Why A Sick Body Needs So Much Vitamin C

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Why A Sick Body Needs So Much Vitamin C

 

The Third Face of Vitamin C

Robert F. Cathcart, M.D.

Journal of Orthomolecular Medicine, 7:4;197-200, 1993.

Copyright ©, 1994 and prior years, Dr. Robert F. Cathcart. Permission granted

to distribute via the internet as long as material is distributed in its

entirity and not modified.

ABSTRACT

Bowel tolerance to orally ingested ascorbic acid increases with the toxicity of

diseases. Bowel tolerance with a disease such as mononucleosis may reach 200 or

more grams per 24 hours without it producing diarrhea. A marked clinical

amelioration or cure is achieved in many disease processes when threshold doses

near bowel tolerance are given. In a sense, it is the reducing equivalents

carried by free radical scavengers that quench free radicals, not the free

radical scavengers themselves. Ascorbic acid can be dramatically useful in

quenching free radicals because it is usually tolerated in amounts necessary to

provide the reducing equivalents necessary to quench almost all the free

radicals generated by severe disease processes. Vitamin C functions are

incidental at these dose levels; the benefit is from the reducing equivalents

carried. To the extent that free radicals are either essential to the

perpetuation of a disease or just part of the cause of symptoms, the disease

will be

cured or just ameliorated. These effects are even more dramatic from

intravenous sodium ascorbate.

Keywords: vitamin C, ascorbate, acute induced scurvy, bowel tolerance, titrating

to bowel tolerance, the ascorbate effect, free radical scavengers, reducing

equivalents.

INTRODUCTION

A clinical experience prescribing doses of ascorbic acid up to 200 or more grams

per 24 hours to over 20,000 patients during the past 23 year period has revealed

its clinical usefulness in all diseases involving free radicals. The controversy

continues over the value of vitamin C mainly because inadequate doses are used

for most free radical scavenging purposes. Paradoxically, the non controversial

use of minute doses of vitamin C in the prevention and treatment of scurvy has

set the minds of many against more creative uses.

I have found vitamin C exceptionally useful in a very high dose range. Its

usefulness is in three such distinct realms that I will describe them as the

three faces of vitamin C.

 

1. vitamin C to prevent scurvy

(up to 65 mg/day.)

2. vitamin C to prevent acute induced scurvy

and to augment vitamin C functions

(1 to 20 grams/day.)

3. vitamin C to provide reducing equivalents

(30 to 200 or more grams/day.)

 

One might criticize the wisdom of my use of these massive doses but Klenner had

successfully utilized them previously. The works of Irwin Stone, Linus Pauling,

and Archie Kalokerinos have supported many of my observations. It was apparent

that in all the studies yielding negative or equivocal results, inadequate doses

were used. In some studies, doses barely bordering on adequate, tease the

investigator with statistically significant but not very impressive beneficial

results.

My early discovery was that the bowel tolerance to ascorbic acid of a person

with a healthy GI tract was somewhat proportional to the toxicity of their

disease. Bowel tolerance doses are the amounts of ascorbic acid tolerated orally

that almost, but not quite, cause diarrhea. A patient who could tolerate orally

10 to 15 grams of ascorbic acid per 24 hours when well, might be able to

tolerate 30 to 60 grams per 24 hours if he had a mild cold, 100 grams with a

severe cold, 150 grams with influenza, and 200 grams or more per 24 hours with

mononucleosis or viral pneumonia (1, 2). Marked clinical benefits in these

conditions occur only at the bowel tolerance or higher levels. I named the

process whereby the patient determined the proper dose as titrating to bowel

tolerance. These increases in bowel tolerance in the vast majority of patients

normally tolerant to ascorbic acid (perhaps 80% of patients) are invariable. The

marked clinical benefits are noted only when a threshold dose,

usually close to the bowel tolerance dose, is consumed. I call this benefit the

ascorbate effect.

