Vitamin C: Requirements, health benefits, overdose & deficiency symptoms

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Vitamin C Supplementation

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Vitamin C Requirements: Optimal Health Benefits vs Overdose

Even many of those who generally do not take nutritional supplements on a regular basis will still take the odd

Vitamin C tablet when feeling a cold coming on, compliments of Linus Pauling's best-seller "Vitamin C and

the Common Cold," which rocketed the immune-enhancing effects of ascorbic acid to fame, and thanks to

the many articles and books which since followed. While the recommended daily or dietary allowance (RDA)

stands now at 75 - 90 mg per day for adults (see bottom of page), a higher dietary reference intake (DRI) is

again in review. However, many of those who regularly supplement Vitamin C, take in the vicinity of 250 mg

to 1,000+mg per day, and there are those who take up to, and beyond 10,000 mg daily.

Headlines about oxidative damage (DNA mutations) attributed to taking Vitamin C in excess of 500 mg per

day had many people step back and reconsider their supplemental routines. In addition, similar studies had

come to light just prior to the Vitamin C revelation about the potential problems of regularly supplementing

Beta Carotene. This however, as it turned out later, only applied to smokers who had used higher doses of

synthetic, but not natural sources of beta carotene, which made the use of natural-source, mixed carotenoids

the preferred choice and more popular.

Once the headlines on the possible DNA-damaging potential from taking higher doses of Vitamin C faded,

most people continued where they left off and resumed their previous regimen again, especially following

publications to the contrary which indicated that the original studies on Vitamin C were flawed, and that epi-

demiological data showed no evidence at all that higher amounts of ascorbic acid caused cancer. (see also

Acu-Cell Disorders "Cancer").

However, questions on what daily amounts of Vitamin C could be considered to be an "overdose" still come

up on a regular basis, to which unfortunately, there is no universal answer applicable to everyone, because

overdosing on Vitamin C - just like overdosing on any other nutrient - is RELATIVE to the level of

those elements that interact with Vitamin C. In other words, it all depends on the combined intake of all

synergistic and antagonistic nutrients, and their ratio to Vitamin C.

Why do some people maintain good health without supplements?

When one analyzes people living to a ripe old age in reasonable health without the help of any supplements,

one finds that they had a lot of odds in their favor. It usually starts with excellent genes, followed by a lack of

factors that tend to upset the biochemical balance necessary to maintain good health. Anything upsetting that

balance will either shorten someone's life, worsen its quality, or require compensation through extra nutritional

support or drug intervention. A centenarian who never touched a supplement in his life has likely maintained

such a balance as a result of little "pro-oxidant" activity, which necessitated little "antioxidant" activity -- just to

mention one example.

On the other hand, let's assume a very healthy individual with similar longevity odds in his favor ends up with

a serious injury early in life. The imbalance introduced to his previously sound chemistry by drug treatments

or organ damage will have him for the rest of his life search for compensatory factors to improve the quality of

life. Unlike before his injury, he is now in the same situation as those born less fortunate health-wise, and may

now have to become more reliant on better nutrition and/or additional supplementation. So the reason for

supplementation, and the amounts needed, change with individual circumstances.

Even without previous injury, there are enough genetic variations or environmentally introduced factors that

are responsible for some people to benefit from ingesting several grams of ascorbic acid per day, in contrast

to those requiring no additional intake. The most common reason is that they likely exhibit excessive levels of

Vitamin C antagonists, or factors that inhibit Vitamin C activity. Of those, by far the most common one is

copper, but there are others, such as excessive levels or intake of zinc, calcium, manganese, Vitamin E...,

or very low levels of nickel, which support Vitamin C.

People with very high Copper levels rarely reach optimum levels of Vitamin C (i.e. optimal benefits), unless

they take in excess of 1,000 mg / day, or unless they lower copper first through other means, and I not only

see patients supplementing Vitamin C in the 5,000 mg -10,000 mg range and just barely reach normal levels,

but they start to suffer from medical symptoms as soon as they reduce that amount.

When exhibiting copper overload, or when there is a tendency to retain too much copper (which applies to a

majority of the population), and if a multi-vitamin / mineral formulation is used, a brand should be chosen that

is copper-free. Iron can be a problem for some people as well, but from personal clinical experience, iron

overload is not the universal problem it has been made out to be by some sources.

In contrast, there may be those whose copper level is on the low side, and they feel a cold coming on, so they

start to take a few grams of Vitamin C. Even after just a few days of doing so, copper levels may drop to a

point of provoking an inflammatory response.

After I traced the first few cases of acute right-sided conjunctivitis to copper deficiency following a short

course of very high ascorbic acid intake by these individuals, subsequent cases were quite amused when

asked about - and confirmed - their recent Vitamin C "overdose" as soon as they walked into my office.

