Vitamin C- The Real Story

by Steve Hickey

  The Body’s Premier Water-Soluble Antioxidant

  Oxidation and reduction are essential to life. Too high a concentration of oxygen poisons tissues, producing free radical damage, which can be prevented by antioxidants. Vitamin C is the most important water-soluble antioxidant in our diet. It is also the main water-soluble antioxidant in plants and is essential for growth.3 Its great abundance in plant tissue allows us to prevent acute scurvy by eating a relatively small amount of fruits and vegetables. Its synthesis in large amounts in both plants and most animals suggests that higher levels may be essential for good health.

  Vitamin C is unusual in that it has two antioxidant electrons that it can donate to prevent oxidation. When ascorbic acid donates one electron, it becomes the ascorbyl radical, which is relatively unreactive, short-lived, and harmless. This lack of reactivity enables vitamin C to intercept dangerous free radicals, donating an electron to satisfy their demand, and thus preventing damage. If an ascorbyl radical donates its second electron, it forms dehydroascorbate. Dehydroascorbate is an oxidized form and can be reduced (given electrons) back to ascorbate, the vitamin C molecule. This reduction and replenishment of vitamin C is performed within cells, but it requires electrons from the cellular metabolism. The metabolic processes in a cell serve two main purposes—to provide chemical energy for reactions and to generate high-energy antioxidant electrons to maintain the redox state of the cell. High doses of vitamin C are unique in that they can provide the cell with a supply of antioxidant electrons without drawing on the cell’s essential energy supply. This is useful for healthy cells, but damaged and stressed cells gain a double benefit—a supply of antioxidant electrons and an energy boost.

  In Sickness and In Health

  Oxidation and free radicals cause disease. Healthy tissue has high levels of ascorbate and low levels of its oxidized form, dehydroascorbate. In the oxidizing environment of sick tissues, vitamin C protects the cells from damage, becoming oxidized to dehydroascorbate in the process.4 An increase in oxidized vitamin C has been shown in many different conditions. Tissue damage in surgery can increase the level of dehydroascorbate relative to ascorbate.5 Diabetics have increased oxidative stress and higher dehydroascorbate levels.6 High levels of oxygen increase dehydroascorbate in mice.7 Similarly, mice with inflammation and arthritis have higher levels of dehydroascorbate. Diabetic kidneys increase vitamin C oxidation in rats, as does inflammation, but antioxidant supplementation can inhibit this effect.8 Other free radical scavengers, such as glutathione, the most abundant antioxidant in cells, can also be used as indicators of damage or poor health.9 The proportion of oxidized glutathione is a measure of tissue damage. Vitamin C and glutathione work together to maintain tissue health.10

  Most animals manufacture vitamin C internally and increase production when sick, thus increasing their ascorbate to dehydroascorbate ratio. This helps return the sick tissues to a healthy, reduced state. Humans, however, having lost the ability to make vitamin C internally, compensate by increasing absorption from the gut: when sick, humans can absorb far more dietary vitamin C, which may help them through the crisis. This response of increasing absorption will only work if there is an abundance of vitamin C in the diet. Since modern human diets generally have a low vitamin C content, the increased absorption will be ineffective unless the person is using dietary supplements.

  Earlier, we saw that applying a vitamin C solution to a cut apple prevents browning and oxidation, at least for a short time. Ultimately, however, the electrons provided by the added vitamin C will be used up and the surface of the apple will eventually turn brown. When the vitamin C has been oxidized, it can no longer protect the apple’s surface. Many dietary antioxidants provide a similarly limited resistance to oxidation. If an antioxidant, such as vitamin E, enters an inflamed or damaged tissue, it will donate electrons to prevent some of the free radical damage. Having donated its electrons, it becomes unable to continue its function as an antioxidant. However, in healthy tissues, metabolism provides energy and electrons to regenerate antioxidants.

