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40:20

Vitamins D and K2

Dr. John Campbell·40:20·Health·C1

Chương · 5

Chương 1·Vitamin D Guidelines and Deficiency

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what a warm welcome to this talk now so many people have asked me to do a video where I include vitamin d and vitamin K and especially vitamin K2 so that's what this is about now if you haven't got time to watch it I'll try and give you a bit of a bottom line although it's very difficult on this kind of video because it's a bit complicated really but um if you've been watching this

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channel you'll be in no doubt about the potential benefits of vitamin D and the fact that in the cold overcast Northern latitudes we're often deficient of it because of the vast majority of it comes from the sunshine so vitamin D that's what we're talking about we'll just look at a couple of guidelines on that as well because there's some interesting things on that

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but then the other question is should we be taking vitamin K2 with it the answer to this seems to be that vitamin K2 is associated with quite a few beneficial effects so it should certainly be part of a healthy diet but taking moderate amounts of vitamin D as I do I'm currently taking 4 000 units a day actually the evidence is not suggesting that it is necessary for me

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to take vitamin K2 with my three or four thousand international units of vitamin D that I take a day over the winter but it may be beneficial for other things there's a more of a sort of a gray area with higher levels of vitamin D but of course you wouldn't be taking high levels of vitamin D you'd only be self-medicating on Lower doses you'd only be taking high levels if you're a

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supervisor by your own doctor in which case he would be advising you and supervising you and of course it goes without saying that you never take medical advice from me you always go to your own doctor now having got that out the way let's move swiftly on so here we see um uh um covid-19 rapid guidelines of vitamin D from the National Institute of Health and Care excellence

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now this obviously is excellent because it's got excellence in the title so uh called nice of course and basically it's still saying so I read this with some excitement I thought oh they've got their act together put us on the 17th of December 2020 but basically it's saying uh same old same old it's talking about the 400 units a day and slightly different amounts for

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different age groups and things so do peruse that with disappointment as I did um so um they're just on vitamin D National Institute for Health and Care Excellence like that one basically it's saying consider 400 international units 10 micrograms per day very low dose so consider taking that and it gives a few provisos but that's basically it's still saying take the same amount

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but then I looked at uh there's various NHS sites this one happens to be from mid Essex check it out for yourself it's in the on the web it's publicly available and let's look at that now this one slightly more interesting it's actually written for uh prescribers and doctors and people like that primarily but it's talking about vitamin D deficiency and prescription guidelines

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um now um it talks there about lifestyle you can read this for yourself but here we have these flow charts now these flow charts are really popular in in modern Healthcare and I must say they are remarkably useful because you can kind of follow them through without knowing too much about the subject and get to a good result so um patients with high risk factors that may increase risk of vitamin D

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deficiency or a patient at a higher risk of having low vitamin D status at risk group right so if they're in that group basically they're saying here does the patient have symptoms indicative of rickets osteomalacia sort of bone thin in thinning or symptomatic low blood calcium levels or symptoms of rickets including uh tetany leg bowing knock knees anterior bowing of the thigh bone of the femur

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painful wrist swelling softening of the score spinal curvature bones I mean I could go on but basically it's um it's focusing on rickets which we've known about for about 100 years now no mention of reduced immunity or autoimmunity or heart disease or cancer of the colon or cancer of the prostate or depression or unexplained aches or pains or multiple sclerosis or the other

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correlates that may well be associated with vitamin d none of that um so just focusing on those things there and then it does go on to make recommendations and it says here if the vitamin D uh this is the uh this is the serum vitamin D the vitamin D and the blood of it's less than 39 moles per liter it gives a treatment option here of oral capsules 40 000 units colic

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calciferol weekly for seven weeks and there's various other flow charts with what to do and the other ones work out giving if the levels are higher it basically it works after giving the 400 units one that we know about so um routine screening of vitamin D levels and prescribing a vitamin D is not advised advisable according to this so it's not too it's not too worried about it as a routine

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let me give you my view on this um I think everyone in the country should have their vitamin D levels measured as a measure of some urgency actually I think and they're their vitamin D levels should be titrated uh according to those according to those levels that's what that's what I would that's what I would think but that's not what this protocol is saying both clinical symptoms and risk factors

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must be present before measuring vitamin D levels in other words this appears to be actually discouraging GPS from checking vitamin D levels so um if I was the teacher marking this I think I'd probably give that across and I'd probably give that across having said that people reading these guidelines have to do it they don't have any choice because these are the

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Official Guidelines and if a doctor was in contravention of the guidelines that then potentially that's not a good situation for him or her um so they're the guidelines as yet there is no clear evidence to prove the risk from non-symptomatic vitamin D deficiency okay proves a big word but I'm not sure I would agree with that I think there's evidence that suggests to the contrary

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in academic essays we always tell students to be tentative it could be suggested that from this it could be reasonably inferred a possible implication of this is because until we have definitive answers we don't have definitive answers and I'm afraid we don't have answers that definitive I believe with vitamin D which suffers this accumulation of evidence anyway

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um adults uh adults if their vitamin D is less than 30 nanomoles per liter which is 12 nanograms per ml or what capsules are 40 000 units that's uh for 40 000 units that's the thousand micrograms or one milligram of colic alcohol and that's the way they spell it that's vitamin D3 they're spelled in a strange way I wouldn't have I would have spelled it with an H but there you go

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um weekly for seven weeks it is what that is what they're saying very similar to um colleagues in India um whose doctors have been prescribing them uh 60 000 units a week for six weeks to top them up uh difference being in India they've been doing that without measuring the blood levels but I agree measuring the blood levels is good so that makes sense if it's very low but to me these

