VITAMIN C, TITRATING TO BOWEL TOLERANCE, ANASCORBEMIA, AND ACUTE INDUCED SCURVY

[Guest guest]

If you have taken pharmacueticals or drugs in the past, been exposed to toxic

substances (and who hasn't been).you most likely have a toxic buildup which can

make you sick. You have been acumulating it over a lifetime.

 

Vitamin C is the great detoxifier. Don't take a laxative, that is mainly to sell

laxatives as " detoxifiers " . The chemical toxins are stored wherever the body can

put them until it gets a chance to detoxify them. They can be in the fat, bones,

organs etc. What can happen all too often in our modern society is that the

intake never ceases Learn and read about vitamin in depth if you want good

health.

 

When the body gets a break because you stopped taking the poison

(pharmacueticals etc) the body starts to detoxify itself using the avalable

amounts of nutrients that is in it and the organ capacities it still has after

you have damaged them wiith the same toxins.

 

You need a nutrient dense diet and supplements to keep up. In fact you can

appear very ill due to the toxins leaching out because they are poisons. You

also must stop putting more in so the body can concentrate on taking them out.

This is particularly important that you eat pure foods. This usually means

organic and no transfatty oils.

 

Vitamin C is the most powerfull and versitle nutrient on the face of the earth.

Read on for some of the cures possible.

 

F.

 

http://www.doctoryourself.com/titration.html

 

VITAMIN C, TITRATING TO BOWEL TOLERANCE, ANASCORBEMIA, AND ACUTE INDUCED SCURVY

 

Robert F. Cathcart, III, M.D. Allergy, Environmental, and Orthomolecular

Medicine 127 Second Street, Los Altos, California 94022, USA Telephone

650-949-2822 http://www.orthomed.com ABSTRACTA method of utilizing vitamin C in

amounts just short of the doses which produce diarrhea is described (TITRATING

TO BOWEL TOLERANCE). The amount of oral ascorbic acid tolerated by a patient

without producing diarrhea increases somewhat proportionately to the stress or

toxicity of his disease. Bowel tolerance doses of ascorbic acid ameliorate the

acute symptoms of many diseases. Lesser doses often have little effect on acute

symptoms but assist the body in handling the stress of disease and may reduce

the morbidity of the disease. However, if doses of ascorbate are not provided to

satisfy this potential draw on the nutrient, first local tissues involved in the

disease, then the blood, and then the body in general become deplete of

ascorbate (ANASCORBEMIA and ACUTE INDUCED SCURVY). The patient is

thereby put at risk for complications of metabolic processes known to be

dependent upon ascorbate. INTRODUCTIONOver the past ten-year period I have

treated over 9,000 patients with large doses of vitamin C (Cathcart 1, 2, 3, 4,

5). The effects of this substance when used in adequate amounts markedly alters

the course of many diseases. Stressful conditions of any kind greatly increase

utilization of vitamin C. Ascorbate excreted in the urine drops markedly with

stresses of any magnitude unless vitamin C is provided in large amounts.

However, a more convenient and clinically useful measure of ascorbate need and

presumably utilization is the BOWEL TOLERANCE. The amount of ascorbic acid which

can be taken orally without causing diarrhea when a person is ill sometimes is

over ten times the amount he would tolerate if well. This increased bowel

tolerance phenomenon serves not only to indicate the amount which should be

taken but indicates the unsuspected and astonishing magnitude of the

potential use that the body has for ascorbate under stressful conditions.

If this massive draw on the small ascorbate stores of the body is not fully

satisfied, the condition of ANASCORBEMIA results. The deficit of ascorbate

probably starts in the tissues directly involved in the disease and then spreads

to other tissues of the body. A condition of localized and then systemic acute

scurvy is produced. This ACUTE INDUCED SCURVY leads to poor healing and

ultimately to complications involving other systems of the body.

Much of the original work with large amounts of vitamin C was done by Fred R.

Klenner, M.D. (6, 7, 8, 9) of Reidsville, North Carolina. Klenner found that

viral diseases could be cured by intravenous sodium ascorbate in amounts up to

200 grams per 24 hours. Irwin Stone (10, 11, 12) pointed out the potential of

vitamin C in the treatment of many diseases, the inability of humans to

synthesize ascorbate, and the resultant condition hypoascorbemia. Linus Pauling

(13, 14) reviewed the literature on vitamin C and has led the crusade to make

known its medical uses to the public and the medical profession. Ewan Cameron in

association with Pauling (15, 16, 17) has shown the usefulness of ascorbate in

the treatment of cancer. BOWEL TOLERANCE METHODIn 1970, I discovered that the

sicker a patient was, the more ascorbic acid he would tolerate by mouth before

diarrhea was produced. At least 80% of adult patients will tolerate 10 to 15

grams of ascorbic acid fine crystals in 1/2 cup water divided

into 4 doses per 24 hours without having diarrhea. The astonishing finding was

that all patients, tolerant of ascorbic acid, can take greater amounts of the

substance orally without having diarrhea when ill or under stress. This

increased tolerance is somewhat proportional to the toxicity of the disease

being treated. Tolerance is increased some by stress (e.g., anxiety, exercise,

heat, cold, etc.)(see FIGURE I). Admittedly, increasing the frequency of doses

increases tolerance perhaps to half again as much, but the tolerances of

sometimes over 200 grams per 24 hours were totally unexpected. Representative

doses taken by tolerant patients titrating their ascorbic acid intake between

the relief of most symptoms and the production of diarrhea were as follows:

