He aha te Mate Cushing? Ngā Tohutohu, Ngā Take, me te Maimoatanga

Ka puta te mate Cushing ina nui rawa te homoni i roto i tō tinana e kiia nei ko te cortisol mō te wā roa. Whakaarohia te cortisol hei homoni ahotea taiao o tō tinana e āwhina ana i a koe ki te whakahaere i ngā āhuatanga wero, engari ki te noho teitei ngā taumata mō ngā marama, tau rānei, ka pā tera ki te tata katoa o ngā wāhanga o tō tinana.

Ka whanake haere tenei āhuatanga, ko te tikanga ka puta haere mai ngā tohu i te wā roa. Kāore te tokomaha e mohio kei te he tetahi mea i te tīmatanga, nā te mea ka ngāwari ngā huringa. Ko te rongo pai, mā te whakamātautau tika me te maimoatanga, ka taea e te nuinga o te hunga e pangia ana e te mate Cushing te kite i te whakapainga nui ki ō rātou tohu me te hauora whānui.

He aha te Mate Cushing?

Ko te mate Cushing he mate homoni e puta mai ana i te whakamahinga roa ki ngā taumata teitei o te cortisol i roto i tō tinana. Ko ō kōpū adrenal, kei runga i ō whatukuhu, ka whakaputa noa i te cortisol hei āwhina i tō tinana ki te whakautu ki te ahotea, ki te whakahaere i te huka toto, me te whakaiti i te mumura.

Ina noho teitei tonu ngā taumata cortisol mō ngā wā roa, ka whakaroa i ngā mahi noa o tō tinana. Ka taea te puta mai tēnei nā te whakaputa nui rawa o tō tinana i te cortisol, nā te tango rānei i ngā rongoā corticosteroid mō te wā roa.

Ka pā te āhuatanga ki te iwi o ngā tau katoa, ahakoa ka tino kitea i roto i ngā pakeke i waenga i ngā tau 20 me te 50. E toru te wā pea te nui o ngā wāhine e whanake ana i te mate Cushing i ngā tāne, ina koa ka puta mai i ngā raruraru o te pūtake pituitary.

He aha ngā tohu o te mate Cushing?

Ka rerekē ngā tohu o te mate Cushing mai i te tangata ki te tangata, ā, ka tino puta haere mai, ka kore pea koe e kite i te tīmatanga. Kei te whakahaere tonu tō tinana i ngā pānga o te whakamahinga homoni ahotea roa, e whakaatu ana i ngā huarahi maha.

Ko ngā huringa tinana tino noa ka kitea e koe:

• Te piki o te taumaha, ina koa kei te taha waenganui me te pūmau o runga
• Te mata porotaka, ki tonu, e kiia ana ko te “mata marama”
• Ngā tohu whero, puru rānei i runga i tō kiri
• Te ngāwari o te whēnu mai i ngā tūnga iti, pānga rānei
• Te whakaora puhoi o ngā kotinga, ngā mate, ngā whēnu rānei
• Te kiri angiangi e ngāwari ana te haehae
• Te ngoikore o ngā uaua, ina koa kei ō ringa me ō waewae
• Te toto teitei
• Te huka toto teitei, te mate huka rānei

I tua atu i ngā tohu tinana, ka pā te mate Cushing ki tō oranga hinengaro me tō hauora hinengaro. Ka pāngia pea koe e ngā huringa ngākau, te pouri, te manukanuka rānei, te uaua ki te aro, te riri rānei e kore e rite ki a koe.

Ka whanake pea etahi i te mea e kiia nei ko te “hump buffalo”, he kohinga ngako i waenga i ngā pakihiwi. Ka kite pea ngā wāhine i ngā wā marama kore ranei i ngā raruraru hua, ka iti pea te hiahia moepuku o ngā tāne, te ngoikore rānei o te erectile.

He mea tika te kī kāore te katoa e pāngia ana e ēnei tohu katoa, ā, ka ngāwari pea ngā tohu o ētahi. Ki te kite koe i te maha o ēnei huringa e puta tahi ana i te wā roa, he mea tika te kōrero ki tō kaiwhakarato hauora.

He aha ngā take o te mate Cushing?

