12-13-2004, 12:28 PM
Dear Reader,
Around this time of year I always get questions about vitamin
C from friends, family and, of course, HSI members. It's no
secret that an ample daily intake of vitamin C may act as a
preventive against the common cold while also reducing the
duration of symptoms once a cold has set in. But how much
vitamin C should be taken, and what form of the vitamin is
most effective?
Here's a question from a member named Gary: "We saw a
naturopathic doctor who promotes giving vitamin C in high
dose intravenously. He says that much more is effectively
absorbed since all the dosage is in the bloodstream. Is this
safe and does he have a point?"
This question is tailor-made for HSI Panelist Allan Spreen,
M.D., so I asked Dr. Spreen to field this one, and here's his
response:
"Sometimes doses are needed that go beyond the intestinal
tract's ability to absorb. There is a point called 'bowel
tolerance' at which no further ingested doses of vitamin C are
useful (other than to flush out the intestinal tract, since bowel
tolerance levels cause diarrhea). Bypassing this route by
using intravenous access can permit far higher absorption of
vitamin C. Depending on the problem, such a technique can
be very useful."
------------------------------------------------------------
The "C" list
------------------------------------------------------------
For those of us who don't need to resort to using intravenous
vitamin C, there are still several different forms of
supplementary C to choose from. Here's Dr. Spreen's quick
rundown of those forms:
* ASCORBIC ACID: This is the standard form of vitamin C.
Calcium ascorbate is one of the salt forms of the nutrient (as
opposed to the acid form). It is usually synthetic, as are other
forms, such as sodium ascorbate, magnesium ascorbate, etc.
It tends to be bitter, while ascorbic acid is sour.
* NATURAL vs. SYNTHETIC: The synthetic vitamin C
molecule is chemically identical to natural forms. The
difference arises in other nutrients that accompany the C,
such as bioflavonoids, which make the C more effective.
That's not to say that I don't prefer natural; it's just that it's
very hard to come by, and extremely expensive. So the
chances of high doses of C (like 1000 milligram capsules)
being all-natural are low. One possibility, however, would be
Sago Palm source vitamin C, which is considered a lower
risk for those who are extremely allergic.
* ROSE HIPS: This natural form of vitamin C is very
expensive, so nobody sells it exclusively (to my knowledge).
Manufacturers put a little in with the synthetic source for
marketing purposes. In its natural state, meaning mixed by
Mother Nature with attending bioflavonoid fractions, there's
little question (to those who treat with it regularly) that less
amount of rose hips is needed for an equivalent biological
action.
* ACEROLA VITAMIN C: This is another natural form
(from a tropical American shrub). Like rose hips, acerola is
usually mixed with synthetic.
* VITAMIN C COMPLEX: This is somewhat non-specific,
and can be any group of
related items, such as multiple salts of C (calcium,
magnesium, potassium, sodium ascorbates, for example).
* ESTER C: There is some issue concerning Ester C, touted
as stronger than the
standard form. I don't think it's any stronger, and neither did
Dr. Linus Pauling, though you'll see commercials that
indicate otherwise. Some people do feel it has less of a
tendency to upset their stomach, however.
* FAT SOLUBLE VITAMIN C: The fat-soluble form of
vitamin C is called ascorbyl palmitate, and is better absorbed
and stored by the body than water-soluble forms. (All the
other forms of C are water-soluble.) Ascorbyl palmitate is
harder to find, and more expensive.
------------------------------------------------------------
Absorb this
------------------------------------------------------------
As I've mentioned in previous e-Alerts, the amount of any
vitamin you take is not necessarily the amount that your body
ends up absorbing and ultimately putting to use.
Stating that, "Absorption is the key to everything," Dr.
Spreen tries to give the body what he calls "luxuriant
amounts" of nutrients (which he believes it can handle in
high doses, as opposed to drugs), and hopes the body gets
what it needs.
Complicating the absorption issue is the fact that your body's
ability to absorb nutrients is not necessarily the same from
one day to the next. Dr. Spreen says, "The degree of vitamin
C absorption changes depending upon the dose ingested and
the body's need at any particular time. For example, 6000
milligrams might cause loose stools in a given healthy person
when the same person during a bout with the flu might be
able to take 20,000 milligrams without difficulty.
"Some people are less tolerant to vitamin C in the acid form.
For them, switching to the salt form (sodium ascorbate,
calcium ascorbate, magnesium ascorbate, etc.) often permits
far higher tolerance."
Dr. Spreen also points out that absorption may be facilitated
by the regular use of vitamin C. "Assuming you take enough
(RDA amounts won't do it), high doses of vitamin C
'awaken' dormant enzyme systems that can utilize the
additional doses of the nutrient. Over a period of time they
get used to having the higher dose and 'jack up' to
accommodate."