TABLE I - USUAL BOWEL TOLERANCE DOSES

GRAMS ASCORBIC ACID NUMBER OF DOSES CONDITION PER 24

HOURS PER 24 HOURS normal 4 - 15 4

- 6 mild cold 30 - 60 6 - 10 severe cold

60 - 100+ 8 - 15 influenza 100 - 150 8

- 20 ECHO, coxsackievirus 100 - 150 8 - 20 mononucleosis

150 - 200+ 12 - 25 viral pneumonia 100 - 200+

12 - 25 hay fever, asthma 15 - 50 4 - 8 environmental

and food allergy 0.5 - 50

4 - 8 burn, injury, surgery 25 - 150+ 6 - 20 anxiety,

exercise and other mild stresses 15 -

25 4 - 6 cancer 15 - 100 4 - 15

ankylosing

spondylitis 15 - 100 4 - 15 Reiter's syndrome 15 -

60 4 - 10 acute anterior uveitis 30 - 100 4 - 15

rheumatoid arthritis 15 - 100 4 - 15 bacterial infections

30 - 200+ 10 - 25 infectious hepatitis 30 - 100 6

- 15 candidiasis 15 - 200+ 6 - 25

FIGURE 1. REPRESENTATIVE DOSES TO TREAT ACUTE SYMPTOMS OF

DISEASE IN PATIENTS VERY TOLERANT TO ASCORBIC ACID

 

GRAMS ASCORBIC ACID ORALLY PER 24 HOURS

1) Note that disease symptom curves indicate very little effect on acute

symptoms until doses of 80-90% of bowel tolerance are reached. Perhaps it is

only near tolerance doses that the ascorbate is pushed into the primary sites of

the disease. 2) Suppression of symptoms in some instances may not be total; but

usually it is very significant and often the amelioration is complete and rapid.

3) Hepatitis may require 30 to 100 grams. TITRATING TO BOWEL TOLERANCEThe

maximum relief of symptoms which can be expected with oral doses of ascorbic

acid is obtained at a point just short of the amount which produces diarrhea.

The amount and the timing of the doses are usually sensed by the patient. The

physician should not try to regulate exactly the amount and timing of these

doses because the optimally effective dose will often change from dose to dose.

Patients are instructed on the general principles of determining doses and given

estimates of the reasonable starting amounts and timing of

these doses. I have named this process of the patient determining the optimum

dose, TITRATING TO BOWEL TOLERANCE. The patient tries to TITRATE between that

amount which begins to make him feel better and that amount which almost but not

quite causes diarrhea.

I think it is only that excess amount of ascorbate not absorbed into the body

which causes diarrhea; what does not reach the rectum, does not cause diarrhea.

It is interesting to know, when one speculates on the exact cause of this

diarrhea, that while a hypertonic solution of sodium ascorbate is being

administered intravenously, the amount of ascorbic acid tolerated orally

actually increases. THE 100 GRAM COLDWhen a person is ill the amount of

ascorbic acid he can ingest without diarrhea being produced increases somewhat

proportionally to the severity or the toxicity of the disease. A cold severe

enough to permit a person to take 100 grams of ascorbic acid per 24 hours during

the peak of the disease, I call a 100 GRAM COLD. INDIVIDUAL RESPONSESPerhaps

one of the most important principles in ORTHOMOLECULAR MEDICINE is BIOCHEMICAL

INDIVIDUALITY (18). Every individual responds to substances differently. Vitamin

C is no exception. However, at least 80% of my patients tolerated ascorbic acid

well. Admittedly, there were relatively few older patients in my practice.

Infants, small children, and teenagers tolerate ascorbic acid well and can

take, proportionate to their body weight, larger amounts than adults. Older

adults tolerate lesser amounts and have a higher percentage of nuisance

difficulties. Patients with multiple food intolerances may have more

difficulties but should attempt taking ascorbate because of benefits often

obtained.

For several years while I was treating only sick people with ascorbic acid, I

was unaware of the number of people who had nuisance problems with maintenance

doses. The tolerance of the sick person to ascorbate is so high as to prevent

many of the complaints one would have if he were well. When ascorbic acid is

prescribed to a sick person, the beneficial effect is obvious enough so that few

complain of the gas and diarrhea. With illness the effects of an overdose do not

last long because of the rapid rate of utilization.

