<International Circulation>: So vitamin D is not going to be protective if you are not deficient?

　　《国际循环》：那么也就是说如果你不是维生素D缺乏就不会从它的治疗中获益吗？

　　Dr Michos: I believe the benefit is in treating those who are deficient. If you are deficient and we treat you I hope that that has health benefits， but if you have adequate vitamin D levels， it is my belief that giving you more doesn’t really help. In the observational data， all of the excess risk (heart attack， stroke and death) were in people with very low levels， levels < 15mg/dl， and there was no excess risk for patients who were either mildly deficient or within a normal range. If you have normal levels of vitamin D， it probably won’t benefit you to get more vitamin D. If you are deficient， it can potentially have a lot of importance. You can get vitamin D toxicity from taking too high a dose supplements if your levels are not been monitored. For a patient taking over-the-counter supplements， it would be very difficult to suffer toxicity with between 1000IU and 2000IU a day. The maximum recommended daily allowance is 4000IU/day and it is even difficult to get toxic at that level. Patients taking much more than that should only be doing it under the direction of their doctor who is monitoring blood levels. There is some concern regarding harm if your blood levels are starting to get above 60 mg/dl. 30~50 mg/dl is considered the adequate range.

　　Dr Michos: 我认为那些缺乏维生素D的人才会从治疗中获益。如果你缺乏维生素D并且进行维生素D治疗，我认为这就有健康益处，但是如果你已经有足够的维生素D水平，我相信再给你进行维生素D的治疗实际上并没有益处。观察性研究资料显示，所有风险的增加（心脏病发作，卒中和死亡）都发生于维生素D水平非常低的患者，他们的维生素D水平< 15mg/dl，而在轻微缺乏维生素D或正常水平的患者都没有发现这些风险。如果你的维生素D水平正常，再获得更多的维生素D也不会使你获益。如果你缺乏维生素D，补充维生素D就会有很多潜在的获益。在没有监测的情况下过多的补充会发生维生素D中毒。对于在药店自行购买维生素D进行补充治疗的患者，每日服用1000 IU和2000 IU基本不会发生中毒。推荐可服用的最大剂量是每日4000 IU，并且在这个剂量下也不容易发生中毒。患者如果服用大于以上剂量的维生素D就必须在医生的指导下进行，并监测维生素D血浆水平。一般认为维生素D的血浆水平过高是有害的。血浆水平超过60 mg/dl就是有害于健康的信号。一般认为达到30~50 mg/dl的水平就足够了。
 

上一页  [1]  [2]  [3]  [4]  [5]  下一页