induna
  • Ubuthakathaka bemisipha, ikakhulukazi ezingalweni ezingaphezulu namathanga
  • Umfutho wegazi ophezulu
  • Ukukhathala nokubuthakathaka
• Izimpawu Zemizwa Nengqondo:
  • Ukucindezeleka nokukhathazeka
  • Ukuthukuthela
  • I-Mood iyashintsha
  • Ubunzima bokugxilisa ingqondo noma ukukhumbula izinto
  • Inkinga yokulala
• Izinkinga zempilo yokuzala:
  • Okungajwayelekile noma yamisa imijikelezo yokuya esikhathini
  • Izinguquko ku-libido
  • Izinkinga zokuzala
  • Izinwele ezinde kakhulu ebusweni, entanyeni, nakwezinye izingxenye zomzimba, isimo esaziwa ngokuthi yi-hirsutism

Kubalulekile ukuqaphela ukuthi lezi zimpawu zingahluka kumuntu nomuntu futhi zingase zingakhombisi njalo amazinga e-cortisol aphezulu. 

Izimbangela Nezici Zengozi Yamazinga E-Cortisol Aphakeme

• Ukucindezeleka Okungapheliyo: Ukucindezeleka kwesikhathi eside kunomthelela omkhulu emazingeni aphezulu e-cortisol kwabesifazane. Uma uhlezi ungaphansi kwengcindezi, isimiso sakho sokuphendula ngokucindezeleka sihlala sisebenza, okuholela ekukhiqizweni kwe-cortisol isikhathi eside. Lokhu kungase kube ngenxa yomsebenzi onzima, izinkinga zezimali, noma imithwalo yemfanelo yomkhaya. 
• Izimo Zezokwelapha: Izimo eziningana zezokwelapha zingabangela amazinga e-cortisol aphakeme. Lokhu kungaba ngenxa yokuthi:
  • Amathumba e-pituitary akhiqiza ihomoni ye-adrenocorticotropic (ACTH) eyeqile.
  • Izimila ze-adrenal gland noma ukukhula ngokweqile kwezicubu ze-adrenal
  • Izimila ezikhiqiza i-Ectopic ACTH kwezinye izingxenye zomzimba
  • I-hyperpituitarism kanye nezinhlobo ezithile zomdlavuza nazo zingaholela emazingeni aphezulu e-cortisol.
• Imithi: Eminye imithi ingakhuphula amazinga e-cortisol:
  • Ukusetshenziswa okungapheli kwemithi ye-glucocorticoid
  • Eminye imithi engase ithinte amazinga e-cortisol ihlanganisa ama-antidepressants athile nama-stimulants.
• Izingozi: Kunezici ezimbalwa ezingakhuphula amathuba okuthuthukisa amazinga e-cortisol aphezulu:
  • Ukuba ngowesifazane (70% wezigameko ze-Cushing's syndrome zenzeka kwabesifazane)
  • Izimo zezokwelapha ezingaphansi ezithinta i-pituitary noma izindlala ze-adrenal
  • ukuhlukumezeka
  • I-Genetic predisposition (ezimweni ezingavamile)

Sifo

Ukuhlonza amazinga e-cortisol aphezulu kwabesifazane kuhilela uchungechunge lokuhlola ukukala i-cortisol emzimbeni, njenge:

• Ukuhlolwa kweCortisol: Ukuhlolwa kwe-cortisol kuyindlela eyinhloko yokuhlola amazinga e-cortisol. Odokotela bangenza lokhu kuhlola ngokusebenzisa amasampula egazi, umchamo, noma amathe.
  • Isivivinyo samahora angama-24 se-urinary cortisol ukukala ukuphuma kwe-cortisol
  • Ukuhlolwa kwe-cortisol yamathe kwaphakathi kwamabili ukuhlola amazinga e-cortisol phakathi kuka-11pm no-12 am lapho kufanele abe phansi khona.
  • Ukuhlolwa kwegazi kulinganisa amazinga e-cortisol ne-adrenocorticotropic hormone (ACTH). 

Uma ukuhlolwa kokuqala kubonisa imiphumela engavamile, odokotela bangase bacele uphenyo olwengeziwe ukuze baqinisekise ukuxilongwa nokuhlonza imbangela eyinhloko. Lokhu kungase kuhlanganise:

• Ukuhlolwa Kokuvuselela Kwe-ACTH: Ukuhlola ukuthi izindlala ze-adrenal zisabela kanjani ku-ACTH yokwenziwa.
• Ukuhlolwa kokucindezelwa kwe-Dexamethasone: Lokhu kulinganisa amazinga e-cortisol ngemva kokuthatha i-dexamethasone, uhlobo lokwenziwa lwe-cortisol.
• Ukuhlola ukuhlolwa: I-MRI noma i-CT scans ihlola i-pituitary kanye nezindlala ze-adrenal ukuthola izimila noma okunye okungajwayelekile.