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are really remarkably low levels less than 13 animals per liter or 12 nanograms per Mill very low levels I would be very uncomfortable with patients or meet me at that level um so it's talking about giving these doses um in contrast the nice guidelines are saying 2 800 units per week so the treatment dose there is 40 000 units the nice guidelines for maintenance is 2800

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which many will think is very low now vitamin D levels of 30 to 50 that's 12 to 29 against well basically it's saying buy your own which is quite a reasonable 400 units per day to say buy your own I mean we did this on a needle all the time if a patient needed ibuprofen and paracetamol such as governments to take paracetamol and ibuprofen you might tell them the best

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way to take it but um you wouldn't need to give it to them because it's readily available OTC over the counter so that's reasonable albeit the recommended dose could be considered low vitamin D levels of um greater than 50 or that's so that's greater than 29 grams per mil by your own and again just consider the 400 units per day depending is is this rather crude summary of what that is

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what of what this uh flow diagram is um is saying but it's there click on it um put a copy on your bedroom wall it's there do whatever you want with it so that's that's vitamin D now I think basically what we're saying is here that there's no change in government uh protocol and policy against uh for vitamin D and it's only advising uh people doctors to treat

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vitamin D with fairly high doses it must be said but only of their vitamin D levels are really quite low and uh actually getting the test uh requires getting through that flowchart so it's a bit difficult so that's vitamin D disappointing to say the least from the UK government no real change there and yet we know there's correlations and and some trial data okay the trial the

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trials are being argued about now but um there's many correlations and observational studies that meet what we've called The Bradford Hill criteria that we've looked at before that indicate a lot of us are short of vitamin D and that is important but that's the government hasn't moved on that um National Institute for Health and Care excellence has not moved on that

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so we could argue now about whether it's excellent or not but you get the idea right now moving on to vitamin K um now two Source vitamin K really K1 and K2 now K1 um we've known about for a long time uh Philo quino Philo quinone is the chemical name for that phyloquinone uh discovered in 1929 and of course since then we've known it's important for blood coagulation in fact the reason

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it's called care it's for the German it's a German Discovery so uh coagula in German it's something like coagula vitamin or something in German but it's spelled with the K so therefore we have the vitamin K are quite reasonable okay for coagulation in German um so quite a sensible name found in plants like leafy greens so vitamin K deficiency can be a problem

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in newborn babies in adults not usually um so that's vitamin K one fairly well known about lack of it causes uh problems with blood clotting uh not common at all in uh in children and adults past the past the baby stage um but let's go into Vitamin K2 now which really is quite a bit different now vitamin K2 uh the information I'm going to get from the National Institutes of Health so there's

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mysteries from there and this is an excellent article I thought on Healthline so um click on that read it for yourself see if your interpretation is the same as mine now the vitamin k2s are the are the menoquinone so it's a different uh chemical and there are subdivisions within that's why I've called it s menoquinones there's not just one of them now these are mostly from bacterial origin

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animal-based and fermented food so a fermented food is a food on which there's been bacterial action I'd say I'm actually I'm a bit peckish just a minute I'm going to um I'm just going to stop and have a quick snack I'll be back with you in a minute um I've just got this recently sauerkraut to tell you the truth I'm talking about you I'm quite got used to it yet it's better with things

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and of course sauerkraut is a is a fermented food this is cabbage and there's been some bacterial action on that cabbage which is generated sauerkraut it's actually quite nice in the right I ate this in Germany and loved it actually but of course in in um I don't know what it's like in the US but in the UK we don't eat many fermented foods so um the vitamin K2 mostly bacterial origin

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so it's the action of the bacteria on the cabbage produce the vitamin K2 animal-based and fermented foods so um we'll look at some other foods that it's in a minute um adult vitamin K now the adequate intakes that's this concept of adequate intakes this I'm pretty sure this is from the National Institutes of Health site I got that um now this is for vitamin k that's sort of the adult female that's

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the adult male range but this is Vitamin K it's not subdivided into vitamin uh K1 and uh K2 so basically we don't have published guidelines on the appropriate dose now a lot of people are saying um you know the the this supplement here for example is 600 is 600 micrograms which seems quite a high which seems quite a high dose you know I mean a lot of supplements are recommending about

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100 micrograms a day so that seems quite high so that might be more weekly dose not that I'm prescribing um ask your doctor if you want to know how much to take but so 100 micrograms a day seems to be roughly the range that people are talking about but um you can't really find well I haven't yet found any specific evidence for that that's why it's a bit reluctant to do

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this because there's a there's a bit of a lack of firm evidence so how much vitamin K2 should we be taking a day that's the amount of vitamin that's did I say d then the amount of vitamin K2 should we be taking a day um well that's the amount of vitamin K we should be taking how much K2 um I don't really know I don't really find published figures on that although around about 100 micrograms a

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day seems to be what people are talking about but what that is based on I don't know you see there's things people say and you've always got to go back to the evidence this is why it's frustrating this is what I'm trying to do here trying to relate to the evidence because I don't know I don't know why I don't want to know what he said she said they said you know we want to know what the

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evidence is based on empiricism so anyway it's in fermented food sauerkraut natto I think is a fermented Sawyer Bean thing um high fat uh high fat Dairy high fat cheese milk from grass-fed cows apparently used to be grass-fed cows presumably the reason for that is the grass will be acted on in the um I don't know what you call them the ruminance is it the stomachs of the cow and um the

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vitamin K2 will be produced there um egg yolks especially animal origin um animal organs rather so Hearts livers um the what we call the awful of the animal gut bacteria in you and me which of course might be decreased with antibiotics because the antibiotics will kill off our gut bacteria now the reason that this does kind of make sense um is that in so we see that the

