About Vitamin C
The greatest problem with using Vitamin C in the hospital is that most doctors view it solely as a vitamin - period. However, it has been demonstrated to be much more and by some doctor to be what the oil is for the motor of the car, an absolutely necessary lubricant.
The synthesis of Vitamin C in different animals
Most animals are capable of producing its own Vitamin C in the liver from the glucose molecule through four different enzyme reactions. Unfortunately, the fourth enzyme is missing in humans, why we are one of few species that can not produce our own Vitamin C. Other species, not capable of producing this vitamin are some primates, guinea-pig, and some rodents. The gene producing the enzyme, L-gulonolactone oxidas (i. e. Gulo), exists in the human genome, but is nonfunctioning due to a mutation. The pathway for synthesis is well known, i. e. 2-keto-L-gulonolactone to L-ascorbic acid [1, 2].
In view of the amount of Vitamin C given as guidelines for adult’s daily intake in our medical tables, 75 mg/day, it might be interesting to compare the requirement per day in other animal species. Cows produce 18 grams/day, gorillas 4,5 grams, cats 180 milligrams/day and goats 13 grams/day, when in a healthy state. However, when the goat is in an unhealthy state or in severe distress it can produce 100 grams/day. Goats are rarely sick.
Measurements of Vitamin C in healthy and sick people
There is an interesting study from Canada, in which they compared concentrations of Vitamin C in plasma in healthy and sick humans. 141 healthy individuals were randomly selected from a city’s population to comprise the reference group. It was found that 84% had Vitamin C values of >28,4 micromoles/L, which were considered normal. Thirteen percent (13%) had subnormal values of < 28,4 micromoles/L while three percent (3%) had values of < 11,4 micromoles/L, suggesting a Vitamin C deficiency [3]. Some experts argue that these normal values are far too low, but are in line with the fact that humans cannot produce its own Vitamin C. And one researcher in particular, Suzanne Humphries, who is a nephrologist with extensive knowledge of Vitamin C, believes that healthy individuals would benefit from much higher values around 100-125 micrograms/L.
The other group consisted of 149 patients admitted to a teaching University hospital with different diseases. Only 21% of these patients had ”normal” plasma levels of >28,4 micromoles/L, 60% had ”subnormal” values of <28,4 micromoles/L and 19% Vitamin C deficiency. It is worth noting that in a second measurement on 52 patients the Vitamin C concentrations had not improved after 17 days of hospital care [3].
It is my belief that the conditions in Scandinavia might be very similar to the Canadian situation, which means that 80 % of our hospital population will have ”subnormal” plasma levels of Vitamin C and 20% concentrations almost in line with scurvy at the admittance to hospital. A colleague of mine has been reaching out to different University laboratories about measurements of Vitamin C in the patient population. But this measurement seems nowhere to be found and which is worse, there seems to exist no ambition to set up such a method.
There is a misconception about Vitamin C being only a ”vitamin” since at least 70 years and the legendary dr. Frederick R. Klenner wrote already in the 1950-ties that ”there are some doctors who would stand at a patient’s side and see him die rather than use ascorbic acid, since in their finite minds this can only be a vitamin” [4].
Very little science about the human requirements of Vitamin C
During the last years several Intensive Care units around the world have started to use relatively moderate doses of Vitamin C intravenously - with extremely good effect, admittedly. The critics of the therapy claim that there are far too few studies about the effects of Vitamin C. However, there are numerous good studies about the matter, although most of these are unknown to most doctors. When searching PubMed by the term ”Vitamin C”, there were 62.238 hits, of which 22.010 had the search term in the title/abstract which makes Vitamin C/Ascorbic acid one of the most well researched substances of all times.
What we are missing, though, are studies about human Vitamin C concentrations for health and disease. Those concentrations considered as ”normal” seems to be just slightly above what will cause scurvy. But Vitamin C is so much more than just a vitamin to avoid scurvy.
If we accept that the requirements for health is greater than we have previously thought, then it is quite easy to raise the plasma levels. Eating e.g. two Kiwi fruits per day, which contain 140 milligrams of Vitamin C will raise the concentration considerably. One study demonstrated that with low Vitamin C diet during 5 weeks one will reduce the plasma concentration from 35 to 20 micromoles/L, whereas eating two Kiwi fruits per day could raise it from 35 to 70 micromoles/L. This was measured through muscle biopsies, which do not have the highest concentrations in the body, though [5]. The eyes and the suprarenal glands needs much more Vitamin C and it is very likely that the concentrations would have been much higher in these organs. We know e.g. that Vitamin C deficient suprarenal glands are not capable of synthezising norepinephrine or epinephrine, which explains the extremely good effect on blood pressure by IV. Vitamin C in patients with septic shock [6].
The reason why Vitamin C is important
Vitamin C has three important functions. It is an antioxidant, 2. an antihistamine, and 3. co-factor for certain important enzymes.
1. In fact, Vitamin C is the body’s most important antioxidant. This trait is due to its ability to give away for free two electrons to those molecules that through oxidation have lost electrons. As is well known: the correct number of negative and positive charges is an absolute requirement for the molecule to enable it to keep its three-dimensional form and function. The proteins, of which 100.000 of different kinds are produced, are extremely dependent on the precise three-dimensional structure since the proteins are the body’s precision instruments, which are like keys fitting into various locks. A protein’s various electric charges will make different parts of the molecule attract or repel other parts of the molecule which will finally decide the protein’s exact three-dimensional structure. This reasoning applies to all biomolecules. When a biomolecule loses one or two electrons, it may also loose its function. This is probably even more important for the 2.000 different enzymes, since their ability to speed up the processes in the body will be lost.