It is important for the physician to understand the principles of treating this

vast majority of tolerant persons. Patients frequently underdose themselves and

need professional guidance to push the doses to effective levels. The small

number of persons, especially elderly persons, intolerant to oral doses are in

my experience able to take intravenous ascorbate without difficulties.

Additionally, patients with severe problems may need to be treated intravenously

if very high doses will have to be maintained for some time for adequate

suppression of symptoms. ANASCORBEMIA -- ACUTE INDUCED SCURVYIt is well

established that certain symptoms are associated with an almost total lack of

vitamin C within the body. Symptoms of scurvy include lassitude, malaise,

bleeding gums, loss of teeth, nosebleeds, bruising, hemorrhages in any part of

the body, easy infections, poor healing of wounds, deterioration of joints,

brittle and painful bones, and death, etc. It is thought that this disease

only occurs with dietary deprivation of vitamin C. However, an analogous

condition is produced as follows:

Well-nourished humans usually contain not much more than 5 grams of vitamin C in

their bodies. Unfortunately, the majority of people have far less ascorbate than

this amount in their bodies and are at risk for many problems related to failure

of metabolic processes dependent upon ascorbate. This condition is called

CHRONIC SUBCLINICAL SCURVY (12).

If a disease is toxic enough to allow for the person's potential consumption of

100 grams of vitamin C, imagine what that disease must be doing to that possible

5 grams of ascorbate stored in the body. A condition of ACUTE INDUCED SCURVY is

rapidly induced. Some of this increased metabolic need for ascorbate undoubtedly

occurs in areas of the body not primarily involved in the disease and can be

accounted for by such functions as the adrenals producing more adrenaline and

corticoids; the immune system producing more antibodies, interferon (19, 20),

and other substances to fight the infection; the macrophages utilizing more

ascorbate with their increased activity; and the production and protection of

c-AMP and c-GMP with the subsequent increased activity of other endocrine glands

(21), etc. Also, there must be a tremendous draw on ascorbate locally by

increased metabolic rates in the primarily infected tissues. The infecting

organisms themselves liberate toxins which are neutralized

by ascorbate, but in the process destroy ascorbate. The levels of ascorbate in

the nose, throat, eustachian tubes, and bronchial tubes locally infected by a

100 gram cold must be very low indeed. With this acute induced scurvy localized

in these areas, it is small wonder that healing can be delayed and complications

such as chronic sinusitis, otitis media, and bronchitis, etc. develop.

I had assumed that much of this ascorbate was used for functions somehow

directly related to neutralizing the toxicity of viral and bacterial diseases.

When ill, one has the internal sense that something of this nature is happening

when bowel tolerance is approached. Recently, however, I had the personal

experience of ingesting 48 grams in an hour and a half when I had a sudden hay

fever reaction to roses. Upon withdrawal from the roses tolerance dropped

rapidly to normal. This experience plus my experiences with many patients under

emotional stress, would indicate that the adrenals are capable of utilizing

large amounts of ascorbate with benefit if it is made available.

This draw on ascorbate, from whatever source, lowers the blood level of

ascorbate to a negligible level. I have coined the term ANASCORBEMIA for this

condition. If this anascorbemia is not rapidly rectified by the oral

administration of bowel tolerance doses of ascorbic acid or by intravenous

administration of ascorbate, the remainder of the body is rapidly depleted of

ascorbate and put at risk for disorders of the metabolic processes dependent

upon vitamin C.

The following problems should be expected with increased incidence with severe

depletion of ascorbate: disorders of the immune system such as secondary

infections, rheumatoid arthritis and other collagen diseases, allergic reactions

to drugs, foods and other substances, chronic infections such as herpes, or

sequelae of acute infections such as Guillain-Barre' and Reye's syndromes,

rheumatic fever, or scarlet fever; disorders of the blood coagulation mechanisms

such as hemorrhage, heart attacks, strokes, hemorrhoids, and other vascular

thrombosis; failure to cope properly with stresses due to suppression of the

adrenal functions such as phlebitis, other inflammatory disorders, asthma and

other allergies; problems of disordered collagen formation such as impaired

ability to heal, excessive scarring, bed sores, varicose veins, hernias, stretch

marks, wrinkles, perhaps even wear of cartilage or degeneration of spinal discs;

impaired function of the nervous system such as malaise,

decreased pain tolerance, tendency to muscle spasms, even psychiatric disorders

and senility; and cancer from the suppressed immune system and carcinogens not

detoxified; etc. Note that I am not saying that ascorbate depletion is the only

cause of these disorders, but I am pointing out that disorders of these systems

would certainly predispose to these diseases and that these systems are known to

be dependent upon ascorbate for their proper function.

Not only is there the theoretical probability that these types of complications

associated with infections or stresses could result from ascorbate depletion,

but there was a conspicuous decrease in the expected occurrence of complications

in the thousands of patients treated with oral tolerance doses or intravenous

doses of ascorbate. This impression of marked decrease in these problems is

shared by physicians experienced with the use of ascorbate such as Klenner (8,

9) and Kalokerinos (22). THE MISSING STRESS HORMONE Stone (11) has described

the genetic defect whereby the higher primates lost the ability to synthesize

ascorbate. This defect is caused by a mutated defective gene for the liver

enzyme, L-gulonolactone oxidase. The higher mammals (except for the higher

primates) developed a feedback mechanism which increases ascorbate synthesis

under the influence of external and internal stresses (23).