As a final note, Dr. Spreen recommends that vitamin C (as
well as other vitamins) be taken in capsule-form or
powdered. If you take a pill-form, make sure it dissolves
quickly in water.
...and another thing
I expect that a survey of HSI members would turn up
relatively few smokers, but I wouldn't be surprised to find
that many of us might be former smokers. And I have to
admit, I count myself among that group. But even those of us
that kicked the habit years ago could still be feeling the
effects of emphysema.
When smoking damages lung alveoli, the gas exchange
process in the lungs is impaired and breathing becomes more
difficult. But an English study has shown that mice induced
with a condition comparable to emphysema experienced a
significant restoration of alveoli and general lung function
when treated with retinoic acid, a form of vitamin A.
This trial confirms the results of earlier research on retinoic
acid that came to similar conclusions. In fact, in 1997 an HSI
member named John wrote to us with this question about one
of those trials: "A recent study found that retinoic acid cured
emphysema in rats. They say that researchers are a long way
from human studies, but would there be any harm in trying
retinoic acid supplements now?"
The short answer to John's question is yes, there could be
harm in trying retinoic acid. Here's how two HSI Panelists
responded in the September 1997 Members Alert:
Martin Milner, N.D.: "The retinoic acid used in the study you
mention is manufactured as a relatively new chemotherapy
drug. The potential side effects are numerous and common,
including headaches (86%), fever (83%), bone pain (77%),
and nausea and/or vomiting (57%). Nutritionally oriented
physicians have been using vitamin A and mixed carotenoids
for years in the treatment of emphysema. Retinoic acid may
offer some further benefit in increasing the number of lung
sacs (alveoli) but at a big price (the side effects). I would not
recommend it."
Michael Rosenbaum, M.D.: "I have never used retinoic acid
for treating emphysema and wouldn't advise anyone to
experiment with it. I have used vitamin A many times,
however, for these reasons: (1) it helps to restore the integrity
of the mucosal lining of the respiratory tract; (2) most folks
with emphysema are or were smokers. Smoking profoundly
depletes Vitamin A; and (3) emphysema patients are prone to
serious lung infections. Vitamin A is an immune stimulant
par excellence. However, therapeutic doses are well above
the RDA and vary from patient to patient. It is necessary to
monitor serum levels."
So while you may be barking up the right tree by using
vitamin A to address emphysema, it would be wise to consult
a doctor before starting a high-dosage vitamin A regimen.
To Your Good Health,
Jenny Thompson
Around this time of year I always get questions about vitamin
C from friends, family and, of course, HSI members. It's no
secret that an ample daily intake of vitamin C may act as a
preventive against the common cold while also reducing the
duration of symptoms once a cold has set in. But how much
vitamin C should be taken, and what form of the vitamin is
most effective?
Here's a question from a member named Gary: "We saw a
naturopathic doctor who promotes giving vitamin C in high
dose intravenously. He says that much more is effectively
absorbed since all the dosage is in the bloodstream. Is this
safe and does he have a point?"
This question is tailor-made for HSI Panelist Allan Spreen,
M.D., so I asked Dr. Spreen to field this one, and here's his
response:
"Sometimes doses are needed that go beyond the intestinal
tract's ability to absorb. There is a point called 'bowel
tolerance' at which no further ingested doses of vitamin C are
useful (other than to flush out the intestinal tract, since bowel
tolerance levels cause diarrhea). Bypassing this route by
using intravenous access can permit far higher absorption of
vitamin C. Depending on the problem, such a technique can
be very useful."
------------------------------------------------------------
The "C" list
------------------------------------------------------------
For those of us who don't need to resort to using intravenous
vitamin C, there are still several different forms of
supplementary C to choose from. Here's Dr. Spreen's quick
rundown of those forms:
* ASCORBIC ACID: This is the standard form of vitamin C.
Calcium ascorbate is one of the salt forms of the nutrient (as
opposed to the acid form). It is usually synthetic, as are other
forms, such as sodium ascorbate, magnesium ascorbate, etc.
It tends to be bitter, while ascorbic acid is sour.
* NATURAL vs. SYNTHETIC: The synthetic vitamin C
molecule is chemically identical to natural forms. The
difference arises in other nutrients that accompany the C,
such as bioflavonoids, which make the C more effective.
That's not to say that I don't prefer natural; it's just that it's
very hard to come by, and extremely expensive. So the
chances of high doses of C (like 1000 milligram capsules)
being all-natural are low. One possibility, however, would be
Sago Palm source vitamin C, which is considered a lower
risk for those who are extremely allergic.
* ROSE HIPS: This natural form of vitamin C is very
expensive, so nobody sells it exclusively (to my knowledge).
Manufacturers put a little in with the synthetic source for
marketing purposes. In its natural state, meaning mixed by
Mother Nature with attending bioflavonoid fractions, there's
little question (to those who treat with it regularly) that less
amount of rose hips is needed for an equivalent biological
action.