Let’s imagine that the audience of a theatre play is required to have a scarf around the neck to be allowed to watch the play. One person of the audience has no scarf but solves his problem be stealing a scarf from his neighbour, who steals it back from his next neighbour. This happens also in the body. Vitamin C is capable of ending this chain reaction of electron stealing by giving away electrons - and even repair previous injuries. The ability of one molecule to steal an electron from another is regulated by something called ”electronegativity”, for the detection and description of which Linus Pauling got the Nobel Prize in chemistry 1954. The electronegativity, by which is meant the ability of an element in the periodic system to steal electrons from other elements, will actually decide how elements are going to join and form certain molecules - and not other. Oxygen has the second highest electronegativity, i. e. 3,5, and is a very reactive substance. Since this tendency to steal electrons from other elements was first detected with oxygen, this reaction is called ”oxidation”. Later it was found out that other elements of the periodic system exhibit the same ability according to the ”electronegativity scale”, why the term ”oxidation” now is assigned to stealing of electrons from other compounds. Fluor has the highest electronegativity of all the elements, i.e. 4,0, and is very detrimental to the body by oxidizing e.g. proteins, enzymes, mitochondrias, DNA. However, the oxidation by oxygen is held under control as long as oxygen is a gas O2 or is hidden as O2 in the hemoglobin, but this oxidative capacity is beneficial at the end of the electron transport chain by creating energy and joining hydrogen to create water.
As an antioxidant and an electron donor Vitamin C also plays an important role in terms of those toxins which are produced by some bacterias during an infection and other poisioning. The harm to the body is due to oxidation, thus electron stealing.
2. Vitamin C is also an important antihistamin. High histamine concentrations almost always mean low Vitamin C concentrations, why Vitamin C might be very valuable for allergic reactions.
3. Vitamin C is an important co-factor for different enzymes in the production of collagen, neurotransmitters, hormones and carnithine. Collagen is a fiber which constitute one third of all proteins in mammals. To be a really strong fiber it has to be twisted around itself at four separate processes, almost in the same way as twisting ropes to make these strong. It is known in detail how collagen is synthezised. When the original proteinfibers are twisted around each other one molecule of Vitamin C (i. e. one stitch) is needed for each circular turn. The three following twists also require a lot of Vitamin C, why the production of collagen is extremely dependent on Vitamin C. There is collagen mainly i bone, skin, tendons and vessel walls. And Vitamin C deficiency is greatly involved in diseases like aorta- aneurysms and other bleedings. Carnithine is needed to be able utilise the ingested fat [7].
Diabetes
It is known that diabetics, even those with a well controlled diabetes type I or II, have a 30% lower concentration of Vitamin C in plasma [8], and that Vitamin C augments the production and the release [9, 10] of insulin. Also, it increases the sensitivity [11, 12] for the released insulin. In one study on guinea pigs with scurvy it was demonstrated that those animals with scurvy had a 2-3 higher concentration of insulin in their pancreatic beta cells than guinea pigs without scurvy. But those with scurvy were unable to release these higher amounts of insulin upon stimulation by increased glucose levels - unless Vitamin C was given concomitantly. And when Vitamin C i given the secretion of insulin is raised even above normal [10]. Furthermore, the concentration of Vitamin C in plasma is reduced upon insulin injections, which consequently worsens the endogenous production and release of as well as the sensitivity for insulin. The lack of Vitamin C induces a vicious cycle in which insulin injections by itself will produce reduced endogenous production, secretion and sensitivity. Thus, there is a greater need for Vitamin C in diabetes and/or inflammation. And it seems that the goal, that is intended by giving insulin injections, more readily is reached by also giving Vitamin C [13] - and at the same time the blood vessels will become more healthy due to the production of collagen.
Heart disease
That heart disease is an inflammatory conditions due to chronic ”oxidative stress” on the blood vessel walls is more and more acknowledged in recent years. Dr. Suzanne Humphries claims that every risk factor for heart disease will be improved by Vitamin C, e.g. the inflammation of the vessel wall [14,15], the cholesterol metabolism [16], and the hypertension [17]. The inner layer of the vessel wall, the endothelium, might be imagined as a layer of ”bricks”which are plastered together with the help of connective tissue. This kind of ”cement” can not be synthezised without Vitamin C. Already in the 1950s it was shown by biopsies that certain parts of the brain and the heart may have extremely low concentrations of Vitamin C (”local scurvy”), usually those parts most exposed for chronic stress although the blood may hold a higher concentration. There is a lot of research about this. Contrary, the literature about exact dosing to oppose this process is missing. Dr. Thomas E. Levy, a professor in cardiology has written a ”bestseller” about this issue called ”Stop America’s no 1 killer! Proof that the origin of ALL Coronary Artery Disease is a clearly reversible arterial scurvy”, containing 650 scientific references.
What is causing the injury ?
