Imbalans Hormonal

Imbalans Hormonal
Ketidakseimbangan hormon pada tubuh bisa menyebabkan berbagai masalah.

Bagikan :


Definisi

Imbalans hormonal terjadi ketika Anda memiliki terlalu banyak atau terlalu sedikit hormon tertentu. Ini adalah istilah umum yang dapat mewakili banyak kondisi terkait hormon yang berbeda.

 

Penyebab

Periode kehidupan tertentu menyebabkan perubahan dan fluktuasi hormon yang lebih dramatis, yaitu pada masa pubertas, kehamilan, dan menopause. Namun, terdapat beberapa kondisi lain yang bisa menyebabkan kadar hormon Anda berubah, seperti stres, gangguan makan atau karena pengobatan tertentu seperti steroid maupun terapi hormon. Pada kondisi ini, umumnya imbalans hormonal lebih bersifat sementara dan akan kembali normal bila penyebab timbulnya imbalans hormonal sudah ditangani.

Meskipun begitu, ada beberapa penyakit yang bisa menyebabkan imbalans hormonal yang signifikan, antara lain:

 

Tumor

Adanya tumor atau nodul pada kelenjar maupun organ yang memproduksi hormon, dapat memengaruhi kemampuannya dalam memproduksi hormon. Bisa terjadi kelebihan atau kekurangan kadar hormon yang akan mengakibatkan gangguan fungsi tubuh. Tumor tersebut bisa muncul pada:

  • Kelenjar adrenal yang berada di atas ginjal, hormon adrenal sendiri berfungsi untuk mengatur metabolisme, sistem kekebalan tubuh, tekanan darah, dan merespon terhadap stres.
  • Kelenjar tiroid yang berada di area leher, hormon tiroid berperan dalam perkembangan otak pada bayi, regulasi suhu tubuh, mengontrol kontraksi otot, mengatur laju metabolisme dan pertumbuhan tubuh, dll.
  • Kelenjar paratiroid yang juga berada di area leher bersama kelenjar tiroid, di mana hormonnya berperan langsung pada tulang, ginjal dan usus halus.
  • Kelenjar hipofisis di otak yang memproduksi hormon untuk merespon terhadap stres, menstimulasi produksi sperma pada pria atau ovulasi pada wanita, pertumbuhan, dll. Tumor pada kelenjar ini menjadi penyebab paling sering dari akromegali (kelebihan hormon pertumbuhan pada orang dewasa).

 

Kerusakan Kelenjar Endokrin

Semua bentuk kerusakan atau cedera pada kelenjar endokrin dapat menyebabkan ketidakseimbangan hormon, biasanya dalam bentuk penurunan produksi hormon. Gangguan kelenjar endokrin bisa terjadi karena berbagai hal, seperti:

  • Luka yang tidak sengaja ditimbulkan saat prosedur operasi

Contoh dari kondisi ini adalah pada kasus operasi leher atau kelenjar tiroid, di mana bisa timbul perlukaan pada kelenjar paratiroid yang tidak disengaja karena letaknya berdekatan dengan kelenjar tiroid.

  • Gangguan aliran darah pada kelenjar endokrin

Kehilangan banyak darah atau kekurangan aliran darah ke kelenjar endokrin dapat menyebabkan kematian jaringan dari kelenjar tersebut yang memproduksi hormon.

  • Infeksi bakteri atau virus

Salah satu komplikasi dari infeksi bakteri yang menyerang selaput otak adalah hipopituarisme, kondisi penurunan kadar hormon hipofisis di otak. Namun komplilkasi ini jarang terjadi.

  • Terapi radiasi

Pengobatan radiasi pada kanker kepala dan leher di beberapa pasien bisa menimbulkan gangguan kelenjar endokrin.

  • Cedera otak atau kepala

Kecelakaan bermotor, jatuh dari ketinggian atau cedera akibat olahraga yang melibatkan kontak fisik bisa menimbulkan cedera pada otak. Jika kelenjar hipofisis yang berada di dalam otak mengalami luka, bisa menimbulkan gangguan dalam produksi hormon.

 

Penyakit Autoimun

Penyakit autoimun terjadi ketika sistem kekebalan yang seharusnya melindungi tubuh dari zat asing, berbalik menyerang sel tubuh sendiri yang sehat. Pada kondisi tertentu, sistem imun bisa menyerang kelenjar atau organ yang memproduksi hormon sehingga menimbulkan imbalans hormonal. Penyakit autoimun sendiri meliputi penyakit Hashimoto, penyakit Graves, diabetes tipe 1, penyakit Addison, dan lain-lain.