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vitamin K2 mostly comes from fermented products like sauerkraut fermented soybeans and animal organs like liver and um hearts and kidneys of animals but of course in Western countries very often we tend to eat the animal skeletal muscle and feed the rest to dogs and things um so why are we one particular part of the animal not the other's a bit strange but if you can imagine in the evolution

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situation when we were hunter-gatherers then um we would kill an animal and we would eat every bit of it because you might not get them the young men might not might not make another kill for another month you would eat the whole animal if we're in on the Savannah 30 40 000 years ago or whatever it was um and also when we were restoring Foods it's not surprising that they could

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become fermented as we stored them with bacterial action so if you imagine the hunter-gatherers hunter-gatherer situation probably eating stored fermented foods and certainly eating animal organs much the more than we do now so we might end up with much less of it um in the modern Western diet having said that in Korea they eat a lot of kimchi I work with Koreans in you

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know when I was teaching in Cambodia and there that they have kimchi with every meal it's like a crunchy vegetable stuff even breakfast I remember asking what it was and they said you don't eat kimchi with every meal you know they eat kimchi with over the meal which presumably provides them with lots of vitamin K2 so it does kind of make sense and it's this you know at the same

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time when we're out there on the Savannah um we wouldn't be as wearing as many clothes and we would be producing lots of vitamin D so it does make sense that the vitamin D from the Sun and the vitamin K2 from animal organs and from fermented food aren't that present in the western diet so it would make sense that we could be short of them right let's go on to look at some of the evidence now um

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and I've put in the links you peruse the evidence see what you think vitamin K might play a role in preventing osteoporosis and coronary heart disease so osteoporosis is very common especially in women basically it's it's um thinning of the bone loss of bone mass which leads to pathological fractures so very common in older people they come in with uh with a broken neck of femur

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we call it a North Neck of femur fracture very common as the neck of femur demineralizes and that's often where the bone breaks first or wrist fractures um forearm fractures especially in other people very common related to osteoporosis because there's a lot of pain and suffering a lot of pain and suffering um so lack of vitamin K2 especially this is K2 we're talking about

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um can be associated with osteoporosis and coronary heart disease I think you probably know this but um if you think about a heart I won't draw a whole month it's kind of a heart like this isn't it's got a it's got a these are the bottom pumping Chambers like that they would be the valves they would be the valves there going off to the arteries then there's valves going down the way

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like that and then there's the top Chambers where the veins are the veins going in like this um top chambers of the heart the Atria and again the valves pointing uh pointing down the way there like that so that's the left side so that will be the aorta and that's the pulmonary arteries going off to the lungs and that's the pulmonary veins and that's the vena cave anyway never mind

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that but all this is the heart muscle The myocardium so in order for these Chambers to pump in order for the heart chambers to pump the blood out they must have contractile myocardium and The myocardium depends on it because it's it's always active that very active muscle of course it's Contracting 67 G80 times a minute so its blood supply depends on these coronary arteries

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and these break down into smaller branches the core coronary arteries because they look a bit like a crown surrounding the heart but the trouble is these get furred up and so the blood doesn't get through to an area of tissue so suppose that's an area of tissue supplied by the arterial Branch if that's getting furred up then there's less blood getting through to that and that's called ischemia

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and then if there's a blood clot there plus all that bit dies there that's called an infarction and because it's The myocardium it's a myocardial infarction so this coronary heart disease really very common still the most common cause of death in the UK I think um so very common um so it's associated with these two diseases the lack of vitamin K2 but what's the level of evidence well it

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just kind of make sense because there's vitamin K dependent proteins now what vitamins do is vitamins are um coenzymes that they work with vitamins work with enzymes so the enzyme won't work on it so it needs the vitamin to make the enzyme work so if there's if there's like calcium in the blood then um vitamin K2 is needed for enzymes that put calcium from the blood into the

có vẻ hợp lý vì có các protein phụ thuộc vitamin K. Vitamin là các coenzym, chúng hoạt động cùng với enzyme, nên enzyme sẽ không hoạt động nếu thiếu vitamin. Vì vậy, nếu có canxi trong máu, thì vitamin K2 cần thiết cho enzyme đưa canxi từ máu vào

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bones which is where you want it to prevent the osteoporosis and there's also other um proteins which require vitamin K2 that uh prevent the prevent the calcium going into the tissues because you don't want tissue and arterial calcification and what we find is when this these arteries start clogging up at the same time there's deposition of calcium in the walls of the arteries the two processes go

xương, nơi bạn muốn nó để ngăn loãng xương. Ngoài ra còn có các protein khác cần vitamin K2 để ngăn canxi đi vào các mô, vì bạn không muốn vôi hóa mô và động mạch. Điều chúng tôi thấy là khi các động mạch này bắt đầu tắc nghẽn, đồng thời có sự lắng đọng canxi trong thành động mạch, hai quá trình này diễn ra

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hand in hand they go side by side so as the arteries clog up they also calcify or as they calcify they also clog up the concomitant processes they go on together they've associated of course which is cause and effect is interesting so with this with this K2 idea it could be that the furring up that the atheroma is more caused by the calcification in which case you want the K2 to take

song song với nhau. Khi động mạch tắc nghẽn, chúng cũng vôi hóa, hoặc khi vôi hóa, chúng cũng tắc nghẽn. Các quá trình đồng thời này đi cùng nhau, tất nhiên có liên quan, vấn đề nhân quả rất thú vị. Với ý tưởng về K2 này, có thể sự tắc nghẽn do mảng xơ vữa là do vôi hóa gây ra, trong trường hợp đó bạn cần K2 để đưa

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the calcium from the tissues back into the blood where the K2 can put it from the blood into the bones to give you strong bones where it's supposed to be now having said that of course I've known for 30 or more years that the atherosclerosis the furring up of the arteries is associated with calcification but I always assumed it was the calcification that came after the uh the uh the atheros the

canxi từ các mô trở lại máu, nơi K2 có thể đưa nó từ máu vào xương để tạo xương chắc khỏe, đúng nơi nó cần. Tuy nhiên, tôi đã biết hơn 30 năm rằng xơ vữa động mạch, sự tắc nghẽn động mạch, có liên quan đến vôi hóa, nhưng tôi luôn cho rằng vôi hóa xảy ra sau khi hình thành mảng xơ vữa. Điều này gợi ý rằng có thể ngược lại.