On the macroscopic level the injury is cause d by 1. chronic stress, regardless of it being emotional or physical, 2. bacterias and viruses secreting toxins, 3. sun light, which by ultra violet beams may cause inflammation and, 4, various chemicals. The chronic emotional stress may cause oxidation in different parts of the nucleus, which hurts nerves, DNA and the synthezised proteins. Antioxidants in fruit and vegetables will protect, though.
On the microscopic level it is caused by free radicals, which are molecules that have lost or are missing one important electron. These radical molecules will then search for a replacing electron which can be stolen from another compound, which then in its turn will miss an essential electron, etc., etc. This follows the laws of physics. An atom with higher electronegativity will steal an electron from an atom with lower electronegativity, which will steal from another one with an even lower electronegativity. In this way the injury is propagated in the whole system. These oxidative injuries may lead to atherosclerosis, cancer, diabetes, rheumatoid arthritis, chronic heart disease, stroke, sepsis etc.
Thee are natural antioxidants in the system that protects against injuries.: 1. enzymes, e.g. glutathion peroxidase, superoxide dismutase (SOD) and catalase, and 2. a. non-enzymes constituted by smaller molecules, e.g. vitamins (C and E), which are directly acting and b. flavinoids in herbs and c. minerals, functioning indirectly to disarm heavy metals and toxins. The great importance about Vitamin C is that it can donate 2 electrons to these biomolecules or enzymes which have lost an electron and also its function - without requiring to steal it electrons back from other molecules. Vitamin C (Ascorbic acid) is quite content by being a generous donor and is not at all mean and stingy. It is a very mild molecule. There are 5 different forms of Vitamin C, the original form Ascorbic Acid, and those forms in which it has donated two electrons and two protons stepwise (2 + 2 = 4), after which the end product, dehydroascorbate (DHA) may be excreted through the kidneys provided that it is in excess - or may be reused in its original form by a conversion in neurons, red blood cells and mitochodrias [18].
The importance of Vitamin C for foetal growth
Vitamin C is very important for the foetal growth. The cells in the body are unable to divide and multiply without Vitamin C. Furthermore, the foetus can not form skin, connective tissue, cartilage, without Vitamin C which is necessary for the formation. Therefore, the foetus will see to it that it gets what it needs from the mother even if she is developing symptoms of Vitamin C deficiency. As a consequence of this foetal demand, the concentration of Vitamin C is doubled in the placenta, umbilical cord and foetus as compared with the mothers blood and three times as high in the foetal fluid, which is swallowed by the foetus. In view of this, the importance of a mother not exhibiting Vitamin C deficiency during pregnancy is easily understood. Thus, many doctors wants the mother to take Vitamin C supplements for the sake of the foetus.
The labor during delivery very stressful for the foetus
Also, it is known that enormous amounts of Vitamin C are consumed during a vaginal delivery, since it is so stressful för the baby. Consequently, the concentration of Vitamin C in the mother’s plasma is much reduced during labor. The foetal stress during labor has been investigated. It was found that the foetal release of catecholamines was ten times as high as in mothers in labor, fifteen times higher as in a competing athlete and 50% higher as in a patient with the suprarenal tumor phaeo-chromocytoma [19]. This enormous stress reaction, however, is functional and activates the entire immune system and empties the lungs of fluid, which are very important adaptions for life outside the uterus. And for this functional adaption there is a huge need for Vitamin C.
Should foetal jaundice be pre-emptied by Vitamin C?
Bilirubin is the body’s second most important antioxidant. The most important is Vitamin C. From this follows that the secretion of bilirubin and jaundice may be the baby’s response to the enormous stress during labor. At present, in 60 - 70 % of the newborns in our delivery wards the bilirubin concentrations are as high as exhibiting jaundice, which may be very dangerous when combined with a low albumin/s. If so, it may cause encephalitis and permanent brain damage. Jaundice is consequently viewed as a disease and has to be treated properly in order to protect the baby against such damages. However, the baby may develop encephalitis despite lower concentrations of bilirubin and also escape encephalitis even with a higher concentration. This suggests that the problem is more complicated and may involve more than these two factors (bilirubin and albumin), which the medical science has focused upon.
In one hospital bilirubin and Vitamin C in plasma were measured simultaneously in the new born babies. It was found that babies with a high concentration of Vitamin C (in average 132 micromoles/L) had a lower bilirubin (65 micromoles/L) than babies with a low Vitamin C (87 micromoles/L), who had higher bilirubin (238 micromoles/L) [20]. This suggests that an inverse relationship between bilirubin and Vitamin C may prevail and that the concentration of bilirubin might be reduced by giving Vitamin C to the mothers during pregnancy. This was done in one clinic in which 89 pregnant women were given 1 gram of Vitamin C every second day during the 1:st trimester. Of the newborns only 24% had mild and 3% moderate jaundice , while 61% had normal concentrations of bilirubin. This is contrary to what is prevalent today in our delivery clinics [21]. It is tempting to speculate what would happen had the mothers ingested Vitamin C each day- and maybe a higher dose - during the whole pregnancy and not only during the 1:st trimester.
The plausible conclusion of this reasoning is that, provided that the newborn has enough of Vitamin C in its body, the bilirubin is not needed as an antioxidant, and there is no risk of brain injuries as a consequence of augmented concentrations of bilirubin. Maybe there is a need for Vitamin C during the entire pregnancy, e.g. 500 milligrams per day. Many women already voluntarily ingest 5-6 grams per day. The present solution within conventional traditions for jaundice in newborns is to give treatment with ultraviolet light or sunshine. However, this is not optimal since phototherapy indeed reduces the concentrations of bilirubin but also simultaneously reduces the concentration of Vitamin C in plasma, Glutathion and Albumin [22]. This will increase the oxidative stress.
