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How many people each year suffer some type of preventable harm that contributes to their death after a hospital visit?
from 46,000 to 78,000
from 78,000 to 132,000
from 132,000 to 210,000
from 210,000 to 440,000

 Vitamins: Vitamin C  

Vitamin C’s vital function in helping produce and maintain healthy collagen allows it to support the body cells and tissues and bring more rapid healing to injured or aging tissues. Therefore, it is used by many physicians for problems of rapid aging, burns, fracture healing, bedsores and other skin ulcers and to speed wound healing after in-jury or surgery. Peptic ulcers also appear to heal more rapidly with vitamin C therapy. The pre- and postsurgical use of vitamin C supplementation can have great benefits. With its collagen function, adrenal support, and immune response support, it helps the body defend against infection, supports tissue health and healing, and improves the ability to handle the stress of surgery. Vitamin A and zinc are the other important pre- and postsurgical nutrients shown by research to reduce hospitalization time and increase healing rates, thereby preventing a number of potential complications.

Vitamin C is also used to aid those withdrawing from drug addictions, addictions to such substances as narcotics and alcohol, as well as nicotine, caffeine, and even sugar—three very common addictions and abuses. High-level ascorbic acid may decrease withdrawal symptoms from these substances and increase the appetite and feeling of well-being. For this reason, it may be helpful in some depression and other mental problems associated with detoxification during withdrawal. Vitamin C also may reduce the effects of pollution, likely through its antioxidant effect, its detoxifying help, and its adrenal and immune support; specifically, it may participate in protecting us from smog, carbon monoxide, lead, mercury, and cadmium.

Vitamin C is a natural laxative and may help with constipation problems. In fact, the main side effect of too much vitamin C intake is diarrhea. For iron-deficiency anemia, vitamin C helps the absorption of iron (especially the nonheme or vegetable-source iron) from the gastrointestinal tract. In diabetes, it is commonly used to improve the utilization of blood sugar and thereby reduce it, but there is no clear evidence that regular vitamin C usage alone can prevent diabetes. There are some preliminary reports that ascorbic acid may help prevent cataract formation (probably through its antioxidant effect) and may be helpful in the prevention and treatment of glaucoma, as well as certain cases of male infertility caused from the clumping together of sperm, which decreases sperm function.

Vitamin C has a probable role in the prevention and treatment of atherosclerosis and, thereby, in reducing the risks of heart disease and its devastating results. It has been shown to reduce platelet aggregation, a factor important in reducing the formation of plaque and clots. Ascorbic acid has a triglyceride- and cholesterol-reducing effect and, more important, may help to raise the "good" HDL. This action needs further investigation, though the research is supportive so far. I haven’t even mentioned the prevention of scurvy, which really takes very little vitamin C, about 10 mg. per day. This disease used to be a big concern and was often fatal unless the victim ate some citrus or other fresh fruit and vegetables containing a small amount of vitamin C.

I do not really want to approach the cancer and vitamin C issue; it deserves a book by itself. However, if we closely analyze the functions (antioxidant, immune support, interferon, tissue health and healing) that vitamin C performs in the body, along with the still mysterious influences of higher-dose ascorbic acid intake, we can see how vitamin C may have a positive influence in fighting and preventing cancer, our greatest twentieth-century medical dilemma.

Deficiency and toxicity: For most purposes, vitamin C, or ascorbic acid, in its many forms of use is nontoxic. It is not stored appreciably in our body, and most excess amounts are eliminated rapidly through the urine. However, amounts over 10 grams per day that some people use and some doctors prescribe are associated with some side effects, though none that are serious. Diarrhea is the most common and usually is the first sign that the body’s tissue fluids have been saturated with ascorbic acid. Most people will not experience this with under 5–10 grams per day, the amount that is felt to correlate with the body’s need and use. Other side effects include nausea, dysuria (burning with urination), and skin sensitivities (sometimes sensitivity to touch or just a mild irritation). Hemolysis (breakage) of red blood cells may also occur with very high amounts of vitamin C. With any of these symptoms, it is wise to decrease intake.

There is some concern that higher levels of vitamin C intake may cause kidney stones, specifically calcium oxalate stones, because of increased oxalic acid clearance through the kidneys due to vitamin C metabolism. This is a rare case, if it does exist, and I personally have not seen, nor do I know any doctors who have seen, kidney stone occurrence with people taking vitamin C. Only people who are prone to form kidney stones or gout should give this any thought. If there is concern, supplementing magnesium in amounts between half and equaling that of calcium intake (which should be done anyway with calcium supplementation) would reduce that risk, at least for calcium-based stones. I usually suggest using a buffered vitamin C preparation with calcium and magnesium, which alleviates this concern.

As far as deficiency problems go, the once fairly common disease called scurvy is very rare these days. However, early symptoms of scurvy or vitamin C deficiency are more likely in formula-fed infants with little or no C intake or in teenagers or the elderly who do not eat any fresh fruits and vegetables. Smokers with poor diets and people with inflammatory bowel disease more often have lower vitamin C blood levels. Other people commonly found to be low in ascorbic acid include alcoholics, psychiatric patients, and patients with fatigue.

