The great vitamin C debate! - Vitamins & Supplements Message Board

Kime · 09-07-2004, 10:00 AM

Hi everyone,

I would like to start a thread discussing the merits and dosages of Vitamin C if anyone is interested. I have noticed that Nat believes that your body can only use 250 mg of vitamin C at a time and that hasn't been my experience at all. Nat, what do you base that on? Have you ever tried taking vitamin C to bowel tolerance when you had a cold? If you haven't, how can you be sure that taking more than 250mg is a waste? There is a lot of conflicting information out there. I have read a couple of web sites that say that it has been "proved" that a person can only use such and such amount of vitamin C, but they usually don't say how the study was conducted or why they are so sure about it. It is true that if you take larger amounts of C your body excretes it much more quickly than if you take small amounts, but that doesn't mean that it doesn't have time to give you benefits before it gets excreted.

My favorite book about vitamin C is "Vitamin C, Infectious Diseases, and Toxins" by Dr. Thomas Levy, even though it doesn't discuss some of the uses of vitamin C such as its action as an antihistamine. As an example it tells of how Klenner used IV vitamin C during the 1948 polio epidemic to cure polio and he didn't have a single death or even paralysis in his 60 cases, although one little girl was already paralysed in both legs when she came to him, she recovered total use of her legs in 19 days. He published his results in what was I think a pediatric journal and it was totaly ignored by the medical community, even though they had nothing at all to fight polio with and the vaccine wasn't developed yet. There is a lot of information on the internet about how Cathcart and Klenner used large doses of vitamin C with incredible results.

In our personal experience we have found vitamin C to be useful for asthma (along with niacin) for my husband in doses of about 12 grams twice a day. A friend of our sons now takes 6 grams twice a day, and he doesn't need to use an inhaler anymore for his allergies. I was fighting a cold and I found that every time the symptoms started to get ahold of me if I took C to bowel tolerance which usually is about 8 grams for me but with the cold it was about 16 grams, then after a few hours my cold symptoms would go away and the cold never got any farther than that. And the most incredible experience that we have had with it, although I hope none of you ever get the chance to relate to it, is that our son struggles with schizophrenia and he had stopped conversing and would hardly ever speak except when someone spoke to him first and even then he didn't say much and he had a lot of other symptoms, too, and for months he was acting more or less like a zombie socially, I was already giving him vitamin C but when I gave it to him to bowel tolerance, which with his illness is an incredible 80-90 grams a day, after 1 day he started talking with his friends and smiling and goofing off with his brother and as we continued at that high level some of the other symptoms gradually went away, too. He isn't completely back to normal, but he is much better and sometimes he is pretty much normal, and when he refuses to take the C, because to tell the truth when you take that much it does give you gas and he doesn't like it, but he gets worse if he has a low dose for a couple of days so we know it is the C that is helping him.

So you see it is our experience with the great things that C has done for us that makes me want to tell other people about it because I know there are a lot of other people who read these boards that could benefit if they knew about it.

I would like to invite any of you who have used C to relate your experiences here. And Nat, if you feel you have compelling evidence that it really is true that the body can only use 250mg of C at a time I would be happy to read about it and this would be a good place to put it, we need to have both sides of the argument here.

Gopherhead · 09-07-2004, 01:11 PM

Quote:

Originally Posted by Kime

I have noticed that Nat believes that your body can only use 250 mg of vitamin C at a time and that hasn't been my experience at all. Nat, what do you base that on? how can you be sure that taking more than 250mg is a waste?

