Bài viết của Bác sĩ Trần Phương Thảo, chuyên khoa Nội Tổng quát, Tiêu hóa Gan mật, Charis Healthcare

Mối lo quen thuộc – và câu hỏi thật sự cần đặt ra

Nếu bạn bị GERD và vẫn muốn uống cà phê mỗi sáng, rất có thể bạn đã nghe lời khuyên “phải bỏ cà phê hoàn toàn”. Câu hỏi là: lời khuyên đó có thực sự dựa trên bằng chứng không?

Câu trả lời ngắn gọn là: không hẳn – và bức tranh thực tế phức tạp hơn nhiều so với những gì được truyền miệng.

GERD là gì và tại sao cà phê bị “đổ lỗi”?

GERD (Gastroesophageal Reflux Disease) xảy ra khi cơ thắt thực quản dưới (Lower Esophageal Sphincter – LES) – van cơ ngăn không cho axit dạ dày trào ngược lên – hoạt động không đúng chức năng. Khi LES giãn ra không đúng lúc, axit từ dạ dày trào vào thực quản và gây ra các triệu chứng quen thuộc: ợ nóng, ợ chua, đắng miệng, đau tức ngực.

Cà phê bị nghi ngờ vì hai lý do cơ chế học:

Thứ nhất, tác động lên LES. Nghiên cứu đăng trên tạp chí Gastroenterology cho thấy cà phê cafein làm giảm áp lực LES ở cả người khỏe mạnh lẫn bệnh nhân viêm thực quản trào ngược – ở nhóm bệnh nhân, áp lực LES giảm từ 9,1 xuống còn 5,5 mmHg sau khi uống cà phê có axit. Cafein được xác định là một trong những hợp chất góp phần vào hiệu ứng này thông qua cơ chế ức chế phosphodiesterase, làm tăng nồng độ cAMP nội bào và gây giãn cơ trơn.

Thứ hai, kích thích tiết axit dạ dày. Nghiên cứu kinh điển trên New England Journal of Medicine (1975) chứng minh rằng cafein kích thích tế bào thành dạ dày tiết axit – tuy nhiên, một phát hiện quan trọng từ cùng nghiên cứu này là cà phê không cafein (decaf) cũng gây tiết axit ở mức tương tự cà phê thường, thậm chí cao hơn đáng kể so với cafein đơn thuần. Điều này cho thấy cafein không phải thủ phạm duy nhất – các hợp chất khác trong cà phê, đặc biệt là axit chlorogenic, cũng đóng vai trò kích thích tiết axit.

Bằng chứng tổng hợp: Mối liên hệ yếu hơn ta tưởng

Khi nhìn vào toàn bộ tổng thể bằng chứng từ các nghiên cứu lâm sàng, một điều đáng ngạc nhiên xuất hiện: mối liên hệ giữa cà phê và GERD không mạnh và không nhất quán như nhiều người vẫn nghĩ.

Một phân tích tổng hợp (meta-analysis) công bố trên PubMed gồm 15 nghiên cứu ca-chứng kết luận không tìm thấy mối liên hệ có ý nghĩa thống kê giữa tiêu thụ cà phê và nguy cơ GERD. Một meta-analysis gần đây hơn – công bố năm 2026 từ nhóm nghiên cứu tại Brigham and Women’s Hospital (Harvard Medical School) – tìm thấy mối liên hệ thuận chiều nhỏ (OR: 1,18) nhưng nhận định rằng “mức độ ảnh hưởng về lâm sàng là không rõ ràng”. Tổng quan hệ thống đăng trên Clinical Gastroenterology and Hepatology (2020) cũng kết luận tương tự: không có bằng chứng từ các nghiên cứu thuần tập ủng hộ khuyến nghị loại bỏ hoàn toàn cà phê ở bệnh nhân GERD.

Một tổng quan năm 2025 trên tạp chí Sports (MDPI) ghi nhận rằng nguy cơ tăng nhẹ với cà phê chỉ xuất hiện nhất quán ở nhóm uống từ 4 ly trở lên mỗi ngày, không phải với mức tiêu thụ vừa phải.

Điều này không có nghĩa là cà phê hoàn toàn vô hại với bệnh nhân GERD – mà có nghĩa rằng tác động phụ thuộc rất nhiều vào cá nhân, liều lượng và cách uống, không phải là quy luật áp dụng cho tất cả mọi người.

Decaf có thực sự “an toàn hơn” không?

The answer is: không hẳn, và phụ thuộc vào triệu chứng cụ thể của bạn.

Nghiên cứu mù đôi trên PubMed (2010) so sánh cà phê thường, decaf và nước trà cho thấy cà phê thường và trà làm giảm áp lực LES đáng kể so với nhóm chứng, trong khi decaf không gây ra hiệu ứng này – nghĩa là về mặt LES, decaf có vẻ ít gây trào ngược hơn.

Tuy nhiên, như đã đề cập, decaf vẫn kích thích tiết axit dạ dày ở mức gần tương đương cà phê thường. Vì vậy, với những người có triệu chứng chủ yếu do tăng tiết axit (ợ chua, nóng rát), decaf chưa chắc đã cải thiện đáng kể. Ngược lại, với những người mà triệu chứng xuất phát từ LES giãn và trào ngược thực sự, decaf có thể là lựa chọn ít tác hại hơn.

Một hướng đi khác đang được nghiên cứu là cà phê khử sáp (dewaxed coffee). Thử nghiệm lâm sàng ngẫu nhiên trên 40 bệnh nhân GERD người Ý (đăng trên Nutrients, 2022) cho thấy nhóm uống cà phê khử sáp có tỷ lệ giảm triệu chứng ợ nóng và ợ trào ngược cao hơn đáng kể so với nhóm uống cà phê thường, đồng thời cần dùng ít thuốc kháng axit hơn. Kết quả này còn sơ bộ và cần thêm nghiên cứu quy mô lớn hơn để xác nhận.

Những yếu tố thực tế ảnh hưởng đến triệu chứng

Bằng chứng hiện tại ủng hộ quan điểm rằng cách uống cà phê quan trọng không kém loại cà phê bạn chọn. Dưới đây là những yếu tố có bằng chứng hỗ trợ:

Uống lúc đói làm nặng hơn triệu chứng. Dạ dày rỗng kết hợp với kích thích tiết axit từ cà phê tạo ra môi trường thuận lợi nhất để axit tiếp xúc trực tiếp với niêm mạc. Uống cà phê sau bữa ăn hoặc kèm thức ăn nhẹ giúp đệm bớt nồng độ axit và làm chậm hấp thu các hợp chất kích thích.

Liều lượng có tác động ngưỡng. Dữ liệu từ nhiều nghiên cứu cho thấy nguy cơ tăng đáng kể chỉ xuất hiện ở mức tiêu thụ cao (≥4 ly/ngày). Một đến hai ly mỗi ngày ở nhiều bệnh nhân không làm trầm trọng thêm triệu chứng.