  Vitamins C and E can act to transfer these antioxidant electrons to free radicals before they can cause damage. Unfortunately, in damaged or sick tissues, cells are under stress and may be unable to provide enough antioxidant electrons from their stressed energy supply to prevent further oxidation damage. Under these conditions, vitamins C and E are described as being rate-limited, since they can only donate electrons at the speed at which they are provided by the cell’s metabolism. Fortunately, as Robert F. Cathcart III suggested, vitamin C is a nontoxic, non-rate-limited antioxidant available in the diet.11

  Suppose, instead of painting the surface of the apple, we allowed a solution of vitamin C to continuously flow across it. The apple could then be maintained in its white, pristine condition, protected by the flow of vitamin C and antioxidant electrons. As the vitamin C molecules donate their electrons, other molecules immediately replace them and the electron supply would be maintained in abundance. Given a constant flow of vitamin C, even a sick or damaged tissue could remain in a reduced (non-oxidized) state.

  Vitamin C is different from the other dietary antioxidants, such as vitamin E or selenium. Other antioxidants do not have the properties needed for vitamin C’s unique antioxidant effect. Some, like selenium, are more toxic and cannot be given in massive doses. Coenzyme Q10 is nontoxic but more fat-soluble and thus is retained in the body, unable to provide the necessary flow. Vitamin E, a mixture of tocopherols and tocotrienol molecules, is also fat-soluble and a large molecule. Ascorbic acid is a small, water-soluble molecule with an exceedingly low toxicity, so it can be given in massive doses (up to 200 grams a day) to provide large amounts of free antioxidant electrons. Dr. Cathcart, who used massive doses to treat disease, first described the potential for vitamin C to act in this way and more recently helped extend this approach to the dynamic flow model.12 In dynamic flow, the body is maintained in a reducing state, in health or disease, by a continuous large intake of vitamin C.

  The body can absorb a sustained large intake of vitamin C, which is distributed around the body. However, at the same time it is being absorbed into the body, the kidneys are rapidly removing vitamin C from the blood. Just like in the flow across the cut apple, the body can now be maintained in a reduced state with minimal free radical damage. Oxidized vitamin C no longer needs to be regenerated by energy from metabolism; it is simply excreted and replaced by fresh intake. A sick cell is in an oxidized state and needs a constant supply of antioxidant electrons and energy. By supplying free antioxidant electrons, dynamic flow vitamin C saves the cell energy and protects it by providing abundant antioxidant electrons.

  Vitamin C Therapy

  Pharmacological doses of vitamin C, as are used to treat disease, should not be confused with basic nutrition. A person may take, for example, 8 grams (8,000 mg) a day to provide antioxidant protection and lower the incidence of infection, and such an intake would be effective provided it was spread through the day in divided doses. However, at the first sign of a cold, this relatively high nutritional intake would need to be dramatically increased.

  People have been misled about the intakes needed for treating the common cold. Many people think the orthomolecular claim is that you should take a gram or two as a treatment. This is a myth. The actual recommendations for vitamin C in treatment of illness are larger. Typically, the dose is increased tenfold or more. The Vitamin C Foundation recommends taking at least 8 grams (8,000 mg) of vitamin C every twenty minutes for 3–4 hours until bowel tolerance, and then smaller dosages every 4–6 hours to prevent recurrence.”13 The apparently large 8-gram nutritional dose is now a minimum to be repeated every twenty minutes!

  Dr. Cathcart has provided estimates of the amount of vitamin C needed to reach bowel tolerance (loose stool) in various diseases. These values range from around 30 grams (30,000 mg) for a mild cold to over 200 grams (200,000 mg) for viral pneumonia. An individual’s bowel tolerance level is proportional to the s
everity of their illness. Many people have claimed that vitamin C does not work against the common cold; generally, these are people who take only a gram or two and expect a therapeutic response. You need the amount of vitamin C that your body indicates it needs—not the amount you think you should take, but the amount that does the job. Oddly enough, orthomolecular physicians and conventional doctors both agree on this: a gram of vitamin C is not an effective treatment for the common cold. The difference is that conventional doctors assume this means that vitamin C can be discounted, while the orthomolecular view is that a 1-gram dose is ridiculously small.

