{"id":5818,"date":"2019-03-31T14:59:56","date_gmt":"2019-03-31T07:59:56","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=5818"},"modified":"2019-03-31T15:11:57","modified_gmt":"2019-03-31T08:11:57","slug":"thieu-vitamin-d-tam-nang-va-ung-thu-da-hieu-sao-cho-dung","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/thieu-vitamin-d-tam-nang-va-ung-thu-da-hieu-sao-cho-dung\/","title":{"rendered":"Thi\u1ebfu Vitamin D, t\u1eafm n\u1eafng, v\u00e0 ung th\u01b0 da: Hi\u1ec3u sao cho \u0111\u00fang?"},"content":{"rendered":"<h2>G\u1ea7n \u0111\u00e2y, <strong>nhi\u1ec1u b\u00e0i b\u00e1o tr\u00ean m\u1ea1ng ch\u1ec9 sai c\u00e1ch l\u00e0m t\u0103ng Vitamin D, h\u01b0\u1edbng d\u1eabn sai c\u00e1ch t\u1eafm n\u1eafng \u0111\u00f4i khi c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ung th\u01b0 da<\/strong>.<\/h2>\n<p>T\u00f4i vi\u1ebft b\u00e0i n\u00e0y \u0111\u1ec3 gi\u1ea3i th\u00edch <strong>vai tr\u00f2 quan tr\u1ecdng c\u1ee7a Vitamin D<\/strong>, c\u00e1ch kh\u00f4ng b\u1ecb thi\u1ebfu vitamin D, c\u00e1ch b\u1ea3o v\u1ec7 da kh\u1ecfi ung th\u01b0 m\u00e0 v\u1eabn c\u00f3 \u0111\u1ee7 Vitamin D d\u00f9ng.<\/p>\n<p><strong>Vitamin D<\/strong> l\u00e0 m\u1ed9t vitamin c\u1ef1c k\u1ef3 quan tr\u1ecdng \u0111\u1ed1i v\u1edbi c\u01a1 th\u1ec3 ch\u00fang ta. Thi\u1ebfu Vitamin D c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn c\u00e1c b\u1ec7nh v\u1ec1 x\u01b0\u01a1ng, c\u01a1 x\u01b0\u01a1ng kh\u1edbp, h\u1ec7 mi\u1ec5n d\u1ecbch, v\u00e0 th\u1eadm ch\u00ed ung th\u01b0 (1,2). Vitamin D gi\u00fap h\u1ea5p th\u1ee5 Calcium (canxi) v\u00e0 Phosphate t\u1eeb ru\u1ed9t, l\u00e0m x\u01b0\u01a1ng ch\u00fang ta \u0111\u1eadm v\u00e0 ch\u1eafc. C\u01a1 th\u1ec3 thi\u1ebfu Vitamin D s\u1ebd kh\u00f4ng h\u1ea5p th\u1ee5 \u0111\u01b0\u1ee3c Calcium, khi\u1ebfn c\u01a1 th\u1ec3 ch\u00fang ta ph\u1ea3i l\u1ea5y Calcium t\u1eeb x\u01b0\u01a1ng \u0111\u1ec3 s\u1eed d\u1ee5ng, d\u1ea7n d\u1ea7n l\u00e0m x\u01b0\u01a1ng y\u1ebfu \u0111i, g\u00e2y ra b\u1ec7nh c\u00f2i x\u01b0\u01a1ng v\u00e0 lo\u00e3ng x\u01b0\u01a1ng. U\u1ed1ng b\u1ed5 sung Calcium (mua t\u1eeb ch\u1ee3 nh\u01b0 Costco b\u00ean M\u1ef9) m\u00e0 c\u01a1 th\u1ec3 thi\u1ebfu vitamin D th\u00ec kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng g\u00ec cho x\u01b0\u01a1ng c\u1ea3 v\u00ec Calcium kh\u00f4ng h\u1ea5p th\u1ee5 \u0111\u01b0\u1ee3c v\u00e0o c\u01a1 th\u1ec3.