There are many well-established functions of vitamin C that help in the handling

of stress. When stressed, the higher mammals can augment these functions by this

feedback mechanism. For the higher primates, including humans, ascorbate can

amount to the MISSING STRESS HORMONE (4).

I have seen strong clinical evidence that not only does the bowel tolerance to

ascorbate increase under stress but that fully satisfying that potential use for

ascorbate markedly reduces secondary diseases and complications following stress

or primary disease. Since 1970, with teaching the bowel tolerance method of

determining proper ascorbic acid doses to patients, I have not had to

hospitalize a single patient for an acute viral disease or a complication from

such a disease if the patient utilized the method. In some cases, such as with

three cases of viral pneumonia, it was necessary to utilize intravenous

ascorbate. Admittedly, I have been lucky because no patient has arrived with

such severe symptoms as to necessitate immediate hospitalization. There have

been many patients where there was no question that they would have required

hospitalization in a very short period of time had not ascorbate been

administered. Some patients not quite taking bowel tolerance doses, but taking

significantly large doses of ascorbate, would not have as dramatic suppression

of acute symptoms but would, nevertheless, avert complications.

MONONUCLEOSISAcute mononucleosis is a good example because there is such an

obvious difference between the course of the disease, with and without

ascorbate. Also, it is possible to obtain laboratory diagnosis to verify that it

is mononucleosis being treated. Early in this study a 23-year-old, 98-pound

librarian with severe mononucleosis claimed to have taken 2 heaping tablespoons

every 2 hours, consuming a full pound of ascorbic acid in 2 days. She felt

mostly well in 3 to 4 days, although she had to continue about 20 to 30 grams a

day for about 2 months.

Many cases do not require maintenance doses for more than 2 to 3 weeks. The

duration of need can be sensed by the patient. I had ski patrol patients back

skiing on the slopes in a week. They were instructed to carry their boda bags

full of ascorbic acid solution as they skied. The ascorbate kept the disease

symptoms almost completely suppressed even if the basic infection had not

completely resolved. The lymph nodes and spleen returned to normal rapidly and

the profound malaise was relieved in a few days. It is emphasized that tolerance

doses must be maintained until the patient senses he is completely well, or the

symptoms will recur. HEPATITIS Acute cases of infectious hepatitis have

responded dramatically. Cases included two orthopaedic surgeons who probably

acquired the disease pricking their hands at surgery and being inoculated with a

patient's blood. With ascorbate treatment laboratory tests including the SGOT,

SGPT, and bilirubins indicated rapid reversal of the disease. In

one of these cases, with the doctorpatient and his treating physicians having

difficulty believing that the ascorbate was responsible for the improvement, the

ascorbate was discontinued. The condition of the patient rapidly deteriorated.

The patient's wife took charge and doled out the ascorbate; again the disease

rapidly subsided with laboratory findings returning to normal.

Usually oral bowel tolerance doses will reverse hepatitis rapidly. Stools

regularly return to normal color in 2 days. It generally takes about 6 days for

the jaundice to clear, but the patient will feel almost well after 4 to 5 days.

Because of the diarrhea caused by the disease, intravenous ascorbate may need to

be used in very severe cases. Often large doses of ascorbic acid, taken orally

despite diarrhea, will cause a paradoxical cessation of the diarrhea.

Morishige has demonstrated the effectiveness of ascorbate in preventing

hepatitis from blood transfusions (24). UNSICKThe phenomenon of symptoms

returning repeatedly if the ascorbate is not continued in high doses is most

convincing. It is possible to have symptoms come and go many times. In fact,

there is often a feeling when titrating to bowel tolerance that symptoms are

beginning to return just before taking the next dose.

Often a patient will sense that he is probably catching some viral disease and

that he is in need of large doses of ascorbic acid. If he is experienced in

taking ascorbic acid he may be able to suppress more than 90% of the symptoms.

He feels that he should take large amounts of ascorbate, does not feel quite

right, and may have peculiar mild symptoms. I call this condition UNSICK.

Recognition of this state is important because it can be mistaken for more

serious conditions. INTRAVENOUS AND INTRAMUSCULAR ASCORBATESymptoms from acute

viral diseases can most frequently be more permanently eliminated with

intravenous sodium ascorbate. While it is true that tolerance doses of oral

ascorbate will usually eliminate complications of acute viral diseases; at

times, such as with certain cases of influenza, the large amount of oral

ascorbate necessary to suppress symptoms over a period of a week or more,

sometimes makes intravenous ascorbate desirable. Clinically large amounts of

ascorbate

used intravenously are virucidal (2, 5, 7, 8).