Cà phê hàm lượng axit thấp và cold brew. Cold brew được chiết xuất bằng nước lạnh trong thời gian dài, tạo ra sản phẩm có độ axit tổng thể thấp hơn cà phê pha nóng truyền thống. Một số bệnh nhân báo cáo dung nạp tốt hơn, tuy nhiên cold brew thường chứa caffein cao hơn – một yếu tố cần cân nhắc riêng.

Rang tối (dark roast) có thể ít kích thích hơn rang nhạt. Quá trình rang ở nhiệt độ cao làm giảm hàm lượng axit chlorogenic – hợp chất được cho là góp phần kích thích tiết axit. Một số nghiên cứu nhỏ ủng hộ giả thuyết này, dù bằng chứng chưa đủ mạnh để đưa ra khuyến cáo cứng nhắc.

Khi nào nên thật sự lo lắng?

Cà phê không phải nguyên nhân gốc rễ của GERD, nhưng có thể là yếu tố khuếch đại triệu chứng ở người đã có bệnh nền. Cần đánh giá lại thói quen và đến gặp bác sĩ tiêu hóa nếu:

• Triệu chứng ợ nóng hoặc ợ chua xảy ra hơn 2 lần mỗi tuần mặc dù đã điều chỉnh chế độ ăn uống
• Xuất hiện dấu hiệu phức tạp hơn: khó nuốt, đau ngực không rõ nguyên nhân, mất cân không chủ ý, nôn ra máu hoặc phân đen
• Triệu chứng không đáp ứng với thuốc kháng axit thông thường (PPI hoặc H2 blocker)
• GERD kéo dài nhiều năm mà chưa được nội soi đánh giá – vì nguy cơ tiến triển thành Barrett’s thực quản cần được tầm soát

Tóm lại: Không phải một câu trả lời cho tất cả mọi người

Bằng chứng hiện tại không ủng hộ khuyến nghị loại bỏ hoàn toàn cà phê cho tất cả bệnh nhân GERD. Thay vào đó, tiếp cận dựa trên personalization được xem là phù hợp hơn: theo dõi phản ứng của cơ thể, điều chỉnh liều lượng và cách uống, và đưa ra quyết định cùng bác sĩ dựa trên mức độ nặng của bệnh.

Nếu một ly cà phê buổi sáng không làm bạn khó chịu – bạn không nhất thiết phải từ bỏ nó. Nhưng nếu triệu chứng xuất hiện hoặc tái đi tái lại, đó là tín hiệu đáng để thảo luận với bác sĩ tiêu hóa để có hướng xử lý phù hợp hơn.

Tài liệu tham khảo chính:

• Feldman M. et al. (1975). Gastric acid secretion and lower-esophageal-sphincter pressure in response to coffee and caffeine. NEJM.
• Brazer S.R. et al. (1980). Inhibitory effect of coffee on lower esophageal sphincter pressure. Gastroenterology.
• Kim J. et al. (2014). Association between coffee intake and GERD: a meta-analysis. PubMed.
• Mehta R.S. et al. (2020). Association between beverage intake and incidence of gastroesophageal reflux symptoms. Clinical Gastroenterology and Hepatology.
• De Bortoli N. et al. (2022). Effect of dewaxed coffee on gastroesophageal symptoms in patients with GERD. Nutrients.
• Talebi S. et al. (2026). Association of coffee intake with risk of GERD and complications: a systematic review and meta-analysis. PubMed / Brigham and Women’s Hospital.
• Wernly B. et al. (2025). Updates in GERD management: from PPIs to dietary and lifestyle modifications. MDPI Sports.

The post Cà Phê và Bệnh Trào Ngược Dạ Dày – Thực Quản (GERD): Khoa Học Nói Gì? appeared first on Charis Healthcare.

Viêm xoang là một trong những bệnh lý Tai Mũi Họng phổ biến nhất, nhưng cũng là bệnh gây nhiều hiểu lầm nhất. Không ít người khi được chẩn đoán viêm xoang đã lập tức lo lắng, thậm chí cho rằng mình mắc một căn bệnh “đeo bám suốt đời”. Thực tế, phần lớn những suy nghĩ này chưa chính xác.

Bài viết dưới đây của Bác sĩ Đoàn Văn Hoàng, chuyên khoa Tai Mũi Họng tại Charis Healthcare sẽ giúp bạn hiểu rõ bản chất bệnh viêm xoang, phân biệt cấp tính và mạn tính, đồng thời giải thích những quan niệm sai lầm thường gặp.

VIÊM XOANG LÀ GÌ?

Xoang là các hốc rỗng nằm trong xương vùng mặt và đầu, bên trong được lót bởi lớp niêm mạc giống niêm mạc mũi. Các xoang này thông với khoang mũi qua những lỗ nhỏ gọi là lỗ thông xoang.

Có thể hình dung đơn giản: Xoang giống như một “quả bóng”. Thành xoang là vỏ bóng. Niêm mạc là lớp ruột bên trong của quả bóng. Lỗ thông xoang là van giúp lưu thông không khí và dịch.

Viêm xoang xảy ra khi lớp niêm mạc này bị viêm, thường do tắc nghẽn đường dẫn lưu, khiến dịch bị ứ đọng trong xoang.

VIÊM XOANG CẤP: Thường bắt đầu từ cảm lạnh

Ở người lớn, phần lớn các trường hợp viêm xoang cấp xuất phát từ một đợt cảm lạnh thông thường.

Khi bị cảm lạnh:

• Niêm mạc mũi và xoang bị sưng nề
• Lỗ thông xoang bị bít tắc
• Dịch không thoát ra ngoài được
• Xoang trở thành môi trường kín → dễ viêm

Quá trình này giống như một dòng kênh bị tắc nghẽn: khi nước không lưu thông, sẽ trở nên tù đọng và dễ phát sinh vấn đề.

HAI DẠNG VIÊM XOANG CẤP CẦN PHÂN BIỆT

VIÊM XOANG CẤP DO VIRUS

Đây là dạng phổ biến nhất, chiếm đa số trường hợp.

Đặc điểm:

• Xảy ra sau cảm lạnh
• Triệu chứng kéo dài khoảng 7–10 ngày
• Tự khỏi khi cơ thể hồi phục

Điều trị:

• Thuốc giảm đau, hạ sốt
• Rửa mũi bằng nước muối sinh lý
• Không cần dùng kháng sinh

VIÊM XOANG CẤP DO VI KHUẨN

Xảy ra khi tình trạng tắc nghẽn kéo dài, tạo điều kiện cho vi khuẩn phát triển.

Dấu hiệu gợi ý:

• Triệu chứng kéo dài trên 10–14 ngày không cải thiện
• Bệnh nặng ngay từ đầu
• Đang đỡ thì đột ngột nặng trở lại

Trong trường hợp này, bác sĩ có thể chỉ định kháng sinh trong thời gian ngắn.

NHỮNG HIỂU LẦM PHỔ BIẾN VỀ VIÊM XOANG CẤP

Hiểu lầm 1: Viêm xoang là bệnh nặng, khó chữa
Thực tế: Phần lớn viêm xoang cấp là do virus và có thể khỏi hoàn toàn.