<\/p>\n<p>C\u00f3 hai lo\u1ea1i Vitamin D ch\u00ednh l\u00e0 D2 v\u00e0 D3. Vitamin D2 (ergocalciferol), c\u00f3 ch\u1ee7 y\u1ebfu t\u1eeb th\u1ee9c \u0103n, v\u00e0 ch\u1ec9 c\u00f3 trong m\u1ed9t s\u1ed1 \u00edt th\u1ee9c \u0103n gi\u00e0u vitamin D, lo\u1ea1i vitamin D2 chi\u1ebfm r\u1ea5t \u00edt trong t\u1ed5ng s\u1ed1 l\u01b0\u1ee3ng Vitamin D ch\u00fang ta c\u00f3. Vitamin D3 (cholecalciferol), t\u1ed5ng h\u1ee3p \u1edf da t\u1eeb ti\u1ec1n ch\u1ea5t Vit D d\u01b0\u1edbi t\u00e1c \u0111\u1ed9ng c\u1ee7a tia c\u1ef1c t\u00edm (UVB, b\u01b0\u1edbc s\u00f3ng 290-320nm) c\u1ee7a \u00e1nh s\u00e1ng m\u1eb7t tr\u1eddi, ph\u1ea3n \u1ee9ng v\u1edbi protein 7-DHC, s\u1ea3n xu\u1ea5t ra vitamin D3. Lo\u1ea1i vitamin n\u00e0y (D3) cung c\u1ea5p ph\u1ea7n l\u1edbn l\u01b0\u1ee3ng vitamin D cho c\u01a1 th\u1ec3. N\u00f3i c\u00e1ch kh\u00e1c, c\u01a1 th\u1ec3 ch\u00fang ta c\u1ea7n \u00e1nh m\u1eb7t tr\u1eddi v\u00e0 l\u00e0n da \u0111\u1ec3 t\u1ea1o ra ph\u1ea7n l\u1edbn nh\u01b0 c\u1ea7u vitamin D. Ch\u1ec9 \u0103n u\u1ed1ng th\u00f4i s\u1ebd kh\u00f4ng \u0111\u1ee7 cung c\u1ea5p vitamin D (ph\u1ea3i \u0103n th\u1eadt nhi\u1ec1u Vitamin D2 m\u1edbi \u0111\u1ee7 nhu c\u1ea7u).<\/p>\n<p>Nh\u01b0ng Vitamin D3 l\u00e0 m\u1ed9t vitamin ph\u1ee9c t\u1ea1p, t\u1ed5ng h\u1ee3p t\u1eeb nhi\u1ec1u th\u00e0nh ph\u1ea7n v\u00e0 c\u1ea7n nhi\u1ec1u n\u01a1i \u0111\u1ec3 s\u1ea3n xu\u1ea5t. S\u1ea3n xu\u1ea5t Vitamin D3 nh\u01b0 s\u1ea3n xu\u1ea5t m\u1ed9t chi\u1ebfc xe h\u01a1i BMW, c\u1ea7n c\u00f3 m\u1ed9t d\u00e2y chuy\u1ec1n l\u1eafp r\u00e1p ho\u00e0n ch\u1ec9nh. Ch\u1ec9 c\u1ea7n m\u1ed9t n\u01a1i trong d\u00e2y chuy\u1ec1n n\u00e0y thi\u1ebfu hay b\u1ecb h\u01b0 th\u00ec c\u01a1 th\u1ec3 ch\u00fang ta kh\u00f4ng s\u1ea3n xu\u1ea5t \u0111\u01b0\u1ee3c Vitamin D3.<\/p>\n<p>B\u01b0\u1edbc \u0111\u1ea7u ti\u1ec1n \u0111\u1ec3 c\u01a1 th\u1ec3 t\u1ed5ng h\u1ee3p Vitamin D l\u00e0 ph\u01a1i n\u1eafng, nh\u01b0ng ph\u1ea3i ph\u01a1i n\u1eafng cho \u0111\u00fang. C\u01a1 th\u1ec3 ch\u00fang ta c\u1ea7n n\u1eafng c\u00f3 tia UVB (ch\u1ee9 kh\u00f4ng ph\u1ea3i tia UVA hay UVC) \u0111\u1ec3 t\u1ed5ng h\u1ee3p vitamin D. Sai l\u1ea7m \u0111\u1ea7u ti\u00ean khi ph\u01a1i n\u1eafng l\u00e0 cho b\u1ec7nh nh\u00e2n ph\u01a1i n\u1eafng bu\u1ed5i s\u00e1ng. Ph\u01a1i n\u1eafng ki\u1ec3u n\u00e0y kh\u00f4ng gi\u00fap g\u00ec cho t\u1ed5ng h\u1ee3p vitamin D v\u00ec n\u1eafng s\u00e1ng s\u1edbm ch\u1ec9 c\u00f3 tia UVA (b\u01b0\u1edbc s\u00f3ng 320-400nm), kh\u00f4ng gi\u00fap g\u00ec cho t\u1ed5ng h\u1ee3p vitamin D3.<\/p>\n<p>Ph\u01a1i n\u1eafng cho \u0111\u00fang th\u00ec ph\u1ea3i ph\u01a1i t\u1eeb 10g tr\u01b0a \u0111\u1ebfn 2g chi\u1ec1u, t\u1ed1t nh\u1ea5t l\u00e0 12g tr\u01b0a, n\u01a1i c\u00f3 tia UVB cao nh\u1ea5t. \u1ede th\u1eddi \u0111i\u1ec3m n\u00e0y, ch\u00fang ta ch\u1ec9 c\u1ea7n 10-15 ph\u00fat ph\u01a1i n\u1eafng l\u00e0 \u0111\u1ee7 ph\u1ee5 t\u00f9ng \u0111\u1ec3 d\u00e2y chuy\u1ec1n s\u1ea3n xu\u1ea5t Vitamin D3 ho\u1ea1t \u0111\u1ed9ng.