{"id":154,"date":"2024-06-12T12:04:24","date_gmt":"2024-06-12T12:04:24","guid":{"rendered":"https:\/\/raypeatbg.com\/?p=154"},"modified":"2024-06-12T12:04:26","modified_gmt":"2024-06-12T12:04:26","slug":"%d1%84%d0%b8%d0%b7%d0%b8%d0%be%d0%bb%d0%be%d0%b3%d0%b8%d1%87%d0%bd%d0%be-%d0%b7%d0%bd%d0%b0%d1%87%d0%b5%d0%bd%d0%b8%d0%b5-%d0%bd%d0%b0-tsh","status":"publish","type":"post","link":"https:\/\/raypeatbg.com\/tr\/2024\/06\/12\/%d1%84%d0%b8%d0%b7%d0%b8%d0%be%d0%bb%d0%be%d0%b3%d0%b8%d1%87%d0%bd%d0%be-%d0%b7%d0%bd%d0%b0%d1%87%d0%b5%d0%bd%d0%b8%d0%b5-%d0%bd%d0%b0-tsh\/","title":{"rendered":"TSH'nin fizyolojik \u00f6nemi"},"content":{"rendered":"

Son y\u0131llarda TSH i\u00e7in \"normal aral\u0131k\" d\u00fc\u015fmektedir. 2003 y\u0131l\u0131nda. Amerikan Klinik Endokrinologlar Birli\u011fi normal aral\u0131k k\u0131lavuzunu 0,3 ila 3,0 mikroIU\/ml olarak de\u011fi\u015ftirmi\u015ftir. Ancak bu d\u00fc\u015f\u00fck aral\u0131k eski standartlara g\u00f6re daha az keyfi olsa da, hala TSH'nin fizyolojik \u00f6neminin anla\u015f\u0131lmas\u0131na dayanmamaktad\u0131r.<\/p>\n\n\n\n

Birka\u00e7 y\u0131l boyunca, TSH'si 2'nin \u00fczerinde olup da rahat\u00e7a sa\u011fl\u0131kl\u0131 olan bir ki\u015fi g\u00f6rmedim ve normal veya sa\u011fl\u0131kl\u0131 miktar\u0131n muhtemelen 1'den az oldu\u011fu izlenimini edindim.<\/strong><\/p>\n\n\n\n

Patolojik olarak y\u00fcksek TSH normal olarak tan\u0131mlan\u0131rsa, meme kanseri, mastalji, MS, fibrotik hastal\u0131klar ve epilepsi gibi \u00f6nemli hastal\u0131klardaki rol\u00fc g\u00f6z ard\u0131 edilmi\u015f olacakt\u0131r. Bu olas\u0131l\u0131k g\u00f6z \u00f6n\u00fcnde bulundurulsa bile, vakalar\u0131n ve kontrollerin ortalama TSH seviyeleri aras\u0131ndaki istatistiksel fark gibi uygun bir kar\u015f\u0131la\u015ft\u0131rma yerine mant\u0131ks\u0131z bir normun kullan\u0131lmas\u0131, bir ili\u015fki oldu\u011funu g\u00f6steren kan\u0131tlara ra\u011fmen hipotiroidizm ile \u00f6nemli hastal\u0131klar aras\u0131ndaki ili\u015fkinin inkar edilmesine yol a\u00e7ar.<\/p>\n\n\n\n

Baz\u0131 ele\u015ftirmenler \u00e7o\u011fu doktorun hastay\u0131 de\u011fil \"TSH'yi tedavi etti\u011fini\" s\u00f6ylemektedir. TSH'nin kendisi anti-enflamatuar etkileri nedeniyle patojenik ise, bu yakla\u015f\u0131m, TSH'yi genellikle aktif triiyodotironin olan T3'e iyi d\u00f6n\u00fc\u015fmeyen tek ba\u015f\u0131na tiroksin ile \"tedavi ettiklerinde\" bile tamamen yarars\u0131z de\u011fildir. Ancak n\u00fcfusun k\u00fc\u00e7\u00fck bir y\u00fczdesindeki birka\u00e7 semptomu hafifletmek, t\u0131p d\u00fcnyas\u0131n\u0131 tiroid tedavisinin ger\u00e7ek olanaklar\u0131na kar\u015f\u0131 k\u00f6rle\u015ftirmeye hizmet etmektedir.<\/p>\n\n\n\n

