Myths and Facts
Rumours,
Claims and Fantasy
______________________
Which expert can you believe,
especially when they are
all so sincere? How can
you know which "facts"
to believe, which to question
and which to dismiss as
errant nonsense? These are
far from trivial issues,
especially in a saga as
complex, long-standing and
contradictory as that related
to Vitamin C. Although it
is not uncommon to have
a majority of "experts"
in any given scientific
field at loggerheads and
in intense competition with
each other, it is not an
everyday occurrence that
a major scientific figure
of a century with two Nobel
prizes has to almost single-handedly
"take on" the
scientific and medical establishment
in order to convince them
of a substance's therapeutic
efficacy. That Linus Pauling
has to a large degree achieved
this goal, in that the medical
evidence in favour of Vitamin
C's health enhancing properties
is now overwhelming, is
a tremendous testimonial
of this man's foresight,
tenacity and scientific
wizardry.
However,
what is the public to think
when prominent and respected
researchers disagree and
contradict each other? Who
can you believe and trust?
Unfortunately, you have
no choice but to exercise
some human qualities like
skepticism, discrimination
and good old-fashioned common
sense. This is actually
what scientists are taught
during their career - to
always be critical, to always
keep an open mind and to
never get attached to the
absolute truth of any theory.
A safe bet is to regard
the "truth" as
the "best working hypothesis"
of the day.
There has
been a fair degree of criticism
of the scientific and medical
research establishment throughout
this book, especially regarding
the slow pace and minimal
level of funding of research
related to natural substances
such as Vitamin C compared
to more expensive and toxic
drugs. However, be this
as it may, there is still
much to be said for the
elaborateness of procedures
of the scientific method,
where eventually facts get
unearthed and distinguished
from erroneous hypotheses,
conjectures and premises.
This is not, however the
case for articles appearing
in the various media (newspapers,
magazines, newsletters),
which, not subjected to
the rigid constraints of
the scientific community,
can run riot in sensationalism,
panic mongering and elaborate
fantasy, with the apparently
well-intentioned motive
of exposing dangerous facts.
Below are several quotations
from one such article(24),
extremely convincingly written,
and with interesting and
speculative hypotheses and
theoretical conclusions
presented as irrefutable
facts. The author alleges
that Vitamin C may be responsible
for CAUSING: infection,
gum problems, depression,
exhaustion, personality
changes, blood sugar problems,
amongst many other things,
including CANCER:
"You
could take every book on
vitamin C and throw it in
the East River! You'll probably
be a lot healthier for it";
"Vitamin
C is lost from the body
so readily because it causes
dramatic physiological effects
that could be dangerous";
"The
inability to produce vitamin
C internally may be one
of the greatest things that
has elevated human beings
over animals. Vitamin C
reduces copper levels, and
the absence of internally
produced ascorbic acid may
have allowed a higher level
of copper to exist in human
brains. There is one species
of dog, the Bedlington Terrier,
who has extremely high levels
of copper and who is so
intelligent that some owners
consider it to be "almost
human";
"This confirms my suspicion
that in some people - about
10-20 percent of the population,
excess vitamin C can contribute
to bone problems, ie osteoporosis";
"I
know from my own experience
that C supplements over
500 mg a day cause me extreme
fatigue. I have also talked
to two other people who
had similar results";
Rather
than literature citations,
the author, a "publisher"
speaks of his opinion, his
suspicion, his experience.
He cites NO research, merely
speaking of his own subjective
opinions, or that of several
friends. It is outrageous
that such serious, unsubstantiated
allegations can be published;
consider the potential harm
such alarmist fantasy could
do, while raising fears
in the public. While personal
experience is always to
be valued, the discriminating
consumer bears in mind that
his own experience is as
valid as the next, and that
neither may represent the
whole situation. Articles
such as this are exceedingly
provocative and as such
are valuable in enabling
us to look at the facts
and our beliefs in a critical
light; however, if the allegations
are mistaken, unsubstantiated
and believed by an uncritical
reader, there is no scientific
organization to which the
author can be held accountable.