Tissues dependent on Vitamin C
Vitamin C has an impact on the structure and integrity of mainly the eyes, in which the requirements are high for development. But it also affects the formation of the skeleton, skin, ligaments, tendons and blood vessels. If the patient exhibit aortic aneurysm This is a sign of Vitamin C deficiency. I have previously mentioned how the formation of collagen is dependent on Vitamin C. The same applies to bone tissue, in which Vitamin C is needed for growth - even if there is enough of calcium and magnesia. For mineralisation other factors are needed like Vitamin D, Vitamin B and Vitamin K2 and trace metals like Cu, Mn, Zn, Bo. So, bone growth is a complicated process in need of many factors, not least Vitamin C. There is a lot of propagation regarding calcium, but it is important to know that it will be of no use if there are not enough of these vitamins, including Vitamin C.
The impact of Vitamin C on infections
Vitamin C has antiseptic and antibacterial features and may be utilised exteriorly for skin leisures and interiorly in the mouth mucosa and palate. It has a long and victorious history against severe bacterial and viral diseases, which is almost totally unknown for the major part of doctors in the whole world (and previously even for me). It started in 1948 with Dr. Frederick R. Klenner’s treatment of patients with polio (even severe polio) in his hometown, Reidsville, N.C., in which he cured ALL consecutive patients (i.e. 60) in his clinic who was diagnosed with polio. Thereafter it has with success been utilised in patients presented with acute hepatitis, viral encephalitis, acute rheumatic fever, ebola, tuberculosis, infectious mononucleosis etc., et. Also, it has been used on toxic mushroom poisoning, trauma, surgery and burn injuries, in which large doses of IV. Vitamin C radically reduces the requirements of fluids. High dose Vitamin C IV. has been used in association with severe infectious diseases since 80 years with extremely good results. In recent years it has also been used on patients with severe sepsis or septic shock in several clinics in different parts of the world, with surprisingly good results.
Some voices are raised, however, for more and larger studies before this treatment modality may be accepted as the ”state of the art” for patients admitted to the ICU due to septic shock. In the medical literature, though, Vitamin C studies are not missing, not even larger studies. When searching PubMed there are 22.010 scientific articles about the positive effects of Vitamin C. Very often it is about the positive effects of very low doses of 1 g/day, but there are other studies on high dose Vitamin C infusions. The Riordan clinic i the US claim that they in a span of 30 years have given 30.000 infusions to patients with different diseases. In view of the fact that IV Vitamin C now is used as an adjunct to antibiotics on infections in many hospitals it is interesting to go through what the scientific literature tells. Therefore I will try to make a short summary of this literature.
Thus:
Vitamin C kills or inactivates all known viruses in vitro and in vivo.
Vitamin C kills or inactivates all viruses in vitro, which it has been tested against, One prominent example is the polio-virus which in 1935 became completely inactivated by Vitamin C and was wholly non-infectious when injected directly into the monkey’s brain [23]. Other prominent examples are herpes-virus, vaccinia-virus, tobacco mosaic-virus, bacteriophage-virus, entero-virus, influenza-virus, and rabies-virus [24-35]. Regarding the effect in vivo, the Vitamin C kills or inactivates all known viruses in adequate doses.
Polio
The most astonishing IV. Vitamin C report is describing what happened during the polio epidemy in USA in the end of 1940-ties [36-39]. Vitamin C had then quite recently been artificially synthezised and Dr. Frederick Klenner tried to give it in large IV. doses (i. e. 350 mg/kg b.w.) to those, who was struck by polio (to the smallest kids he gave IM. injections 2 grams x 2). ALL of his 60 patients were cured from polio. Fifty-seven (57) of those regained mobility within only 1-2 days and were definitely cured. For two patients it took additionally three days and for the last patient two weeks. This was 6-7 year old girl who had been diagnosed with polio two weeks earlier and since four days days before the start of the treatment had been completely paralyzed with flaccid legs from the waist and downwards [37]. There was no doubt about this being polio - and not a reversible other condition - since this happened during the worst imaginable polio epidemic in USA and the polio diagnoses were ascertained by lumbar punction and liquor analyses in more than half of the 60 cases. The probability that this recovery would happen by chance is zero. And yet this cure did not get any attention - and has not as yet got any attention.
When Dr. Frederick Klenner presented his sensational findings at a medical conference regarding polio in Chicago the next year, he did not, however, get any questions at all in the following debate and everything blew off in silence. The conference were instead fully engaged in discussing the new ”iron lung”. Some years later, 1952, it was demonstrated that IV Vitamin C in much smaller doses [39] and also orally Vitamin C 50-80 grams, given over ten days [38] would reduce the temperature and speed up the healing of polio.