TSH'nin tiroid d\u0131\u015f\u0131ndaki bir\u00e7ok h\u00fccre tipi \u00fczerinde do\u011frudan etkileri vard\u0131r ve muhtemelen \u00f6dem, fibrozis ve mastositoza do\u011frudan katk\u0131da bulunur. E\u011fer insanlar \"TSH eksikli\u011finin\" etkilerinden endi\u015fe duyuyorlarsa, o zaman WD Denckla'n\u0131n deneylerindeki hipofiz eksikli\u011fi olan hayvanlar\u0131n veya TSH, prolaktin ve b\u00fcy\u00fcme hormonu olmayan ancak normal farelerden yakla\u015f\u0131k bir y\u0131l daha uzun ya\u015fayan do\u011fal hipofiz eksikli\u011fi olan farelerin ola\u011fan\u00fcst\u00fc uzun \u00f6m\u00fcrl\u00fcl\u00fc\u011f\u00fcn\u00fc a\u00e7\u0131klamalar\u0131 gerekti\u011fini d\u00fc\u015f\u00fcn\u00fcyorum.<\/p>\n\n\n\n

\u00c7ok d\u00fc\u015f\u00fck TSH'nin bir \u015fekilde zararl\u0131 oldu\u011funa dair bir kan\u0131t bulunmamakla birlikte, normal aral\u0131\u011f\u0131n alt s\u0131n\u0131r\u0131n\u0131 belirlemek i\u00e7in bir temel de yoktur.<\/strong><\/p>\n\n\n\n

Baz\u0131 tiroid kanseri t\u00fcrleri genellikle TSH tamamen bask\u0131lanarak kontrol alt\u0131na al\u0131nabilir. TSH, fibroblastlar ve ya\u011f h\u00fccreleri, derideki pigment h\u00fccreleri, mast h\u00fccreleri ve kemik ili\u011fi h\u00fccreleri d\u0131\u015f\u0131ndaki h\u00fccrelerde reaksiyonlar \u00fcretti\u011finden, melanom da dahil olmak \u00fczere \u00e7e\u015fitli kanserlerin geli\u015fiminde bir rol\u00fc oldu\u011fu ortaya \u00e7\u0131karsa \u015fa\u015f\u0131rt\u0131c\u0131 olmaz.<\/p>\n\n\n\n

Karaci\u011fer de dahil olmak \u00fczere bir\u00e7ok \u015fey tiroid sisteminin i\u015flevini d\u00fczenler ve hipofiz, tiroid hormonlar\u0131n\u0131n sentezini ve salg\u0131lanmas\u0131n\u0131 etkileyen fakt\u00f6rlerden yaln\u0131zca biridir.<\/p>\n\n\n\n

Ya\u015flanma, enfeksiyon, travma, uzun s\u00fcreli kortizol, somatostatin, dopamin veya L-dopa, adrenalin, amfetamin, kafein ve ate\u015f fazlal\u0131\u011f\u0131, tiroid hormonlar\u0131ndan gelen geri bildirim etkisine ek olarak TSH'yi d\u00fc\u015f\u00fcrebilir. TSH normal veya d\u00fc\u015f\u00fck g\u00f6r\u00fcnebilirken ayn\u0131 zamanda ger\u00e7ek hipotiroidizm de olabilir.<\/strong><\/p>\n\n\n\n

TSH ve di\u011fer hipofiz hormonlar\u0131n\u0131n strese ba\u011fl\u0131 bask\u0131lanmas\u0131, tehlikeli derecede yo\u011fun stres s\u0131ras\u0131nda bireysel sinir liflerinde meydana gelen koruyucu inhibisyonu an\u0131msat\u0131r ve hipotalamus sinirlerinde veya ba\u015fka bir beyin b\u00f6lgesinde b\u00f6yle bir \"parabiyotik\" s\u00fcreci i\u00e7erebilir. Organizma \u00e7ok iyi durumdayken hipofiz hormonlar\u0131n\u0131n g\u00f6receli olarak ortadan kalkmas\u0131 (\u00f6rne\u011fin ASTH ve kortizol\u00fcn \u015feker veya pregnenolon taraf\u0131ndan bask\u0131lanmas\u0131), bireysel sinir liflerinin y\u00fcksek enerjiyle kapat\u0131lmas\u0131yla paralellik g\u00f6sterir.<\/p>\n\n\n\n