Chronic conjunctivitis can occur from originally higher copper stores being more gradually depleted as a

result of an ongoing, excessive intake of Vitamin C. Or, it can develop secondary to a high intake of other

copper antagonists, such as Sulfur (MSM, glucosamine sulfate).

In another chronic copper deficiency / high Vitamin C example, a young boy was brought into my office to

investigate the reason why his leg bones were soft and becoming increasingly malformed. It turned out that

his father was giving him 2,000 mg of Vitamin C a day, starting shortly after he was born, which resulted in a

severe, long-term copper deficiency. Reducing the Vitamin C to more reasonable levels, and recommending

some copper-rich foods for the boy, corrected the condition.

Ascorbic acid lowers Zinc directly, and it lowers it indirectly by supporting Iron uptake, so while higher intake

of Vitamin C would likely be beneficial for those suffering from some forms of anemia, leukemia, left-sided

ovarian cysts, or from prostatitis, it could compromise benign prostatic hypertrophy, certain liver conditions

(hemochromatosis), or more serious kidney disease (renal failure).

Larger amounts of Vitamin C lower Manganese levels and aid greater insulin production in those capable of

producing insulin, which may be beneficial for Type II diabetics, but it would worsen those with hypoglycemic

tendencies that exhibit low sodium, since sodium slows insulin response, so a high intake of Vitamin C would

create larger insulin spikes. (see also Acu-Cell Disorders "Hypoglycemia").

By lowering manganese, Vitamin C affects glycogen stores in the liver, decreasing the liver's ability to store

larger amounts. Manganese has some control over the liver's ability to break down estrogen, so too much

Vitamin C can affect the length of the menstrual cycle and worsen low estrogenic-types of PMS. On the other

hand, congestive liver disease of the right large liver lobe will benefit from a greater intake of Vitamin C by

reducing the symptoms of high estrogenic-types of PMS, while at the same time reducing the risk to develop

estrogen-sensitive types of cancers or (fibroid) tumors that may result from a lifelong higher mean average of

estrogen.

Calcium metabolism is much affected by Vitamin C intake. For patients who suffer from calcium overload,

larger amounts of Vitamin C are an effective part of the daily regimen to keep calcium soluble and prevent it

from calcifying soft tissue. Frequently, low stomach acid levels are involved with elevated calcium as well,

for which higher Vitamin C intake is also beneficial, however acidifying strategies such as supplementing

glutamic acid with betaine HCl and pepsin, are additionally required in most of these cases. Some patients

also find lemon or lime juice, pineapple juice, or apple cider vinegar helpful for their digestion under the same

circumstances.

The proper amount of Vitamin C increases bioavailability of calcium, while very high intake of ascorbic acid

will eventually put extra demands on calcium stores (bone) to make up calcium loss, which is also reflected in

lower cellular levels of calcium. There are lots of people whose copper and zinc levels are excessively high,

making Vitamin C an ideal remedy since it is capable of lowering both, however the large amounts needed

can at the same time significantly reduce calcium levels to the point of seriously accelerating bone loss. One

way around that problem is using buffered Vitamin C, such as calcium ascorbate or sodium ascorbate (if the

kidneys can handle the extra sodium).

With low calcium levels, there are a number of possible symptoms such as insomnia, or light / restless sleep,

anxieties, leg cramps (left-sided only, unless magnesium is also low), increased daytime fatigue, joint pains

(more so left-sided), brittle nails with vertical ridges due to low calcium ratios, or increasingly horizontal,

groove-like ridges as a result of prolonged, severe deficiency.

Some of my patients requiring very large doses of Vitamin C have supplemented a small amount of Nickel,

which has helped reduce Vitamin C requirements considerably, and with it the detrimental effects of higher

dosages of ascorbic acid on the rest of the system (like lowering calcium too much), and also because of

different forms of Vitamin C - such as sodium ascorbate - not always being readily available in some areas.

While Vitamin C and Vitamin E exhibit synergistic properties in regard to antioxidant activity, increasing the

amounts of one also increases the requirements of the other, otherwise a ratio conflict, or balance problem

with nickel takes place, which can change vasodilating or vasoconstrictive properties of the coronary arteries.

While this is generally not a major problem for the average, healthy individual, it can be detrimental for those

suffering from angina-related conditions. (see also Acu-Cell Nutrition "Nickel & Cobalt" which discusses the

relationship of nickel to Vitamin C and Vitamin E).

So should one supplement or not?

The difference between healthy people who supplement Vitamin C and other basic nutrients, and healthy

ones who do not, can perhaps be compared to younger versus older people facing the same medical crisis.

Younger people simply tend to handle various medical situations better, or recover faster than older ones, so

supplementing may perhaps be compared to lowering someone's biological age.