Ukwelashwa

Ukwelashwa kwamazinga aphezulu e-cortisol kwabesifazane kuncike kumbangela ewumsuka. Odokotela ngokuvamile batusa indlela ehambisanayo esekelwe esimweni esithile somuntu nezimpawu, okuhlanganisa:

• Kulabo abasebenzisa imithi ye-glucocorticoid, odokotela bangase basikisele ukwehlisa umthamo noma bashintshele kwenye engeyona i-glucocorticoid. 
• Uma isimila sibangela i-Cushing's syndrome, kungase kudingeke ukuhlinzwa noma ukwelashwa ngemisebe. Kwezinye izimo, zombili izindlala ze-adrenal zingadinga ukususwa, inqubo eyaziwa ngokuthi i-bilateral adrenalectomy.
• Imithi idlala indima ebalulekile ekulawuleni amazinga e-cortisol lapho amanye amakhambi aphezulu e-cortisol engafaneleki. Izidakamizwa ezifana ne-ketoconazole, i-osilodrostat, ne-mitotane zingasiza ukulawula ukukhiqizwa kwe-cortisol. I-Mifepristone igunyazwe ngokucacile kubantu abane-Cushing's syndrome abanoshukela ophezulu noma thayipha 2 sikashukela.
• Kubalulekile ukuqaphela ukuthi ngemva kokwelashwa, umzimba ungase ukhiqize i-cortisol enganele okwesikhashana. Ukwelashwa esikhundleni se-Cortisol kungase kudingeke ezimweni ezinjalo, ngezinye izikhathi impilo yonke. 
• Ngokuhambisana nokungenelela kwezokwelapha, izinguquko zendlela yokuphila zingasiza ukuphatha amazinga e-cortisol. Lokhu kuhlanganisa amasu okunciphisa ukucindezeleka, ukuvivinya umzimba njalo, nokudla okunempilo. 

Uzoyibona Nini Udokotela

Uma unezimpawu zamazinga e-cortisol aphezulu kwabesifazane, kubalulekile ukubonana nodokotela. Kufanele uthintane nodokotela uma ubona:

• Ukukhuluphala ngokushesha, ikakhulukazi ebusweni, esiswini, nangemuva kwentamo
• Ubuthakathaka bemisipha 
• Ukulimala okulula nokuphola kancane kwenxeba
• Imizwa iyashintsha, okuhlanganisa ukukhathazeka nokucindezeleka
• Inkinga yokulala noma ukukhathala njalo
• Imijikelezo yokuya esikhathini engavamile noma izinguquko ku-libido

Ngingawehlisa kanjani amazinga e-cortisol aphezulu?

Ezinye izindlela ezingehlisa amazinga e-cortisol ngokwemvelo yilezi: 

• Yehlisa Ingcindezi: Ukubeka izinto ezibalulekile kuqala nokugwema izingcindezi ezingadingekile kungasiza ekulawuleni amazinga okucindezeleka. Ukuzijwayeza izindlela zokuphumula ezifana nokuvivinya umzimba kokuphefumula, ukuzindla okuqondisiwe, noma i-yoga kungase kuqalise ukusabela komzimba okuphumuzayo, kuphikisane nokusabela kokucindezeleka.
• Izinguquko Zokudla: Ukudla okulinganiselayo kubalulekile ekulawuleni amazinga e-cortisol. Ukwandisa i-fiber yokudla ngemifino, izithelo, ubhontshisi, nokusanhlamvu kungazuzisa. Omega-3 ama-fatty acids, atholakala ezinhlanzini nasezindaweni zasolwandle, nawo angasiza. Kubalulekile ukunaka ushukela ne-caffeine, ikakhulukazi kusihlwa, njengoba kungaphazamisa ikhwalithi yokulala.
• Ukulala Okuhle: Ukulala ngokwanele kubalulekile ekulawuleni i-cortisol. Ukugcina ishejuli yokulala enempilo futhi engaguquki kanye nokuthuthukisa isimiso esihle sokulala kungathuthukisa ikhwalithi yokulala. 
• Umsebenzi Womzimba: Ukuzivocavoca njalo kunganciphisa amazinga e-cortisol, kodwa ukukhetha imisebenzi enomthelela ophansi noma ophakathi kubalulekile ukuze ugweme ukuvusa impendulo yokucindezeleka. 
• Yeka Ukubhema:  Ukuyeka ugwayi ingaba nomthelela omuhle emazingeni e-cortisol. 