Kami memiliki artikel mengenai diabetes mellitus tipe 1 yang bisa Anda baca di sini.

 

Faktor Risiko

Ada beberapa faktor yang sering dikaitkan dengan peningkatan risiko terjadinya imbalans hormonal. Berat badan berlebih hingga obesitas, kurangnya aktivitas fisik serta pola makan yang tidak sehat bisa meningkatkan risiko Anda mengalami fluktuasi kadar hormon di tubuh. Stres yang tidak dikelola dengan baik serta penuaan juga dapat membuat seseorang rentan mengalami imbalans hormonal.

 

Gejala

Oleh karena tubuh Anda memproduksi lebih dari 50 hormon yang berbeda, Anda dapat mengalami beberapa gejala yang berbeda tergantung dengan kadar hormon apa yang meningkat atau berkurang di tubuh.

Imbalans hormonal yang sering terjadi meliputi kondisi yang memengaruhi metabolisme tubuh. Banyak hormon dan proses yang terlibat dalam metabolisme.

Salah satu dari gejala di bawah ini bisa dirasakan oleh pasien imbalans hormonal. Gejala imbalans hormonal yang bisa memengaruhi metabolisme tubuh antara lain:

  • Perubahan detak jantung menjadi melambat atau cepat
  • Peningkatan atau penurunan berat badan yang tidak jelas sebabnya
  • Keluhan pencernaan seperti sembelit atau diare
  • Tubuh terasa kelelahan
  • Mati rasa dan kesemutan
  • Depresi atau cemas
  • Gangguan regulasi suhu tubuh
  • Masalah kulit seperti jerawat
  • Rambut tumbuh berlebih, tumbuh sedikit atau rontok
  • Haus berlebih dan frekuensi buang air kecil meningkat
  • Siklus haid yang tidak normal
  • Masalah kesuburan atau penurunan gairah seksual
  • Hot flashes yang bisa ditemukan pada wanita menopause
  • Vagina kering, menipis atau mengalami peradangan pada wanita
  • Disfungsi ereksi atau kesulitan mendapat/mempertahankan ereksi pada pria
  • Ginekomastia atau pembesaran payudara pada pria
  • Penurunan massa otot

 

Diagnosis

Ketika Anda datang ke fasilitas kesehatan untuk berkonsultasi, dokter akan bertanya mengenai keluhan, riwayat medis dan pengobatan yang sudah Anda lakukan secara mendetail. Dokter selanjutnya akan melakukan pemeriksaan fisik pada tubuh untuk mencari tanda yang menunjang hasil wawancara, serta pemeriksaan penunjang. Tergantung gejala Anda, dokter dapat menyarankan beberapa pemeriksaan penunjang seperti:

  • Pemeriksaan darah untuk memeriksa kadar hormon bila dokter mencurigai Anda menderita gangguan hormon tertentu, seperti hormon tiroid, estrogen, testosteron, kortisol, dan lain-lain.
  • Pemeriksaan urine juga bisa dilakukan, seperti untuk memeriksa kadar hormon terkait siklus menstruasi.
  • USG untuk mendapat gambaran pada rahim, indung telur (ovarium), testis, kelenjar tiroid, atau kelenjar hipofisis.
  • Pemeriksaan pencitraan lain seperti x-ray, MRI, scan kelenjar tiroid.

 

Tata Laksana

Pengobatan imbalans hormonal akan bergantung pada penyakit penyebabnya. Terapi yang diberikan akan disesuaikan dengan kondisi Anda, apakah Anda mengalami peningkatan kadar hormon di atas normal atau penurunan kadar hormon yang lebih rendah dari normal. Pilihan pengobatan sendiri bisa meliputi pemberian obat-obatan, terapi radiasi, prosedur operasi atau kombinasi berbagai metode pengobatan.

Jika Anda memiliki kadar hormon yang lebih rendah dari normal, umumnya bisa diberikan terapi pengganti hormon sesuai dengan hormon yang menurun. Selain terapi medis, dokter dapat merekomendasikan perubahan gaya hidup untuk membantu mengontrol imbalans hormonal. Anda bisa disarankan untuk mengubah pola makan, meningkatkan aktivitas fisik, dan mencapai berat badan ideal.