In April of 2000, the Food and Nutrition Board of the National Academy of Sciences released Dietary Reference Intakes (DRI) for Vitamin C, Vitamin E, Selenium, and Carotenoids. The central premise of the report did not perpetuate the prevailing popular thought that large doses of antioxidants will prevent chronic diseases. Instead the panel concluded that at this time, insufficient scientific evidence exists to sustain claims that ingesting megadoses of dietary antioxidants can prevent certain chronic illnesses such as cardiovascular disease or cancer. In some instances recommended nutrient levels were reduced from the previous report in 1989; e.g., for the first time upper tolerable levels of ingestion (UL) were established to prevent the harmful effects of over consumption of essential nutrients, such as vitamin C, vitamin E, and selenium.(1)

Dr. Mark Levine, Chief of Molecular and Clinical Nutrition at the National Institutes of Health (NIH), and author of a research project which proposed an increased RDA dose amounts in the Journal of the American Medical Association publication, suggested, "At 100 milligrams all the tissues are saturated, at 200 milligrams, the blood plasma is saturated, but at 500 milligrams dose, then absorption levels appear complete, and rate of absorption begins to decrease.

A review of clinical trials published in the April 21st issue of the Journal of the American Medical Association concluded that 200 mg a day is the maximum human cells can absorb, making anything above that level a waste. As vitamin C is water soluble anything not used by the body quickly passes out.

The suggestion is then for those who are moderately active [1-2 hours per day], who live in a congested city environment, who work indoors enclosed within the closed confines of other workers, who are exposed to environmental toxins or commercial generated toxic substances, who come from a family predisposed to degenerative autoimmune disorders, who smoke, who drink alcohol, who eat less than 5 servings per day fresh vegetables and fruits, to take 2 to 4 divided doses ranging from 200-500 milligrams each dose as tolerated by a healthy solid-stool excretion is reasonable.

More research pointing to the inefficacy of megadosing.

Vitamin C in health and disease. Journal of Contemporary Dental Practice. 2004 May 15;5(2):1-13.

The current recommended dietary allowance (RDA) of vitamin C is 75 mg for woman and 90 mg for men, based on the vitamin's role as an antioxidant as well as protection from deficiency. High intakes of the vitamin are generally well tolerated, however, a Tolerable Upper Level (TUL) was recently set at 2 g based on gastrointestinal upset that sometimes accompanies excessive dosages. Several populations warrant special attention with respect to vitamin C requirements. These include patients with periodontal disease, smokers, pregnant and lactating women, and the elderly.

Criteria and recommendations for vitamin C intake. Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. JAMA. 1999 Apr 21;281(15):1415-23.

Recommendations for vitamin C intake are under revision by the Food and Nutrition Board of the National Academy of Sciences. Since 1989 when the last recommended dietary allowance (RDA) of 60 mg was published, extensive biochemical, molecular, epidemiologic, and clinical data have become available. We applied these criteria to the Food and Nutrition Board's new guidelines, the Dietary Reference Intakes, which include 4 reference values. The estimated average requirement (EAR) is the amount of nutrient estimated to meet the requirement of half the healthy individuals in a life-stage and gender group. Based on an EAR of 100 mg/d of vitamin C, the RDA is proposed to be 120 mg/d. If the EAR cannot be determined, an adequate intake (AI) amount is recommended instead of an RDA. The AI was estimated to be either 200 mg/d from 5 servings of fruits and vegetables or 100 mg/d of vitamin C to prevent deficiency with a margin of safety. The final classification, the tolerable upper intake level, is the highest daily level of nutrient intake that does not pose risk or adverse health effects to almost all individuals in the population. This amount is proposed to be less than 1 g of vitamin C daily. Physicians can tell patients that 5 servings of fruits and vegetables per day may be beneficial in preventing cancer and providing sufficient vitamin C intake for healthy people, and that 1 g or more of vitamin C may have adverse consequences in some people.

A new recommended dietary allowance of vitamin C for healthy young women. Levine M, Wang Y, Padayatty SJ, Morrow J.

The recently released Recommended Dietary Allowance of vitamin C for women, 75 mg daily, was based on data for men. We now report results of a depletion-repletion study with healthy young women hospitalized for 186 +/- 28 days, using vitamin C doses of 30-2,500 mg daily. The relationship between dose and steady-state plasma concentration was sigmoidal. Only doses above 100 mg were beyond the linear portion of the curve. Plasma and circulating cells saturated at 400 mg daily, with urinary elimination of higher doses. Biomarkers of endogenous oxidant stress, plasma and urine F(2)-isoprostanes, and urine levels of a major metabolite of F(2)-isoprostanes were unchanged by vitamin C at all doses, suggesting this vitamin does not alter endogenous lipid peroxidation in healthy young women. By using Food and Nutrition Board guidelines, the data indicate that the Recommended Dietary Allowance for young women should be increased to 90 mg daily.