<\/p>\n<p>V\u1ea5n \u0111\u1ec1 l\u00e0 tia n\u1eafng l\u00fac tr\u01b0a (c\u00f3 c\u1ea3 UVA v\u00e0 UVB) l\u00e0 t\u00e1c nh\u00e2n ch\u00ednh g\u00e2y ra ung th\u01b0 da, d\u1eabn \u0111\u1ebfn h\u00e0ng ng\u00e0n ca t\u1eed vong m\u1ed7i n\u0103m t\u1ea1i M\u1ef9. UVA c\u0169ng l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y \u0111\u1ed3i m\u1ed3i, l\u00e0m l\u00e3o ho\u00e1 da, m\u1ea5t n\u01b0\u1edbc, v\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c \u0111\u1ebfn da. Tia UVA\/UVB g\u00e2y ung th\u01b0 da b\u1eb1ng c\u00e1ch l\u00e0m bi\u1ebfn \u0111\u1ed5i DNA, l\u00e0m ch\u00fang d\u1ecb bi\u1ebfn, d\u1ea7n d\u1ea7n d\u1eabn \u0111\u1ebfn ung th\u01b0.<\/p>\n<p>\u0110\u1ec3 ng\u0103n ng\u1eeba ung th\u01b0 da, c\u00e1c nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ec9 ra kem ch\u1ed1ng n\u1eafng c\u00f3 t\u00e1c d\u1ee5ng hi\u1ec7u qu\u1ea3 nh\u1ea5t ng\u0103n ng\u1eeba ung th\u01b0 da. C\u00e1c nghi\u00ean c\u1ee9u \u0111\u1ed1i ch\u1ee9ng cho th\u1ea5y d\u00f9ng kem c\u00f3 ch\u1ec9 s\u1ed1 SPF 15 hay cao h\u01a1n gi\u1ea3m kh\u1ea3 n\u0103ng ph\u00e1t tri\u1ec3n ung thu da d\u1ea1ng v\u1ea3y (SCC) \u0111\u1ebfn 40% hay gi\u1ea3m 50% v\u1edbi ung th\u01b0 \u00e1c t\u00ednh h\u1eafc t\u1ed1 da (Melanoma), v\u00e0 gi\u1ea3m t\u1ed1c \u0111\u1ed9 l\u00e3o ho\u00e1 \u0111\u1ebfn 24% (3,4,5).D\u00f9ng kem ch\u1ed1ng n\u0103ng s\u1ebd ng\u0103n c\u1ea3n tia t\u1eed ngo\u1ea1i (UVA\/UVB) t\u1eeb 80-98% tu\u1ef3 \u0111\u1ed9 SPF.<\/p>\n<p>Nh\u01b0 v\u1eady, ch\u00fang ta c\u1ea7n t\u1eafm (ph\u01a1i ) n\u1eafng \u0111\u1ec3 t\u1ea1o ra Vitamin D3 nh\u01b0ng vi\u1ec7c ph\u01a1i n\u1eafng c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ung th\u01b0 da. V\u1eady th\u00ec t\u1eafm (ph\u01a1i n\u1eafng) sao cho t\u1ed1t m\u00e0 v\u1eabn gi\u1ea3m r\u1ee7i ro ung th\u01b0 da?<\/p>\n<p>C\u00f3 nh\u00e0 nghi\u00ean c\u1ee9u cho r\u1eb1ng n\u1ebfu d\u00f9ng kem ch\u1ed1ng n\u1eafng c\u00f3 SPF cao (50 tr\u1edf l\u00ean) c\u1ea3n kho\u00e1 \u0111\u1ebfn 98-99% tia t\u1eed ngo\u1ea1i UVB\/UVA th\u00ec b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 b\u1ecb thi\u1ebfu vitamin D3. Tuy nhi\u00ean, nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng, d\u00f9 d\u00f9ng SPF cao \u0111\u1ebfn 50 ho\u1eb7c 70, c\u00e1c b\u1ec7nh nh\u00e2n v\u1eabn kh\u00f4ng h\u1ec1 thi\u1ebfu vitamin D3 (6,7). C\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u gi\u1ea3i th\u00edch d\u00f9 ch\u1ec9 1-2% tia UBV xuy\u00ean qua da, s\u1ed1 l\u01b0\u1ee3ng