Hiểu lầm 2: Cứ viêm xoang là phải dùng kháng sinh
Thực tế: Kháng sinh chỉ cần thiết khi có dấu hiệu nhiễm vi khuẩn.

Hiểu lầm 3: Tôi chưa từng bị viêm xoang nên không thể mắc
Thực tế: Bất kỳ ai bị cảm lạnh đều có thể xuất hiện viêm xoang cấp.

VIÊM XOANG MẠN TÍNH: Khi bệnh trở nên kéo dài

Viêm xoang mạn tính được xác định khi tình trạng viêm kéo dài trên 3 tháng.

Khác với viêm xoang cấp, ở giai đoạn này:

• Niêm mạc xoang đã bị tổn thương lâu dài
• Khả năng hồi phục hoàn toàn rất hạn chế
• Bệnh có xu hướng tái phát nhiều lần

NGUYÊN NHÂN CỦA VIÊM XOANG MẠN TÍNH

Viêm xoang mạn không do một nguyên nhân đơn lẻ mà thường là sự kết hợp của nhiều yếu tố:

• Di truyền: Gia đình có người mắc bệnh đường hô hấp
• Cấu trúc mũi xoang: Lỗ thông xoang hẹp, dễ tắc
• Môi trường: Khói bụi, ô nhiễm, thuốc lá, dị ứng

Những yếu tố này khiến quá trình viêm kéo dài và khó kiểm soát.

TRIỆU CHỨNG CỦA VIÊM XOANG MẠN TÍNH

Khác với cấp tính, triệu chứng thường âm thầm và kéo dài:

• Nghẹt mũi dai dẳng
• Chảy dịch mũi (thường chảy xuống họng)
• Cảm giác nặng đầu, đau vùng mặt
• Giảm hoặc mất khứu giác
• Ho kéo dài, hay phải khạc đờm

Chính vì triệu chứng không rầm rộ nên nhiều người chủ quan, không đi khám sớm.

NHỮNG HIỂU LẦM VỀ VIÊM XOANG MẠN

Hiểu lầm 1: Viêm xoang mạn có thể chữa khỏi hoàn toàn
Thực tế: Đây là bệnh mạn tính, mục tiêu điều trị là kiểm soát, không phải chữa khỏi hoàn toàn.

Hiểu lầm 2: Không cần điều trị nếu chịu được
Thực tế: Bệnh có thể tiến triển nặng hơn và gây biến chứng.

ĐIỀU TRỊ VIÊM XOANG MẠN TÍNH

Điều trị nội khoa

• Rửa mũi bằng nước muối sinh lý
• Tránh môi trường ô nhiễm, khói thuốc
• Dùng thuốc theo chỉ định của bác sĩ

Phẫu thuật xoang

Được chỉ định khi:

• Điều trị nội khoa không hiệu quả
• Bệnh tái phát nhiều lần trong năm
• Có tắc nghẽn rõ trên hình ảnh CT

PHẪU THUẬT XOANG: Có phải là giải pháp triệt để?

Một câu hỏi rất thường gặp là: “Phẫu thuật có chữa khỏi hẳn viêm xoang không?”

Câu trả lời là không.

Tuy nhiên, điều này không có nghĩa là phẫu thuật không hiệu quả.

Mục tiêu của phẫu thuật:

• Giải quyết tình trạng tắc nghẽn
• Khôi phục lưu thông của xoang
• Giảm triệu chứng, tần suất tái phát và biến chứng

Hiểu đơn giản, phẫu thuật giúp “khơi thông dòng chảy”, chứ không làm niêm mạc trở về trạng thái ban đầu.

SỰ THẬT QUAN TRỌNG: Không phải ai cũng cần mổ

Thống kê cho thấy:

• Phần lớn trường hợp viêm xoang là cấp tính
• Chỉ một tỷ lệ nhỏ tiến triển thành mạn tính
• Trong số đó, chỉ một phần nhỏ cần phẫu thuật

Điều này có nghĩa là đa số bệnh nhân có thể kiểm soát bệnh bằng điều trị nội khoa.

PHÒNG NGỪA VIÊM XOANG: Bắt đầu từ phòng cảm lạnh

Do viêm xoang cấp thường khởi phát từ cảm lạnh, việc phòng bệnh nên bắt đầu từ những thói quen đơn giản:

• Giữ ấm cơ thể khi thời tiết thay đổi
• Đeo khẩu trang khi ra ngoài
• Tránh khói bụi, thuốc lá
• Rửa tay thường xuyên
• Vệ sinh mũi bằng nước muối sinh lý

KẾT LUẬN

Viêm xoang không phải là “bản án suốt đời” như nhiều người vẫn nghĩ.

• Viêm xoang cấp rất phổ biến và có thể khỏi hoàn toàn
• Viêm xoang mạn tính cần được kiểm soát lâu dài
• Phẫu thuật chỉ áp dụng cho một số ít trường hợp cần thiết

Hiểu đúng về bệnh là bước quan trọng nhất giúp bạn điều trị hiệu quả và tránh những lo lắng không cần thiết.

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I received a 48-year-old male patient who came for a routine health check-up. As usual, for the past 3-4 years, he was advised to have a colonoscopy to screen for cancer according to his age. After much procrastination, he decided to do a colonoscopy this time.

After the colonoscopy, he shared: “The procedure was more comfortable than I expected, I slept and it was done, no pain at all.” The results showed 5 polyps – pre-cancerous tumors, including a large polyp. All of the polyps were removed during the examination, preventing the risk of progression to cancer. Thanks to that, he avoided complicated surgery and now only needs regular monitoring. This story shows that screening is not only simple but can also save lives effectively.

Official recommendation: Start at age 45

According to the latest guidelines from the American Cancer Society, everyone 45 and older should start screening for colorectal cancer, even if they have no symptoms. Previously, the recommended age was 50, but recent studies have shown that the disease is appearing in younger people, even under 50. In Vietnam, this trend is also evident, with many cases being diagnosed earlier.

There are several suitable screening methods:

• Colonoscopy: Most comprehensive, allowing immediate detection and removal of polyps.
• Fecal occult blood test (FIT test): The patient takes a small stool sample to test for hidden blood that is not visible to the naked eye. A positive result requires a colonoscopy to find the cause, usually done annually.
• Virtual colonoscopy (CT colonography): Using abdominal CT scan to recreate 3D image of colon, detect polyps without inserting endoscope into anus. Patients only need to take laxatives beforehand, pump light air into colon, lie down for 5-10 minutes to take the scan - safe, painless.

People should consult their doctor to choose the right method, especially if there is a family history of the disease (starting earlier than 45 years of age and recurring more often).

Why is screening important?

Colorectal cancer is one of the most common cancers, ranking third in cases and second in deaths globally (according to WHO). However, it is the most preventable cancer if detected early. Polyps – benign tumors – can exist for many years without causing symptoms, but they are “precursors” to cancer. Screening helps remove polyps before they become malignant, reducing the risk of cancer by up to 90%. If cancer is detected early, the cure rate exceeds 90%, with less invasive treatment and lower costs.