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atheroma formation so this is kind of hinting that it might be the other way around I'm going to need quite a lot of evidence just to prove that but that's you know it's interesting it's interesting it's interesting idea um which is the chicken and which is the egg sort of thing which is the cause and which is the effect anyway vitamin K2 supplement May improve bone health and heart health while

Tôi sẽ cần khá nhiều bằng chứng để chứng minh điều đó, nhưng đó là một ý tưởng thú vị, giống như chuyện con gà và quả trứng, cái nào là nguyên nhân, cái nào là kết quả. Dù sao, bổ sung vitamin K2 có thể cải thiện sức khỏe xương và tim mạch, trong khi

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vitamin K1 has no significant effect or no significant benefit so that is suggested by this evidence here um so check that one out so in other words this is clearly differentiating between the effects of vitamin K1 and the effects of vitamin K2 vitamin K1 for the blood clotting vitamin K2 to promote calcification of Bones and reduce Health calcification of tissues is the is the hypothesis there

vitamin K1 không có tác dụng đáng kể hoặc lợi ích đáng kể. Điều này được gợi ý bởi bằng chứng ở đây. Vì vậy, hãy kiểm tra điều đó. Nói cách khác, điều này phân biệt rõ ràng giữa tác dụng của vitamin K1 và vitamin K2. Vitamin K1 cho đông máu, vitamin K2 thúc đẩy vôi hóa xương và giảm vôi hóa mô là giả thuyết ở đây.

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um now this study here gives evidence that it promotes bone calcification um three-year low-dose uh menoquinone seven that's the type of vitamin K2 involved supplement helps decrease bone loss in healthy post-menopausal women sounds good to me of course you need to evaluate the validity of this because some people would disagree but these are the studies that are providing the evidence

Nghiên cứu này cung cấp bằng chứng rằng nó thúc đẩy vôi hóa xương. Bổ sung liều thấp menaquinone-7 (loại vitamin K2) trong ba năm giúp giảm mất xương ở phụ nữ sau mãn kinh khỏe mạnh. Nghe có vẻ tốt với tôi. Tất nhiên bạn cần đánh giá tính hợp lệ của điều này vì một số người có thể không đồng ý, nhưng đây là những nghiên cứu cung cấp bằng chứng

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for this sort of hypothesis that is being um that is being developed around the world um the ultimate answer yes of course we don't know may prevent tissue calcification so preventing the calcification of the arteries especially you get this quite a lot in um in the peripheral arteries as well I remember the first time I haven't got a copy but I looked at an x-ray and you

cho loại giả thuyết đang được phát triển trên toàn thế giới. Câu trả lời cuối cùng, tất nhiên chúng ta không biết, có thể ngăn ngừa vôi hóa mô, đặc biệt là ngăn vôi hóa động mạch. Bạn thấy điều này khá phổ biến ở các động mạch ngoại biên. Tôi nhớ lần đầu tiên, tôi không có bản sao, nhưng tôi đã xem một bức X-quang và bạn

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could see the bones and then there was like these other two bones going up and down through the top of the legs the hip joints and of course there weren't bones at all there were calcified femoral arteries so it can it can be quite pronounced calcification of arteries which of course we don't want so this um that this article is saying May prevent tissue calcification tissue specific

có thể thấy xương, và sau đó có hai 'xương' khác chạy lên xuống qua đỉnh chân, khớp hông, và tất nhiên đó không phải xương mà là động mạch đùi bị vôi hóa. Vì vậy, vôi hóa động mạch có thể khá rõ rệt, điều mà chúng ta không mong muốn. Bài báo này nói rằng có thể ngăn ngừa vôi hóa mô. Sử dụng menaquinone-4 (một loại vitamin K2 khác) đặc hiệu mô

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utilization of methaquin 4 that's another type of vitamin K2 results in the prevention of arterial calcification in Warfare untreated rat so that's an animal study but there you go that's this is the way the evidence develops another study K2 you know it reduces blood vessel calcification whereas again vitamin K1 did not so again differentiating between the K1 and the K2

dẫn đến ngăn ngừa vôi hóa động mạch ở chuột không được điều trị. Đó là một nghiên cứu trên động vật, nhưng đó là cách bằng chứng phát triển. Một nghiên cứu khác: K2 làm giảm vôi hóa mạch máu, trong khi vitamin K1 thì không. Một lần nữa phân biệt giữa K1 và K2.

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dietary intakes of vitamin K2 is associated with the juice we reduce risk of coronary heart disease from the Rotterdam study so quite a few that is accumulating that do seem to be strengthening this link between adequate amounts of vitamin K2 increased bone mineralization giving stronger bones which is what we want but at the same time preventing calcification of the soft tissues which

Lượng vitamin K2 trong chế độ ăn có liên quan đến giảm nguy cơ bệnh tim mạch vành từ nghiên cứu Rotterdam. Khá nhiều bằng chứng đang tích lũy và dường như củng cố mối liên hệ này giữa lượng vitamin K2 đầy đủ, tăng khoáng hóa xương, cho xương chắc khỏe hơn, đồng thời ngăn ngừa vôi hóa các mô mềm, điều mà

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we don't want we don't want calcified soft tissues I mean an artery you know if you feel your pulse in your wrist you know just feel your pulsing and the wrong way around can I do it on that one so feel the knobbly bone there feel your pulse just in there um just on that you'll feel the elasticity it's going like this as the pulse goes through it well there's one in your neck the pulse

chúng ta không muốn. Tôi không muốn các mô mềm bị vôi hóa. Ví dụ, động mạch, nếu bạn sờ mạch ở cổ tay, bạn sẽ cảm thấy độ đàn hồi khi mạch đập. Có một động mạch ở cổ, mạch đập khắp nơi, động mạch cảnh ở cổ. Vấn đề là khi sóng áp lực mạch đập đi qua, thành động mạch co lại và duy trì áp lực trong thời kỳ tâm trương, khi tim không co bóp.