No self-respecting scientist
would dare to make such
sweeping prognostications
about complex physiological
phenomena. Hence the eternally
appropriate "caveat
emptor" buyer beware
for each of us.
Over the
years Vitamin C has been
implicated in causing certain
conditions and interfering
with certain diagnostic
tests(99). These issues
have recently been thoroughly
reviewed by Cheraskin(54)
and Pauling(166); an updated
summary of the major concerns
and latest evidence is hereby
presented.
Vitamin
C Causes Kidney Stones
_________________________
As indicated
in Fig. 3 (Chapter 3), oxalic
acid is one of the by-products
of Vitamin C metabolism,
and there has been a rather
long-standing concern that
consumption of large amounts
of Vitamin C could cause
the formation of calcium
oxalate kidney stones. The
clinical evidence(132,212-3),
recently reviewed separately
by Cheraskin(54), Pauling(166)
and Rivers(178) indicate
that, in fact, Vitamin C
does NOT cause kidney stones
in "normal" individuals(188).
The several reported such
cases involving Vitamin
C indicate that oxalate
metabolism and contributory
factors to kidney stones
are rather complicated:
other factors include dietary
oxalate consumption, low
calcium and magnesium intake,
EDTA consumption, B6 deficiency,
high tryptophan, Vitamin
D and sucrose, low water
consumption and persistently
acid urine. In fact, some
research indicates that
oxalate may actually be
a minor component in kidney
stone formation, in that
some people with normal
oxalate excretion make kidney
stones, and others with
large oxalate excretion
do not(54). According to
Rivers at the 3rd Int. Conference
on Vitamin C, 1987 "ingestion
of large quantities of the
Vitamin (C) does not constitute
a risk factor for calcium
oxalate stone formation
in most healthy persons".
Cheraskin(54)
and Cathcart(49) have both
pondered why Vitamin C does
not seem to produce kidney
stones, even though oxalate
metabolism can be increased.
Both these physicians, with
clinical experience with
many thousands of patients,
have reached similar theoretical
conclusions about why Vitamin
C may actually PREVENT kidney
stones:
1. Vitamin
C makes the urine more acidic,
thereby reducing the binding
of calcium with oxalate;
2. Vitamin C binds calcium,
thereby reducing calcium's
free form, making it unavailable
for binding with oxalate;
3. Vitamin C enhances the
frequency of urination,
making it less likely for
stones to form;
4. Vitamin
C is a mild urinary tract
disinfectant, thereby reducing
the focii of infections
around which calcium oxalate
cystals could be deposited.
There do
appear to be individuals
who may have a congenital
defect in their oxalate
metabolism and who are therefore
prone to forming kidney
stones. Since calcium oxalate
stones form in acidic urine,
using forms of Vitamin C
which keep the urine alkaline
such as sodium ascorbate
may prevent these stones(166).
Individuals with such a
history or tendency should
explore Vitamin C, and indeed,
their entire supplementation
programme, with a professional
othomolecular physician.
Individuals with a history
of kidney stones, renal
impairment and individuals
on kidney dialysis should
not ingest large amounts
of Vitamin C unless under
medical supervision(178).
Further clinical research
documenting the effects
of the different forms of
Vitamin C, including the
mineral ascorbates and Ester-CR
ascorbate would help to
lay to rest this theoretical
concern which has not materialized
amongst the considerable
populations of Vitamin C
users.
Vitamin C Causes Gouty Arthritis
_________________________
Concerns
that Vitamin C could cause
gouty arthritis in predisposed
persons have not materialized;
not a single report has
appeared in the literature(54,166).
In fact, Vitamin C has recently
been proposed as a treatment
for gout, due to its ability,
with high doses, to lower
serum uric acid levels.
According to Rivers, "The
evidence does not support
claims for an ascorbic acid
induced uricosuria"(178).
Vitamin C Destroys Vitamin
B12
________________________
The original
report by Herbert &
Jacob(102), alleging that
Vitamin C destroys Vitamin
B12, has been refuted by
several reliable research
studies(2,103,144-5,160).