Think of screening like a routine checkup for your house: You don’t wait for the roof to break down before fixing it, but you get it checked out every year to avoid disaster. Similarly, colonoscopy helps proactively “maintain” your digestive system.

Clearing up common misconceptions

Many people are hesitant to get screened due to misconceptions. Here are some points to clarify:

1. “No one in my family has it, so I don't need to worry”: False. About 75-90% cases of colorectal cancer occur in people with no family history. Everyone 45 years of age and older should be screened.
2. “I go to the toilet normally, have no stomachache so I am healthy”: Not true. Polyps and early cancers often do not cause obvious symptoms such as diarrhea, constipation or bleeding. Many of my patients feel completely normal but still discover problems during endoscopy.
3. “This cancer is rare and not dangerous”: In fact, it is the leading cause of death in many countries, but regular screening can reduce mortality by 60-70%.

Advice from doctors

Your health is your most precious asset! If you are 45 or older, schedule a screening today. Modern endoscopy is safe, quick (about 20-30 minutes), and virtually painless under light anesthesia. Don’t wait for symptoms – act early to protect yourself and your family.

“45 years old, let's start!”

The post BAO NHIÊU TUỔI NÊN NỘI SOI ĐẠI TRÀNG TẦM SOÁT UNG THƯ? appeared first on Charis Healthcare.

Vitamin D plays many essential roles in the body, most notably in develop and strengthen bones. Although vitamin D deficiency has declined due to fortified dairy products, it is still a common problem, especially in the elderly. This article will help you understand the causes, how to recognize, treat, and safely prevent vitamin D deficiency.

What is vitamin D and why do our bodies need it?

Vitamin D is a fat-soluble vitamin that acts as a smart “transporter”:

• Helps absorb calcium and phosphorusfrom food in the intestine into the blood.
• Stabilize blood calcium levels, thereby promoting bone health.
  Additionally, vitamin D is also thought to benefit muscle function and the immune system, although more research is needed in these areas.

Where does our body get vitamin D?

There are two main sources of vitamin D:

1. Sunlight:Our skin can synthesize vitamin D when exposed to sunlight. However, this ability is affected by the season, time of day, age, skin color and health status. Important Note: Sun exposure is not recommended as a primary means of vitamin D supplementation due to the risk of skin cancer.
2. Food:Food sources rich in natural vitamin D include fatty fish (salmon, mackerel), cod liver oil and egg yolksIn many countries, industrial cow's milk is the most common source of supplementation. Cereals and some other products are also often fortified with vitamin D.

Why are we deficient in vitamin D?

There are three main groups of causes:

• Not getting enough through diet:Diets low in foods rich in vitamin D are common in infants (especially those who are exclusively breastfed), the elderly, and people who do not consume dairy products.
• Poor absorption:Some diseases such as Celiac, Crohn or gastric bypass surgery may reduce the ability to absorb vitamin D from the gut.
• Metabolic disorders:Diseases of liver or kidney Chronic use may interfere with the conversion of vitamin D into the active form the body can use.

Consequences of vitamin D deficiency

Severe vitamin D deficiency can lead to:

• Ricketsin children (soft and deformed bones).
• Osteomalaciain adults (soft bones, pain).

However, the more common condition is “subclinical deficiency” – lower than normal vitamin D levels that do not cause obvious symptoms. This condition can still lead to:

• Reduced bone density(osteoporosis).
• Increased risk of falls and fractures.

Therefore, detecting and treating vitamin D deficiency is very important for maintaining long-term bone and joint health.

How to know if you have vitamin D deficiency?

Blood test called 25-hydroxyvitamin D [25(OH)D] is the gold standard for diagnosis. However, there are differences between organizations in the threshold for defining deficiency:

• According to Institute of Medicine (National Academy of Medicine), level ≥20 ng/mL (50 nmol/L)is considered sufficient for most healthy people.
• Meanwhile, American Endocrine Associationand many other experts recommend the level above 30 ng/mL (75 nmol/L) is optimal for ensuring bone and overall body health.

Based on these recommendations, deficiency is usually identified when the concentration below 20 ng/mL and serious shortage when below 12 ng/mL (30 nmol/L)Your doctor will interpret the results based on your specific health condition.

Treatment of vitamin D deficiency: How to supplement properly?

• Vitamin selection:The two common forms are Vitamin D2 (ergocalciferol) and Vitamin D3 (cholecalciferol). Vitamin D3 is often preferred. because it is more effective in raising blood vitamin D levels.
• Dosage:Treatment dose depends on the severity of deficiency and will be doctor's specific instructions. Typically, treatment involves an initial high dose for a few weeks to allow for rapid recovery, followed by a daily maintenance dose.
  • Reference example:Severely deficient people may need to take 50,000 IU/week for 8 weeks, then maintain 800–1,000 IU/day.
• Don't forget Calcium:When supplementing vitamin D, make sure to get enough calcium from your diet (milk, small fish with bones, tofu, green vegetables) or supplements.
• Monitor:Your doctor will recommend a blood test after about 3 months of treatment to evaluate the effectiveness and adjust the dose accordingly.
• Warning:Taking too much vitamin D can be toxic, leading to hypercalcemia or kidney stones. Follow the instructions and avoid taking more than one vitamin D supplement at the same time.

Deficiency Prevention – Easier Than You Think!

• For healthy adults:Additional 800 IU (20 mcg) vitamin D3 daily This is usually enough to maintain a stable level. This is the general recommended dose. Specific needs may be higher in some subjects (such as obese people, dark skin) and should be consulted with a doctor.
• For infants and young children:Additional recommendations 400 IU (10 mcg) vitamin D daily as early as a few days after birth. Vitamin D is often included in multivitamin drops for babies.
• Food:Increase foods rich in vitamin D such as salmon, tuna, egg yolks and formula.
• Absolutely not.Excessive sunbathing or using tanning beds to supplement vitamin D increases the risk of skin cancer.

The post HIỂU ĐÚNG VỀ THIẾU HỤT VITAMIN D appeared first on Charis Healthcare.

1. When the body “resists” itself: what is type 2 diabetes?

Type 2 diabetes (also known as type 2 diabetes mellitus) is a chronic medical condition that disrupts the body's ability to use and store energy. Specifically:

• Sugar (Glucose)is the primary fuel source for every cell.
• Insulinis a hormone produced by the pancreas, which acts as a “key” to open the door for sugar to pass from the blood into the cells.
• In people with type 2 diabetes, the body experiences a condition called insulin resistance(cells do not respond well to insulin) and over time, the pancreas does not produce enough insulin. As a result, sugar builds up in the blood, leading to high blood sugar.

If not well controlled, prolonged high blood sugar can cause many serious complications.