He maha ngā take pea o te mate Cushing, engari ka puta katoa mai i te nui rawa o te cortisol i roto i tō tinana. He mea nui te mōhiotanga ki te take, nā te mea ka āwhina i te whakatau i te huarahi maimoatanga pai mō tō āhuatanga motuhake.

Ko te take tino noa ko te tango i ngā rongoā corticosteroid mō ngā wā roa. Ka whakamahia auautia ēnei rongoā, penei i te prednisone, te hydrocortisone rānei, hei whakaora i ngā āhuatanga penei i te mate huango, te mate rheumatoid, te mate pūkahukahu mumura rānei. Ina tangohia i ngā rā nui, te wā roa rānei, ka taea e rātou te arahi ki ngā pānga rite ki te nui rawa o te cortisol taiao.

Ka taea hoki e tō tinana te whakaputa nui rawa i te cortisol nā ngā āhuatanga maha:

• Pituitary adenoma – he mate pūngāwerewere noa i roto i tō pūtake pituitary e whakaputa ana i te nui rawa o te ACTH (te homoni e kī ana ki ō kōpū adrenal kia whakaputa i te cortisol)
• Ngā mate pūngāwerewere adrenal – ngā tipu i runga i ō kōpū adrenal e whakaputa tika ana i te nui o te cortisol
• Te mate ACTH ectopic – ina whakaputa ngā pūngāwerewere i ētahi atu wāhanga o tō tinana i te ACTH

Ko te take pituitary, e kiia ana ko te mate Cushing, e 80% pea te nui o ngā keehi e whakaputa ana tō tinana i te nui rawa o te cortisol. Ko ēnei pūngāwerewere pituitary he mea ngāwari noa, ko te tikanga kāore i te mate pukupuku, engari ka puta tonu ngā raruraru mā te whakaroa i tō toenga homoni.

Kāore i te noa, ka taea e ngā pūngāwerewere i roto i ō ngā huha, i ō pancreas rānei, i ētahi atu okana rānei te whakaputa i te ACTH, ka arahi ki te whakaputa nui o te cortisol. E kiia ana tēnei ko te mate ACTH ectopic, ā, he hiahia ki ngā huarahi maimoatanga rerekē i ngā take e pā ana ki te pituitary.

Nōhea te haere ki te taote mō te mate Cushing?

Me whakaaro koe ki te haere ki tō kaiwhakarato hauora ki te pāngia koe e ngā tohu maha o te mate Cushing, ina koa ki te pāngia ana e rātou tō oranga o ia rā, te kino ake rānei i te wā roa. Nā te whanake haere o tēnei āhuatanga, he ngāwari te whakakore i ngā tohu tīmatanga hei koroheketanga noa, te ahotea rānei.

Whakatau rā ki te kite koe i te piki o te taumaha kaore i te whakamārama tahi me ētahi atu tohu penei i te ngāwari o te whēnu, te ngoikore o ngā uaua, ngā huringa ngākau rānei. Ko ēnei whakakotahitanga o ngā tohu e hiahia ana ki te aromatawai hauora, ahakoa ka iti pea te tohu kotahi.

Rapua te tiaki hauora kia tere ake ki te whanake koe i ngā tohu kino penei i te toto teitei rawa, ngā huringa ngākau kino, te pouri rānei, ngā tohu o te mate huka (te matewai nui, te mimi auau), te uaua rānei ki ngā mahi o ia rā nā te ngoikore o ngā uaua.

Ki te tangohia e koe ngā rongoā corticosteroid i tēnei wā, ā, kei te pāngia koe e ēnei tohu, kaua e mutu te tango i ō rongoā, nā te mea ka kino tēnei. Engari, kōrerohia ō māharahara ki te taote i whakahau ai i a rātou kia taea ai e rātou te aromatawai i tō āhuatanga me te whakarereke pea i tō maimoatanga.

He aha ngā take morearea mō te mate Cushing?

He maha ngā take ka piki ai tō tūponotanga ki te whanake i te mate Cushing, ahakoa te whai i ngā take morearea, kāore te tikanga ka whanake koe i te āhuatanga. Ka taea e te mōhiotanga ki ēnei take te āwhina i a koe me tō kaiwhakarato hauora ki te tūpato ki ngā tohu pea.