The study by Herbert &
Jacob was severely flawed
in that it contained errors
in estimating the amount
of Vitamin B 12 contained
in food by a factor of 5.
Again, Rivers(178): "The
evidence has consistently
demonstrated that Vitamin
B12 in food and the body
is not destroyed by ascorbic
acid".
Vitamin C Causes Sterility
____________________
The proposed hypothesis
in the mid-1970's that Vitamin
C might prevent conception
and thus reduce fertility
in women has not been substantiated,
and has been refuted by
physicians such as Abraham
Hoffer(54). In fact, in
experiments carried out
in Japan and Ireland(54),
it appears that Vitamin
C may actually INCREASE
fertility and aid in conception,
in addition to regulating
ovulation and controlling
spontaneous abortion in
pregnant women(166).
On the
male side, research indicates
that Vitamin C may enhance
male fertility. A placebo
controlled trial with 30
men conducted by Dawson
and co-workers(66) indicated
that Vitamin C improved
sperm in terms of total
count, viability, motility
and reduced sperm agglutination.
Vitamin C Causes Iron Overload
_________________________
Vitamin
C is one of the main promoters
of dietary iron absorption,
along with meat and fish(96).
Vitamin C can form soluble
iron complexes and reduce
ferric to ferrous iron.
The main dietary inhibitors
of iron absorption are phytates
found in pulses and polyphenols(96).
Tea, and to a lesser extent,
coffee, inhibit iron absorption(183).
Vitamin C's enhancement
of iron absorption is normally
regarded as a positive attribute;
nevertheless, concerns have
been raised postulating
that Vitamin C could have
the effect of increasing
iron absorption so much
as to cause excessive iron
or iron overload.
According to Rivers who
recently reviewed the research
evidence "the regulatory
mechanisms that control
body iron stores override
any pronounced alterations
in food iron availability...Concern
that massive doses of ascorbic
acid might lead to pressive
iron accumulated in healthy
iron-replete individuals
appears unwarranted"(178).
In fact
research indicates that
Vitamin C can actually help
to reduce excessive iron
stores in individuals with
iron-overload disorders.
Such individuals have subnormal
white blood cell levels
of Vitamin C, caused by
their excessive iron storage.
When Vitamin C is administered
to restore normal white
cell levels excessive iron
is excreted(231).
Therefore
the evidence seems to point
to Vitamin C having a pivotal
homeostatic role with respect
to iron - it promotes iron
absorption in iron-deficient
individuals and accelerates
iron excretion in people
with excessive iron.
Vitamin
C Interferes with Serum
Glucose Levels and Causes
Diabetes
_____________________________________________________
Concerns
that taking high doses of
Vitamin C could affect serum
glucose levels, interfere
with diagnostic blood and
urinary tests for glucose(148)
and actually cause diabetes
have prompted studies to
assess Vitamin C's effect
upon blood and urinary glucose
levels.
Studies
by Katz & Di Silvio(124),
Prauer(170) and Spiegel
& Pinili (194) clearly
showed that serum glucose
levels are not affected
by Vitamin C, and that taking
large doses of Vitamin C
would not interfere with
glucose blood tests. In
order to determine whether
Vitamin C could interfere
with urinary glucose, especially
important for diabetics,
Nahata & McLeod(159)
performed a total of 360
copper detection tests on
10 male subjects' urine
samples, with 9 replicates
per each of the 4 dosage
regimes, ranging from 4-6
gm Vitamin C. Not a single
false-positive reaction
occurred. Tests have also
been developed in which
Vitamin C does not interfere
with urinary glucose determinations(34).
Vitamin C Interferes with
Blood Stool and Urinary
Tests
___________________________________________
Jaffe and coworkers at the
NIH reported in 1975(114)
that ingesting large quantities
of Vitamin C masks the detection
of blood in stool samples,
and, in 1979(115), of blood
in urine, and for several
years it was required to
stop Vitamin C supplementation
for 24-36 hours previous
to having blood stool and
urine tests performed. However,
Dr. Jaffe, being a resourceful
clinical pathologist in
addition to a strong advocate
of Vitamin C's therapeutic
effects, went on to develop
a new test for blood in
the stool which is not interfered
with by Vitamin C(116).
