辣椒從小就要开始吃，长大後オ开始吃，腸胃可能受不了

請問醫師，聽説鉄過量對男士身體不好，購買男士綜合維他命是否應該購買不含鉄的產品？

謝謝帥醫師

一向佩服張醫師製作影片的用心。但是本片的內容卻有幾個不當的地方。 只有3號P V C聚氯乙烯塑膠加工時需要使用塑化劑。其他塑膠除非加工時受到回收料的污染，根本不含塑化劑.所以才會有你說的瓶裝飲料塑膠瓶沒有比玻璃瓶塑化劑高！塑膠食品容器不是塑化劑的污染源。 台灣人體內塑化劑高是因為我們日常都會接觸到P VC製品。台塑是世界上最大的PVC原料生產工廠。南亞則是世界上最大的加工廠。塑化劑最大的污染源應該是PV C塑膠地板、塑膠壁紙、塑膠布、人造皮革、塑膠門窗等建材（公車裡邊除了金屬與玻璃外幾乎都是PVC製品），還有水管軟管電線電纜等等這些我們日常都會接觸到，這才是塑化劑主要的污染源。強調隱藏版的塑化劑實在是見樹不見林！因為偶爾污染兩三天內塑化劑就會排出體外，實在沒有必要那麼危言聳聽。 天天穿PVC拖鞋走PVC地板，坐PVC皮沙發。用PVC電線充電，帶PVC手套用PVC水管洗餐具，在蓋PVC透明膠布的餐桌上，鋪PVC餐具墊上用餐等等。這些才是日常的污染源，相形之下，隱藏版實在微不足道！

請問張醫師，我有自費去醫院做一些檢查 ，維生素D 30.5。血鐵質 300.73 ，單位ng/ml，B-12 618.8 pg/ml， 我平常的保健品有在吃阿利他命A25，這樣子會有影響嗎？請問張醫師，我該注意什麼，還是有什麼建議，謝謝你。