Ko te take morearea nui ko te whakamahinga roa o ngā rongoā corticosteroid. Ki te tangohia e koe ēnei rongoā mō ngā āhuatanga penei i te mate huango, te mate ngāngā, ngā mate autoimmune rānei, ka piki tō tūponotanga ki ngā rā nui me ngā wā maimoatanga roa. Heoi, he mea tika auautia ēnei rongoā mō te whakahaere i ngā āhuatanga hauora kino, no reira ko ngā painga te nuinga e nui atu ana i ngā tūponotanga.

Ka takaro hoki ngā take taupori i tētahi wāhanga:

• Ko te wahine, ina koa i waenga i ngā tau 20-50
• Te whai i te hītori whānau o ngā mate endocrine
• Te whai i ētahi āhuatanga ira e pā ana ki te whakaputa homoni

Mō te mate Cushing e pā ana ki te pituitary, kāore he maha o ngā take morearea ka taea te aukati, nā te mea ka whanake haere ngā pūngāwerewere pituitary kaore he take mārama. Heoi, ka nui ake te hiranga o te mōhiotanga ki ngā tohu ki te whai koe i ētahi atu mate endocrine, te hītori whānau rānei o ngā āhuatanga e pā ana ki te homoni.

He mea nui te mahara kaore te nuinga o te iwi e whai ana i ēnei take morearea e whanake i te mate Cushing. Ko ēnei take anake te tikanga ka pai ake te mōhio ki ngā tohu pea me te kōrero i ngā māharahara ki tō kaiwhakarato hauora.

He aha ngā raruraru pea o te mate Cushing?

Ki te kore e maimoatia, ka taea e te mate Cushing te arahi ki ngā raruraru hauora kino, nā te mea ka pā ngā taumata cortisol teitei ki ngā pūnaha tinana maha. Ko te rongo pai, ka taea te whakapainga nui o ēnei raruraru mā te maimoatanga tika, ina koa ka kitea wawe.

Ko ngā raruraru tino noa e pā ana ki tō hauora ngākau me tō hauora metabolic:

• Te toto teitei e taea ai te whakamātautau i tō ngākau me ō oko toto
• Te mate huka momo 2 mai i ngā taumata huka toto teitei
• Te mate ngākau me te piki o te tūponotanga o te mate ngākau, te pōka rānei
• Te mate osteoporosis me te piki o te tūponotanga o te whati iwi
• Ngā mate auau nā te pūnaha ārai ngoikore
• Ngā kōhatu whatukuhu mai i te ngaro o te kāratiuma

He mea nui hoki ngā raruraru hauora hinengaro, ā, ka uru atu ki te pouri kino, te manukanuka, i ngā keehi onge rānei, te psychosis, ngā whakaaro whakamomori rānei. Ka rite te kino o ēnei pānga hinengaro ki ngā raruraru tinana, ā, ka taea te whakapainga mā te maimoatanga.

Ka whanake pea etahi i te ngaro o ngā uaua, ka taea te whakarahi i te uaua o ngā mahi o ia rā. Ka pāngia pea ngā wāhine e ngā raruraru hua, ngā wā marama kore rānei, ka iti pea ngā taumata testosterone o ngā tāne e pā ana ki tō rātou hauora whānui me te oranga pai.

Ko te mea nui hei mahara ko te mea ahakoa ka wehi ēnei raruraru, ka taea te whakahoki mai i te nuinga, te whakapainga nui rānei mā te maimoatanga tika. Ka taea e te whakamātautau wawe me te whakahaere tika te aukati i ēnei hua kino maha.

Me pēhea te whakamātautau i te mate Cushing?

He hiahia ki ngā mahi maha te whakamātautau i te mate Cushing, nā te mea ka taea e ngā tohu te puta mai i ētahi atu āhuatanga, ā, ka rerekē ngā taumata cortisol i ia rā. Ka tīmata tonu tō kaiwhakarato hauora ki te kōrero tino pai mō ō tohu me tō hītori hauora.