Stres, TSH'yi bask\u0131laman\u0131n yan\u0131 s\u0131ra, ger\u00e7ek tiroid fonksiyonunu bask\u0131lamak i\u00e7in ba\u015fka \u015fekillerde de etki eder.<\/p>\n\n\n\n

\u00d6rne\u011fin kortizol, solunum enerjisi ve karbondioksit \u00fcretiminden sorumlu olan T4'\u00fcn T3'e d\u00f6n\u00fc\u015f\u00fcm\u00fcn\u00fc engeller.<\/p>\n\n\n\n

Adrenalin, kortizol \u00fcretiminin artmas\u0131na yol a\u00e7man\u0131n yan\u0131 s\u0131ra lipolitiktir ve \u00e7oklu doymam\u0131\u015fsa tiroid hormonu \u00fcretimini ve ta\u015f\u0131nmas\u0131n\u0131 engelleyen ve ayr\u0131ca mitokondrinin solunum i\u015flevlerine m\u00fcdahale eden ya\u011f asitlerini serbest b\u0131rak\u0131r.<\/p>\n\n\n\n

Adrenalin, T4'\u00fcn T3'e d\u00f6n\u00fc\u015f\u00fcm\u00fcn\u00fc azalt\u0131r ve ters T3 olu\u015fumunu art\u0131r\u0131r.<\/p>\n\n\n\n

Adrenalinin ve serbest ya\u011f asitlerinin en y\u00fcksek oldu\u011fu gece saatlerinde TSH genellikle zirve yapar . <\/strong>TSH'nin kendisi lipolizi ind\u00fckleyerek dola\u015f\u0131mdaki serbest ya\u011f asitlerinin seviyesini art\u0131rabilir. Bu durum, y\u00fcksek TSH seviyesinin bazen doymam\u0131\u015f ya\u011f asitlerinin antimetabolik etkileri nedeniyle fonksiyonel hipotiroidizme katk\u0131da bulunabilece\u011fini d\u00fc\u015f\u00fcnd\u00fcrmektedir.<\/p>\n\n\n\n

Bunlar, tiroid fonksiyonunu yorumlarken laboratuvar TSH sonu\u00e7lar\u0131na \u00e7ok fazla \u00f6nem verilmemesi gerekti\u011fini d\u00fc\u015f\u00fcnmenin ana nedenleridir.<\/p>\n\n\n\n

http:\/\/raypeat.com\/articles\/articles\/hypothyroidism.shtm<\/a><\/p>","protected":false},"excerpt":{"rendered":"