Isiphetho

Ukuqonda umthelela wamazinga e-cortisol aphezulu kwabesifazane kuyadingeka empilweni nempilo yonke. Ukusuka ezinguqukweni zomzimba ezifana nokuzuza kwesisindo kanye nobuthakathaka bemisipha kuya kuzimpawu zemizwa ezifana ukukhathazeka nokushintshashintsha kwemizwelo, i-cortisol ephakeme ingaba nemiphumela efinyelela kude emzimbeni nasengqondweni yowesifazane. Ukubona lezi zimpawu kusenesikhathi nokufuna iseluleko sezokwelapha kungaholela ekuxilongweni nasekulashweni okufika ngesikhathi, okungase kuvimbele izinkinga zempilo ezingathi sína. Ukuphatha amazinga e-cortisol ngokuvamile kuhilela inhlanganisela yokungenelela kwezokwelapha kanye nezinguquko zokuphila. Khumbula, isimo somuntu ngamunye sihlukile, ngakho ukusebenza eduze nodokotela ukuze wenze uhlelo lomuntu siqu kubalulekile. 

Imibuzo Evame Ukubuzwa

1. Ingabe i-cortisol iyihomoni yokucindezeleka? 

Yebo, i-cortisol ivame ukubizwa ngokuthi 'i-hormone yokucindezeleka'. Idala impendulo yokucindezeleka komzimba. Lapho ubhekene nesimo esicindezelayo, umzimba ukhulula i-cortisol ukuze ikusize ubhekane nosongo.

2. Yenzani i-cortisol ephezulu emzimbeni wami? 

Amazinga e-cortisol aphezulu aholela ekuzuzeni isisindo, ikakhulukazi endaweni ephakathi nendawo nangaphezulu, abangela izinduna, anciphise isikhumba sakho, futhi akwenze ugwaze kalula. Ungase futhi ube buthakathaka kwemisipha, ukukhathala okukhulu, ukucasuka, nobunzima bokugxila. I-cortisol ephezulu inganyusa umfutho wegazi namazinga kashukela egazini.

3. Umzimba wami uwalawula kanjani amazinga e-cortisol? 

Umzimba wakho ulawula amazinga e-cortisol ngesistimu eyinkimbinkimbi ehlanganisa i-hypothalamus, i-pituitary gland, nezindlala ze-adrenal. Lolu hlelo oluyinkimbinkimbi lwaziwa ngokuthi i-hypothalamic-pituitary-adrenal axis. Lapho amazinga e-cortisol ephansi, i-hypothalamus itshela indlala ye-pituitary ukuthi ikhiphe ihomoni elibhekele ukuthuthukiswa kwe-cortisol ngezindlala ze-adrenal.

4. Yini eyenza i-cortisol inyuke? 

Izici eziningana zingabangela amazinga e-cortisol ukuthi akhuphuke. Lokhu kungase kuhlanganise ukucindezeleka okungapheli, izimo ezithile zezokwelapha (ezifana ne-Cushing's syndrome), neminye imithi, ikakhulukazi i-corticosteroids.

5. Ngazi kanjani uma ngine-cortisol ephezulu? 

Uma uhlangabezana nezimpawu zamazinga e-cortisol aphezulu, njengokukhuluphala ngokushesha, ubuthakathaka bemisipha, ukushintshashintsha kwemizwelo, noma ukulala okunenkinga, kungase kube izimpawu eziyisixwayiso zamazinga aphezulu e-cortisol. 

6. Yini ebangela amazinga aphansi e-cortisol? 

Amazinga aphansi e-cortisol, aziwa ngokuthi ukuntuleka kwe-adrenal, angabangelwa izinkinga zezindlala ze-adrenal (isifo sika-Addison) noma izinkinga nge-pituitary gland. Kungase futhi kwenzeke ngemva kokuyeka ukwelashwa kwe-corticosteroid yesikhathi eside ngokushesha kakhulu. Izimpawu ze-cortisol ephansi zingase zihlanganise ukukhathala, ukuncipha, umfutho wegazi ophansi, nokuba mnyama kwesikhumba.

UDkt. Bipin Kumar Sethi

MBBS, MD (Umuthi), DM (Endocrinology)
I-CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad, CARE Hospitals, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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