2. Don't Get Confused: How Are Type 1 and Type 2 Diabetes Different?

These are two main forms of the disease with different causes:

• Type 1 diabetes:The body stops producing insulin because the immune system mistakenly attacks pancreatic cells. usually begins in children and adolescents, but can also occur in adults.
• Type 2 diabetes:The body still produces insulin but does not use it effectively (insulin resistance). This is the most common form, accounting for about 90% cases.

3. Who is susceptible? – Identifying risk factors

Type 2 diabetes is thought to be caused by a combination of factors:

• Hereditary:If a parent or sibling has the disease, your risk is higher. Certain ethnic groups, such as Asians, African Americans, and Hispanics, are also at higher risk.
• Lifestyle:Unhealthy diet (high in sugar, fat, low in fiber), lack of physical activity leading to overweight and obesity are major risk factors.
• History of gestational diabetes:Women who have had gestational diabetes have a higher risk of developing type 2 diabetes later in life.

4. Your body is "speaking up": Warning signs you need to pay attention to

• Many people have no obvious symptoms in the early stages. As the disease progresses, signs may appear such as:
  • Thirst a lot, frequent urination.
  • Blurred vision.
  • Tired, lethargic.
  • Slow healing wound
• Doctors rely on the following blood tests to diagnose the disease and may repeat them several times to confirm:
  • Fasting blood sugar:≥ 126 mg/dL (7.0 mmol/L).
  • Random blood sugar:≥ 200 mg/dL (11.1 mmol/L) with symptoms.
  • HbA1c (Test reflects average blood sugar over 3 months):≥ 6.5%.
  • Oral glucose tolerance test:≥ 200 mg/dL (11.1 mmol/L) at 2 hours.

Note: These values are for reference only according to the Diagnosis and Treatment Guidelines of the Vietnamese Ministry of Health. Diagnosis must be performed and confirmed by a physician.

5. Living Positively: The Journey to Controlling Diabetes Is Not Difficult

Managing type 2 diabetes is not a stressful battle, but a journey where you learn to be more intimate with and listen to your body. You can live a happy and healthy life thanks to a combination of these simple solutions:

• Eat Smart – Delicious and Healthy:Don't feel like you have to give up all your favorite foods. See this as an opportunity to explore new, healthier foods.
  • Prioritize fiber:Increase green vegetables and low-sugar fruits (like guava, apple, grapefruit) in every meal. Fiber helps sugar enter the blood more slowly and steadily.
  • Choose good starch:Prioritize whole grains such as brown rice, rye bread, oats. The most important thing is to eat in moderation. and divide meals during the day.
  • Limit “bad” sugar:Minimize soda, candy, and sugary drinks. Get in the habit of reading nutrition labels before you buy.
• Gentle exercise – A joy every day:You don't need to train like an athlete. Just do some light, healthy activities.
  • Walk:Walking briskly for 30 minutes a day is a great way to help your body use sugar more efficiently.
  • Gardening, cleaning the house:These seemingly small tasks also help burn significant energy.
  • Dance, yoga:Relaxing and good for your health.
• Use medicine properly – A reliable companion:When lifestyle changes aren't enough, oral or injectable medications can be a great help. Make them a part of your daily routine, like brushing your teeth or washing your face. Strictly follow your doctor's instructions., do not stop taking the medicine or change the dose on your own.
• Monitor yourself – Know yourself to control your disease:
  • Self-monitoring of blood sugar:This is the most direct way to know how your body reacts to food and activities. Consider it a good habit to adjust in time.
  • Periodic re-examination:This is an opportunity for doctors to evaluate the overall effectiveness of treatment (through the HbA1c index) and promptly detect any abnormalities.

6. Prolonged high blood sugar: unpredictable consequences for health

Prolonged high blood sugar can damage many organs, leading to:

• Cardiovascular complications:Heart attack, stroke.
• Renal complications:Kidney failure.
• Eye complications:Reduced vision, blindness.
• Neurological complications:Numbness and ulcers in the feet.
• Other complications:Infection.

Important advice:

Although it is a chronic disease, with understanding and active management, people with type 2 diabetes can live healthy, active lives and significantly reduce the risk of complications. Be proactive in seeking information from reliable sources such as Vietnam Ministry of Health, Vietnam Endocrinology and Diabetes Association, or other medical facilities have reputation.

The post HIỂU ĐÚNG VỀ BỆNH TIỂU ĐƯỜNG TUÝP 2 ĐỂ SỐNG KHỎE MẠNH HƠN appeared first on Charis Healthcare.

Type 2 diabetes is a chronic disorder that disrupts the way your body uses and stores sugar (glucose) and other forms of energy.

• Sugar (Glucose)is the primary fuel for every cell.
• Insulinis the “key” produced by the pancreas, which helps bring sugar from the blood into the cells.
• In type 2 diabetes, your body becomes insulin resistance(the cells don't respond well), and over time, the pancreas doesn't produce enough insulin. As a result, sugar builds up in the blood, causing hyperglycemia.

Being overweight, especially fat stored in the abdomen and liver, increases the body's need for insulin, making the condition worse. If left untreated, prolonged high blood sugar can lead to many dangerous complications.

2. Treatment goals: What should you aim for?

The main goal is to keep your blood sugar within target range and manage comorbidities (such as high blood pressure, high cholesterol) to minimize the risk of complications.

• Blood sugar control: The key to preventing complications
  This helps prevent long-term damage to the eyes, kidneys, nerves, and heart.
  • Blood sugar monitoring at home:Your doctor may ask you to check yourself, especially if you take insulin or other medications that put you at risk for hypoglycemia.
  • HbA1c test – “Measurement” of average blood sugar:This is a blood test that reflects your average blood sugar level over 2-3 months.
  • The general HbA1c target is <7%, but will be thorough personalizationbased on your age, disease duration, comorbidities, and risk of hypoglycemia. Some people may aim for <6.5%, while others (such as older adults) may aim for <8.0%. Your doctor will help you determine the safest and most appropriate target.
• Protect your heart: Reduce the risk of cardiovascular complications
  Cardiovascular complications (such as heart attack and stroke) are the most common and serious problem. You can significantly reduce your risk by:
  • Stop smoking.
  • Good control of blood pressure and blood lipidsthrough diet, exercise and medication.
  • Use low-dose aspirinif recommended by a doctor.

3. The Golden Rule: Are Lifestyle Changes Really Important?

HAVE. Diet and exercise are the cornerstones of managing type 2 diabetes.

• Smart Nutrition:Dietary changes help control weight, blood pressure, and improve insulin response.
  • The most important thing:Should be avoided completely. added sugars in soft drinks, canned fruit juices, and candies. At the same time, strictly limited Refined starches like white rice, white bread, noodles, pho… and replace with whole grains when possible.
  • Portion controland choose healthy foods.
• Regular exercise:Exercise helps lower blood sugar by improving insulin sensitivity, even if you don't lose weight.

4. Medication Groups: Which Is Right for You?

When lifestyle changes are not enough, medications can be a powerful aid.