Acute hepatitis
Similar rapid healing processes by Vitamin C have been noted when treating Acute Hepatitis [40-43], which usually has a very prolonged healing pattern and sometimes will be converted to chronic hepatitis. Acute hepatitis normally takes 2-6 months to heal. With Vitamin C the patients recovered clinically after only 3 - 4 days with Vitamin C and the laboratory values were always normalised within 7-10 days. In 1962 Dalton used 2 grams of IV Vitamin C for only six days to heal the hepatitis and 1974 Dr. Frederick Klenner used about half the dose we utilise for our septic shock patients (i. e. 1,5 grams every 6 hour) but during 10 days. His formula contained 0,5 - 0,7 grams of Vitamin C IV. 2 -3 times per day for 4 days and the 10 grams orally for 10 days. With this regimen a total remission of the hepatitis was achieved within 4 days [43]. Cathcart reported 1981 that he had treated several hundred cases of acute hepatitis, but could not recall a single case that did not respond to Vitamin C, neither could he recall any case that had been converted to chronic hepatitis [41]. Two years later (1983) Owens used a combination of IV and oral Vitamin C [42]. It can be noted that Vitamin C has a greater influence on acute hepatitis compared with chronic hepatitis.
The remarkable case with the Swineflu
Some years ago there was a case in New Zealand which got a lot of public attention through the TV-program ”60 minutes”. It is about the farmer Alan Smith, 56 years of age and it later on turned into political health care issues. Alan went to Fiji with friends and his wife for fishing. He was then struck by a very severe infection in his upper airways [44], and the whole scenario may be followed in this video: [https://www.youtube.com/watch?v=VrhkoFcOMII]. According to his wife Alan became severely ill on the evening of June 26, 2009, was coughing and snoring, very rapidly fell into coma, and almost couldn’t breath. It was impossible to wake him up during the night why his wife thought he was going to die (he would remain in coma for 9 weeks). He was quickly transported to Tauranga Hospital in Fiji, was intubated and connected to a respirator for artificial ventilation. He was diagnosed with severe Swineflu (H1N1). An acute pulmonary X-ray demonstrated completely ”white lungs”. Two days later, on June 28, he arrives home at the University Hospital of Auckland, New Zealand, by an aeroplane equipped with ECMO (ExtraCorporeal Membrane Oxygenation) and a team of very specialised in the matter doctors. The course of his clinical condition is very stormy the following weeks. When after three weeks of care in the respirator + ECMO + coma without improvements, he was also diagnosed with leukemia, the doctors gathered the family members to discuss his situation on Monday July 20. The best thing to do, they said, was to end the respirator care and the ECMO. All ”consultants” agreed that there were no chances whatsoever for the patient to survive both leukemia and severe Swineflu. The whole family opposed this decision adamantly and demanded that high dose IV. Vitamin C would be tried first - which they had heard about. Alan was only 56 years of age and they wanted to make sure that everything possible had been tried. The doctors refused - arguing that the scientific proofs were lacking. The relatives then asked - ”what exactly might be lost in doing so?” By reading the notes from the patient’s chart, which had been demanded by the relatives, and are displayed in the TV-program ”60 minutes”, we can follow this controversy. The team of doctors (”consultants”) are holding a new meeting with the relatives on Tuesday morning and from the chart we can read (time 8.54): ”All responsible doctors at the ICU have now had a new meeting. We all agree that Vitamin C will not add anything valuable. We all agree that Mr. Smith will not survive. One consultant, however, is a little puzzled and argues that they should wait a couple of more days before disconnecting the patient from the ECMO -machine. Therefore it is reasonable to wait until Friday. If Mr. Smith until then has not shown any progress he will be disconnected from the ECMO.”
It is also noted in the chart that since the relatives are such strong believers in high dose Vitamin C IV. there are no reasons to deny the patient this treatment. On Tuesday evening and Wednesday morning the patient is receiving his first doses of Vitamin C, 25 grams x 2 IV., after consultations about the dose with the American professor in cardiology, Dr. Thomas Levy, a known expert on high dose IV Vitamin C. The X-Ray on Thursday morning demonstrates that both lungs are almost completely filled with air (time 9.43). Patient improves very quickly in those three days up to Friday and can breath by his own after 4 days why the ECMO is disconnected.
During the weekend the patient suddenly worsens again. It was found out that a new ”consultant” on call had turned off the Vitamin C infusion - without notifying the relatives - since he did not believe in Vitamin C. The relatives again start a fight with the doctors about Vitamin C infusions. The doctors at the clinic refuse, but after 2 days (on Tuesday July 29) they agree to continue the infusion, but now in a much reduced dose - 1 gram x 2. Again the patient makes progress but at a much slower pace than during the first three days and can not be sent to his home hospital after only one week, which had been planned. Actually, they had to wait several weeks.
When Alan Smith arrives at the hospital in the city where he lives the relatives once again clash with yet another doctor who ”does not believe in” Vitamin C and therefore refuses to administer the drug - even in the low dose of 1 gram times 2. Facing this strong resistance again the relatives contact a lawyer specialised in health care laws. And there was a verdict from the Supreme Court in New Zealand stating that doctors according to health care laws have an obligation to confer with the relatives before licentiously discontinuing various treatments. This verdict probably took some time. The patient is waking up from his coma after 9 weeks and can take liposomal Vitamin C 6 grams per day orally. This form of administration is taken up in the body 2-3 times faster [45] and in much higher concentrations than ordinary water soluble tablets from the Pharmacy. Furthermore, it will be available intracellularly almost instantly [46, 47] and enters all organelles, mitochondrias, cell nucleus, DNA etc. [48, 50]. The patient improves further with this treatment since 6 grams of liposomal Vitamin C causes higher plasma concentrations than 1 gram of intravenous Vitamin C - although at a slower pace than high dose IVC. After some more weeks the patient was completely recovered and it was now found that he was free of his leukemia.