n\u00e0y c\u0169ng \u0111\u1ee7 \u0111\u1ec3 t\u00e1c \u0111\u1ed9ng v\u00e0o qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t vitamin D3. Th\u00eam n\u1eefa, ch\u00fang ta ch\u1ec9 c\u1ea7n kho\u1ea3ng 10-20 ph\u00fat ph\u01a1i UVB l\u00e0 \u0111\u1ee7 \u0111\u1ec3 s\u1ea3n xu\u1ea5t n\u00ean ch\u00fang ta kh\u00f4ng c\u1ea7n ph\u1ea3i ph\u01a1i n\u1eafng qu\u00e1 l\u00e2u d\u1eabn \u0111\u1ebfn r\u1ee7i ro ung th\u01b0 da.<\/p>\n<p>T\u00f3m l\u1ea1i, d\u00f9ng kem ch\u1ed1ng n\u1eafng c\u00f3 SPF cao (50) v\u00e0 ra ph\u01a1i n\u1eafng bu\u1ed5i tr\u01b0a l\u00e0 kh\u00f4ng s\u1ee3 thi\u1ebfu Vitamin D. M\u1eb7c qu\u1ea7n \u00e1o ho\u1eb7c \u1edf trong v\u0103n ph\u00f2ng c\u00f3 ki\u1ebfng bu\u1ed5i tr\u01b0a n\u1eafng s\u1ebd c\u1ea3n ph\u1ea7n l\u1edbn tia UVB, do v\u1eady s\u1ebd kh\u00f4ng \u0111\u1ee7 \u0111\u1ec3 t\u1ed5ng h\u1ee3p vitamin D3. Nghi\u00ean c\u1ee9u cho th\u1ea5y ch\u00fang ta c\u1ea7n ph\u01a1i tay, ch\u00e2n, ng\u1ef1c, v\u00e0 b\u1ee5ng 2-3 l\u1ea7n m\u1ed9t tu\u1ea7n l\u00fac tr\u01b0a trong v\u00f2ng 10-20 ph\u00fat l\u00e0 \u0111\u1ee7 vitamin D3 cho c\u01a1 th\u1ec3(8).<\/p>\n<p>M\u1ed9t c\u00e1ch kh\u00e1c m\u00e0 nhi\u1ec1u ng\u01b0\u1eddi ch\u1ecdn l\u00e0 u\u1ed1ng vitamin D3 h\u1eb1ng tu\u1ea7n (mua lu\u00f4n chi\u1ebfc xe BMW, kh\u1ecfi s\u1ea3n xu\u1ea5t) cho kho\u1ebb, kh\u1ecfi c\u1ea7n ph\u01a1i n\u1eafng \u0111\u00fang c\u00e1ch, r\u1ed3i thoa kem ch\u1ed1ng n\u1eafng cho m\u1ec7t. Li\u1ec1u th\u01b0\u1eddng d\u00f9ng l\u00e0 5000 IU\/ tu\u1ea7n hay 1000-2000 IU\/ h\u1eb1ng ng\u00e0y. Tuy nhi\u00ean, u\u1ed1ng vitamin D3 l\u00e2u d\u00e0i c\u0169ng c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 t\u00e1o b\u00f3n, cao Calicum, hay h\u01b0 th\u1eadn.<\/p>\n<p>T\u1ed1t nh\u1ea5t l\u00e0 qu\u00fd v\u1ecb n\u00ean ki\u1ec3m tra vitamin D th\u01b0\u1eddng xuy\u00ean v\u1edbi BS. L\u01b0\u1ee3ng vitamin D l\u00e0 th\u1ea5p n\u1ebfu d\u01b0\u1edbi 30 ng\/ml, t\u1eeb 30-50 ng\/ml l\u00e0 okay, v\u00e0 125 ng\/ml tr\u1edf l\u00ean l\u00e0 cao (c\u00f3 nguy c\u01a1 ng\u1ed9 \u0111\u1ed9c). D\u1ef1a v\u00e0o \u0111\u1ed9 thi\u1ebfu vitamin D, m\u1ee9c \u0111\u1ed9 t\u1eafm (ph\u01a1i) n\u1eafng, ngh\u1ec1 nghi\u1ec7p, m\u00f4i tr\u01b0\u1eddng s\u1ed1ng, v\u00e0 l\u00e0n da c\u1ee7a b\u1ec7nh nh\u00e2n (da c\u00e0ng \u0111\u1eadm th\u00ec h\u1ea5p thu UVB c\u00e0ng th\u1ea5p), BS s\u1ebd ch\u1ec9nh s\u1eeda ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb thi\u1ebfu vitamin D th\u00edch h\u1ee3p.<\/p>\n<p>1. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr2004 (6 suppl); 80:1678S-1688S.