• Metformin – First choice:Most newly diagnosed people will start with Metformin. It helps your body respond better to insulin.
  • Side effects:Nausea, diarrhea, and bloating may occur, but these usually subside when taken with meals.
  • Gastrointestinal side effects usually subside. If you experience them, you can ask your doctor about Metformin extended-release (XR/ER), causing fewer digestive side effects.
• When a second dose is needed:If your blood sugar and HbA1c are not at your target after 2-3 months, your doctor may recommend adding another medication. The choice will depend on your weight, your risk of hypoglycemia, your medical conditions, and cost.

Below are some common drug groups:

• Sulfonylurea group (Eg: Glipizide, Glimepiride):Stimulates the pancreas to produce insulin. Caution is advised as it may cause hypoglycemia and gain weight.
• DPP-4 Inhibitors (Eg: Sitagliptin, Linagliptin):Increases insulin secretion when eating, rarely causes hypoglycemia and does not affect weight.
• SGLT2 Inhibitors (Eg: Empagliflozin, Dapagliflozin):Helps eliminate sugar through urine. Very beneficial for patients with chronic heart or kidney disease. Possible side effects: urinary or genital infections.
• GLP-1 Agonists (Eg. Liraglutide, Dulaglutide, Semaglutide):The injection helps increase insulin secretion, reduce appetite and effectively support weight loss. Beneficial for the cardiovascular system. Common side effects are nausea.
• Insulin:Prescribed when oral medications are not effective enough, or initially if blood sugar is too high. Close monitoring is required to avoid hypoglycemia.

Note: All medications and regimens should be prescribed and monitored by a medical specialist.

5. Living with the disease: How to no longer be a burden?

Living with type 2 diabetes can be stressful and anxiety-provoking at times. Monitoring your blood sugar, eating right, exercising, and taking medication every day is a big responsibility.

• You are not alone.Please share with family and friends for support and encouragement.
• Don't hesitate to talk to your doctoror your healthcare provider if you feel overwhelmed, discouraged, or have any questions about your treatment plan.
• Seek psychological supportfrom counselors or social workers when needed. Taking care of your mental health is just as important as controlling your blood sugar.

The post ĐIỀU TRỊ BỆNH TIỂU ĐƯỜNG TUÝP 2 – HÀNH TRÌNH KIỂM SOÁT ĐƯỜNG HUYẾT appeared first on Charis Healthcare.

Gallbladder: The intelligent 'coordinator' of the digestive system

The gallbladder is a small, pear-shaped organ about 7–12 cm long, located just below the liver, in the upper right abdomen. The main functions of the gallbladder include:

• Stores and concentrates bile produced continuously by the liver.
• When we eat (especially foods high in fat), the gallbladder contracts to push bile into the small intestine, helping to digest fat and absorb fat-soluble vitamins (A, D, E, K).

Where do gallstones come from? What types of stones are there?

Gallstones are solid “stones” formed from bile components, located in the gallbladder or bile ducts. They can range in size from a few mm to 3–4 cm, rarely larger than a quail egg. In Vietnam, there are 2 main types of gallstones:

1. Cholesterol stones (majority): yellow or white, often found in obese people, women, and people who lose weight quickly.
2. Pigment gallstones (less common): black or brown, often seen in people with congenital hemolytic anemia, cirrhosis, and prolonged biliary tract infections.
3. Mixed gravel: is the common form, combining both cholesterol and bile pigments.

Are you at high risk? Get tested now!

High-risk groups include:

• Women (2–3 times higher risk than men)
• Age over 40
• Obesity (especially abdominal obesity)
• Have given birth many times
• Have a blood relative (parent, sibling) with gallstones

Other risk factors common in Vietnamese people:

• Losing weight too quickly (>1.5 kg/week)
• Diabetes, sedentary
• Long-term use of birth control pills or estrogen-containing drugs
• Regularly skipping breakfast, skipping meals, and eating irregularly

Body "alarm": Warning signs of gallstones

1. “Silent” gravel (70–80% cases): No symptoms, only discovered by chance during a routine health ultrasound. However, silent stones still have the risk of causing complications later, so they need to be monitored regularly.
2. Typical biliary colic:
   • Sudden, severe pain in the right lower rib area or above the navel
   • Pain radiating to the right shoulder or back
   • Usually appears a few hours after a fatty meal (for example, roast duck, hot pot, fried food, etc.)
   • Accompanied by nausea, vomiting, and inability to lie still
   • The pain lasts for several hours and then subsides when the gallbladder stops contracting.
3. Dangerous complications (require immediate hospitalization):
   • Acute cholecystitis: continuous pain, high fever, abdominal distension
   • Jaundice, yellow eyes due to stones falling into the common bile duct
   • Acute pancreatitis due to gallstones – can be life-threatening

How to early detection gallstones?

Abdominal ultrasound is a simple, accurate method on 95%, reasonable cost and is the best way to detect gallstones today. If complications are suspected, the doctor will order additional blood tests, CT scan or MRCP.

Gallstone Treatment: When to Intervene?

1. Asymptomatic stones: Only need to monitor periodically by ultrasound every 6-12 months, no intervention is needed.
2. Have symptoms or complications: Cholecystectomy (laparoscopic) is the most radical and safest treatment method today.
   • Advantages: Small incision, less pain, can usually be discharged within 1-3 days If there are no complications, high aesthetics.
   • After gallbladder removal, most people live completely normal lives. However, some people may experience symptoms such as diarrhea or indigestion when eating a lot of fat in the early stages, because bile is no longer stored and regulated centrally. These symptoms usually improve over time.
3. Non-surgical treatment (very rarely applied in Vietnam):
   • Taking stone-dissolving medication (ursodeoxycholic acid): only effective for small cholesterol stones, must be taken for 1–2 years, high recurrence rate.
   • Percutaneous or shock wave lithotripsy: few facilities perform, easy to relapse.

Gallstone Prevention: The Secret Is in Lifestyle!

You can significantly reduce your risk of gallstones with simple lifestyle changes:

• Maintain a reasonable weight, avoid belly fat
• Eat breakfast regularly every day, do not fast for too long
• Limit fried foods, animal fats, animal skin, and organs.
• Increase green vegetables, fruits, fiber, drink enough 2-2.5 liters of water/day. Drinking enough water helps dilute bile, reducing the risk of forming new stones.
• Exercise at least 30 minutes/day, 5 days/week
• Regular health check-ups and abdominal ultrasounds every 1-2 years (especially for women over 40 years old and people at high risk)

Message

Gallstones are not a “sentence” and can be completely prevented with a scientific lifestyle. Listen to your body! If you experience unusual pain in the upper right abdomen after a fatty meal, do not be subjective, go to the doctor immediately for timely detection and treatment.

Wishing you and your family good health!

The post SỎI MẬT (SỎI TÚI MẬT) – NHỮNG ĐIỀU CẦN BIẾT ĐỂ BẢO VỆ SỨC KHỎE appeared first on Charis Healthcare.