As a consequence of the very absurd handling of the case (had the will of the doctors prevailed, he would have died) New Zealand authorities have created a law stating that doctors are forbidden to deny patients treatment with IVC, if this is a demand from the patient or his relatives. If the responsible doctor do not himself want to administer the drug he has an obligation to refer the patient to a doctor who is willing to do so.
Other viruses
Vitamin C IV. has also been used very successfully on other severe virus infections like viral encephalitis, and in this disease the patients very often were in coma at the start of the treatment [51-54]. When Vitamin C infusion is started the patients normally will become conscious after some hours only and go home after some days. Mononucleosis, which has a very prolonged recovery process for up to 6 months, with the risk of rupturing the enlarged liver and spleen, will heal within 4 days with Vitamin C IV treatment [40].
Vitamin C will completely heal many non-virus infections
Although Vitamin C kills all viruses in vitro and in vivo, it does kill most but not all bacterias. However, it is almost always bacteriostatic. Furthermore, it always strengthens the immun system - in fact, through about 20 different mechanisms. Vitamin C cures diphteria, tetanus, acute rheumatic fever, staphylococcus-, streptococcus- and pseudomonas-infections, and beneficially affects diseases like malaria [55], lepra, typhoid fever, brucellos, trichinosis, dysentery (amoeba- and bacillar-), tryponosomal infections (Chaga’s disease) [56].
One study from Bangladesh on patients with tetanus may have a certain interest to it. It concerns the effect of conventional treatment of tetanus with anti-tetanus serum compared with Vitamin C. Besides the two different treatment groups, Vitamin C vs. Placebo, the patients were grouped in age groups (1-12 vs. 13-30 years). All patients were given anti-tetanus serum after having been diagnosed with tetanus, but patients belonging to the treatment group also got Vitamin C 1 gram/day intravenously (IVC) in addition. In the age group 1-12 years 74,2 % of the controls died in spite of anti-tetanus serum whereas none died in the treatment group, who had IVC in addition. In the age group 13- 30 years, 67,8 % of the controls died whereas only 37 % died in the treatment group [57]. The impression here is that IVC might be more important to give than anti-tetanus serum, despite the fact that the latter is on the WHO:s 2016 list over essential medications. The deaths are obscured by the fact that the two age groups were given very different amounts of IVC per kilo bodyweight. It is very tempting to speculate about what would happen if the patients in the higher age group (13 - 30 years) would have been given the same dose per kilo as patients in the lower age group (1 - 12 years).
The literature about malaria demonstrates very good responses even with low doses of Vitamin C [55]. There are about 1000 articles published about Vitamin C and tuberculosis. The response is very slow. IVC will kill the tubercle, but the effect is slow since the tubercle multiply very slowly. Sometimes the tubercle is not killed since it will become encapsulated and will have no effect on mortality.
Vitamin C is a non-specific antidot against toxins and poisons
Vitamin C has been shown to neutralise poisonings due to mercury, lead, chrome, arsenic, cadmium, nickel, vanadium, aluminium, fluor [58], snake- and spider-poison [50, 54], alcohol-intoxication (limited effect, though) [59], barbiturates [50, 54, 60], poisonous mushrooms [61], six different pesticides [54, 58], strychnine and tetanus-toxin [62-64], and pertussis in the combination bacteria/toxin. Vitamin C is specifically beneficial for the latter. Dr. Thomas Levy who has written extensively about this matter says that he is not aware of any toxin or poison which can not be neutralised by Vitamin C. He even claims that it might be more beneficial than antiserum, since it does not display any of the symptoms of disease, which in some people are associated with receiving antiserum. Dr. Laing, who has written many articles about Vitamin C, felt such confidence in the neutralizing effect of Vitamin C that in 1984 he in front of an audience ingested three times lethal dose of poisonous mushrooms, which was immediately neutralized by taking Vitamin C.
There is one more story worth telling. In the American South it once happened that three 8-9 year old boys arrived in the Emergency Room with very severe pesticide poisoning. It is well known that in the summer evenings in this area the air is filled with large black balls of insects, especially after raining. Therefore, the crop-spraying was massive. Boys of this age tended to think it’s fun running after the crop-spraying tractors or aeroplanes. So did these three boys. They had hidden in the crop-field as the crop-spraying plane made its deep dives over the field and happened to unload its heavy cloud of pesticides just above the boys’s hiding place. The boys became immediately severely ill and arrived at the hospital with heavy breathing problems. They were taken care of by three different doctors. One of these was dr. Frederick Klenner who immediately gave a large dose of IVC to his patient who recovered completely and was sent home from the hospital the next day. The two other boys were not that lucky but died [58]. It is not clear what kind of treatment the received, probably antihistamins and fluids.
Vitamin C is beneficial in chronic diseases and radiation
It has been demonstrated that Vitamin C beneficially affects chronic diseases like borelia, AIDS, chronic hepatitis and tuberculosis. Vitamin C neutralizes the radiation damages and repairs the injuries. In an experimental study Ala Ketola et. al. showed that Vitamin C prevented rats from dying after having been exposed for whole body ionizing radiation [65]. Furthermore, in a clinical study on patients with cancer (2001), Kennedy et. al. proved that Vitamin C prevented the adverse effects of radiation [66].