The sodium ascorbate used intravenously and intramuscularly must contain no

preservatives. Usually there is only a small amount of EDTA in the preparation

to chelate trace amounts of copper and iron which might destroy the ascorbate.

Solutions containing sodium ascorbate 250 or 500 mgm per cc can be obtained. The

250 mgm solutions may be used in young children intramuscularly in doses usually

350 mgm/kg body weight up to every 2 hours. When the volume of the material

becomes too great for intramuscular injections, then the intravenous route

should be used. Inadequate doses will be ineffective. Quite frequently a child

initially refusing oral ascorbate will cooperate after injections if given the

alternative. While this method of persuasion seems cruel, it is better than the

complications which might otherwise occur. These intramuscular injections can be

used in a crisis situation. Kalokerinos (22) describes cases where certain death

in infants already in shock has been averted by

emergency intramuscular ascorbate.

For intravenous solutions concentrations of 60 grams per liter are made with the

250 or 500 mgm/cc sodium ascorbate diluted with Ringer's lactate, 1/2N saline,

1N saline, D5W, or distilled water for injection. I prefer the latter, but one

has to be absolutely sure that an error is not made and pure water given.

Ascorbate is more efficient intravenously than orally probably because chemical

processes in the gut destroy a percentage of that orally administered. Doses of

400 to 700 mgm/kg of body weight per 24 hours usually suffice. Rate of infusion

and the total amount administered can be determined by making sure that symptoms

are suppressed and that the patient not become dehydrated or receive sodium too

rapidly. Local soreness in the vein caused by too rapid infusion is relieved by

slowing the intravenous infusion. One gram of calcium gluconate should be added

to the bottles each day to prevent tetany.

I have not yet seen a case of phlebitis develop as a result of ascorbate

administration. This rarity of phlebitis possibly suggests that this condition

sometimes has something to do with ascorbate depletion.

Frequently I have the patient take oral doses of ascorbic acid at the same time

he is taking intravenous sodium ascorbate. Bowel tolerance is actually increased

by concomitant use of intravenous ascorbate. Care and experience is necessary

with concomitant use because tolerance drops precipitously when the intravenous

infusion is discontinued. BACTERIAL INFECTIONSAscorbic acid should be used with

the appropriate antibiotic. The effect of ascorbic acid is synergistic with

antibiotics and would appear to broaden the spectrum of antibiotics

considerably. I found that penicillin-K orally or penicillin-G intramuscularly

used in conjunction with bowel tolerance doses of ascorbic acid would usually

treat infections caused by organisms ordinarily requiring ampicillin or other

more modern synthetic penicillins. Cephalosporins were used in conjunction with

ascorbic acid for staphylococcus infections. The combination of tetracycline and

ascorbate was used for nonspecific urethritis; however,

patients who had previously repeated recurrences of nonspecific urethritis

found they were free of the disease with maintenance doses of ascorbate. I am

not sure that the tetracycline was necessary even in the acute cases, but it was

used for legal reasons. Some other cases of unknown etiology such as two cases

of Reiter's disease and one case of acute anterior uveitis also responded

dramatically to ascorbate.

A most important point is that patients with bacterial infections would usually

respond rapidly to ascorbic acid plus a basic antibiotic determined by initial

clinical impressions. If cultures subsequently proved the selection of

antibiotic incorrect, usually the patient was well by that time.

In the case of a 45-year-old man who had developed osteomyelitis of the 5th

metacarpal of the right hand following a cat bite, a partial amputation of the

hand had been recommended and surgery scheduled. Consultants agreed. The patient

delayed surgery and signed himself out of the hospital. He was given intravenous

ascorbate 50 grams a day for 2 weeks. The infection resolved rapidly. While this

patient had destruction of the distal end of the metacarpal, there has been no

recurrence of the infection (25).

This case illustrates the frequent problem of an indolent infection with an

organism non-responsive to the most sophisticated antibiotic treatment which

then may respond rapidly to treatment with intravenous ascorbate.

Treating simultaneously with the appropriate antibiotic plus ascorbate has the

additional advantage that if, unexpectedly, the infection is actually viral, the

infection will be suppressed and the incidence of allergic reaction to the

antibiotic reduced. VITAMIN C AND ALLERGYPatients seemed not to develop their

first allergic reaction to penicillin when they had taken bowel tolerance

ascorbate for several doses. Among the several thousand patients given

penicillin, two cases of brief rash were seen in patients who had taken their

first dose of penicillin along with their first dose of ascorbate. If one

understands the reasons for bowel tolerance doses of ascorbate, it is obvious

that these patients were not as yet " saturated. " I saw three patients who had

taken penicillin without ascorbate who had developed an urticarial rash. These

cases rapidly responded to oral ascorbic acid. Only a single dose of

antihistamine was usually used. I would have anticipated longer reactions in

most

of these cases. I saw one case of a delayed serum sickness type of penicillin

reaction in a ten-year-old girl who had not taken ascorbate previously. The rash

in this patient did not immediately respond to ascorbic acid. The rash took

about two weeks to completely resolve; however, if the ascorbate was not taken

regularly to tolerance, the rash would worsen. It was difficult to maintain high

doses in this patient.