High blood pressure (also known as hypertension) is a very common condition, but if not well controlled, it can lead to many serious complications such as stroke, heart failure, heart attack, kidney failure and dementia. Worldwide, high blood pressure is the leading risk factor for death from cardiovascular disease.

Fortunately, we can effectively lower blood pressure by making lifestyle changes: eating healthy, exercising regularly, and losing weight (if overweight/obese). Each lifestyle change has its own benefits. have their own positive contribution, But The effectiveness will be multiplied most strongly when they are combined synchronously.However, lifestyle changes often only reduce blood pressure moderately, so many people still need additional medication to reach their target blood pressure.

How is blood pressure measured?

Blood pressure is recorded as two numbers:

• Top number (systolic blood pressure): pressure in the blood vessels when the heart contracts.
• Bottom number (diastolic pressure): pressure when the heart rests between beats.

Blood pressure classification table according to the Ministry of Health

Based on the 2024 Guidelines for Diagnosis and Treatment of Hypertension of the Vietnam Hypertension Association and the Vietnam Cardiology Association (*), this disease is divided into levels based on the following reference value table:

Note: HATT = systolic blood pressure; HATTr = diastolic blood pressure.

(*) https://timmachhoc.vn/phac-do-53-chan-doan-va-dieu-tri-tang-huyet-ap/

Anyone with mildly elevated or high blood pressure needs to make immediate lifestyle changes. Your doctor will consider prescribing medication if you have stage 2 or stage 1 hypertension with heart disease or a high heart risk.

Changing your diet – the strongest “medicine” that doesn't require a prescription

1. Reduce salt (sodium)
   • Salt is the "culprit" that increases blood pressure.
   • Most of the salt we eat does not come from the salt shaker on the dining table but from processed foods, canned foods, fast foods, and concentrated fish sauces/dipping sauces.
   • The ideal goal for heart health is less than 1,500 mg sodium/day, however, a realistic and widely recommended goal is less than 2,000 mg sodium/day (equivalent to 5 grams of salt). Let's start with this goal.
2. Increased potassium (unless you have kidney disease)
   • Potassium helps counterbalance the harmful effects of salt.
   • Foods rich in potassium: bananas, oranges, sweet potatoes, spinach, tomatoes, beans, fish…
3. Limit alcohol
   • Men: no more than 2 units of alcohol/day.
   • Women: no more than 1 unit/day. (1 unit = 350 ml beer or 150 ml wine or 30 ml spirits)
   • Drinking too much and drinking in a row is very dangerous for blood pressure.
4. Eat lots of vegetables and fiber
   • Goal: at least 5 servings of fruits and vegetables/day.
   • Fiber (20–35 g/day) helps lower blood pressure and is good for the intestines.
5. Eat fish 2-3 times/week
   • Especially marine fish rich in omega-3 (salmon, mackerel, tuna…).
6. Cut down on excessive caffeine
   • People who are not used to drinking coffee may experience a temporary increase in blood pressure.
   • For regular drinkers, the effects may be less pronounced. However, to be safe, you should monitor your own blood pressure response after drinking coffee and limit if blood pressure increases.
7. DASH diet – the “golden weapon” to control blood pressure
   • DASH = Dietary Approaches to Stop Hypertension.
   • Characteristics: lots of fruits and vegetables, whole grains, low-fat dairy, little red meat, little saturated fat and sweets.
   • When combining DASH + salt reduction → can reduce systolic blood pressure by 11–12 mmHg (equivalent to the effect of one drug).

Exercise regularly

• Aerobic exercise (brisk walking, jogging, cycling, swimming): 150–300 minutes/week of moderate intensity or 75–150 minutes/week of vigorous intensity.
• Combine weight training/strengthening exercises 2 sessions/week.
• Just walking briskly 30 minutes a day, 5 days a week can help reduce blood pressure by 4–9 mmHg.
• Most importantly: it must be sustainable.

Lose weight if overweight/obese

• Just lose about 5% of body weight (e.g. 4kg for a person weighing 80kg) can significantly lower blood pressure.
• BMI ≥ 23 (in Asians) is overweight, ≥ 25 is obese.
• How to lose weight effectively and sustainably: eat fewer calories + move more.

Things to avoid

• NSAID pain relievers (ibuprofen, diclofenac, naproxen…) can increase blood pressure.
• Oral contraceptives (in some people).
• Decongestants, diet pills, stimulants (including narcotics). → Tell your doctor about all medications and supplements you are taking.

Get enough sleep

• Sleep 7–9 hours every night.
• Long-term sleep deprivation increases the risk of high blood pressure.

What if I change my lifestyle but my blood pressure is still high?

→ You may need to take additional blood pressure medication. There are many safe and effective medications available. Your doctor will choose the one that is best for you.

In Summary – What Can You Do Today?

1. Measure your blood pressure regularly at home.
2. Significant salt reduction (less than 5 g salt/day).
3. Eat lots of vegetables and fruits, at least 500–800 g/day.
4. Walk briskly for 30 minutes every day.
5. If overweight, try to lose 3–5 kg in the first 3 months.
6. Get enough sleep and limit alcohol.

Just by consistently making these small changes, you can completely control your blood pressure well, significantly reducing the risk of stroke and heart attack – without having to rely completely on medication!

Wish you always healthy!

The post HUYẾT ÁP CAO: CHẾ ĐỘ ĂN VÀ GIẢM CÂN appeared first on Charis Healthcare.

In Vietnam, about 20–251 TP3T adults have fatty liver (increased from ~101 TP3T to this level in the past 10 years), mainly due to the habit of eating a lot of starch, sweets, little exercise and increasingly "hypertrophied" waistline and >901 TP3T not due to alcohol. This is non-alcoholic fatty liver disease – the new name globally is MASLD (fatty liver related to metabolic disorders) and when there is severe inflammation it is called MASH.

1. MASLD fatty liver and hepatitis by What is MASH fatty liver?

• MASLD (formerly known as NAFLD): a condition in which fat accumulates in the liver due to metabolic factors such as being overweight, high blood sugar, high blood lipids, high blood pressure.
• MASH (formerly called NASH): when the liver is not only fatty but also inflammation and can leave scars (cirrhosis). This is a more serious stage, which can progress to cirrhosis or even liver cancer if not well controlled.

If you have both metabolic fatty liver and drink a lot of alcohol, it is called MetALD (both reasons).

2. Who is susceptible? Fatty liver disease?

More than 80–90% of people with steatohepatitis have at least one of the following factors (usually a combination of factors):

• Overweight, obesity (especially abdominal fat)
• Type 2 diabetes or prediabetes (insulin resistance)
• High blood fat (high triglycerides, high bad cholesterol)
• High blood pressure

The above quartet is called metabolic syndrome – “soldiers” often go together and are also the leading cause of severe fatty liver in our country today.

3. Common symptoms

Extremely “silent”! Most people no obvious symptoms. A few may see:

• Prolonged fatigue, lethargy
• Mild pain in the right subcostal region (liver area)
• Flatulence, indigestion

Therefore, the disease is often only detected during a routine health check-up or abnormal blood test.