Most patients are started at first with hourly doses of ascorbic acid powder

dissolved in small amounts of water. Later, after the patient has learned to

accurately estimate the dose necessary to achieve the ascorbate effect,

comparable doses of tablets or capsules are also used. Where patients are

intolerant to adequate amounts of ascorbic acid orally and the severity of the

disease warrants it, intravenous sodium ascorbate is used.

Failures are related to individual difficulties in taking the proper adequate

doses. I now have had 22 years to gather clinical experience and to reflect on

this phenomenon.

I want to emphasize the importance of this increasing bowel tolerance with

increasing toxicities of diseases. The sensation of detoxification one

experiences at these doses is unmistakable.

The effect is so reliable and dramatic in the tolerant patient as to make

obvious the fact that something very important, that has not been widely

appreciated before, is going on.

 

THE THREE FACES

Vitamin C probably always functions by being an electron donor. At the lowest

dose level (the first face), it is necessary as a vitamin to prevent scurvy. It

is essential for certain metabolic functions which are well described and mostly

non controversial.

At a second level (the second face) vitamin C is still used as a vitamin but

larger doses are necessary to maintain its basic vitamin C functions because the

vitamin is destroyed rapidly in diseased or injured tissues where there is an

overabundance of free radicals. I described the resulting state of deficiency,

if the vitamin C is not replaced, as acute induced scurvy (1, 2). There is ample

evidence of this depletion of vitamin C by stress and disease as recently

reviewed in the literature.

Additionally, the recent extensive research on vitamin C has concerned itself

with certain functions that may be augmented by higher than minimal doses of

vitamin C (20). Strangely, any usefulness of these larger than minimal doses of

vitamin C remain mostly neglected by clinicians. This level is from about 1 to

20 grams a day. Benefits vary from person to person.

At this second level, as in studies reviewed by Pauling (11) and more recently

by Hemil„ (20), there may be expected a slight decrease in the incidence of

colds but a more significant reduction in the complications and the duration of

colds. Personally, I am impressed by the number of patients (but certainly not

all) who tell me that they have not had a cold for years since reading Pauling's

book and taking vitamin C. Patients with chronic infections frequently have

those infections cured for the first time. Antibiotics work synergistically with

these doses. A surprising number of elderly persons benefit from doses of this

magnitude and may indeed have what Irwin Stone described as chronic subclinical

scurvy (10).

The third level of doses (the third face) is virtually undiscussed in the

literature but is the most interesting. These doses range usually from 30 to 200

grams or more per 24 hours. The most important concept to understand is that

while incidentally at these dose levels the vitamin C performs all the functions

of levels one and two, it is mostly thrown away for the reducing equivalents it

carries (3). With these doses it is possible to saturate the body with reducing

equivalents, neutralize the excessive free radicals, and drive a reducing redox

potential into involved tissues. Inflammations mediated by free radicals can be

eliminated or markedly reduced. In many instances patients with allergies or

autoimmune disease have their humeral immunity controlled while their cellular

immunity is augmented (19). To the extent that free radicals are either

essential to the perpetuation of a disease or just part of the cause of

symptoms, the disease will be cured or just ameliorated.

The list of diseases involving free radicals continue to grow. Infections,

cardiovascular diseases, cancer, trauma, burns both thermal and radiation,

surgeries, allergies, autoimmune diseases and aging are now included. It is more

difficult to think of a disease that does not involve free radicals. Progressive

nutritionists routinely give vitamin C, vitamin E, beta carotene, selenium, NAC,

etc. to counter free radicals. I certainly agree with this practice. However,

there is one important concept neglected.

In the spirit that if you throw a bucket of water on a fire, it is the water

that puts the fire out, not the bucket; it is the reducing equivalents carried

by the free radical scavengers that quench the free radicals, not the free

radical scavenger itself.

Most of the reducing equivalents utilized by non enzymatic free radical

scavengers do not come from the ingested free radical scavengers but come

through glycolysis, the citric acid cycle, NADPH, FADH2, glutathione, etc.