太困難了解😂

重點在血中濃度，若有異常，必須儘早檢查其他器官的功能

字幕英文翻譯 English translation of the video transcript ⬇⬇⬇⬇⬇⬇⬇⬇⬇⬇⬇ If you were to ask me which vitamin I find the most complex, I would, without hesitation, tell you it’s vitamin B12. Let’s explore why. First of all, a single molecule of B12 undergoes a highly intricate journey from dietary intake to being absorbed into cells. This process requires various bodily conditions and specific proteins to facilitate its path. If even one step of this chain malfunctions, it can lead to a B12 deficiency in the body. Additionally, the B12 molecule is the largest of all vitamins. Not only is it large, but it also has an extraordinarily complex and diverse structure. This complexity results in four naturally occurring forms of B12, each with distinct chemical properties. These variations make B12 metabolism particularly susceptible to issues caused by genetic factors, affecting its usability in the human body. While it’s true that vitamin B12 can be easily obtained from animal-based foods, the increasing prevalence of vegetarianism poses a significant challenge for this group to get adequate B12 intake. But even among those who don’t follow a vegetarian diet, modern dietary habits rely increasingly on processed foods as a primary calorie source. These processed or ultra-processed foods, though convenient and energy-dense, often lack sufficient trace elements, including vitamin B12. So don’t assume that simply paying attention to your diet means you won’t be deficient in B12. Statistics show that up to 20% of the population is deficient in vitamin B12, and the likelihood increases with age. However, the problem doesn’t end there. While dietary deficiencies of B12 can be addressed with supplements, research in recent years has raised concerns about over-supplementation. Studies suggest that long-term consumption of high doses of B12, or blood tests showing excessive B12 concentrations, can significantly increase the risk of certain cancers or mortality rates. Conversely, insufficient dietary B12 intake or low blood B12 levels are also associated with increased mortality. In other words, both excess and deficiency pose risks. This presents a frustrating dilemma: a vitamin deficiency that leads to severe illness is widespread, yet over-supplementation can also harm the body. So, what’s the solution? In this video, I’ll address several important questions, such as the differences among various forms of vitamin B12, their distinct impacts on the body, and how to supplement B12 long-term in a safe and effective way. Finally, I’ll attempt to explain why long-term use of vitamin B12 or high blood concentrations may cause adverse effects, along with the potential scientific reasons behind this. These are critical topics, so be sure to watch until the end! Let’s begin with a brief explanation of how a vitamin B12 molecule journeys from food to body cells. First, it binds with haptocorrin (a type of transcobalamin protein) in the mouth and is carried into the stomach. Haptocorrin, a protein secreted by salivary glands, acts as a protector, shielding B12 from being destroyed by stomach acid. Next, the B12 molecule, escorted by haptocorrin, passes through the acidic environment of the stomach and reaches the duodenum, where it switches to binding with intrinsic factor (IF). The intrinsic factor then delivers B12 to the intestinal lining, where it is absorbed into the bloodstream. Once in the bloodstream, the B12 molecules bind with a different transcobalamin protein (Type II) and are transported to cells needing vitamin B12. The transcobalamin proteins-Type I (haptocorrin), intrinsic factor, and Type II-are the three key proteins involved in B12 transportation. When the Type II protein enters the cell with B12, they separate, allowing B12 to be released. At this stage, cellular enzymes cleave the B12 molecule, detaching its core from the molecular "caps" attached to it. Imagine B12 as a group of individuals wearing four distinct hats. Once the hats are removed, they all look identical, and their differences are defined by the hats (or molecular groups) they wear. These molecular groups come in four types: methyl, cyano, hydroxy, and adenosyl. These represent the four natural forms of B12 found in foods and supplements, each with slightly different physiological properties. When B12’s core is freed by enzymes, cells can reattach different caps based on current physiological needs. For instance, if a cell requires B12 in the cytoplasm, it adds a methyl group, forming methylcobalamin, which serves as a coenzyme for critical cytoplasmic enzymes. Alternatively, if the mitochondria need B12, an adenosyl group is added, forming adenosylcobalamin, which acts as a coenzyme in mitochondrial energy production. In essence, while there are four "hats," only two-methyl and adenosyl-are functionally active in the body as coenzymes. Coenzymes are enzyme assistants, crucial for executing biochemical tasks. For example, vitamin C, another coenzyme, aids collagen-synthesizing enzymes in building and stabilizing collagen structures. Without vitamin C, collagen synthesis is impaired, leading to scurvy, a severe condition characterized by unhealed wounds, loose teeth, and bleeding. Thus, the notion that methylcobalamin is the "best" B12 supplement is not entirely accurate. Regardless of the B12 form consumed, enzymes within cells will remove the molecular group, and the body will reassemble B12 based on its needs. Let’s move on to the next question: do different forms of B12 have distinct physiological effects, and which is best for the body? While all four forms bind strongly to the three transport proteins, there are slight differences in their properties. For example, hydroxocobalamin is better suited for individuals with slower B12 metabolism or certain genetic disorders that hinder the conversion of B12 into its active coenzyme forms. Intravenous hydroxocobalamin can address this issue because it binds more tightly to transport proteins, allowing more time for conversion within cells. Moreover, hydroxocobalamin is quicker to release its hydroxy group, making it more readily usable. Research shows that most B12 in the blood of healthy adults comes from hydroxocobalamin, comprising about 50% of total B12. Hydroxocobalamin is also a treatment for cyanide poisoning, utilizing its ability to rapidly exchange its hydroxy group with cyanide, forming non-toxic cyanocobalamin. Conversely, methylcobalamin is less tightly bound to transport proteins and is more quickly excreted through urine. While it’s an active coenzyme, the belief that it’s inherently superior lacks strong justification. Cyanocobalamin, though less popular, has the advantage of stability, making it ideal for long-term storage in supplements. Its stability compensates for its lesser reactivity compared to hydroxocobalamin. Now, let’s address why excessive B12 intake or high blood levels are associated with health risks. Excess B12 intake has been linked to an increased risk of esophageal cancer, with studies showing a 75% higher risk in those with the highest intake levels compared to the lowest. This risk is even more pronounced in non-drinkers, with nearly a threefold increase. While some hypothesized this risk was due to red meat (a common B12 source), studies have shown it’s not related to dietary sources but to B12 itself. Over-supplementation may disrupt DNA methylation processes, leading to cellular damage and long-term harm. Regarding blood B12 levels, studies consistently show a J-shaped curve for mortality, with optimal levels between 400 and 500 ng/ml. Levels above or below this range are linked to higher death rates due to insufficient or excessive B12’s effects on vital functions like DNA synthesis, nerve health, and red blood cell production. But why can high concentrations of vitamin B12 also be detrimental to health? There are several possible explanations. First, free vitamin B12 in the bloodstream is filtered out by the kidneys. If kidney function is impaired, vitamin B12 levels in the blood can become elevated. In other words, high B12 levels may reflect underlying kidney dysfunction. Similarly, when liver function declines, in cases of certain cancers, or in patients with blood-related diseases such as leukemia, the body tends to produce more transcobalamin proteins. These proteins have a strong affinity for vitamin B12, causing it to remain in the bloodstream for a longer time. Therefore, detecting high levels of vitamin B12 may actually indicate the presence of these underlying chronic conditions. Lastly, excess vitamin B12 is stored in the liver. However, in cases of liver disease where significant liver cell death occurs, the stored vitamin B12 is released from the damaged liver cells, leading to elevated levels in the bloodstream. To summarize, excessively high concentrations of vitamin B12 in the blood are often indicators of underlying liver disease, kidney disease, cancer, or blood disorders. These chronic illnesses inherently have a negative impact on survival rates. In today’s video, I’ve addressed the previously raised questions about vitamin B12, hoping to provide you with a deeper understanding of this essential vitamin. In clinical practice, for nutrients like vitamin B12 and vitamin D-where maintaining blood concentrations within a specific range is crucial-regular blood tests are important to ensure they stay at ideal levels. As for how much to supplement and for how long, this depends on your blood concentration levels. There isn’t a fixed dosage or duration. Regular monitoring of blood levels is the best way to ensure you’re getting the maximum benefits from nutritional supplements. That wraps up today’s video. Thank you all for watching, and I’ll see you in the next episode. Bye-bye!