* ACEROLA VITAMIN C: This is another natural form
(from a tropical American shrub). Like rose hips, acerola is
usually mixed with synthetic.
* VITAMIN C COMPLEX: This is somewhat non-specific,
and can be any group of
related items, such as multiple salts of C (calcium,
magnesium, potassium, sodium ascorbates, for example).
* ESTER C: There is some issue concerning Ester C, touted
as stronger than the
standard form. I don't think it's any stronger, and neither did
Dr. Linus Pauling, though you'll see commercials that
indicate otherwise. Some people do feel it has less of a
tendency to upset their stomach, however.
* FAT SOLUBLE VITAMIN C: The fat-soluble form of
vitamin C is called ascorbyl palmitate, and is better absorbed
and stored by the body than water-soluble forms. (All the
other forms of C are water-soluble.) Ascorbyl palmitate is
harder to find, and more expensive.
------------------------------------------------------------
Absorb this
------------------------------------------------------------
As I've mentioned in previous e-Alerts, the amount of any
vitamin you take is not necessarily the amount that your body
ends up absorbing and ultimately putting to use.
Stating that, "Absorption is the key to everything," Dr.
Spreen tries to give the body what he calls "luxuriant
amounts" of nutrients (which he believes it can handle in
high doses, as opposed to drugs), and hopes the body gets
what it needs.
Complicating the absorption issue is the fact that your body's
ability to absorb nutrients is not necessarily the same from
one day to the next. Dr. Spreen says, "The degree of vitamin
C absorption changes depending upon the dose ingested and
the body's need at any particular time. For example, 6000
milligrams might cause loose stools in a given healthy person
when the same person during a bout with the flu might be
able to take 20,000 milligrams without difficulty.
"Some people are less tolerant to vitamin C in the acid form.
For them, switching to the salt form (sodium ascorbate,
calcium ascorbate, magnesium ascorbate, etc.) often permits
far higher tolerance."
Dr. Spreen also points out that absorption may be facilitated
by the regular use of vitamin C. "Assuming you take enough
(RDA amounts won't do it), high doses of vitamin C
'awaken' dormant enzyme systems that can utilize the
additional doses of the nutrient. Over a period of time they
get used to having the higher dose and 'jack up' to
accommodate."
As a final note, Dr. Spreen recommends that vitamin C (as
well as other vitamins) be taken in capsule-form or
powdered. If you take a pill-form, make sure it dissolves
quickly in water.
...and another thing
I expect that a survey of HSI members would turn up
relatively few smokers, but I wouldn't be surprised to find
that many of us might be former smokers. And I have to
admit, I count myself among that group. But even those of us
that kicked the habit years ago could still be feeling the
effects of emphysema.
When smoking damages lung alveoli, the gas exchange
process in the lungs is impaired and breathing becomes more
difficult. But an English study has shown that mice induced
with a condition comparable to emphysema experienced a
significant restoration of alveoli and general lung function
when treated with retinoic acid, a form of vitamin A.
This trial confirms the results of earlier research on retinoic
acid that came to similar conclusions. In fact, in 1997 an HSI
member named John wrote to us with this question about one
of those trials: "A recent study found that retinoic acid cured
emphysema in rats. They say that researchers are a long way
from human studies, but would there be any harm in trying
retinoic acid supplements now?"
The short answer to John's question is yes, there could be
harm in trying retinoic acid. Here's how two HSI Panelists
responded in the September 1997 Members Alert:
Martin Milner, N.D.: "The retinoic acid used in the study you
mention is manufactured as a relatively new chemotherapy
drug. The potential side effects are numerous and common,
including headaches (86%), fever (83%), bone pain (77%),
and nausea and/or vomiting (57%). Nutritionally oriented
physicians have been using vitamin A and mixed carotenoids
for years in the treatment of emphysema. Retinoic acid may
offer some further benefit in increasing the number of lung
sacs (alveoli) but at a big price (the side effects). I would not
recommend it."
Michael Rosenbaum, M.D.: "I have never used retinoic acid
for treating emphysema and wouldn't advise anyone to
experiment with it. I have used vitamin A many times,
however, for these reasons: (1) it helps to restore the integrity
of the mucosal lining of the respiratory tract; (2) most folks
with emphysema are or were smokers. Smoking profoundly
depletes Vitamin A; and (3) emphysema patients are prone to
serious lung infections. Vitamin A is an immune stimulant
par excellence. However, therapeutic doses are well above
the RDA and vary from patient to patient. It is necessary to
monitor serum levels."
So while you may be barking up the right tree by using
vitamin A to address emphysema, it would be wise to consult
a doctor before starting a high-dosage vitamin A regimen.
To Your Good Health,
Jenny Thompson