4. How do I know if I have it? Fatty liver disease?

The doctor will do a series of tests in the following order:

1. Testing blood: Liver enzymes ALT, AST can increase slightly or clearly, but there are also cases where liver enzymes are normal even though the liver is inflamed (MASH).
2. Abdominal ultrasound: liver is bright (fatty), but ultrasound cannot distinguish between simple fatty liver or fatty hepatitis.
3. Liver stiffness measurement (FibroScan): non-invasive method to know if the liver is severely cirrhotic or not.
4. Liver biopsy (rarely required): indicated when it is necessary to accurately determine the degree of inflammation and fibrosis, or when other causes are suspected (viral hepatitis, autoimmune...).

5. Treatment – What to do to make the liver healthy again?

The good news is: Fatty liver disease It is possible to improve and even return to near normal. if we change our lifestyle properly.

1. A. Things to do immediately (most important)

1. Lose weight slowly and sustainably
   • Lose 5–10% weight → liver fat is significantly reduced.
   • It is best to lose 0.5–1 kg/week (losing too quickly is harmful to the liver).
   • Combine healthy eating + regular exercise 150 minutes/week (brisk walking, cycling, swimming… are all fine).
2. Control blood sugar, blood fat, blood pressure
   • Take medication regularly if you have diabetes or high blood fat (medications such as Statins are generally safe and have superior benefits., but need to be monitored regularly by a doctor).
   • Eat bland food, reduce fried foods, limit white rice - cakes - soft drinks.
3. Limit alcohol completely (Alcohol is the "number 1 enemy" of an inflamed liver).
4. Vaccination
   • Hepatitis A, hepatitis B (if not immune) for additional liver protection.

1. B. Current medications

• Vitamin E (800 IU/day): sometimes doctors use it for people with severe fatty liver disease, without diabetes. However, This treatment dose must be prescribed by a specialist and closely monitored, do not use it on your own.

• Resmetirom: New drug approved by FDA 2024, under testing and not yet popular in Vietnam.

• Some diabetes medications (such as pioglitazone, semaglutide) are also very effective in reducing liver fat.

6. Prognosis – Is the disease dangerous?

• Fortunately, most people with simple fatty liver will no progression, life expectancy is almost normal.

• About 10–25% people with fatty liver disease, if not controlled, will progress to cirrhosis after 10–20 years, or even liver cancer.

Great news: Just lose weight + exercise regularly, liver enzymes can return to normal in 3-6 months, and the risk of cirrhosis is greatly reduced!

Final advice from the doctor

The liver is the most “gentle and grateful” organ in the body. We just need to:

• Lose 5–7 kg (if overweight)
• Quit or reduce alcohol
• Exercise regularly, eat lots of vegetables and fish, and less bad starch.

→ The liver will have a great ability to regenerate itself. This is the cornerstone of treatment, which may help reduce or delay the need for additional liver-specific medications. However, medications to treat underlying diseases such as diabetes and hyperlipidemia still need to be maintained as prescribed.

Go for regular check-ups every 6–12 months (blood tests, ultrasounds) for close monitoring.

Wish everyone always have a healthy liver!

Dr. TRAN PHUONG THAO, USMLE Step 3, General Internal Medicine, Gastroenterology, Hepatobiliary

The post GAN NHIỄM MỠ LIÊN QUAN ĐẾN RỐI LOẠN CHUYỂN HÓA (MASLD) VÀ VIÊM GAN NHIỄM MỠ (MASH) appeared first on Charis Healthcare.

1. What is Creatinine? Why is it important?

Creatinine is a waste product produced by the muscles every day. Healthy kidneys filter it and excrete it in the urine. When the kidneys are damaged, creatinine “gets stuck” in the blood → its concentration increases.

• Creatinine values are considered normal when they fall within reference range printed on your test result sheet. This range may vary between laboratories, but is generally within 60-110 µmol/L for men and 45-90 µmol/L for women. The most important thing is to compare your results with the reference range of the place where you had the test.
• The elderly, thin people, pregnant women… can be a little shorter.

If your creatinine is slightly elevated (e.g. 120–150) and you have no symptoms, don’t be complacent! It could be a sign that your kidneys are “calling for help” in stages 2–3, and can still be saved.

2. eGFR – “Golden index” to assess kidney function

eGFR (estimated Glomerular Filtration Rate) = estimated glomerular filtration rate. This is a number that tells you how well your kidneys are filtering your blood (in mL/min/1.73m²).

• ≥ 90: Normal kidney function (Stage 1 if there are other signs of kidney damage)
  • 60–89: Mild decline in kidney function (Stage 2 if there are other signs of kidney damage). In the elderly, this may be a physiological decline in kidney function.
  • 30–59: Moderate chronic kidney failure (Stage 3)
  • 15–29: Severe chronic kidney failure (Stage 4)
  • < 15: End-stage renal failure (Stage 5)

eGFR is automatically calculated from three parameters: blood creatinine, age, gender and race. Just one blood stick is enough to know whether the kidneys are in the “green, yellow or red zone”.

3. Relationship between creatinine and eGFR

You can imagine it simply like this:

• Increased creatinine → decreased eGFR (like stagnant wastewater in the filtration system)
• The higher the creatinine, the lower the eGFR → the more "tired" the kidneys

A common practical example of a doctor: A patient, male, 58 years old, went for a routine check-up and found creatinine 135 µmol/L (slightly high), eGFR 52 → detected stage 3 kidney failure due to 6 years of diabetes. Fortunately, thanks to early detection, the patient controlled blood sugar + blood pressure well, significantly slows disease progression, after 3 years eGFR is still 48, no need for dialysis.

4. Who is susceptible to kidney failure without knowing it?

• People with diabetes, long-term high blood pressure
• Overweight, belly fat
• Smoking and drinking a lot of alcohol
• Family has someone with kidney disease
• Regular use of painkillers (NSAID group), herbal medicines of unknown origin

5. What to do to protect your kidneys today?

1. Drink enough water (1.5–2 liters/day, unless restricted by a doctor)
2. Eat a low-salt diet (<5g salt/day), reduce fried foods and soft drinks.
3. Good control of blood sugar (HbA1c < 7%) and blood pressure (< 130/80)
4. Exercise regularly 30 minutes/day
5. Regular health check-ups every 6-12 months, creatinine + eGFR test even if you don't feel tired

Conclusion

The kidneys do not speak when they are in pain, they just “silently” weaken. Creatinine and eGFR indexes are the “voices” of the kidneys. Do not wait until you urinate less, have edema, or have difficulty breathing to rush to the doctor. A blood test can help you save on the high cost of dialysis and keep your healthy life for another 10-20 years. Healthy kidneys – A new, complete life!

Dr. TRAN PHUONG THAO, USMLE Step 3, specializing in General Internal Medicine, Gastroenterology and Hepatobiliary Medicine.

The post Chỉ số Creatinin huyết thanh và eGFR – “Báo động” sức khỏe thận bạn không thể bỏ qua appeared first on Charis Healthcare.