The symptoms of scurvy are produced primarily by the effects of the lack of ascorbic acid on collagen formation, causing reduced health of the tissues. The first signs of depletion may be related to vitamin C’s other functions as well, where deficiency could lead to poor resistance to infection and very slow wound healing. Easy bruising and tiny hemorrhages, called petechiae, in the skin, general weakness, loss of appetite, and poor digestion may also occur. With worse deficiency, nosebleeds, sore and bleeding gums, anemia, joint tenderness and swelling, mouth ulcers, loose teeth, and shortness of breath could be experienced. During growth periods, there could be reduced growth, especially of the bones. The decrease in collagen may lead to bone brittleness, making the bones more fragile. The progression and health of the teeth and gums are also affected. In breastfeeding women, lactation may be reduced. With the elderly, vitamin C deficiency could enhance symptoms of senility. The bleeding that comes from capillary wall fragility may lead to clotting and increased risk of strokes and heart attacks.

An important note is that many medical problems have been found to be associated with low blood levels of vitamin C. These problems include various infections, colds, depression, high blood pressure, arthritis, vascular fragility, allergies, ulcers, and cholesterol gallstones.

Most of these symptoms and problems can be easily avoided with minimal supplementation of vitamin C or a diet well supplied with fresh fruits and vegetables. Since the average diet has much less vitamin C than that of our ancestors, it is important for us to be aware of our ascorbic acid intake.

Requirements: The RDA for adults is considered to be 60 mg. We need only about 10–20 mg. to prevent scurvy, and there is more than that in one portion of most fruits or vegetables. Infants need 35 mg.; about 50 mg. between ages one and fourteen and 60 mg. afterward are the suggested minimums. During pregnancy, 80 mg. are required; 100 mg. are needed during lactation. Realistically, between 100–150 mg. daily is a minimum dosage for most people.

Vitamin C needs, however, are increased with all kinds of stress, both internal (emotional) and external (environmental). Smoking decreases vitamin C levels and increases minimum needs. Birth control pills, estrogen for menopause, cortisone use, and aspirin also increase ascorbic acid requirements. Both nicotine and estrogen seem to increase copper blood levels, and copper inactivates vitamin C. In general, though, absorption of vitamin C from the intestines is good. Vitamin C (as ascorbic acid) taken with iron helps the absorption of iron (and many minerals) and is important in treating anemia, but the iron decreases absorption of the ascorbic acid. Overall, it is probably best to take vitamin C as it is found in nature, along with the vitamin P constituents (discovered later)—the bioflavonoids, rutin, and hesperidin. These may have a synergistic influence on the functions of vitamin C, although there is no conclusive research on humans to support this theory.

Vitamin C is the most commonly consumed nutrient supplement and is available in tablets, both fast-acting and time-released, in chewable tablets, in powders and effervescents, and in liquid form. It is available as ascorbic acid, L-ascorbic acid, and various mineral ascorbate salts, such as sodium or calcium ascorbate. One of my favorite formulas, which was developed by Stephen Levine at Nutricology in San Leandro, California, is a buffered powder made from sago palm that contains 2,350 mg. of vitamin C per teaspoon, along with 450 mg. of calcium, 250 mg. of magnesium, and 99 mg. of potassium. It gets into the body quickly and is very easy on and often soothing to the stomach and intestinal lining. The potassium-magnesium combination can often be helpful for fatigue, and this formula is a good vehicle for fulfilling calcium needs.

Vitamin C works rapidly, so the total amount we take over the day should be divided into multiple doses (four to six) or taken as a time-released tablet a couple of times a day. When increasing or decreasing vitamin C intake, it is best to do so slowly because our body systems become accustomed to certain levels. Some nutritionists describe a problem of rebound scurvy in infants, especially when a high amount is taken by the mother during pregnancy but then the infant gets very little after birth and so suffers some deficiency symptoms. I have seen nothing confirming this in the literature. Overall, though, it is probably wise to reduce vitamin C intake slowly after taking high amounts, rather than to drop abruptly.

My basic suggestion for vitamin C use is about 2–4 grams per day with a typical active and healthy city lifestyle. Based on previous levels in our native diets, Linus Pauling feels that the optimum daily levels of vitamin C are between 2,500 and 10,000 mg. Clearly, requirements for vitamin C vary and may be higher according to state of health, age (needs increase with years), weight, activity and energy levels, and general metabolism. Stress, illness, and injuries further increase the requirements for ascorbic acid. Many authorities suggest that we take at least 500 mg. of vitamin C daily to meet basic body needs.

During times of specific illnesses, especially viral infections, doctors who use megadose vitamin C treatment suggest at least 20–40 grams daily, some of it intravenously. Vitamin C has been used safely and effectively in dosages of 10 grams or more dripped slowly (over 30–60 minutes) into the blood to reach optimum tissue levels before excretion, so as to bathe the cells in vitamin C. Some doctors prescribe what is called "bowel tolerance" daily intake of vitamin C—that is, increasing the oral dose until diarrhea results and then cutting back. This level can vary greatly from a few grams to 100 grams or more. The claim is that our body knows what we need and will respond by changing the water balance in the colon when we have had enough. Physician Robert Cathcart has used vitamin C this way in his practice for years to treat many problems, with claimed good success; yet, I do not have the experience to make an adequate conclusion. This practice does, however, add further mystery to the vitamin C controversy. More research is definitely needed regarding ascorbic acid, and new discoveries will likely be made.

(Excerpted from Staying Healthy with Nutrition ISBN: 1587611791)
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 About The Author
Elson Haas MDElson M. Haas, MD is founder & Director of the Preventive Medical Center of Marin (since 1984), an Integrated Health Care Facility in San Rafael, CA and author of many books on Health and Nutrition, including ...more
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