Patients who had known-previous-allergic reactions to penicillin were never

given the antibiotic anticipating that vitamin C would protect them. I suspect

that the deficit of body ascorbate produced by disease may have something to do

with malfunction of the immune system and the development of allergies. However,

whether ascorbate may give some protection from an antibiotic known previously

to cause an allergic reaction in a patient, when subsequent reactions might

involve anaphylaxis, is a question which must be approached very carefully.

Certainly, inadequate doses of ascorbate could be disastrous.

Patients with mononucleosis, untreated with ascorbate, have a very high

incidence of allergic reaction to penicillin. It is interesting that this same

disease seems to cause some of the highest bowel tolerances of any disease.

As can be seen from the previous discussion of the increasing bowel tolerance

phenomenon, there is undoubtedly increased utilization of ascorbate under

stressful conditions. If this increased utilization creates a deficit, there may

be malfunctions of various systems of the body such as the immune system which

are dependent on ascorbate. Therefore, it should not be surprising that certain

malfunctions of the immune system and adrenal glands associated with stress

might be ameliorated by ascorbate.

Hay fever is controlled in the majority of patients. Bowel tolerance doses are

usually required only at the peak of the season; otherwise, more modest doses

suffice. Many patients find the effect of ascorbate more satisfactory than

immunizations or antihistamines and decongestants. The dosages required are

frequently proportional to exposure to the antigen.

Asthma is most often relieved by bowel tolerance doses of ascorbate. A child

regularly having asthmatic attacks following exercise is usually relieved of

these attacks by large doses of ascorbate. So far all of my patients having

asthmatic attacks associated with the onset of viral diseases have been

ameliorated by this treatment.

Large clinical studies will be necessary to prove this point, but for now

prudent practice would be to take large doses ofascorbate when stressed or when

ill.

This theory begins to make some sense of the observation that many patients will

develop allergic disorders or other diseases following combinations of stress,

disease, and malnutrition. Immunologists should be particularly interested in

the control of these allergic problems and particularly the dramatic responses

of cases of ankylosing spondylitis, Reiter's disease, and acute anterior

uveitis. All three of these problems have a high association with the HLA-B27

antigen. The possibility that ascorbate might have some value in controlling the

immune response at the gene level should be thoroughly investigated because

there could be some basic implications in histocompatibility (graft acceptance),

cancer control, and destruction of foreign invaders. Ascorbate would appear to

help stabilize some homeostatic mechanisms. CANDIDA ALBICANSYeast infections

occur less frequently in patients treated with antibiotics if bowel tolerance

doses of ascorbic acid are simul- taneously used.

Ascorbic acid seems to reduce the systemic toxicity considerably but does not

eliminate the primary infection. It has been helpful to patients with allergic

problems secondary to candida. FUNGUS INFECTIONSAlthough ascorbic acid should

be given in some form to all sick patients to help meet the stress of disease,

it is my experience that ascorbate has little effect on the primary fungal

infections. Systemic toxicity and complications can be reduced in incidence. It

may be found that appropriate antifungal agents will better penetrate tissues

saturated in ascorbate. TRAUMA, SURGERY, AND BURNSSwelling and pain from

trauma, surgery, and burns are markedly reduced by bowel tolerance doses of

ascorbic acid. Doses should be given a minimum of 6 times a day for trauma and

surgery. Burns can require hourly doses. Serious burns, major trauma, and

surgery should be treated with intravenous ascorbate. The effect of ascorbate on

anesthetics should be studied. Barbiturates and many narcotics

are blocked, (26) so their use as anesthetic agents will be limited when

ascorbate is used during surgery. While practicing orthopaedic surgery, I had

some experience with trauma cases in which I used ascorbic acid

post-operatively. There was virtual elimination of confusion in elderly patients

following major surgeries such as with hip fractures when ascorbate was given.

This confusion is commonly ascribed to fat embolization and the subsequent

inflammation provoked in the tissues by the emboli. I did several menisectomies

where one knee had been done before vitamin C was used, and the other side after

vitamin C was used. The pain and post-operative recovery time were lessened

considerably. The amount of inflammation and edema following injury and surgery

were markedly reduced. The pain medications used were relatively minimal. My

limited experience in replacing skin flaps avulsed by trauma indicated a whole

degree of lessened difficulties with much greater success.

Anyone who has done animal surgery other than on humans is impressed by the

rapid recovery rate. Humans loaded with ascorbate would appear to recover

similarly to the animals which make their own ascorbate in response to stress.

In the past, vitamin C administered to patients in hospitals post-operatively

has been in trivial amounts never exceeding several grams. I predict that

reimplantations of major amputations, even transplant surgeries, and especially

fine surgeries of the eyes, ears, or fingers will enjoy a phenomenal increase in

success rate when ascorbate is utilized in doses of 100 grams or more per 24

hours.