27:23

is all over the place carotid artery in the neck and the whole point is that once it's moved out with a pulse pressure wave it the arterial War contracts again and that maintains the pressure during what we call Di sisterly the time when the heart is not Contracting so sisterly when the heart is Contracting and then the arterial elastic wall pushes down on that and

Trong thời kỳ tâm thu, tim co bóp, và sau đó thành động mạch đàn hồi đẩy xuống, duy trì tưới máu mô trong thời kỳ tâm trương. Nhưng nếu động mạch bị vôi hóa và cứng lại, nó không thể làm điều đó, gây rối loạn. Đó chính xác là điều chúng ta không muốn, cũng như liên quan đến xơ vữa động mạch, tắc nghẽn động mạch, liên quan đến huyết khối, đông máu bệnh lý,

27:45

that maintains blood perfusion of the tissue during diastyly but of course if the if the artery is calcified and hardened it can't do that so it messes things up so it's exactly what we don't want um as well as being associated with it with atherosclerosis the clogging up of the arteries which of course is associated with thrombosis the plot of the pathological clotting of the blood

làm tắc nghẽn nguồn cung cấp máu cho mô và gây nhồi máu, như nhồi máu cơ tim hoặc nếu xảy ra ở động mạch lên não, đó là nhồi máu não, tức đột quỵ. Đây là cơ sở của nhiều bệnh lý. Vitamin K2 có thể giúp ích cho sức khỏe răng miệng, điều này hợp lý vì xương và răng chắc khỏe thường đi cùng nhau, đặc biệt với vitamin D.

28:08

which blocks off the blood supply to the tissues and causes infarction such as a myocardial infarction or if it occurs in the arteries that go to the brain are cerebral infarction that would be a stroke this is the basis of a lot of pathology a vitamin K2 may help with dental health which makes sense strong bones and teeth do tend to go together don't they especially with vitamin D so

Vitamin D và K2 đặc biệt liên quan đến sức khỏe răng miệng tốt và xương chắc khỏe. Mối liên hệ giữa nồng độ vitamin K2 thấp và ung thư gan, ai biết được, có thể điều này chỉ ra sự thật. Ung thư gan ở đây được gọi là ung thư biểu mô tế bào gan, dạng ung thư gan nguyên phát, khi ung thư thực sự bắt đầu trong gan. Bạn có thể biết

28:32

the vitamin D and the K2 have been particularly associated with good dental health under strong bones links between low levels of vitamin K2 and liver cancer well who knows maybe this indicates it's true the liver cancer here is called a hepatocellular carcinoma it's the primary form of liver cancer it's when the liver when the cancer actually starts in the liver so you probably know

với ung thư, có vị trí nguyên phát nơi ung thư bắt đầu, sau đó nó có thể di căn đến vị trí khác. Toàn bộ vấn đề với ung thư là nó di căn, lan rộng khắp cơ thể, cuối cùng có thể dẫn đến carcinomatosis, ung thư khắp nơi. Ung thư biểu mô tế bào gan là dạng ung thư bắt đầu trong gan. Rất thường chúng ta thấy

29:01

with Cancers you get a primary site which is where the cancer starts and then it can metastasize it can spread to another site there's a whole problem with cancer of course it metastasizes spreads around the body the Persian can end up with carcinomatosis with cancer everywhere so the hepatocellular carcinoma is the start that the form of cancer that starts in the liver very often we do see

ung thư di căn từ đại tràng đến gan, gan là vị trí thứ phát, nhưng ở đây nói về dạng ung thư gan nguyên phát. Cần thêm dữ liệu, tất nhiên, như với tất cả các nghiên cứu này, nhưng có liên quan thú vị đến việc ngăn ngừa ung thư tuyến tiền liệt tiến triển. Bài báo đó, hãy kiểm tra nếu bạn quan tâm đến ung thư tuyến tiền liệt. Tôi đã xem xét

29:24

cancer that spread from the colon for example to the liver the liver as a as a secondary site but this is talking about the primary form of liver cancer more data needed of course as with all of these studies but interesting links with preventing Advanced prostate cancer so that paper there check it out if you're interested in prostate cancer and I have been looking at uh

không ngạc nhiên ở giai đoạn cuộc đời tôi. Ung thư tuyến tiền liệt là ung thư phổ biến nhất ở nam giới, vì vậy gần đây tôi đã xem xét nó. Nó trở nên phổ biến hơn theo tuổi tác. Mối liên hệ giữa mức độ ung thư tuyến tiền liệt tăng và mức vitamin D thấp dường như đang tích lũy, bằng chứng cho thấy mức vitamin D tốt giúp ngăn ngừa ung thư tuyến tiền liệt trong phòng ngừa

29:49

not surprising really for my stage of life um prostate cancer is the most common cancer in men so I've been looking at it lately it gets more common with age of course and the um the links between increased levels of prostate cancer and low levels of vitamin D seem to be accumulating so the evidence that good levels of vitamin D are helping to prevent prostate cancer in the prevention of

ung thư tuyến tiền liệt đang được tích lũy. Nhưng ở đây mối liên hệ là với vitamin K2. Vì vậy, từ đó có thể chỉ ra rằng mức vitamin D và vitamin K2 tốt kết hợp có thể giúp giảm tỷ lệ ung thư tuyến tiền liệt. Bạn thấy đấy, dinh dưỡng học thật bực bội, những gì chúng ta biết còn hạn chế, thật khó để thực hiện các thử nghiệm lâm sàng thích hợp về điều này.