Ka tīmata tonu te tukanga whakamātautau ki ngā whakamātautau toto me te mimi hei ine i ō taumata cortisol. Ka hiahia pea koe ki te kohikohi i tō mimi mō te 24 haora, te tango rānei i te rongoā e kiia nei ko te dexamethasone hei kite i te whakautu o tō tinana. Ka āwhina ēnei whakamātautau ki te whakatau mena kei te piki tonu ō taumata cortisol.

Ki te whakaatu ngā whakamātautau tīmatanga i te mate Cushing, ka whakahau tō taote i ngā whakamātautau atu hei kimi i te take:

• Ngā tirohanga MRI o tō pūtake pituitary hei kimi i ngā pūngāwerewere
• Ngā tirohanga CT o ō kōpū adrenal
• Ngā whakamātautau toto hei ine i ngā taumata ACTH
• I ētahi wā ngā tirohanga atu hei kimi i ngā pūngāwerewere i ētahi atu wāhanga o tō tinana

Ka roa pea te tukanga whakamātautau i ngā wiki, ngā marama rānei, nā te mea me tino mōhio te taote ki te whakamātautau i mua i te whakahau i te maimoatanga. Ka āwangawanga pea tēnei, engari he mea nui te whakamātautau tika hei whakatau i te huarahi maimoatanga pai.

I ētahi wā, ka whakahau pea ngā taote ki te mahi tahi me tetahi endocrinologist, he tohunga i ngā mate homoni, hei āwhina i te whakamātautau me te whakarite maimoatanga. He pūkenga atu ēnei tohunga i te whakahaere i ngā āhuatanga homoni uaua penei i te mate Cushing.

He aha te maimoatanga mō te mate Cushing?

Ka whakawhirinaki te maimoatanga mō te mate Cushing ki te take o ō taumata cortisol teitei, engari ko te whāinga tonu ko te whakaiti i te cortisol ki ngā taumata noa me te whakahaere i ngā raruraru kua whanake. Ko te rongo pai, ka kite te nuinga o te iwi i te whakapainga nui ki ō rātou tohu mā te maimoatanga tika.

Ki te puta mai tō mate Cushing i ngā rongoā corticosteroid, ka mahi tahi tō taote ki a koe hei whakaiti haere i te rā, te whakarereke rānei ki ētahi atu maimoatanga. Me mahi tenei tukanga i te ngāwari me te ata, kia kore ai e puta ngā tohu tango me te whakarite kia mau tonu te whakahaere i tō āhuatanga taketake.

Mō te mate Cushing e puta mai ana i ngā pūngāwerewere, ko ngā huarahi maimoatanga:

• Te pokanga hei tango i ngā pūngāwerewere pituitary, ngā pūngāwerewere adrenal, ētahi atu pūngāwerewere whakaputa homoni rānei
• Te rongoā radiation mō ngā pūngāwerewere pituitary kaore e taea te tango katoa mā te pokanga
• Ngā rongoā e aukati ana i te whakaputa cortisol, te mahi rānei
• I ētahi wā, te tango i ngā kōpū adrenal e rua, ka whai muri i te whakakapi homoni ora

Ko te pokanga te maimoatanga tino pai mō ngā pūngāwerewere pituitary, nā te mea ka taea te whakaora i te āhuatanga ki te tangohia katoa te pūngāwerewere. Ko te nuinga o ngā pokanga pituitary ka mahia mā te ihu, ko te tikanga kāore he tapahi o waho me ngā wā whakaora tere.

Ka aro hoki tō rōpū hauora ki te whakahaere i ngā raruraru penei i te toto teitei, te mate huka, te mate osteoporosis rānei. Ka āwhina tēnei huarahi whānui ki te whakapainga i tō hauora whānui mā te whakahaere i te kore toenga homoni taketake.

Ka roa te whakaora, ā, ka kore pea koe e kite i ngā whakapainga i te tīmatanga. Ka tīmata te nuinga o te iwi ki te pai ake i roto i ngā marama torutoru i muri i te maimoatanga angitu, ahakoa ka roa pea te tau, neke atu rānei mō ētahi tohu kia tino mutu.

Me pēhea te whakahaere i te mate Cushing i te kāinga?

Ahakoa he mea nui te maimoatanga hauora mō te mate Cushing, he maha ngā mea ka taea e koe te mahi i te kāinga hei tautoko i tō whakaora me te whakahaere i ngā tohu. Ka pai ake te mahi o ēnei rautaki ina whakakotahitia ki tō maimoatanga hauora i whakahaua, kāore hei whakakapi mōna.