The limited stress-coping mechanisms of humans seems to be the result of rapid

ascorbate depletion. With surgery this leads to vascular thrombosis, hemorrhage,

infection, edema, drug reactions, shock, adrenal collapse with limited

adrenaline and steroid production, etc. CANCERI have avoided the treatment of

cancer patients for legal reasons; however, I have given nutritional consults to

a number of cancer patients and have observed an increased bowel tolerance to

ascorbic acid. Were I treating cancer patients, I would not limit their ascorbic

acid ingestion to a set amount but would titrate them to bowel tolerance. Ewan

Cameron's advice against giving cancer patients with widespread metastasis large

amounts of ascorbate too rapidly at first should be heeded. He found that

sometimes extensive necrosis or hemorrhage in the cancer could kill a patient

with widespread metastasis if the vitamin was started too rapidly (16).

Hopefully, in the future ascorbic acid will be among the initial

treatments given cancer patients. The additional nutritional needs of cancer

patients are not limited to ascorbic acid, but certainly the stress involved

with having the disease depletes ascorbate levels in the body. Ascorbate should

be used in cancer patients to avert disorders of ascorbate deficiency in various

systems of the body including the immune system. BACK PAIN FROM DISC

DISEASEGreenwood (27) observed that 1 gram a day would reduce the incidence of

necessary surgery on discs. At bowel tolerance levels, ascorbic acid reduces

pain about 50% and lessens the difficulties with narcotics and muscle relaxants

(2). It is not, however, the only nutritional support that patients with back

pain should receive. ARTHRITISBowel tolerance is not increased by degenerative

arthritis although occasionally ascorbate has some beneficial effect.

Ankylosing spondylitis and rheumatoid arthritis do increase tolerance. Clinical

response varies. Norman Cousins (28) curing his own ankylosing spondylitis with

ascorbate is not unexpected. With these and other collagen diseases, food and

chemical allergies can sometimes be found. It may be that the blocking of

allergic reactions with augmented adrenal function is one of the reasons these

patients are sometimes benefitted. SCARLET FEVERThree cases with typical

sandpaper-like rash, peeling skin, and diagnostic laboratory findings of scarlet

fever have responded within an hour or overnight. I think this immediate

response is due to the neutralization of the small amount of streptococcus toxin

responsible for the disease. Although I have not seen a case of acute rheumatic

fever, I would anticipate rapid effects. HERPES: COLD SORES, GENITAL LESIONS,

AND SHINGLESAcute herpes infections are usually ameliorated with bowel tolerance

doses of ascorbic acid. However, recurrences are common

especially if the disease has already become chronic. Zinc in combination with

ascorbic acid is more effective for herpes; however, caution and regular

monitoring of patients on zinc should be done.

For chronic herpes, intravenous ascorbate may also be of benefit. CRIB DEATHS

(SUDDEN INFANT DEATH SYNDROME)I would agree with Kalokerinos (22) and Klenner

(8) that crib deaths are often caused by sudden ascorbate depletions. The

induced scurvy in some vital regulatory center kills the child. This induced

deficiency is more likely to occur when the diet is poor in vitamin C. All of

the epidemiologic factors predisposing to crib deaths are associated with low

vitamin C intake or high vitamin C destruction. MAINTENANCE DOSESMaintenance

doses are established by the patient taking bowel tolerance doses 6 times a day

for at least a week. He observes if there is any unexpected benefit such as

clearing of sinuses, decrease in allergies, increase in energy, etc. Should any

chronic problem be benefitted, then the dose is decreased to the minimum amount

producing the effect. Otherwise a dose such as 4 to 10 grams a day divided in 3

to 4 doses is recommended.

In addition, the patient is told to increase the dose on stressful days. If a

patient well tolerates ascorbic acid dissolved in water, then after a short

period of time his taste will begin to regulate the dosages. Most patients can

easily sense their ascorbate needs.

Patients who take ascorbate in large amounts over a long period of time should

probably suppliment with vitamin A and a multiple mineral preparation. The

" Fortified Formulation for Nutritional Insurance " of Roger Williams (29) is

recommended as a base. COMPLICATIONSIt is my experience that ascorbic acid

probably prevents most kidney stones. I have had a few patients who had had

kidney stones before starting bowel tolerance doses who have subsequently had no

more difficulty with them. Acute and chronic urinary tract infections are often

eliminated; this fact may remove one of the causes of kidney stones. Six

patients have had mild pain on urination; five of these patients were over fifty

and none had stones.

Three out of thousands had a light rash which cleared with subsequent doses. It

was difficult to evaluate the cause of this because of concomitant infections.

Several patients had discoloration of the skin under jewelry of certain metals.

A few patients complaining of small sores in the mouth with the taking of small

doses of ascorbate had them clear with bowel tolerance doses.

Patients with hidden peptic ulcers may have pain, but some are benefitted.

Mineral ascorbates can be used for maintenance doses in these cases. Two

patients who had mild epigastric discomfort with maintenance doses of ascorbic

acid who after being given ascorbate by vein for several days were then able to

tolerate the acid orally.