30:16

prostate cancer are accumulating are accumulating but here the link is with vitamin K2 uh so that is that link there so from this it would indicate that maybe good levels of vitamin D and levels of vitamin K2 combined um might help reduce the incidence of prostate cancer you see dietetics it's so frustrating what we know is so limited it's so hard to do proper clinical trials on this

Trong khoảng 30 năm, tôi đã dạy ý tưởng rằng ăn thực phẩm béo làm tăng cholesterol. Bây giờ chúng ta lo lắng nhiều hơn về đường. Và tôi luôn tuân theo các hướng dẫn, nhưng hóa ra các hướng dẫn không chính xác như mong muốn. Vì vậy, dinh dưỡng học rất bực bội, không chắc chắn về nhiều mặt. Nhưng dù sao, chúng ta đang làm video bây giờ, vậy

30:51

you know for about 30 years I taught this idea that eating fatty food increases your cholesterol um now we're much more worried about sugar you know um and yeah I always followed the guidelines but the guidelines it turns out weren't as accurate as would have liked them to be so dietetics is very frustratingly um uncertain in many respects but anyway we're doing the video now so

hãy tiếp tục. Chúng ta đã cam kết. Tác dụng hiệp đồng với vitamin D, đặc biệt là vitamin K2. Hiệp đồng, hai cộng hai bằng bảy, không phải tác dụng cộng gộp mà là tác dụng tăng cường. Chúng có thể tăng cường lẫn nhau. Vitamin D và vitamin K có tác dụng đa hướng (pleiotropic), thực ra có nghĩa là nhiều hơn một, và có nghĩa là hành động hoặc chuyển động. Về cơ bản, nó nói rằng hai thứ cùng nhau, 'pleio' thực ra là tiếng Hy Lạp có nghĩa là nhiều hơn, vì vậy không chỉ vitamin K một mình, không chỉ vitamin D một mình, mà cả hai cùng nhau tạo ra nhiều hơn một và có tác dụng bổ sung, hơi giống như nói tác dụng hiệp đồng.

31:17

let's get on with it we've committed ourselves uh synergistic effects with vitamin D so this is saying synergistic effects with a vitamin K2 especially and vitamin D so synergistic Synergy um two plus two equals seven sort of thing that it's not an additive effect it's a is an enhanced effect they can't enhance each other vitamin d and vitamin K as a pleiotrophic now that actually

Các chất dinh dưỡng đa hướng hoạt động tốt cùng nhau, đó là những gì nó nói. Tầm quan trọng lâm sàng đối với hệ thống xương và tim mạch, và bằng chứng sơ bộ về sự hiệp đồng. Bài báo này tuyên bố điều thú vị. Bây giờ chúng ta đang nói hơi dài hôm nay, nhưng tôi sẽ nhanh chóng xem qua một trong những điều mà mọi người rất lo lắng về bổ sung vitamin D và

31:46

means more than one so um and that means action really or movement so basically it's saying that the two together paleo actually is Greek for more I think so there's more so it's not just the vitamin K on its own it's not just the vitamin D on its own it's the two together making more than one and that has an additional effect it's a bit it's a bit like saying a synergistic effect

đó là tăng nồng độ canxi máu. Có vẻ như bạn phải có nồng độ vitamin D rất cao mới gặp vấn đề đó. Hãy xem bằng chứng về điều đó. Tỷ lệ tăng canxi máu liên quan đến tăng vitamin D trong thực hành lâm sàng. Bài báo này, hãy kiểm tra, đừng tin lời tôi, các bài báo đều ở đó. Xác định nồng độ vitamin D mà tại đó nguy cơ tăng canxi máu cao. Lý do tôi do dự là ở Anh, chúng tôi đánh vần 'aemia' với 'a', ở Mỹ họ bỏ qua 'a', điều đó hợp lý hơn nhiều, nhưng tôi đã quá già để thay đổi. Tăng canxi máu, canxi cao trong máu.

32:11

uh the paleontrophic nutrients they work well together is what it's saying clinical importance to the skeletal and cardiovascular systems and preliminary evidence for synergy so this paper claims interesting now we're going on a bit long today but I'm just I'm just going to quickly go through um well one of the things that people are very worried about the vitamin D supplement and uh

Số lượng trong nghiên cứu, 25.000. Tăng vitamin D được định nghĩa là nồng độ vitamin D lớn hơn 169 nmol/L, không cao lắm, đó là 64 ng/mL. Trong kết quả vitamin D của tôi từ NHS khi tôi làm xét nghiệm, nó nói rằng tổng nồng độ vitamin D trên 229 nmol/L được coi là cao. Vì vậy, nghiên cứu này đặt ngưỡng thấp hơn nhiều so với phòng thí nghiệm NHS cụ thể này. Nhưng đây là kết quả.

32:39

it is increased blood calcium levels and it looks like you have to have very high vitamin D levels for that to be a problem let's just have a look at the evidence for that um prevalence of hypocalcemia related to hypervitaminosis D in clinical practice this paper here check it out don't take my word for anything the papers are all there um determine the content so you want to

Kết quả: 382 mẫu được xác định là tăng vitamin D lần đầu, chỉ 382 trong số 25.000 mẫu. 39 trong số đó có nồng độ canxi cao trong máu, 10,2%. Nhưng đây là những người có nồng độ vitamin D cao bất thường. Một số có nồng độ vitamin D từ 161 đến 375, nhưng hầu hết cao hơn nhiều, hầu hết ở mức 375 nmol/L, tương đương 159 ng/mL, mà tôi nghĩ mọi người đều đồng ý là cao. Mặc dù họ nói rằng 161 là cao, họ định nghĩa là trên 160, là cao. Ở 15 đối tượng, tăng canxi máu có thể được quy cho vitamin D.