甲基B12(methylcobalamin) 氰基B12(cyanocobalamin) 氫氧基B12(hydroxylcobalamin) 去氧腺苷B12(adenosylcobalamin)

此部教學影片怎麼沒有聲音？

想請問張醫師，那比起這些莓果，一直被您誤認的桑葚呢XD 因為我住的縣市離桑葚產地的鄉鎮蠻近的，想問問桑葚的營養價值?

醫生，您好 想問一下長期吃合利他命保健品， 維生素b1誘導體每錠含量25mg, 維生素b2每錠含量2.5mg, 維生素b6每錠含量2.5mg, 維生素b12每錠含量5μg, 請問醫生是否該停止補充呢？

謝謝張醫師的分享

請問張醫師 那一種補充品比較安全 ？

想請問張醫師，在搜尋國外網站可以買得到的 B 群補充品，發現國外的 B 群基本上都是做大劑量的，想請問張醫師這是為什麼呢？

感謝張醫師的詳盡說明 11:47 血液中B12的濃度宜維持在450左右，太高或太低，死亡率都會上升 13:16 維他命B12在血液中的濃度過高，代表身體出狀況，可能是肝臟疾病、腎臟疾病、癌症、或血液疾病 13:33 補充B12時，要注意讓血液中濃度控制在400到500之間 13:50 必須定期抽血檢查，以便確保維他命B12的血中濃度；維他命D也是如此。

中锅GDP数据造假，拿到世界经济老2. 但是股市世界倒数第一。贪官污吏腐败世界第1. 造假世界第一。房地产泡沫世界第一 烂尾楼世界第1，房子严重 过剩，质量很差。基本都偷工减料 豆腐渣工程 ，毛胚房，并且至少30%的公摊面积，仅仅40年住房实际使用寿命，烂尾楼还要百姓还贷，都是李鹏猴子无能 胡几把 温狗蛋好大喜功，给后世留下的祸根。房地产开发商勾结地方政府 银行 房地产中介 投机炒房客 它们狼狈为奸 互相勾结 行贿受贿 吃回扣 大肆敛财。中国股市没有投资价值，都是骗钱 工具。IPO造假很多，上市不严，退市太少，没有股民赔偿机制。上市公司，会计事务所，券商和证监会的某些蛀虫4方面狼狈为奸。中国的政策都是空口号 ，没有实际行动

如何去監測血中濃度，是去醫院還是哪裡呢？請提供資訊參考

太學術性了. 太多醫學專門名詞, 一般人都聽不明白. 不如直接一些, 有那些食物富含 B12 吧.

请问什么是地中海饮食？

氫氧基是否adeno?

說明很詳細，謝謝你

但食物中的b12含量，是否有簡單的計算參考，不同食物來源的b12的型態有沒有參考資料呢

感謝醫師

請問醫師 DPDS對狗有害 對人體呢 是否也會造成類似的傷害呢

谢谢分享关於vitamin B12，最近有市面上介绍的日本保健品，里面有其中一个成份vitamin B12-cyanocobalamin-氰钴胺素，请问这vitaminB 12是安全使用吗？

很感謝張醫師講解！👍👍👍👏👏👏

謝謝醫生細心的解釋, 收穫滿滿! 柴柴好可愛!😍😍

我還未吃B12前是540pmol/L 看來我不能吃B群了

那柴犬是真的嗎？😊

這集長知識了👍👍👍👍👍

請問醫師，B群是在飯後吃，還是空復吃好，謝謝

👍👍👍

有柴柴，按讚🎉🎉🎉

好醫師！

張醫師講解非常專業，一定花了不少時間準備！喜歡柴總❤

感谢分享这个信息很重要

感謝醫師用淺顯易懂的方式解說這麼複雜的機制😂 很有收穫！❤

邊講解邊魯狗😂

雖然有一點複雜但醫師講的還蠻清楚的。謝謝醫師。 看到柴柴了❤

视频实在太优秀了,作为同行的我十分佩服，一定要向您学习。欢迎来海燕论坛交流!

我们住在印尼的华裔，一天不吃辣椒不行嘢，没有辣椒，食物淡淡的吃起来完全没劲儿。😅

那劑量一天要吃多少才可以呢

謝謝醫師的詳細解釋

B12 食用機轉好複雜！

解惑了，謝謝醫師。

还有孤零零的食物是胡萝卜，白萝卜，豆芽，白菜，蕃茄，茄子，长豆，包菜🤣🤣🤣😅 在我们印尼本地再便宜不过的食物。

謝謝🙏醫生👏👏👏👏👏🌷

請問醫師： 您提到「枸杞不耐熱」所以不要煮，請問不耐熱指的溫度是幾度呢？ 所以入菜時稍微拌炒營養也會流失囉？🥲 冬天時之前都會泡熱水加枸杞，這樣就不能熱泡了是嗎？😅

雲芝也有同樣效果嗎？