  Conventional medicine’s evident confusion over nutritional and pharmacological doses is not necessarily innocent. When Linus Pauling first published his book Vitamin C and the Common Cold, the establishment attacked him without sympathy or consideration of the science. Throughout his career, Dr. Pauling had been involved in scientific disputes, but this was something of a different nature. To try to brand one of the leading scientists of all time as a quack because he suggested that vitamin C could help against the common cold was odd. It seems strange that the medical establishment would get so upset over a simple vitamin and the common cold. Surely, some of the detractors had read the literature and were aware of the evidence for the effects of massive doses. Notably, if the claims for vitamin C were accepted, pharmaceutical companies might lose more than a few profits from cold medications.

  If clinical studies with appropriate doses of vitamin C had been performed, there might be no vitamin C controversy. However, since Dr. Pauling’s book, conventional medicine has been careful to avoid doing (and therefore having anyone read) studies on massive doses of vitamin C. By defining a single gram of vitamin C as a large dose, repeated clinical trials have studied limited doses in the range of up to a gram or so. These “high doses” of vitamin C, in the range of 500–1,500 mg, have repeatedly been shown to have a mixed and inconsistent effect on the progress of a common cold. Now you can see why that is so. The media is quick to notice these studies, preferentially disseminating negative information to the public and inaccurately assuring people that vitamin C is ineffective.

  There is a huge difference between the size of the suggested therapeutic doses and those used merely to investigate vitamin C’s nutritional properties. Therapeutic doses are more than 1,000 times the Recommended Dietary Allowance (RDA)/Dietary Reference Intake (DRI) value. Comparing the nutritional doses to pharmacological doses of vitamin C is equivalent to suggesting a small tree is similar in height to Mount Everest: just as no one would suggest a child requires oxygen or an ice axe to climb a tree, orthomolecular doctors do not claim that gram-level doses of vitamin C will cure disease.

  One of the first scientists to realize that massive doses of vitamin C could force the body into a reducing state, and thus help combat disease, was Irwin Stone, Ph.D. He noticed that a range of diseases increase the ratio of oxidized to reduced vitamin C: the more severe the illness, the greater the oxidation.14 Over time, this led to the idea that perhaps a disease process requires oxidation and produces an excess of free radicals. If this is the case, then a dynamic flow of vitamin C might neutralize free radicals, returning sick tissue to a reducing redox state. Vitamin C modifies cell signaling, modulates the body’s immune response, prevents shock, and lowers inflammation. The body’s response to stress is optimal in a reducing environment. If correct, this would mean that vitamin C could protect against a wide range of insults and disease states.

  Frederick R. Klenner, M.D., suggested that, in human disease, vitamin C follows the law of mass action: in reversible reactions, the extent of chemical change is proportional to the active masses of the interacting substances. In other words, the more vitamin C taken, the greater is the effect. Giving low megadoses might, at best, suppress symptoms while prolonging the duration of the disease. In the intervening half century, other physicians such as Drs. Robert Cathcart, Abram Hoffer, and Tom Levy have repeatedly reported similar observations. These clinical observations are consistent with all the known scientific facts and, given the size of the reported effects, cannot be explained by the placebo effect.

  The aim of vitamin C therapy is to keep the ratio of ascorbate to dehydroascorbate high. This is accomplished by keeping the incoming supply on the high side. Doing so will provide damaged cells with a reducing environment and will facilitate their recovery. Typically, antioxidants are engaged in a continuous oxidation-reduction cycle, and this cycling uses energy from the metabolic pathways of the cell.15 Remember that stressed cells are unable to regenerate sufficient antioxidants to meet the increased demand, and that’s why we have to come to their rescue with high doses of ascorbate.

  Our tabletop model for this damage and stress is a cut apple. By supplying sufficient vitamin C in a continuous flow, we can keep the apple’s surface in a pristine state. This process can work with other tissues. Massive doses of vitamin C will extinguish most free radicals and replenish antioxidants that have become oxidized. It enhances redox signaling within the damaged tissue, helping to provide an appropriate healing response to the illness.