 

Komplikasi

Imbalans hormonal dihubungkan dengan banyak kondisi kesehatan jangka panjang. Tanpa pengobatan yang tepat, Anda dapat berisiko mengalami komplikasi penyakit serius seperti:

  • Diabetes mellitus
  • Tekanan darah tinggi
  • Penyakit jantung
  • Peningkatan kadar kolesterol
  • Sleep apnea
  • Kerusakan ginjal
  • Depresi dan cemas
  • Pengeroposan tulang
  • Kehilangan massa otot
  • Infertilitas atau gangguan kesuburan
  • Disfungsi seksual

 

Pencegahan

Ada hal-hal yang bisa Anda lakukan untuk menjaga kesehatan tubuh Anda dan mengurangi risiko bagi tubuh untuk mengalami ketidakseimbangan hormon. Anda dapat melakukan hal berikut:

  • Menjaga berat badan ideal
  • Memiliki diet atau pola makan yang bergizi seimbang
  • Membatasi makanan yang tinggi gula dan lemak serta makanan kemasan
  • Berolahraga atau melakukan aktivitas fisik secara teratur
  • Menghindari stres berlebih
  • Berhenti merokok atau menggunakan produk tembakau

 

Kapan Harus ke Dokter

Hormon berperan dalam berbagai fungsi tubuh. Oleh karena itu, ketidakseimbangan hormon bisa menyebabkan timbulnya beragam gejala dan bahkan komplikasi penyakit. Jika Anda mengalami keluhan yang sudah menyebabkan rasa tidak nyaman, nyeri, mengganggu aktivitas sehari-hari dan keluhan tidak kunjung hilang, penting untuk berkonsultasi dengan dokter.

 

Mau tahu informasi seputar penyakit lainnya? Cek di sini, ya!

 

 

Writer : dr Tea Karina Sudharso
Editor :
  • dr Hanifa Rahma
Last Updated : Minggu, 14 April 2024 | 20:21

Hormonal imbalance: Causes, symptoms & treatment (2022) Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/22673-hormonal-imbalance (Accessed: April 14, 2023). 

Osborn, C.O.K. (2023) Everything you need to know about hormonal imbalanceHealthline. Healthline Media. Available at: https://www.healthline.com/health/hormonal-imbalance (Accessed: April 14, 2023). 

Hormonal imbalance: Symptoms, causes, and treatment (2022) Medical News Today. MediLexicon International. Available at: https://www.medicalnewstoday.com/articles/321486 (Accessed: April 14, 2023).