Vitamin C DOES NOT cause the formation of kidney stones
A common objection against high dose IV. Vitamin C has been that it may contribute to the formation of kidney stones. However, this is a misconception which is rejected by large studies. Jackson et. a. followed 275 patients during a 16 years long period in which time span 194.054 grams of Vitamin C were administered (=705 grams per patient). There were no signs of kidney stone formation or other side effects [73]. According to Jackson there is no known toxic dosing of Vitamin C associated with formation of kidney stones. In another even larger study by Curhan 1999 on 85.557 women without a history of kidney stones (”Harvard Study”) it was concluded that Vitamin C is not involved in the kidney stone formation. Therefore, there are no reasons to have any restrictions for intake of Vitamin C [74]. This latter study was followed up with the ”Harvard Prospective Health Professional Follow-up Study”, which demonstrated that those persons having the largest intake of Vitamin C had a lower risk for kidney stones than those with the lowest intake. One study, though, demonstrated the opposite [75], but in that study a concomitant large intake of calcium was not accounted for. In another study by Casciari et al. (2001) Vitamin C infusions of 50 grams/day were continuously give for 8 weeks to terminal cancerpatients without any negative side effects [76]. And in one investigation of Vitamin C in relation to their history of kidney stones in 10.000 patients there were no increased risk of kidney stones. The opposite was corroborated - the higher concentration of Vitamin C in plasma the lower incidence of kidney stones [77].
In patients with a history of kidney stones, 55 other factors have actually been identified, which increase the amounts of oxalate and the risk of kidney stone formation. And it should be noted that in pregnant women the urine is oversaturated with calcium-oxalate, due to the augmented foetal requirements of calcium for bone formation - without higher risk for the formation of kidney stones.The higher risk of stone formation in patients with increased oxalate values does only exist in those with a history of kidney stones [78]. With such a broad safety, it is therefore remarkable, that Vitamin C now is used all over the world - except in hospitals [79].
You can kill yourself by water intoxication (e.g. psychiatric patient) but not that easily by Vitamin C. Does that mean that water is more toxic than Vitamin C [80]? LD50 for Vitamin C is 10 grams per kilo bodyweight. In the literature there is mention of one patient who was given 300 grams of Vitamin C in one day. He experienced a slight discomfort in the sides of chest/abdomen which was readily relieved by fluids and loop diuretics. Thus, Vitamin C has surprisingly broad safety marginals and is very mild to the body.
REFERENCES:
[1] Horio F, Ozaki K, Yoshida A, Makino S, Hayashi Y (1985). Requirement for ascorbic acid in a rat mutant unable to synthesize ascorbic acid. J Nutr 115:1630–1640
[2] Lane DJ, Lawen A (2009). Ascorbate and plasma membrane electron transport-enzymes vs efflux. Free Radic Biol Med 47:485–495)]
[3] Gan R, Eintracht S, Hoffer LJ. ’Vitamin C deficiency in a university teaching hospital.’ J Am Coll Nutr. 2008 Jun;27(3):428-33.) PMID: [’18838532’]
[4] [The black widow spider: Case history, Tri-State Med J, Dec 1957, Vol 5, No 10, pp 15-28.]
[5] Carr AC, Bozonet SM, Pullar JM, Simcock JW, Vissers MC. ’Human skeletal muscle ascorbate is highly responsive to changes in vitamin C intake and plasma concentrations’. Am J Clin Nutr. 2013 Apr;97(4):800-7. Epub 2013 Feb 27. PMID: [’23446899’]
[6] Akiko Amano, Makoto Tsunoda, Toshiro Aigaki, Naoki Maruyama, Akihito Ishigami. Effect of ascorbic acid deficiency on catecholamine synthesis in adrenal glands of SMP30/GNL knockout mice. Eur J Nutr (2014) 53:177-185
[7] Uttara B1, Singh AV, Zamboni P, Mahajan RT. ’Oxidative stress and neurodegenerative diseases: a review of upstream and downstream antioxidant therapeutic options.’ Curr Neuropharmacol. 2009 Mar;7(1):65-74. PMID: [’19721819’]
[8] Sargeant LA, Wareham NJ, Bingham S, Day NE, Luben RN, Oakes S, Welsh A, Khaw KT. Vitamin C and hyperglycemia in the European Prospective Investigation into Cancer--Norfolk (EPIC-Norfolk) study: a population-based study. Diabetes Care. 2000 Jun;23(6):726-32.
PMID: [’10840986’]
[9] Wells WW, Dou CZ, Dyas LN, Jung CH, Kalbach HL, Xu DP: Ascorbic acid is essential for the release of insulin from scorbutic guinea pig pancreatic islets. Proc Natl Acad Sci U S A 92:11869–11873, 1995 PMID: [’8524865’]
[10] Dou C, Xu DP, Wells WW: Studies on the essential role of ascorbic acid in the energy
dependent release of insulin from pancreatic islets. Biochem Biophys Res Commun 231:820–822, 1997 PMID: [´9070901’]
[11] Mason SA, Della Gatta PA, Snow RJ, Russell AP, Wadley GD. Ascorbic acid supplementation improves skeletal muscle oxidative stress and insulin sensitivity in people with type 2 diabetes: Findings of a randomized controlled study. Free Radic Biol Med. 2016 Apr; 93:227-38. doi: 10.1016/j.freeradbiomed.2016.01.006. Epub 2016 Jan 13.