33:03

determine the concentrations of vitamin D at which the risk of hyper high calcium emir in the blood calcium High purse High uh the reason I'm hesitating is in the in the UK we spell itemia a e m i a in the States you don't bother with the a which of course is much more sensible but too old to change really so hyper high calcium Emir in the blood right number in the study good number in

Về cơ bản, đó là 15 trên tổng số đó. Và mặc dù nồng độ canxi, nói thật, tôi sẽ không thoải mái với bệnh nhân có nồng độ canxi này, nhưng theo lời họ, nó không đạt đến giá trị nguy kịch. Nồng độ canxi cao không đạt đến giá trị nguy kịch. Vì vậy, bài báo này dường như nói rằng mặc dù nồng độ vitamin D cao, nồng độ canxi không đạt đến giá trị nguy kịch. Cao bất thường, nhưng họ nói không nguy kịch.

33:35

the study 25 000. a hypervitaminosis d was defined at uh vitamin D levels of greater than 169 moles per liter not that high actually that's 64 nanograms per ml now on my vitamin D uh thing that I got from the NHS when I did my test it actually says there that um total vitamin D levels above 229 moles per liter are considered high so this was this study was setting a much lower threshold than this

Kết luận: Tăng canxi máu do vitamin D chiếm ít hơn 4% tổng số tăng vitamin D được phát hiện. Nhưng tất nhiên, đây là những người có nồng độ vitamin D cao bất thường. Vấn đề ở hầu hết các vĩ độ phía bắc là mọi người thiếu vitamin D, đây là những người có nồng độ đặc biệt cao. Tỷ lệ rất thấp trong số các xét nghiệm được thực hiện. Vì vậy, để kết luận từ bài báo đó: nồng độ vitamin D cao có thể liên quan đến nồng độ canxi cao không? Có, đó là những gì nó nói, nhưng đó là những người có nồng độ rất cao. Và hãy nhắc lại, mức NHS tôi có ở đây là 84,49 nmol/L, trong khi họ nói chỉ cao khi đạt 220 nmol/L.

34:04

particular NHS lab does but this is the result we have so results um 382 samples were identified as the first recorded hypervitomnosis D so that's just 382 as the first occurrence out of the 25 000. samples taken 39 of those presented with high levels of calcium in the blood 10.2 percent but these are people with abnormally high levels of vitamin D remember um some had vitamin D levels between 161

Và đó là với tôi dùng khoảng 3.000 đơn vị mỗi ngày. Nhưng tất nhiên tôi không thể nói bạn nên dùng bao nhiêu vì điều này không phải là... Ý tôi là tôi đang cố gắng bảo vệ mình, rõ ràng tôi không thể kê đơn cho bạn. Nhưng ngoài ra, hai người có thể dùng cùng một lượng vitamin D và có nồng độ máu rất khác nhau, đó là cách nó hoạt động. Vì vậy, cách chính xác duy nhất để làm điều này là đến bác sĩ, kiểm tra nồng độ vitamin D của bạn, vì hãy nhớ tôi đã tự kiểm tra và làm xét nghiệm khác, cả hai đều cho kết quả khác nhau. Và lý tưởng nhất là điều chỉnh nồng độ vitamin D của bạn, nhưng hiện tại không có khả năng NICE làm điều đó. Đó là lý do tại sao tôi vẫn dùng 4.000 đơn vị mỗi ngày trong mùa đông.

34:38

and 375 but most they were much higher most of them there were 375 nanomoles per mil which is 159 grams per ml which I think everyone would agree is high although they are saying we can't get away from the fact that paper is saying 161 is is uh High that they Define it as above 160 which is high in 15 subjects hyper hypercalcemia could be attributed to vitamin D so basically

Dù sao, hãy để lời cuối cho Healthline: Không có bằng chứng mạnh mẽ nào chứng minh rằng lượng vitamin D vừa phải có hại nếu không có đủ lượng vitamin K. Vì vậy, nếu bạn đang dùng lượng vitamin D vừa phải, không có bằng chứng bạn cần dùng vitamin K cùng với nó, theo Healthline. Tuy nhiên, nghiên cứu đang được tiến hành và bức tranh có thể trở nên rõ ràng hơn trong tương lai gần.

35:07

that's 15 out of that many all together and although the calcium level and to tell you the truth I would be uncomfortable with the patients of these calcium levels but this to use their words uh it didn't reach critical values the high calcium levels didn't reach critical values so this paper seems to be saying that even though the vitamin D levels were high the calcium levels

Hy vọng là vậy. Vì vậy, những gì họ nói là lượng vitamin D bổ sung vừa phải, không có bằng chứng rằng lượng vitamin D vừa phải có hại nếu không có đủ lượng vitamin K. Điều này về cơ bản nói rằng những người dùng lượng vitamin D vừa phải chỉ vì họ đang dùng vitamin D không cần dùng thêm vitamin K, họ không cần dùng thêm vitamin K.