  The flow of fresh vitamin C through the body means that diseased cells get a large “free” supply of antioxidant electrons, lowering the demand on the cells’ energy metabolism. Massive doses of vitamin C free other molecules from acting as antioxidants and help restore normal metabolic function.16 Vitamin C provides injured cells with a free supply of antioxidant electrons, helping return the injured body to good health.

  The body’s need for vitamin C increases dramatically when sick. The amount of vitamin C a person can absorb increases as health decreases. Providing a dynamic flow of vitamin C through the body returns the damaged tissue back to a reducing state and health.

  CHAPTER 6

  Infectious Diseases

  “Do not let yourself be tainted with a barren skepticism.”

  —LOUIS PASTEUR (ATTRIBUTED)

  Areader of the DoctorYourself.com website relayed a story about how, one Monday morning some years ago, he had a fever of 102°F, although normally he rarely suffered illness. He immediately set about taking 10 grams (10,000 mg) of vitamin C each hour, expecting to get loose stools quickly. However, despite this massive intake, he did not reach bowel tolerance on the first day. The next day, he increased the dose to 15 grams each hour. Two days later, still feeling sick, he endeavored to take an entire bottle of vitamin C (250 grams). He would have arranged an intravenous infusion, but he was unwell and no doctors nearby provided this therapy. He gradually became annoyed by the fact that he could not induce loose stools. On Friday, a friend took him to a local hospital to ensure that he was not seriously ill. The hospital recommended that he be admitted but were unable to provide an immediate diagnosis. He declined the offer and went home, where he continued taking massive amounts of vitamin C. On saturday night, his fever broke, with profuse sweating. He went to an internist, who declared him to be in perfect health.

  Two weeks earlier, this same man had received emergency calls from the health department. Three people from a hotel where he had stayed had become ill with similar symptoms. Each had gone to a different hospital and had died, a few days later, from Legionnaires’ disease, a rare form of pneumonia that may follow inhalation of minute droplets of water contaminated with Legionella bacteria.1 Severe Legionnaires’ disease has an overall mortality rate of 10–30 percent,2 and 30–50 percent of patients need intensive care.3 Following blood tests, one of the nation’s leading Legionnaires’ disease experts confirmed that the man had a fatal form of legionellosis. The physician initially doubted the validity of the results, which were confirmed by a second test. The doctor seemed surprised that the subject had survived … and then stated that vitamin C could not be a factor. some medical practitioners persist in the rather unscientific denial of the effectiveness of vitamin C in such conditions; in this case, the physician had no direct evidence upon which to base such a statement. The patient, however, now had a satisfactory explanat
ion for not achieving bowel tolerance, even with huge oral intakes of vitamin C.

  Pneumonia

  The anecdote about vitamin C’s action in Legionnaires’ disease is intriguing, but vitamin C is also reported to be an effective treatment for more common forms of pneumonia. Here, we use pneumonia to represent the large number of infectious diseases for which people have claimed vitamin C to be an effective treatment or even cure.4

  Prevention is obviously easier than treating severe illness. Immediate use of hourly gram doses of vitamin C up to saturation will usually stop bronchitis or pneumonia from ever starting. Robert F. Cathcart III, M.D., advocated treating pneumonia with up to 200,000 mg (200 grams) of vitamin C daily, often taken intravenously. (Pneumonia is a severe disease and needs immediate medical attention by a qualified physician. Also, intravenous sodium ascorbate should only be administered by a doctor.) A person can simulate this process by taking vitamin C in frequent large doses by mouth. When one of the authors (A.W.S.) had pneumonia, he took 2,000 mg of vitamin C every six minutes to reach saturation. His daily dose was over 100,000 mg (100 grams). Fever, cough and other symptoms were reduced in hours and complete recovery took just a few days. This response was comparable to that expected from an antibiotic, but the ascorbate was both safer and cheaper.