Ann Intern Med. 2004 Apr 6;140(7):533-7. Vitamin C pharmacokinetics: implications for oral and intravenous use.Padayatty SJ, Sun H, Wang Y, Riordan HD, Hewitt SM, Katz A, Wesley RA, Levine M.

CONCLUSIONS: Oral vitamin C produces plasma concentrations that are tightly controlled. Only intravenous administration of vitamin C produces high plasma and urine concentrations that might have antitumor activity. Because efficacy of vitamin C treatment cannot be judged from clinical trials that use only oral dosing, the role of vitamin C in cancer treatment should be reevaluated.

Pharmacokinetic perspectives on megadoses of ascorbic acid. Blanchard J, Tozer TN, Rowland M. American Journal of Clinical Nutrition. 1997 Nov;66(5):1165-71.

Ascorbic acid (vitamin C) is commonly used as a dietary supplement, often in megadoses. However, as the daily oral dose is increased, the concentration of ascorbic acid in the plasma and other body fluids does not increase proportionally, but instead tends to approach an upper limit. For example, when the daily dose is increased from 200 to 2500 mg (from 1.1 to 14.2 mmol) the mean steady state plasma concentration increases only from approximately 12 to 15 mg/L (from 68.1 to 85.2 mumol/L). The analysis indicates that both saturable gastrointestinal absorption and nonlinear renal clearance act additively to produce the ceiling effect in plasma concentrations. As a consequence of this ceiling effect, there is no pharmacokinetic justification for the use of megadoses of ascorbic acid.

From the American Cancer Society:

Quote:

Megadosing: The "More Is Better" Myth
The 1990’s saw a trend of "megadosing" antioxidants such as vitamin C, beta carotene, and vitamin E. Despite the fact that no scientific studies have ever proven that large doses of vitamin C can prevent or cure colds, many people still hold this belief. You may have heard a wide variety of claims about the benefits of taking large doses of certain vitamins. However, the practice of using large doses of vitamins to attack disease has no scientific basis.

In fact, large doses of some vitamins can be dangerous and toxic. For example, too much vitamin C can interfere with the body’s ability to absorb copper, a metal that is essential to our body chemistry. Other side effects of megadosing with vitamin C include gastrointestinal disturbances, kidney stones and excess iron absorption. Too much phosphorous can inhibit
the body’s absorption of calcium. Large doses of fat-soluble vitamins such as A, D, and K are not excreted quickly by the body and can easily reach toxic levels. Consult with your doctor before starting a regimen of large doses of any vitamin.

An Upper Intake Level (UL) of 2 g/d was recently set by the Institute of Medicine due to extremely high amounts causing diarrhea.

Also: individuals with a history of kidney problems of any kind may not be candidates for vitamin C supplements due to increased urinary oxalate formation in oxalate kidney stone formers. Infants born to mothers taking 6 g or more of vitamin C may develop rebound scurvy after birth, due to the sudden drop in intake.

It's quite possible that your tolerance to megadoses of Vit C is high, this does not mean that it applies to everyone. Suggesting that this practice is both very common and very safe for everyone is misleading, IMHO. I realise this is a health forum and that no one expects us to be medical professionals, however, I learned a long time ago that advice which is given in response to a simple post can be read and acted upon by many, not just the original poster - you never know who you are 'talking' to.

Cheers,
Nat

1. The antioxidants--vitamin C,vitamin E, selenium, and carotenoids. Johnson LJ, Meacham SL, Kruskall LJ. Journal of Agromedicine. 2003;9(1):65-82.

Kime · 09-07-2004, 04:59 PM

Thank you for your reply. It will probably take me a day or two to reply because I want to document my answer well.