35:29

didn't reach critical values abnormally High yes critically high they are saying not conclusion hypercalcemia due to vitamin D represented less than four percent of the total hypervitaminosis D detected but of course this is people with abnormally high levels of vitamin D the problem in most northern latitude is people that are low in vitamin D these are people with particularly high levels

Tuy nhiên, bằng chứng chúng ta đã xem xét chỉ ra rằng khá nhiều người trong chúng ta có thể thiếu vitamin K, và sự thiếu hụt vitamin K2 này, vì chúng ta không ăn đủ nội tạng và không ăn đủ thực phẩm lên men, có thể liên quan đến loãng xương và vôi hóa mô. Và đó là điều mạnh mẽ nhất tôi có thể nói, vì đó là tất cả bằng chứng chúng ta có. Đó là lý do tại sao tôi hơi ngần ngại làm điều đó, vì tôi biết bằng chứng chưa kết luận, nhưng đó là đánh giá của tôi về bằng chứng hiện tại và đó là kết luận của tôi.

35:55

uh very low percentage of the tests performed so um to conclude from that paper um can high levels of vitamin D be associated with high levels of calcium yes they can that's what it's saying but they're people with very high levels and just remind ourselves the NHS level I have here so my level here was uh 84.49 moles per liter um whereas they're saying it's only High

Vì vậy, cá nhân tôi sẽ tiếp tục dùng vitamin D cho đến khi tôi có thể tiếp xúc với ánh nắng mặt trời, và tôi đang cân nhắc dùng một ít vitamin K2. Hãy thảo luận với nhà cung cấp dịch vụ chăm sóc sức khỏe của bạn và xem họ nghĩ gì. Được rồi, đó là video đó. Tôi hy vọng nó tạo ra sự rõ ràng hơn là nhầm lẫn, nhưng nó thực sự khó hiểu vì chúng ta không có câu trả lời chắc chắn. Cơ thể con người quá phức tạp, tương tác với nhiều thứ, ai có thể hiểu được? Và tuy nhiên, có một số điều chúng ta có thể làm

36:27

when it gets to uh 220 nanomots per liter and that was with me taking about 3 000 units per day but of course I can't tell you what to take because and this is just not I mean I am trying to cover myself obviously I can't I can't prescribe for you but um apart from that two people can take the same amount of vitamin D and end up with very different blood levels that's just the way it is

mà chúng ta biết là có hại và một số điều có lợi. Một số điều có lợi, một số có hại, không phải lúc nào cũng rõ ràng cái nào là cái nào. Nhưng đó là quá trình đang diễn ra. Nếu có thêm bằng chứng, tôi chắc chắn sẽ thảo luận, nhưng tôi không hy vọng có điều gì quá chắc chắn vào lúc này.

36:50

so the only correct way to do this is to go to your doctor get your vitamin D levels checked because remember I tested myself on that and I did another testing they both came out different and ideally titrate your vitamin D levels but there's no likelihood of nice doing that at the moment that's why I'm still taking my 4 000 units a day over winter um anyway um

Vâng, tôi đang nói lan man, điều đó có nghĩa là tôi đã nói hết mọi thứ. Cảm ơn bạn đã xem, nghiêm túc đấy, tôi hy vọng nó có ích.

37:13

let's leave the last word to a health line um no strong evidence proves that moderate amounts of vitamin D are harmful without an adequate intake of vitamin K so there we go if you're taking moderate levels of vitamin D there's no evidence that you need to take vitamin K with that according to Healthline however research is ongoing and the picture might become clearer in the near

37:42

future well let's hope so so what they're saying is moderate levels of vitamin D supplement do not there's no evidence that moderate amounts of vitamin D are harmful without inadequate intake of vitamin K so this is saying basically people taking moderate amounts of vitamin D just because they're on vitamin D need not take extra vitamin K they don't need to take extra vitamin K is what that is

38:13

saying having said that the evidence we've looked at does indicate that quite a few of us might be short of vitamin K and that this shortage of Vitamin K Vitamin K2 that this because we don't get enough organs and we don't need enough fermented food this may be associated with osteoporosis and it may be associated with calcification of the tissues and that is as strongly as I can

38:41

put it because that is all the evidence that we have so that's why I was a bit reluctant to do that because I know the evidence is not conclusive but that is my review of the current evidence and they are my conclusions so personally I'm going to carry on taking my vitamin D until I still can get some overall sun exposure and I am considering taking some um some vitamin

39:10

K2 so talk it over with your healthcare provider and see what they think okay that is that video um I hope that created more clarity than confusion but it is confusing because we don't have definitive answers you know the the this human body is just so complicated it interacts with so many things who can understand it um and yet there are some things that we can do

39:46

that we know are harmful and there's some things that we can do that we know are beneficial um some things are beneficial some things are harmful it's not always clear which is which um but that's the ongoing process I need more evidence comes to light I will certainly be uh discussing it but um I'm not holding my breath for anything too definitive at the moment

40:12

yeah that I'm waffling now that means that means I've said everything so thank you of course for watching seriously I hope it's helped

Transcript

Hiển thị

Vitamin D Guidelines and Deficiency

This chapter discusses the prevalence of vitamin D deficiency in northern latitudes and the speaker's disagreement with official guidelines. The NICE guidelines recommend only 400 IU/day of vitamin D, focusing on rickets and bone issues. The speaker believes everyone should have their vitamin D levels measured and titrated. Vitamin K2 may have benefits but is not necessary with moderate vitamin D doses like 4000 IU/day.

Chương này thảo luận về sự phổ biến của tình trạng thiếu vitamin D ở các vĩ độ phía bắc và sự bất đồng của diễn giả với các hướng dẫn chính thức. Hướng dẫn của NICE chỉ khuyến nghị 400 IU/ngày vitamin D, tập trung vào bệnh còi xương và các vấn đề về xương. Diễn giả cho rằng mọi người nên được đo và điều chỉnh nồng độ vitamin D. Vitamin K2 có thể có lợi ích nhưng không cần thiết với liều vitamin D vừa phải như 4000 IU/ngày.

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