Dietary free radical scavengers carry in on ingestion only a small percentage of

the total reducing equivalents carried by those scavengers during their lifetime

in the body. After their first pass neutralizing free radicals, the free radical

scavenger must be recharged with reducing equivalents made available in the

mitochondria.

Consider the following: 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 without it producing

diarrhea. 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. Subsequently, all my young

mononucleosis patients with excellent GI tracts have responded similarly and

have had equivalent increases in bowel tolerance during the acute stage of the

disease.

I believe that the loose stools caused by excessive doses of ascorbic acid

orally ingested is due to a resulting hypertonicity of ascorbate in the rectum.

Water is attracted into the rectum by the increased osmotic pressure and results

in a benign diarrhea. With toxic illnesses, the ascorbate is destroyed rapidly

in the involved tissues resulting in a rapid absorption from the gut. Of the

ascorbate, what does not reach the rectum, does not cause diarrhea. Intravenous

sodium ascorbate does not cause diarrhea and, in fact, increases bowel tolerance

to orally ingested ascorbic acid while the IV is running. With hypertonicity of

the ascorbate both in the blood and in the rectum, the osmotic pressure of the

ascorbate is more equal on both sides of the bowel wall so no diarrhea results.

If the diarrhea was cause by other metabolic processes, diarrhea would be caused

by intravenous ascorbate.

It should be noted that in some cases of pathological diarrhea, ascorbic acid

stops the diarrhea. Presumably in these cases some of the increased destruction

of ascorbate is from free radicals in the bowel. However, in most toxic systemic

diseases there is no reason to believe that the destruction of the additional

ascorbate occurs directly in the bowel, so it is a safe hypothesize that this

increased destruction occurs in the interior of the body.

The increased tolerance to ascorbic acid orally provides an interesting and

somewhat useful measure of the toxicity of a disease. Probably it is somewhat a

measure of the free radicals involved in a disease. I describe a cold that at

its maximum makes it possible for a patient to just tolerate 100 grams of

ascorbic acid orally without diarrhea, a " 100 gram cold. " Patients, appearing to

be well, who have a tolerance over 20 to 25 grams per 24 hours probably have

some subclinical condition which is being hidden by their own free radical

scavenging system.

Patients with chronic infections (and a normally strong stomach) can ingest

enormous amounts of ascorbic acid. One of my chronic fatigue patients is

functional only because of his ingestion of 65 pounds of ascorbic acid in the

past 12 months. In 22 years, I, personally, have ingested approximately 361

kilos ( 797 lbs ) ( 4.3 times my body weight ) of ascorbic acid because of

chronic allergies and perhaps chronic EBV.

Considering the reducing equivalents carried by such amounts of ascorbic acid,

one can only guess at the turnover rate of the non enzymatic free radical

scavengers in a patient acutely ill with a 200 gram mononucleosis. However, one

gains the impression that all the non enzymatic free radical scavengers would

have to be rereduced many times a day.

AN ANALOGY

Suppose you owned a farm and on one end of the property there was a barn and on

the other end of the property there was a water well. One day the barn catches

fire and neighbors come with buckets to set up a bucket brigade between the

water well and the barn and are putting out the fire when the well goes dry.

My use of ascorbate is like thousands of neighbors coming from miles around,

each with a bucketful of their own water, throwing their own water on your fire

once, and then leaving.

CONCLUSION

Because of the invariable (in patients tolerant to ascorbic acid) increasing

bowel tolerance to ascorbic acid in patients roughly in proportion to the

toxicity of their disease, there has to be something happening to ascorbate in

the sick patient other than its being used as vitamin C in the classic sense.

The amelioration or sometimes cure of different diseases appears related to the

importance of free radicals in the perpetuation of the paticular disease.