However, until such time
as a blood in urine detection
test is developed which
is not masked by Vitamin
C, it will still be necessary
to refrain from taking Vitamin
C prior to taking such a
diagnostic test.
Vitamin
C Causes Rebound Scurvy
___________________________
Allegations
that suddenly stopping Vitamin
C after taking prolonged
large doses could actually
cause "rebound scurvy"(214)
have been investigated in
research studies. Hornig
and co-workers, after administering
massive doses of Vitamin
C to guinea pigs over a
prolonged period reported
that results "disprove
the hypothesis that the
regular ingestion of large
doses of ascorbic acid may
lead to systemic conditioning,
i.e., accelerated ascorbic
acid metabolism or excretion
due to a possible induction
of the participating enzymes"(106).
Nevertheless, it is vital
that Vitamin C NOT BE STOPPED
SUDDENLY, especially with
individuals with cancer
and AIDS(43,48,166). A sudden
depletion of that person's
ascorbic acid level could
massively lower their resistance,
making them extremely vulnerable
to infection and disease.
When large doses of Vitamin
C are taken, the entire
enzymatic machinery, including
metabolites, goes into operation(166).
In this way, because of
an adequate supply of ascorbic
acid, more of Vitamin C
is converted to metabolite
products. If Vitamin C is
suddenly withdrawn, the
person's biochemistry will
continue to produce these
metabolites for a week or
two, despite the fact that
there is not an adequate
Vitamin C level in the blood.
Since Vitamin C is so vital
for almost every body system,
from brain to heart to the
immune system, this can
be exceedingly dangerous
for severely ill persons.
For these
reasons, it is most important
that anyone who has been
taking more than 5 gm Vitamin
C daily on a maintenance
dosage taper off gradually,
if they decide to reduce
their daily Vitamin C supplementation.
Summary of Vitamin C Safety
Considerations
__________________________________
As reported by Rivers in
the 1987 Vitamin C Conference(178)
"the practice of ingesting
large quantities of ascorbic
acid will not result in
calcium oxalate stones,
increased uric acid excretion,
impaired Vitamin B12 status,
iron overload, systemic
conditioning or increased
mutagenic activity in healthy
individuals".
In other
words, do not necessarily
panic when reading alarming
articles about the dangers
of Vitamin C. They may not,
and thus far in fact, have
NOT been true. No reported
case of a serious illness
from Vitamin C exists, and
in animal studies, administration
of 1/2% body weight of Vitamin
C produced no side effects.
This amounts translates
into 350 gm for a human
being!
THE VITAMIN C NETWORK -
MINERAL AND DRUG INTERACTIONS
The nature of the interaction
of Vitamin C with other
nutrients - vitamins and
minerals, and drugs(176),
is far from completely understood.
In the summation report
of Rivers at the most recent
Vitamin C Conference in
1987(178) "The interaction
of ascorbic acid with dietary
essential mineral elements
other than iron is not included
in this review. Research
on this topic is revealing
interesting results, but
is insufficient at this
time to formulate valid
conclusions".
Although
there may not as yet be
comprehensive knowledge
regarding the interaction
of Vitamin C and other nutrient
elements and drugs, there
have been to date, at least
preliminary data demonstrating
some of the complex synergistic
actions of Vitamin C with
other substances. These
are summarised in Table
9 below:
Table 9:
Interactions of Vitamin
C with Other Nutrients
_________________________________________
Nutrient Vitamin C: Co-factors
Ref.