It is my experience that high maintenance doses reduce the incidence of gouty

arthritis. I have not seen difficulties with giving large amounts of ascorbic

acid to patients with gout. Almost all my patients have been Caucasian, so I

have no comment on the report that ascorbate can cause certain blood problems in

certain non-white groups (30).

There has been no clinical evidence as Herbert and Jacob (31) suspected that

ascorbic acid destroys vitamin B12.

If maintenance doses of ascorbic acid in solution are used over very long

periods of time I would rinse the teeth after each dose. I would not brush my

teeth with calcium ascorbate.

There is a certain dependency on ascorbic acid that a patient acquires over a

long period of time when he takes large maintenance doses. Apparently, certain

metabolic reactions are facilitated by large amounts of ascorbate and if the

substance is suddenly withdrawn, certain problems result such as a cold, return

of allergy, fatigue, etc. Mostly, these problems are a return of problems the

patient had before taking the ascorbic acid. Patients have by this time become

so adjusted to feeling better that they refuse to go without ascorbic acid.

Patients do not seem to acquire this dependency in the short time they take

doses to bowel tolerance to treat an acute disease. Maintenance doses of 4 grams

per day do not seem to create a noticeable dependency. The majority of patients

who take over 10-15 grams of ascorbic acid per day probably have certain

metabolic needs for ascorbate which exceed the universal human species need.

Patients with chronic allergies often take large maintenance

doses.

The major problem feared by patients benefiting from these large maintenance

doses of ascorbic acid is that they may be forced into a position where their

body is deprived of ascorbate during a period of great stress such as emergency

hospitalization. Physicians should recognize the consequences of suddenly

withdrawing ascorbate under these circumstances and be prepared to meet these

increased metabolic needs for ascorbate in even an unconscious patient. These

consequences of ascorbate depletion which may include shock, heart attack,

phlebitis, pneumonia, allergic reactions, increased susceptibility to infection,

etc., may be averted only by ascorbate. Patients unable to take large oral doses

should be given intravenous ascorbate. All hospitals should have supplies of

large amounts of ascorbate for intravenous use to meet this need. The millions

of people taking ascorbic acid makes this an urgent priority. Patients should

carry warnings of these needs in a card prominently displayed

in their wallets or have a Medic Alert type bracelet engraved with this

warning. CONCLUSIONThe method of titrating a patient's dosage of ascorbic acid

between the relief of most symptoms and bowel tolerance has been described.

Either this titration method or large intravenous doses are absolutely necessary

to obtain excellent results. Studies of lesser amounts are almost useless. The

oral method cannot by its very nature be investigated by double blind studies

because no placebo will mimic this bowel tolerance phenomenon. The method

produces such spectacular effects in all patients capable of tolerating these

doses, especially in the cases of acute self-limiting viral diseases, as to be

undeniable. A placebo could not possibly work so reliably, even in infants and

children, and have such a profound effect on critically ill patients. Belfield

(32) has had similar results in veterinary medicine curing distemper and kennel

fever in dogs with intravenous ascorbate. Although dogs

produce their own ascorbate, they do not produce enough to neutralize the

toxicity of these diseases. This effect in animals could hardly be a placebo.

It would be possible to conduct a double blind study on intravenous ascorbate;

however, doses would have to be determined by someone experienced with this

method.

Part of the difficulty many have with understanding ascorbate is that claims for

its benefits seem too many. Most of these clinical results merely indicate that

large doses of ascorbate augment the healing abilities of the body already known

to be dependent upon minimal doses of ascorbate.

I anticipate that other essential nutrients will be found being utilized at

unsuspectedly rapid rates in disease states. Compli- cations caused by failures

in systems dependent upon those nutrients will be found. The magnitude of

supplimentations necessary to avert those complications will seem extraordinary

by standards accepted today.

 

 

 

 

 

 

 

 

 

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23:61-88, 1971.

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preventive medicine. J. Int. Acad. Prev. Med., 1:45-49, 1974.

10. Stone, I. Studies of a mammalian enzyme system for producing evolutionary

evidence on man. Am. J. Phys. Anthro., 23:83-86, 1965.

11. Stone, I. Hypoascorbemia: The genetic disease causing the human requirement

for exogenous ascorbic acid. Perspectives in Biology and Medicine, 10:133-134,

1966.

12. Stone, I. The Healing Factor: Vitamin C Against Disease. Grosset and Dunlap,

New York, 1972.

13. Pauling, L. Vitamin C and the Common Cold. W.H. Freeman and Company, San

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International Academy of Preventive Medicine, 2:10-26, 1975.

--

----- Robert F. Cathcart,M.D. -----

--- Allergy, Environmental, and ---

----- Orthomolecular Medicine -----

------- Orthopedic Medicine -------

--- 127 Second Street, Suite 4 ---

--- Los Altos, California, USA ---

---- Fax: 650-949-5083 ----