The sudden marked benefit in many disease processes which is achieved at doses

near to the bowel tolerance level suggests that a reducing redox potential is

forced into the affected tissues only at those dose levels. This ascorbate

effect only at the high dose levels is also suggestive that something other than

classic functions of vitamin C is involved. This ascorbate effect is more

compatible with principles of redox chemistry.

Only a small percentage of the total reducing equivalents donated by non

enzymatic free radical scavengers to neutralize free radicals, come in on the

ingested nutritional free radical scavengers. Ascorbate is unique in that the

body can tolerate doses adequate to supply the necessary reducing equivalents to

quench the free radicals generated by severely toxic disease processes. The

vitamin C is thrown away for the reducing equivalents it carries. Only in this

way can the large amounts of free radicals generated by the most toxic disease

processes be rapidly quenched.

REFERENCES

1. Cathcart RF. The method of determining proper doses of

vitaminC for the treatment of disease by titrating to bowel

tolerance. J Orthomolecular Psychiatry 1981; 10: 125-32.

2. Cathcart RF. Vitamin C: titrating to bowel tolerance,

anascorbemia, and acute induced scurvy.

Medical Hypotheses 1981; 7:1359-76.

3. Cathcart RF. A unique function for ascorbate.

Medical Hypotheses 1991; 35: 32-7.

4. Klenner FR. Virus pneumonia and its treatment with vitamin C.

J. South. Med. and Surg. 1948; 110: 60-3.

5. Klenner FR. The treatment of poliomyelitis and other virus

diseases with vitamin C.

J. South. Med. and Surg. 1949; 111:210-4.

6. Klenner FR. Observations on the dose and administration of

ascorbic acid when employed beyond the range of a vitamin in

human pathology. J. App. Nutr. 1971; 23: 61-88.

7. Klenner FR. Significance of high daily intake of ascorbic

acid in preventive medicine.

J. Int. Acad. Prev. Med. 1974; 1:45-9.

8. Stone I. Studies of a mammalian enzyme system for producing

evolutionary evidence on man.

Am. J. Phys. Anthro. 1965; 23:83-6.

9. Stone I. Hypoascorbemia: The genetic disease causing the human

requirement for exogenous ascorbic acid.

Perspectives in Biology and Medicine 1966; 10: 133-4.

10. Stone I. The Healing Factor: Vitamin C Against Disease.

Grosset and Dunlapp, New York, 1972.

11. Pauling L. Vitamin C and the Common Cold.

W.H. Freeman and Company, San Francisco, 1970.

12. Pauling L. Vitamin C, the Common Cold, and the Flu.

W.H.Freeman and Company, San Francisco, 1976.

13. Pauling L. How to Live Longer and Feel Better.

W.H. Freeman and Company, New York, 1986.

14. Kalokerinos A. Every Second Child.

Keats Publishing, Inc., New Canaan, 1981.

15. Cathcart RF. Clinical trial of vitamin C. Letter to the

Editor, Medical Tribune, June 25, 1975.

16. Cathcart RF. Vitamin C in the treatment of acquired

immunedeficiency syndrome (AIDS).

Medical Hypotheses 1984; 14(4): 423-33.

17. Cathcart RF. Vitamin C: the nontoxic, nonrate-limited,

antioxidant free radical scavenger.

Medical Hypotheses 1985; 18:61-77.

18. Cathcart RF. HIV infection and glutathione (Letter to editor

concerning Vitamin C tolerance in AIDS).

Lancet 1990; 335(8683);235.

19. Cathcart RF. The vitamin C treatment of allergy and the

normally unprimed state of antibodies.

Medical Hypotheses 1986;21(3): 307-21.

20. Hemil H. Vitamin C and the common cold.

Br J Nutr 1992; 67:3-16.

 

Robert F. Cathcart, M.D.

Allergy, Environmental, and Orthomolecular Medicine

Orthopedic Medicine

127 Second Street, Suite 4, Los Altos, California, USA

Telephone: 650-949-2822

Fax: 650-949-5083

 

 

 

 

 

 

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