The above graph illustrates what percentage of the population will enjoy optimal benefits from extra Vitamin C

supplementation - not counting dietary sources of Vitamin C. These amounts are based on average, cellular

requirements of Vitamin C, which go beyond the recommended deficiency-preventive minimum intake (RDA /

DRI). Instead, they take into account the synergistic and antagonistic effect of all other nutrients that interact

with Vitamin C as well, to encompass a much wider scope of disease prevention.

However, even optimal requirements tend to fluctuate under specific medical circumstances and may need to

be adjusted upwards to meet extra cellular demands (i.e. with injuries, viral / bacterial infections, high stress

situations, and other factors such as food binges [ chocolate ] resulting in copper overload).

If uncertain what one's actual requirements are, 500 mg of Vitamin C / day is universally considered to be

safe and covers basic requirements, even though that amount will not be an optimal intake for a good portion

of the population. In addition, it is better to use a basic multi-vitamin / mineral formulation with as many

essential ingredients as possible, but not much higher than the RDA / DRI, despite the fact that this may

not provide optimal amounts of nutrients. The reason is simply that no multi-formulation will ever provide all

essential nutrients in their optimal configuration for everyone.

Requirements not only vary from one person to another, but they vary for the same person over a lifetime.

In addition, the nutrients not provided will increasingly become deficient ratio-wise if a high-potency

supplement is used. Unfortunately, optimal intake of Vitamin C - or any other nutrient - can usually only be

achieved by those who have the resources to measure their actual individual requirements.

"Bowel Tolerance" supplementation of Vitamin C only measures one's tolerance to the type of Vitamin C

and the amounts used, but it does not reflect optimal intake.

Randomly megadosing on single nutrients (including Vitamin C) creates a risk of significantly imbalancing

one's system, and it makes little difference whether water-soluble vitamins like Vitamin C and B-vitamins are

used or not. While excessive intake of fat-soluble vitamins, as well as overdosing on a number of minerals

can be toxic, even water-soluble nutrients can do an amazing amount of damage when regularly overdosed

on during their sometimes short journey through the body. Being educated about nutrition and trying to take

control of one's health is highly commendable, but sometimes it certainly helps to have a medical professional

check out what all that supplementation is actually doing to one's system.

Any time a single nutrient is supplemented at excessive amounts, one is really dealing with a much more

powerful drug-like effect. And although this has a greater potential to help a medical situation, it equally has

the potential of making a particular medical condition worse, or even create new ones if inappropriately used.

Supplementing above-RDA / DRI amounts of Vitamin C will most certainly have a positive effect on people's

general health, however the decision to megadose on Vit C (> 5,000 mg) - or any other nutrient - should at

least be supported with some valid reasons or clinical evidence. In most cases, it is the synergistic effect of

several similar nutritional compounds that yield the best results because of their more food-like attributes,

and their lesser chance of provoking side effects.

Rutin and Hesperidin are the main flavonoids / bioflavonoids - or accessory nutrients - that form an ascorbic

acid or Vitamin C complex. Both function synergistically with Vitamin C in regard to numerous health issues

which are addressed further below. (see also Acu-Cell "Bioflavonoids").

Ascorbic Acid, or Vitamin C is an essential nutrient that Humans, as well as Apes and Guinea pigs must

obtain from dietary sources. Most other animals produce ascorbic acid in the liver from glucose, and in

much higher amounts than we get from our diets today.

Vitamin C is found mostly in fruits and vegetables, where the highest concentrations are in fresh, raw foods,

while whole grains, seeds, or beans contain very little Vitamin C, except when they are sprouted, which raises

the ascorbic acid content. Similarly, animal foods contain almost no Vitamin C, although raw fish has enough

to prevent deficiency symptoms. Vitamin C is water-soluble and one of the least stable vitamins. Cooking

can destroy much of the Vitamin C content in food, and it is easily oxidized in air and sensitive to light. Being

mostly contained in the watery part of fruits and vegetables, Vitamin C is easily lost during cooking in water,

so the steaming of vegetables minimizes its loss.

Ascorbic acid was isolated from lemons in 1932, following the discovery of its link to scurvy. It was first
written about circa 1500 B.C. and described by Aristotle in 450 B.C. as a syndrome characterized by lack of

energy, tooth decay, gum inflammation, and bleeding problems. A high percentages of sailors with the British

navy and other fleets used to die from scurvy until James Lind discovered that the juice of lemons could cure

and also prevent the disease. The ships then routinely carried limes for the sailors to consume daily, and thus

these sailors became known as "limeys." Only about 10 mg of Vitamin C is necessary to prevent scurvy.