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      • vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • CategoryHealtTopics.php#11aicare_prod_new1.43msselect * from `categories` where (`slug` != 'penyakit-a-z' and `slug` != 'obat-a-z' and `slug` != 'pemeriksaan-a-z' and `parent_id` = '0') and `categories`.`deleted_at` is null order by `order` asc
      Bindings
      • 0: penyakit-a-z
      • 1: obat-a-z
      • 2: pemeriksaan-a-z
      • 3: 0
      Hints
      • Use SELECT * only if you need all columns from table
      • The != operator is not standard. Use the <> operator to test for inequality instead.
      Backtrace
      • app/Repositories/Categories/CategoryHealtTopics.php:11
      • app/Http/Controllers/WebController.php:376
      • vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • WebController.php#377aicare_prod_new128msselect * from `posts` where `status` = 1 and `publish_date` <= '2025-04-06 20:30:48' and `content_type` = 'article' and `posts`.`deleted_at` is null order by RAND() limit 7
      Bindings
      • 0: 1
      • 1: 2025-04-06 20:30:48
      • 2: article
      Hints
      • Use SELECT * only if you need all columns from table
      • ORDER BY RAND() is slow, try to avoid if you can. You can read this or this
      Backtrace
      • app/Http/Controllers/WebController.php:377
      • vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:205
    • WebController.php#391aicare_prod_new9.72msupdate `posts` set `views_count` = 732 where `id` = 6985
      Bindings
      • 0: 732
      • 1: 6985
      Backtrace
      • app/Http/Controllers/WebController.php:391
      • vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:205
    • ActivityLogger.php#174aicare_prod_new4.92msinsert into `activity_log` (`log_name`, `properties`, `batch_uuid`, `event`, `subject_id`, `subject_type`, `description`, `updated_at`, `created_at`) values ('default', '[]', null, 'updated', 6985, 'App\\Models\\Admin\\Post', 'updated', '2025-04-06 20:30:48', '2025-04-06 20:30:48')
      Bindings
      • 0: default
      • 1: []
      • 2: 
      • 3: updated
      • 4: 6985
      • 5: App\Models\Admin\Post
      • 6: updated
      • 7: 2025-04-06 20:30:48
      • 8: 2025-04-06 20:30:48
      Backtrace
      • vendor/spatie/laravel-activitylog/src/ActivityLogger.php:174
      • vendor/spatie/laravel-activitylog/src/Traits/LogsActivity.php:88
      • app/Http/Controllers/WebController.php:391
      • vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
    • single-post-healthpedia.blade.php#37aicare_prod_new790μsselect * from `users` where `users`.`id` = 31 limit 1
      Bindings
      • 0: 31
      Hints
      • Use SELECT * only if you need all columns from table
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::web.v2.single-post-healthpedia:37
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new5.94msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 173 and `categories`.`deleted_at` is null
      Bindings
      • 0: 173
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#11aicare_prod_new630μsselect * from `categories` where `categories`.`id` = 5 and `categories`.`deleted_at` is null limit 1
      Bindings
      • 0: 5
      Hints
      • Use SELECT * only if you need all columns from table
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::web.v2.partials.article-popular:11
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new5.78msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 9246 and `categories`.`deleted_at` is null
      Bindings
      • 0: 9246
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new5.76msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 2361 and `categories`.`deleted_at` is null
      Bindings
      • 0: 2361
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new5.63msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 5873 and `categories`.`deleted_at` is null
      Bindings
      • 0: 5873
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new6.22msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 1704 and `categories`.`deleted_at` is null
      Bindings
      • 0: 1704
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new5.7msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 6482 and `categories`.`deleted_at` is null
      Bindings
      • 0: 6482
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new5.74msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 3751 and `categories`.`deleted_at` is null
      Bindings
      • 0: 3751
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new5.7msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 6532 and `categories`.`deleted_at` is null
      Bindings
      • 0: 6532
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new5.7msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 5199 and `categories`.`deleted_at` is null
      Bindings
      • 0: 5199
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new5.88msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 5671 and `categories`.`deleted_at` is null
      Bindings
      • 0: 5671
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new5.92msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 5254 and `categories`.`deleted_at` is null
      Bindings
      • 0: 5254
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new6.14msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 6972 and `categories`.`deleted_at` is null
      Bindings
      • 0: 6972
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • web_layout.blade.php#122aicare_prod_new860μsselect * from `pages` where `slug` = 'about-us' limit 1
      Bindings
      • 0: about-us
      Hints
      • Use SELECT * only if you need all columns from table
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::layouts.v2.web_layout:122
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • web_layout.blade.php#547aicare_prod_new820μsselect * from `faqs` limit 1
      Hints
      • Use SELECT * only if you need all columns from table
      • The SELECT statement has no WHERE clause and could examine many more rows than intended
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::layouts.v2.web_layout:547
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • web_layout.blade.php#551aicare_prod_new1.06msselect * from `term_policies`
      Hints
      • Use SELECT * only if you need all columns from table
      • The SELECT statement has no WHERE clause and could examine many more rows than intended
      Backtrace
      • view::layouts.v2.web_layout:551
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    App\Models\Admin\Post
    51Post.php#?
    App\Models\Admin\Category
    21Category.php#?
    App\User
    4User.php#?
    App\Models\Admin\Tag
    3Tag.php#?
    App\Models\TermPolicy
    3TermPolicy.php#?
    App\Models\Admin\Page
    1Page.php#?
    App\Models\Admin\Faq
    1Faq.php#?
        locale
        id
        _token
        9JFzGbzPH7WS1hbplxQ6Yb6Newl9OYdneoLJK6KB
        _previous
        array:1 [ "url" => "https://ai-care.atmatech.id/healthpedia-penyakit/imbalans-hormonal" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        path_info
        /healthpedia-penyakit/imbalans-hormonal
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:19 [ "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] "x-real-ip" => array:1 [ 0 => "18.221.190.79" ] "x-forwarded-for" => array:1 [ 0 => "18.221.190.79" ] "x-forwarded-proto" => array:1 [ 0 => "https" ] "x-forwarded-scheme" => array:1 [ 0 => "https" ] "host" => array:1 [ 0 => "ai-care.atmatech.id" ] "connection" => array:1 [ 0 => "keep-alive" ] ]
        request_cookies
        []
        
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