BetsyAnn · 09-07-2004, 11:01 PM

The posts on vitamin C have really sparked my interest. I have been doing a little on-line research and have found some interesting stuff.

There is an article on the web titled "The Ascorbate Effect in Infectious and Autoimmune Diseases" by Robert F. Cathcart M.D.

He explains the vitamin c effect as the benefits you get from taking the usual, small to moderate amount of vitamin c that your body requires each day.

He classifies the ascorbate effect to be where massive amounts of vitamin c are taken and you are "mostly throwing away the vitamin C for the electrons carried." He claims that with massive amounts of vitamin C you are able to "neutralize the massive amounts of free radicals generated mostly by the damage to mitochodria of infectious diseases, allergies, and injuries."

When you are ill your body is unable to make the necessary electrons available. Depending on the disease there will huge amounts of free radicals
that need to be neutralized so the normal amount of vitamin C will be ineffective. The more free radicals you have the more C it will take to get to bowel tolerance.

The author gives a very indepth explaination about all of this. It is very interesting. I recommend the article to anyone who is interested in the "miracle of vitamin C."

When the medical community says that there is no scientific evidence they merely mean that there have not been massive double blind cross over studies, which are almost always paid for by large pharmaceutical companies. It does not mean that there is actually no evidence.

Taking large amounts of vitamin C is generally considered harmless even by the medical community. The best evidence is to try it and see if it works for you. If it doesn't it would definitely be too much of a nusiance to continue.

I have some arthritis in my knee and ankle that is caused by an injury I sustained 11 years ago. I have been able to live with it quite effortlessly as long as I take ibuprofen. However, I have found that I feel better when I don't take ibuprofen-it causes acid reflux at night.

Well, I visited the doctor the other day for an unrelated issue and mentioned my joint pain and preference to avoid Ibuprofen. He sugguested I try Vioxx because it was less likely to irritate my stomach and he gave me a few samples. I read the information that came with it and I was really quite frightened. I will spare you from a list of all of the possible complications but I will mention that several of them can lead to "hospitalization or death."

I am much more willing to give the vitamin c a try and consider it a much more benign alternative. I am already finding alot of relieve from omega-3-fish oil daily and epsom salts with no negative side effects so I am very inclined to give the C a run.

Kime · 09-08-2004, 11:27 AM

Since the research on women was undoubtedly conducted in the same manner as the research on men, I am only going to address the research on men since I have more information on that study.

Quote:

Pharmacokinetic perspectives on megadoses of ascorbic acid. Blanchard J, Tozer TN, Rowland M. American Journal of Clinical Nutrition. 1997 Nov;66(5):1165-71.

Ascorbic acid (vitamin C) is commonly used as a dietary supplement, often in megadoses. However, as the daily oral dose is increased, the concentration of ascorbic acid in the plasma and other body fluids does not increase proportionally, but instead tends to approach an upper limit. For example, when the daily dose is increased from 200 to 2500 mg (from 1.1 to 14.2 mmol) the mean steady state plasma concentration increases only from approximately 12 to 15 mg/L (from 68.1 to 85.2 mumol/L). The analysis indicates that both saturable gastrointestinal absorption and nonlinear renal clearance act additively to produce the ceiling effect in plasma concentrations. As a consequence of this ceiling effect, there is no pharmacokinetic justification for the use of megadoses of ascorbic acid.

What this essentially is saying that no matter how much vitamin C a person takes (orally) the blood plasma level can't be increased much beyond the amount that is reached when they take 200mg a day and so there can't be any clinical benefit from taking more and implies that therefore anyone who says that they have experienced a benefit must be experiencing a placebo effect.

It doesn't say here where this information comes from, but since the amounts of C used and the blood plasma levels are identical it is safe to assume that the data comes from the studies conducted by researchers at the National Institutes of Health (NIH) in 1996. [Proceedings Natl Acad Sci 93:14344-8, 1996]

In this study the blood plasma levels were tested 12 hours after the vitamin C was taken, so while it does prove that when a person takes larger doses of vitamin C the "extra" is mostly excreted within 12 hours, does it really prove that there is not only a "ceiling" but a very low ceiling effect that prevents the blood plazma from rising much above the level reached by taking 200mg? Lets look at another NIH study which was published in the March 2004 issue of the Annals of Internal Medicine...

