超劑量維他命療法 是一種透過攝取超過每日建議攝取量 的維他命 來預防或治療疾病的方式。
超劑量維他命療法在替代醫學 當中相當普遍,也被稱為正分子療法 [ 1] 。而大眾對於正分子療法看法不一,有部分評論認為正分子療法 只是潮流性的食物盲從現象 和醫療噱頭 。
適量的維他命能夠有效預防或治療維他命缺乏所造成的疾病,但超劑量維他命療法是否能夠治療疾病仍然眾說紛紜[ 2] [ 3] ,目前部分醫學證據只能證明在正常範圍中,增加攝取量對身體有益,若是攝取過量,可能會產生毒性(例如維生素A和維生素D),也有可能直接被身體代謝,是否有特別的治療效果則有待商榷[ 4] [ 5] 。目前研究顯示在風濕性疾病 [ 6] 、青光眼 [ 7] 及思覺失調症 [ 8] 等都沒有顯著的效果,同時,部分研究認為有些維生素的膳食補充品可能是有益的,但也有些可能是有害的[ 9] [ 10] 。而有相關案例則指出,超劑量維他命療法可能會影響病患的血糖測定,進而干擾治療的進行[ 11] 。
用途
維生素C
台灣對於成年男性及女性的維生素C推薦膳食攝取量為為100毫克/天[ 12] 。而根據北美参考膳食摄入量 ,成年男性維生素C的推薦膳食攝取量(RDA)為每天90毫克,成年女性為每天75毫克,但不要超過每日2,000毫克[ 13] 。目前,對於超劑量的維生素C是否能有效治療或預防各類疾病,仍存有諸多討論。
癌症
萊納斯·鮑林 (Linus Pauling)發表之研究稱靜脈注射維生素 C 可顯著延長晚期癌症患者的壽命[ 14] ,這種觀點與某些研究的結果並不一致。根據一篇系統回顧文獻,未有高品質的證據證實口服或靜脈注射維生素C能在癌症患者身上起到抗癌作用,僅有微弱證據說明靜脈注射維生素C能提高癌症患者生活質量,且靜脈注射維生素C具有潛在毒性。維生素C對於癌症患者的治療效果並未得到充分支持[ 15]
另外,妙佑医疗国际 (Mayo Clinic)對於癌症患者進行了三項雙盲安慰劑對照隨機試驗,得到維生素C對於癌症患者並無治療效果的結論。該文獻稱經過了33年、且參與的患者達1591人的研究,仍未確定維生素C對於癌症的療效有任何顯著具有臨床意義的抗癌活性。[ 16]
普通感冒
根據一篇關於不同劑量的維生素C與感冒治療的臨床試驗回顧,每天200毫克服用維生素C,並不能降低一般人群的普通感冒發生率,但在兒童中,每日1至2克的維生素 C 可使感冒持續時間縮短 18%,在成人中,每日1至4克的維生素 C 可使感冒持續時間縮短 8%[ 17] 。成年人試驗的分組報告指出,維生素C補充品能夠減少於亞北極地區的馬拉松運動員、滑雪者或士兵中半數感冒的發生[ 18] 。有一篇文獻也提到維生素 C 可以縮短並緩解普通感冒,並可在特定條件下和特定人群中預防感冒[ 19] 。另一篇綜合分析則發現維生素C於預防及減少兒童的上呼吸道感染的持續時間方面具有統計學意義[ 20]
痛風
一篇統合分析文章指出額外的維生素C補充能夠顯著降低血中尿酸濃度,這是一種痛風的危險因子[ 21] ;另一篇前瞻性研究則指出了中維生素C的攝取量與罹患痛風的風險呈現負相關,補充維生素C可能有助於預防痛風。[ 22]
維生素E
台灣對於成年男性及女性的維生素E推薦膳食攝取量為12毫克/天(美國為15毫克/天)。[ 12] 美國食品與營養委員會 另根據動物實驗模型顯示高劑量維生素E導致出血,制定可耐受最高攝取量 為1000毫克(1500國際單位)/天。[ 23] 在美國,隨著研究顯示服用維生素E補充劑並無明顯好處,甚至有負面效果,維生素E使用量近年有降低趨勢。[ 24] 一統合分析顯示維生素E補充劑與心血管疾病(非致命性中風及心肌梗塞)及其死亡率無相關性。[ 25] 另一綜合分析則顯示高劑量維生素E會提高全因死亡率。[ 26]
菸鹼素
台灣及美國對於成年男性的菸鹼素推薦膳食攝取量為16毫克/天,女性為14毫克/天。菸鹼素在美國可作為處方藥,分為速放劑型(500毫克膠囊,一日最多3000毫克)及延長釋放劑型(500或1000毫克膠囊,一日最多2000毫克);亦可作為營養補充品使用(500-1000毫克膠囊)。菸鹼素有時會與其他種類降血脂藥合併使用。[ 27] 系統性文獻回顧顯示菸鹼素對心血管疾病及其死亡率無明顯效果,即使菸鹼素可以提高高密度脂蛋白 濃度。副作用包括提升糖尿病風險等。[ 28] [ 29] [ 30]
相關條目
參考資料
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