Son y\u0131llarda TSH i\u00e7in \"normal aral\u0131k\" d\u00fc\u015fmektedir. 2003 y\u0131l\u0131nda. Amerikan Klinik Endokrinologlar Birli\u011fi normal aral\u0131k k\u0131lavuzunu 0,3 ila 3,0 mikroIU\/ml olarak de\u011fi\u015ftirmi\u015ftir. Ancak bu d\u00fc\u015f\u00fck aral\u0131k eski standartlara g\u00f6re daha az keyfi olsa da, hala TSH'nin fizyolojik \u00f6neminin anla\u015f\u0131lmas\u0131na dayanmamaktad\u0131r. \u00c7\u00fcnk\u00fc... Okumaya devam et TSH'nin fizyolojik \u00f6nemi<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"iawp_total_views":373,"footnotes":""},"categories":[3],"tags":[29,30],"class_list":["post-154","post","type-post","status-publish","format-standard","hentry","category-3","tag-29","tag-30","entry"],"yoast_head":"\n\u0424\u0438\u0437\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u043d\u043e \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0435 \u043d\u0430 TSH - \u0440\u0435\u0439 \u043f\u0438\u0439\u0442 \u0431\u044a\u043b\u0433\u0430\u0440\u0438\u044f<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/raypeatbg.com\/tr\/2024\/06\/12\/\u0444\u0438\u0437\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u043d\u043e-\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0435-\u043d\u0430-tsh\/\" \/>\n<meta property=\"og:locale\" content=\"tr_TR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u0424\u0438\u0437\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u043d\u043e \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0435 \u043d\u0430 TSH - \u0440\u0435\u0439 \u043f\u0438\u0439\u0442 \u0431\u044a\u043b\u0433\u0430\u0440\u0438\u044f\" \/>\n<meta property=\"og:description\" content=\"\u041f\u0440\u0435\u0437 \u043f\u043e\u0441\u043b\u0435\u0434\u043d\u0438\u0442\u0435 \u0433\u043e\u0434\u0438\u043d\u0438 \u201e\u043d\u043e\u0440\u043c\u0430\u043b\u043d\u0438\u044f\u0442 \u0434\u0438\u0430\u043f\u0430\u0437\u043e\u043d\u201c \u0437\u0430 TSH \u043d\u0430\u043c\u0430\u043b\u044f\u0432\u0430. \u041f\u0440\u0435\u0437 2003 \u0433. \u0410\u043c\u0435\u0440\u0438\u043a\u0430\u043d\u0441\u043a\u0430\u0442\u0430 \u0430\u0441\u043e\u0446\u0438\u0430\u0446\u0438\u044f \u043d\u0430 \u043a\u043b\u0438\u043d\u0438\u0447\u043d\u0438\u0442\u0435 \u0435\u043d\u0434\u043e\u043a\u0440\u0438\u043d\u043e\u043b\u043e\u0437\u0438 \u043f\u0440\u043e\u043c\u0435\u043d\u0438 \u0441\u0432\u043e\u0438\u0442\u0435 \u043d\u0430\u0441\u043e\u043a\u0438 \u0437\u0430 \u043d\u043e\u0440\u043c\u0430\u043b\u043d\u0438\u0442\u0435 \u0433\u0440\u0430\u043d\u0438\u0446\u0438 \u043d\u0430 0,3 \u0434\u043e 3,0 microIU \/ ml. \u041d\u043e \u0432\u044a\u043f\u0440\u0435\u043a\u0438, \u0447\u0435 \u0442\u043e\u0437\u0438 \u043f\u043e-\u043d\u0438\u0441\u044a\u043a \u0434\u0438\u0430\u043f\u0430\u0437\u043e\u043d \u0435 \u043f\u043e-\u043c\u0430\u043b\u043a\u043e \u043f\u0440\u043e\u0438\u0437\u0432\u043e\u043b\u0435\u043d \u043e\u0442 \u043f\u043e-\u0441\u0442\u0430\u0440\u0438\u0442\u0435 \u0441\u0442\u0430\u043d\u0434\u0430\u0440\u0442\u0438, \u0442\u043e\u0439 \u0432\u0441\u0435 \u043e\u0449\u0435 \u043d\u0435 \u0441\u0435 \u043e\u0441\u043d\u043e\u0432\u0430\u0432\u0430 \u043d\u0430 \u0440\u0430\u0437\u0431\u0438\u0440\u0430\u043d\u0435 \u043d\u0430 \u0444\u0438\u0437\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u043d\u043e\u0442\u043e \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0435 \u043d\u0430 TSH. \u0417\u0430… Okumaya devam et \u0424\u0438\u0437\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u043d\u043e \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0435 \u043d\u0430 TSH\" \/>\n<meta property=\"og:url\" content=\"https:\/\/raypeatbg.com\/tr\/2024\/06\/12\/\u0444\u0438\u0437\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u043d\u043e-\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0435-\u043d\u0430-tsh\/\" \/>\n<meta property=\"og:site_name\" content=\"\u0440\u0435\u0439 \u043f\u0438\u0439\u0442 \u0431\u044a\u043b\u0433\u0430\u0440\u0438\u044f\" \/>\n<meta property=\"article:published_time\" content=\"2024-06-12T12:04:24+00:00\" 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