Ascorbic acid is used up more rapidly with alcohol use, smoking, and under stressful conditions. Other

factors that increase Vitamin C requirements include viral illness and fever, Aspirin and other medications

(sulfa antibiotics, cortisone), environmental toxins (DDT), and exposure to heavy metals such as mercury,

lead, or cadmium. Vitamin C is involved in the formation and maintenance of collagen, which is the basis of

connective tissue found in capillary walls, skin, ligaments, cartilage, vertebral discs, joint linings, bones and

teeth. Collagen, and thus Vitamin C, is needed for wound healing and to maintain healthy blood vessels.

Vitamin C helps thyroid hormone production and the metabolism of folic acid, tyrosine, and tryptophan, and

it stimulates adrenal function and the release of norepinephrine and epinephrine, which are stress hormones.

However, prolonged stress depletes Vitamin C in the adrenals and decreases blood levels. Ascorbic acid is

important in cellular immune functions, where it may be helpful against bacterial, viral, and fungal diseases.

At higher amounts, Vitamin C may decrease the production of histamine, thereby reducing allergy potential.

A combination of very high doses of Vitamin C + Vit E + Vit B12 has been found effective in lessening the

symptoms of shingles (herpes zoster), provided they are all taken at the earliest onset of the attack.

Vitamin C helps the absorption of iron (particularly the vegetable, or non-heme form), so it is helpful for iron-

deficiency anemia. Other conditions that benefit from ascorbic acid metabolism include diabetes (for insulin

production), certain cases of male infertility, as well as arteriosclerosis, atherosclerosis, cataracts, glaucoma,

and musculoskeletal degeneration (mostly by Vitamin C keeping calcium soluble and preventing it from going

too high).

When no other test methods are available, most doctors recommend the "Bowel Tolerance Challenge" for

determining the optimal intake of Vitamin C - by ingesting increasing amounts of ascorbic acid until diarrhea

sets in, then reducing Vitamin C to a tolerated dose, which - as mentioned above - only reflects someone's

tolerance to the type of Vitamin C used, but it does not assure meeting actual requirements. ¤

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Dietary Reference Intake (DRI) is the latest term replacing daily dietary reference values such as:

Adequate Intake (AI *), Nutrient Reference Value (NRV), Tolerable Upper Intake Level (UL), Estimated

Average Requirements (EAR), and Recommended Dietary Allowance / Intake (RDA / RDI).

Vitamin C / Ascorbic Acid:

DRI (RDA):MalesFemales

0 - 6 months

40 mg AI *

40 mg

AI *

6 - 12 months

50 mg

AI *

50 mg AI *

1 - 5 years

20 mg

5 - 10 years

25 mg

10 - 18 years

45 - 75 mg

45 - 65 mg

18 years +

90 mg

75 mg

pregnant / lactating

+ 45 mg

smoking

+ 35 mg

Therapeutic Range:250 mg - 25,000 mg+

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Cellular / Intracellular Attributes and Interactions:

Vitamin C Synergists:Vitamin C Antagonists:

Nickel, Iron, phosphorus, germanium, selenium,

Manganese, zinc, calcium, Vitamin E,

tin, Vitamin A, adrenals, [cobalt, Vitamin B15],

copper, [cobalt, Vitamin B12], estrogen,

Low Levels / Deficiency - Symptoms and/or Risk Factors:

Scurvy, slow wound healing, anemia, easy bruising, shortness of breath, fatigue, nosebleeds, gastrointestinal

problems, frequent infections, dermatitis, chronic gingivitis, impaired formation and maintenance of collagen,

impaired multiple hormonal functions, increased risk for various cancers, arthritis, reduced insulin production,

some types of male infertility, vascular degeneration, depression, gallstones.

High levels / Overdose / Toxicity / Negative Side Effects - Symptoms and/or Risk Factors:

Diarrhea, abdominal cramps, high stomach acid, increased urination, insomnia, irritability, PMS, joint pains,

osteoporosis, headaches, hypoglycemia, weakness, anemia, may increase infections by causing copper

deficiency, reduced estrogen, reduced progesterone, reduced prolactin.

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Vitamin C Sources:

Citrus fruit, green peppers, sweet and hot peppers, potatoes, spinach, parsley, cabbage, broccoli, Brussels

sprouts, rose hips, black currants and other berries, tomatoes, horseradish, watercress. ¤

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General recommendations for nutritional supplementation: To avoid stomach problems and promote better

tolerance, supplements should always be taken earlier, or in the middle of a larger meal. When taken on an

empty stomach or after a meal, there is a greater risk of some tablets causing irritation, or eventually erosion

of the esophageal sphincter, resulting in Gastroesophageal Reflux Disease (GERD). It is also advisable not

to lie down immediately after taking any pills. When taking a very large daily amount of a single nutrient, it is

better to split it up into smaller doses to not interfere with the absorption of other nutrients in food, or nutrients

supplemented at lower amounts.

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Vitamin C Requirements & Benefits

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