<br \/>\n2. Holick MF. Vitamin D: a millenium perspective. J Cell Biochem 2003; 88(2):296-307. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/12520530. Accessed April 26, 2016.<br \/>\n3. Van der Pols JC, Williams GM, Pandeya N, Logan V, Green AC. Prolonged prevention of squamous cell carcinoma of the skin by regular sunscreen use. Cancer Epidemiol Biomarkers Prevent 2006; 15:2546-2548.<br \/>\n4. Green AC, Williams GM. Point: sunscreen use is a safe and effective approach to skin cancer prevention. Cancer Epidemiol Biomarkers Prevent 2007; 16(10):1921-1922.<br \/>\n5. Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol 2011; 29(3):257-263. doi: 10.1200\/JCO.2010.28.7078.<br \/>\n6. Hughes MCB, Williams GM, Baker P, Green AC. Sunscreen and prevention of skin aging: a randomized trial. Ann Intern Med 2013; 158(11):781-790. 10.7326\/0003-4819-158-11-201306040-00001.<br \/>\n7. Farrerons J, Barnadas M, Rodriguez J, et al. Clinically prescribed sunscreen (sun protection factor 15) does not decrease serum vitamin D concentration sufficiently either to induce changes in parathyroid function or in metabolic markers. Br J Dermatol 1998; 139(3):422-427.<br \/>\n8. Vitamin D &amp; the sun: what does the sun do for me? A transcription of part 1 of Dr. Michael Holick&#8217;s January 22nd, 2013 webinar. Grassroots Health, a Public Health Promotion Organization. <a href=\"http:\/\/www.grassrootshealth.net\/holicksuntranscription\" rel=\"noopener\">www.grassrootshealth.net\/holicksuntranscription<\/a>.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>G\u1ea7n \u0111\u00e2y, nhi\u1ec1u b\u00e0i b\u00e1o tr\u00ean m\u1ea1ng ch\u1ec9 sai c\u00e1ch l\u00e0m t\u0103ng Vitamin D, h\u01b0\u1edbng d\u1eabn sai c\u00e1ch t\u1eafm n\u1eafng \u0111\u00f4i khi c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ung th\u01b0 da. T\u00f4i vi\u1ebft b\u00e0i n\u00e0y \u0111\u1ec3 gi\u1ea3i th\u00edch vai tr\u00f2 quan tr\u1ecdng c\u1ee7a Vitamin D, c\u00e1ch kh\u00f4ng b\u1ecb thi\u1ebfu vitamin D, c\u00e1ch b\u1ea3o v\u1ec7 da kh\u1ecfi ung [&#8230;]\n","protected":false},"author":1,"featured_media":5819,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5818","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5818","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=5818"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5818\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/5819"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=5818"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=5818"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=5818"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}