This study was done to compare blood levels achieved by oral and IV doses of vitamin C. I am only going to look at the oral levels since that is what we are talking about at the moment. When 3000 milligrams was given orally every 4 hours, concentrations were (220 micromole), considerably more than twice as much as what was believed to be the maximum that could be achieved through oral consumption (70-85 micromole)

So the later NIH study proves that the blood plasma levels can indeed be significantly changed by oral doses of vitamin C. But can these levels be tolerated and do they have a beneficial effect?

Quote:

High intakes of the vitamin are generally well tolerated, however, a Tolerable Upper Level (TUL) was recently set at 2 g based on gastrointestinal upset that sometimes accompanies excessive dosages.

Quote:

An Upper Intake Level (UL) of 2 g/d was recently set by the Institute of Medicine due to extremely high amounts causing diarrhea.

Abram Hoffer, M.D., Ph.D reported that in his work with cancer patients, almost all of whom were at least 60 years old, that nearly all of them could tolerate 12 grams of vitamin C divided into 3 doses a day. If any developed diarrhea, they would merely lower the dose.

In my personal experience, which admitedly only includes about 15 people, I have never seen an adult sized person who could not take 5 grams of vitamin C at a time without getting diarrhea. (Added 9/12/04: I take it back! After months of taking vitamin C one of my sons and I are both just barely reaching bowel tolerance with a 5 gram dose. Before I needed 8 grams to reach tolerance except that I needed more when I had a cold. I guess my body was using the extra C before to get rid of stored toxins or something like that.) There are probably some people indeed who cannot tolerate more than 2 grams a day, but I believe that they are exceedingly few. Even our 8 year old son takes 2 grams twice a day without getting any diarrhea at all. Every person in my family except our 8 year old has experienced the diarrhea caused by taking a larger dose of vitamin C, and it is nothing more than a minor nuisance that goes away quickly and then you can avoid having it again by lowering the dose. (With doses larger than 5 grams you can get bloating if you take it on a full stomach, though.) I have already related our experience of how vitamin C helps us, so I won't repeat it here.

Andrew Saul, PhD, reports that by giving his children vitamin C from birth, the general dose being 1/2 the age of the child in grams of C per day, his two children went clear through college without ever needing a single dose of antibiotic. I know my children had considerable amounts of antibiotics when they were young. I can't put the reference here because it is an internet site, but you can find it if you want.

Klenner and Cathcart report on the use of vitamin C with very good results for many illnesses such as polio, hepatitis, influenza, and also to neutralize toxins such as snake bites and carbon monoxide poisoning, on 10's of thousands of patients and not one serious side effect. They used it both orally and IV. This information is available online and in the book by Thomas Levy.

Pitt and Costrini conducted a randomized bouble-blind placebo-controlled trial with 674 marine recruits in a training camp and discovered that 2000mg of vitamin C a day resulted in only one case of pneumonia among the C group and 8 among the control group. Pitt and Costrini. (1979) Vitamin C prophylaxis in marine recruits. Journal of the American Medical Association
241(9):908-911 Other studies have confirmed these results.

These are just a few of the many examples that give evidence for the usefulness of vitamin C at higher dosages. It is true that there have been studies to "prove" that vitamin C doesn't help, for example, cold symptoms, but these studies have been conducted using small amounts of vitamin C and are more or less the equivalent of someone conducting a study on the usefulness of Tylenol for headaches using 1/4 of a tablet instead of using the amount that was known to be safe and useful.

Prescription and over the counter drugs kill at least 100,000 Americans each year, and cause serious injury to over 2 million. This figure is for drugs used as directed, it does not include overdoses. No one has ever died of any amount of vitamin C. I'll respond to the safety issues in my next post, hopefully on Friday because I have a busy day tomorrow.