Arotake ki te kai i te kai tōtika e āwhina ana ki te whakahaere i te huka toto me te tautoko i te hauora iwi. Ko te tikanga ko te whiriwhiri i ngā witi katoa, ngā pūmua angiangi, ngā hua, ngā huawhenua rānei, mā te whakaiti i ngā kai tukatuka, te huka nui, te konutai rānei. Nā te mea ka pā te mate Cushing ki te huka toto, ka tino āwhina te mahi tahi me tetahi kaiwhakaako kai.

Ka taea e te whakakori ngāwari te āwhina i ngā tohu maha, engari tīmata i te ngāwari, nā te mea he mea noa te ngoikore o ngā uaua. Ka taea e te hikoi, te kauhoe, te whakakori uaua māmā rānei te āwhina ki te pupuri i te nui o ngā uaua me te nui o te iwi. Tirohia tonu ki tō kaiwhakarato hauora i mua i te tīmatanga o ngā mahi whakakori hou.

He mea nui te whakahaere i tō hauora hinengaro:

• Whakaarohia te tohutohu, te rongoā rānei hei āwhina i te whakahaere i ngā huringa ngākau me te ahotea
• Whakamahia ngā tikanga whakaiti ahotea penei i te manawa hohonu, te whakaaroaro rānei
• Pupuri i ngā hononga pāpori, kaua hoki e wehewehe koe
• Whiwhi moe tika, ahakoa ka uaua pea tēnei ki te mate Cushing

Tūpato atu ki tō kiri, nā te mea ka ngoikore pea i te noa. Whakamahia ngā hua tiaki kiri ngāwari, tiakina koe i te rā, kia tūpato hoki ki te karo i ngā whara ka arahi pea ki ngā whara whakaora puhoi.

Pupuri i te ara o ō tohu me ngā huringa ka kite koe. Ka taea te whakamahi i tēnei mōhiohio mō tō kaiwhakarato hauora ki te whakarereke i tō mahere maimoatanga me te aroturuki i tō ahunga whakamua.

Me pēhea te whakarite mō tō whakatau taote?

Ka taea e te whakarite mō tō whakatau te āwhina i te whakarite kia whiwhi koe i te nuinga mai i tō wā ki tō kaiwhakarato hauora. Nā te mea ka rerekē ngā tohu o te mate Cushing, ka puta haere mai, ka tino nui te whakarite pai.

I mua i tō whakatau, tuhia katoa ō tohu, ngā mea pea e kore e rite. Tāpirihia te wā i kite tuatahi ai koe i ia tohu me te kino ake rānei i te wā roa. Tangohia ngā whakaahua ki te kite koe i ngā huringa i tō ahua, nā te mea ka taea te āwhina i tō taote ki te kite.

Whakaritea he rārangi katoa o ngā rongoā katoa e tangohia ana e koe, tae atu ki ngā rongoā whakahaua, ngā rongoā kore whakahau, ngā taapiri rānei. Arotake ki ngā rongoā corticosteroid katoa kua tangohia e koe, tae atu ki te wā i tīmata ai koe me ngā rā kua whakamahia e koe.

Kawe mai ngā mōhiohio mō tō hītori hauora me tetahi hītori whānau o ngā mate homoni, ngā raruraru endocrine rānei. Ki te whai koe i ngā whakamātautau toto o mua, ngā whakaahua hauora rānei, kawe mai ēnei hua ki te taea.

Tuhia ngā pātai e hiahia ana koe ki te ui ki tō taote:

• He aha ngā whakamātautau e hiahia ana ahau ki te whakau i te whakamātautau?
• He aha pea te take o ōku tohu?
• He aha ōku huarahi maimoatanga?
• E hia te wā pea ka kite i te whakapainga?
• He aha ngā raruraru me te titiro atu?

Whakaarohia te kawe mai i tētahi hoa whakawhirinaki, mema whānau rānei ki tō whakatau. Ka taea e rātou te āwhina i a koe ki te mahara ki ngā mōhiohio nui me te whakarato i te tautoko hinengaro i te wā pea he wā ahotea.

