Articles written by me on Self-care and Palliative Medicine
On Self-Care & Palliative Medicine

Do You C?

Ascorbic Acid, the scientific name for Vitamin C, was formally identified in lemons in 1928, but the symptoms of disease created by Vitamin C deficiency had been described for thousands of years previously. Aristotle, in 450 B.C. described a syndrome characterized by fatigue, gum inflammation, tooth decay, and bleeding problems. These same symptoms, later named scurvy, were a common malady of seasoned eighteenth century sailors who had extended voyages without fruits and vegetables. Once the British navy became “limeys” with their daily consumption of limes on long voyages, their scurvy problems ceased; other cultures discovered that powdered rose hips, acerola cherries or regular consumption of spruce-needle teas could provide the same protection. And in this country today, Vitamin C is still the most widely used supplement–even among landlubbers.

Did you know that most animals produce their own Vitamin C? Apparently, humans, primates, guinea pigs, and a subtype of bats are the only critters who must obtain this essential nutrient from dietary sources. And, essential it is! With varied and abundant health benefits, Vitamin C is best known as a cell protector, immunity booster, and a powerful antioxidant. This vitamin has a critical role in the production and maintenance of collagen (a substance found in skin, ligaments, bones, and other connective tissues), in the formation of red blood cells and the maintenance of strong blood capillaries, and in assisting other nutrients (such as iron) to be absorbed. Vitamin C is necessary in the production of antibodies, in maintaining normal white blood cell activity, and even in promoting optimal functioning of brain and nervous system. And, as an antioxidant, it provides protection against free radical compounds that contribute heavily to the initiation of disease and the aging process in our bodies.

Though Vitamin C doesn’t really seem to prevent colds, it does appear to lessen the severity and duration of colds and flu. It helps to keep gums strong and healthy, to speed wound healing, and to minimize bruising. Vitamin C appears to work in conjunction with Vitamin E to protect LDL cholesterol from oxidation, and consequently decrease plaque build up in coronary arteries. It has protective effect in decreasing cataract formation, and as a natural antihistamine, it can be helpful in relieving allergy and asthma symptoms. Also, as a powerful antioxidant and immune booster, Vitamin C is being widely studied as a protection or adjunctive therapy for some cancers. So how much Vitamin C do we really need in our daily consumption, and what are the best sources?

Well, it depends on who you ask. The current RDA for Vitamin C is between 60–100mg for most adults. Although this figure is being reconsidered as possibly too low, it is an amount that is easily obtained from one orange and 3 ounces of cooked broccoli each day(though only a few diehard Californians would consume broccoli on a regular, daily basis!). And, if an individual makes fruits and vegetables a dietary mainstay (consuming them two to three times a day in the forms of raw, green salads, fresh fruits and juices, and lightly cooked or steamed vegetable dishes), it’s fairly easy to consume 250–500mg of Vitamin C per day in natural dietary form.

There are a host of Vitamin and Supplement experts providing advice to a bewildered health-conscious public. Andrew Weil recommends between 1000-2000 mgs of Vitamin C two or three times per day. Michael Janson, M.D., author of The Vitamin Revolution in Health Care, believes 3 to 4 grams per day to be the “baseline for most people.” Two time Nobel prize winner, Linus Pauling, took 18 grams of Vitamin C daily and remained a vital, active man up into his 90s. And, another Vitamin guru, Robert Cathcart, M.D., advocates “bowel tolerance” dosages of Vitamin C. He maintains that our bodies will alert us with diarrhea when we have consumed sufficient Vitamin C; and the sicker we are, the more Vitamin C we need and can absorb without bowel problems. As an example, he cites bowel tolerance in healthy people as 10 to 15 grams per day, while people with colds tolerate 30 to 60 grams per day, and people with serious illness can handle as such as 200 grams per day. Though this notion is provocative, I’m not ‘boweled over’ by the implications. So, what’s a pragmatic approach when experts have such divergent opinions?

Get as much Vitamin C as you can from your diet. Plenty of fruits and vegetables–especially in raw form provide the best natural sources. Remember, Vitamin C is water-soluble and heat sensitive, so it is not stored in the body and can be inactivated by cooking. Citrus fruits, cantaloupes, strawberries, red and green peppers, broccoli, tomatoes, parsley, dark leafy greens, and cabbage are excellent dietary sources. Additionally, in foods, we get all the important Vitamin C co factors (such as bioflavonoids) which are not necessarily present in supplements. People who depend primarily on supplements for their Vitamin C (or for any nutrients) are “hoping the supplements contain the same mix of micronutrients found in foods. That’s hoping for too much.” (Katharine Colton, 1998) Consider supplementing natural sources of the vitamin with 1 to 6 grams/day especially during periods of illness or acute stress. And remember, smokers, diabetics, heavy alcohol consumers, the elderly, and women on birth control pills all have higher Vitamin C needs. Now, after all of this helpful information, orange you glad you read my Insight this week?

Stephen L. Hines, M.D.
October 2000

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