____________________________
Calcium
Assists in calcium absorption
Mg, CT, PTH 93
Cadmium
Reduces body burden of Cadmium
Zinc 38,65
Chromium
Alters toxic form of chromium
Copper
May reduce copper levels
65,168
Cysteine
May reduce levels of cysteine
65
Folic Acid
Prevents destruction of
folic acid 65
Iron Enhances
absorption of iron 96
L-Carnitine
Required for synthesis of
L-Carnitine 135
Lead Reduces
body burden of lead Copper,
Zinc 38,65
Lysine
May Reduce levels of lysine
65
Mercury
Reduces body burden of mercury
38,65
Zinc May
reduce levels of zinc; is
a co-factor of
zinc in prostaglandin synthesis
65,91
_______________________________
The above
data is to be regarded as
preliminary; in fact, an
article by Calabrese et
al(38) failed to show any
effect at all of Vitamin
C upon levels of cadmium,
lead and mercury in 45 males
over a 2 month period. However,
these individuals had normal
levels, and it would be
more appropriate to study
the effect of Vitamin C
in individuals with a high
body burden of these toxic
metals.
Vitamin
C and Drug Interactions
_______________________________
Just as Vitamin C can modulate
the action of certain drugs(25,173,192)
(see Chapter 11), so can
certain drugs affect Vitamin
C's effects(93,99). It is
emphatically suggested that
individuals who are taking
such medications become
fully informed about the
entire range of their side
effects and metabolic interactions.
A brief compilation of some
of the major drugs and their
interactions with Vitamin
C is presented in Table
10:
Table 10:
Vitamin C and Drug Interactions
________________________________
Drug Interaction
with Vitamin C
________________________
Alcohol
Vitamin C detoxifies, prevents
"hangover" and
liver damage(245)
Aspirin
Depletes Vitamin C levels,
inhibits Vitamin C absorption(54,65)
Anti-coagulants
Vitamin C decreases anti-coagulant
effects(93)
Barbiturates
Depletes Vitamin C levels.
Vitamin C increases barbiturate
effects(93)
Heroin
Vitamin C relieves withdrawal
symptoms(79)
Methadone
Vitamin C relieves withdrawal
symptoms(79,187)
Oral Contraceptive
Depletes Vitamin C levels(54)
Sulfa Drugs
Decreases Vitamin C effects(93)
Tetracycline
Decreases Vitamin C effects(93)
Tobacco
Depletes Vitamin C levels(192).
Smokers use 25 mg of Vitamin
C per cigarette, which translates
into 1/2 gm per pack.
Tranquillizers
Vitamin C assists in withdrawal,
reduces withdrawal side
effects(54)
Vitamin
C, Alcohol Detoxification
and Relief of Hangovers
____________________________________________
Research
investigating Vitamin C's
ability to aid in detoxification
following alcohol and drug
abuse is one of the most
promising avenues of research
being pursued today (54,79,187).
In a highly promising report
prepared by Zannoni and
co-workers(245) at the Third
Conference on Vitamin C,
Vitamin C was described
as being able to oxidize
alcohol in the following
manner: Vitamin C generates
a peroxide which is then
used by catalase in the
oxidation of alcohol. The
body has an ascorbate-dependent
detoxification system which
is more active than the
alcohol dehydrogenase or
Cytochrome P-450 microsomal
systems. In one study, whereas
half the alcohol-dosed guinea
pigs developed liver necrosis,
none of the Vitamin C-treated
animals developed liver
damage.
In humans,
Vitamin C was demonstrated
to significantly enhance
alcohol clearance, and even
to effect substantial improvements
in behaviour, especially
motor coordination. And,
since Vitamin C reduces
fat accumulation in the
liver following alcohol
consumption, it appears
that Vitamin C may protect
against direct damage to
the liver from alcohol.
Experiments
for the Future
____________________
It would
appear to be self-evident
that the interaction of
Vitamin C, itself such a
ubiquitous and complexly
integral part of the entire
body's biochemistry, with
other equally complex vitamins
and minerals, is not simple.
Biochemistry and homeostatic
metabolism normally provides
for an elaborate system
of feedback loops and safety
valves, to ensure our proper
functioning. Knowledge about
how large doses of Vitamin
C interact with other essential
nutrients is eagerly awaited.