He aha te mea nui hei tango mō te mate Cushing?

He āhuatanga ka taea te whakahaere te mate Cushing e puta mai ana ina nui rawa te cortisol i roto i tō tinana mō te wā roa. Ahakoa ka taea te puta mai ngā tohu me ngā raruraru nui, ko te mea nui hei mahara ko te nuinga o te iwi ka kite i te whakapainga nui mā te whakamātautau me te maimoatanga tika.

Ko te ki mō ngā hua angitu ko te kite wawe me te maimoatanga. Ki te pāngia koe e ngā tohu maha ka taea te whakaatu i te mate Cushing, ina koa ki te pāngia ana e rātou tō kounga o te ora, kaua e whakaroa ki te kōrero ki tō kaiwhakarato hauora.

Ka whakawhirinaki te angitu o te maimoatanga ki te take taketake, engari ahakoa i ngā keehi uaua, he maha ngā huarahi maimoatanga kei te wātea. Ka tumanako te nuinga o te iwi ki te kite i te whakapainga haere mai i ō rātou tohu i roto i ngā marama ki ngā tau i muri i te maimoatanga angitu.

Mahara ko te whakaora he tukanga, kāore he huringa po. Kia manawanui ki a koe ano i te whakatika o tō tinana ki ngā taumata cortisol noa, kia mau tonu te kōrero ki tō rōpū hauora i roto i tō haerenga maimoatanga.

Ngā pātai auau e ui ana mō te mate Cushing

Ka taea te mutu ake te mate Cushing i a ia ano?

Kāore te mate Cushing e mutu noa atu me te kore maimoatanga. Ki te puta mai i te rongoā, ka pai ake pea ngā tohu ina whakaitihia, mutu rānei te rongoā i raro i te tirotiro hauora. Heoi, ki te puta mai i ngā pūngāwerewere, ētahi atu āhuatanga hauora rānei, he hiahia tonu te maimoatanga motuhake hei whakarite i ngā taumata cortisol me te aukati i ngā raruraru.

E hia te wā ka roa te whakaora mai i te mate Cushing?

Ka rerekē te wā whakaora i runga i te take me te huarahi maimoatanga. Ka tīmata te pai ake o ētahi i roto i ngā marama torutoru i muri i te maimoatanga angitu, ka roa pea te tau, neke atu rānei mō ētahi atu ki te kite i te whakapainga katoa. Ka roa pea te whakarite i ngā huringa tinana penei i te tohatoha taumaha me te kaha o ngā uaua i ngā tohu penei i ngā huringa ngākau, ngā raruraru moe rānei.

He rite te mate Cushing ki te mate Cushing?

Ko te mate Cushing tētahi momo motuhake o te mate Cushing. Ko te mate Cushing te kupu whānui mō te nui o te cortisol, ahakoa te take. Ko te mate Cushing te tohu motuhake ki ngā keehi e puta mai ana i te pūngāwerewere pituitary e whakaputa ana i te nui rawa o te ACTH, ka arahi i ngā kōpū adrenal ki te whakaputa nui o te cortisol.

Ka taea e te ahotea te puta i te mate Cushing?

Ahakoa ka taea e te ahotea roa te piki i ngā taumata cortisol mo te wā poto, kāore e tino puta te mate Cushing. Heoi, ka taea e ngā tohu o te ahotea roa te whakakotahi i ngā tohu o te mate Cushing, ko te take tenei he mea nui te aromatawai hauora tika. Ko te mate Cushing pono e puta mai ana i ngā āhuatanga hauora, ngā rongoā rānei, kāore i te ahotea hinengaro anake.

Me tango rongoā mō te ora i muri i te maimoatanga?

Ka whakawhirinaki tēnei ki tō maimoatanga motuhake me te whakautu o tō tinana. Ki te whai koe i te pokanga hei tango i te pūngāwerewere pituitary, ā, he angitu katoa, ka kore pea koe e hiahia ki ngā rongoā ora. Heoi, ki te tangohia ngā kōpū adrenal e rua, ka hiahia koe ki te whakakapi homoni ora. Ka mahi tahi tō kaiwhakarato hauora ki a koe hei whakatau i te mahere whakahaere ora pai mō tō āhuatanga.