[12] Donin AS et al. Fruit, vegetable and vitamin C intakes and plasma vitamin C: cross-sectional associations with insulin resistance and glycaemia in 9-10 year-old children. Diabet Med. 2016 Mar;33(3):307-15. doi: 10.1111/dme.13006. Epub 2015 Nov 23. PMID: [’26498636’]
[13] Kodama M, Kodama T, Murakami M, Kodama M. Diabetes mellitus is controlled by vitamin C treatment. In Vivo. 1993 Nov-Dec;7(6A):535-42.
[14] Villacorta L, Azzi A, Zingg JM. Regulatory role of vitamins E and C on extracellular matrix components of the vascular system. Mol Aspects Med. 2007 Oct-Dec;28(5-6):507-37. Epub 2007 Jun 2. PMID: [’17624419’]
[15] Paterson JC. Some Factors in the Causation of Intimal Haemorrhages and in the Precipitation of Coronary Thrombi. Can Med Assoc J. 1941 Feb;44(2):114-20. PMID: [’20321982’]
[16] McRae MP. Vitamin C supplementation lowers serum low-density lipoprotein cholesterol and triglycerides: a meta-analysis of 13 randomized controlled trials. J Chiropr Med. 2008 Jun;7(2):48-58. PMID: [’19674720’]
[17] Juraschek SP, Guallar E, Appel LJ, Miller ER 3rd. Effects of vitamin C supplementation on blood pressure: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2012 May;95(5):1079-88. Epub 2012 Apr 4. PMID: [’22492364’]
[18] Wilson JX Regulation of vitamin C transport. Annu Rev Nutr. 2005; 25: 105-25. PMID: [’16011461’]
[19] Lagercrantz H, Slotkin TA. The "stress" of being born.Sci Am. 1986 Apr;254(4):100-7. PMID: [’3961465’]
[20] Abdul-razzak KK, Nusier MK, Obediat AD, Salim AM. Antioxidant vitamins and hyperbilirubinemia in neonates.Ger Med Sci. 2007 Jun 25;5: Doc03. PMID: [’19675711’]
[21] Garbelli G. [Use of vitamin C in pregnancy, especially in prevention of jaundice of the newborn]. Quad Clin Ostet Ginecol. 1957 Jan;12(1):55-9. PMID: [’13420320’]
[22] Dahiya K, Tiwari AD, Shankar V, Kharb S, Dhankhar R. Antioxidant status in neonatal jaundice before and after phototherapy. Indian J Clin Biochem. 2006 Mar;21(1):157-60. PMID: [’23105589’]
[23] Jungeblut CW. Inactivation of poliomyelitis virus in vitro by crystalline vitamin C (Ascorbic acid). J Exp Med. 1935 Sep 30;62(4):517-21. PMID: [’19870431’]
[24] Holden och Resnick 1936, The in vitro action of synthetic crystalline ascorbic acid on herpes virus Journal of Immunology 31: 455-462
[25] Holden and Molloy Further experiments on the inactivation of herpes virus by Vitamin C (l-ascorbic acid) Journal of Immunology 33: 251-257
[26] Kligler and Bernkopf (1937) Inactivation of vaccinia virus by ascorbic acid and glutathione Nature 139: 965-966.
[27] Turner G (1964) Inactivation of vaccinia virus by ascorbic acid. J Gen Microbiol 35: 75-80 PMID: [’14171261’]
[28] Loikin M (1936) A study of ascorbic acid as an inactivation agent of tobacco mosaic virus Contr Boyce Thompson Inst Pl Research 8: 455.
[29] Murata (1975) Mechanism of inactivation of bacteriophage deltaA containing single-stranded DNA by ascorbic acid. PMID: [’1214179’]
[30] Morgan (1976) The mechanism of DNA strand breakage by vitamin C and superoxide and the protective roles of catalase and superoxide dismutase PMID: [’181730’]
[31] Richter (1982) Rapid inactivation of bacteriophage T7 by ascorbic acid is repairable. PMID: [’7044421’]
[32] Samuni (1983) On the cytotoxicity of vitamin C and metal ions. A site-specific Fenton mechanism. PMID: [’6317379’]
[33] Salo (1978) Inactivation of enteroviruses by ascorbic acid and sodium bisulfite. PMID: [’29558’]
[34] Cheng (2012) [An in vitro study on the pharmacological ascorbate treatment of influenza virus]. [Article in Chinese] PMID: [’22931805’]
[35] Amato G (1937) Azione dell’acido ascorbico sul virus fisso della rabia c sulfa tossina tetanica. Giornale di Batteriologica Virologia et Immunologia (Torino) 19: 843-847; rabies virus inactivated in vitro.
[36] http://www.seanet.com/~alexs/ascorbate/194x klenner-fr-southern med surg-1949-v111-n7-p209.htm
[37] http://www.seanet.com/~alexs/ascorbate/195x klenner-fr-southern med surg-1951-v103-n4-p104.htm
[38] Greer E. Vitamin C in acute poliomyelitis. Med Times. 1955 Nov;83(11):1160-1. PMID: [’13279345’]
[39] Baur H. [Poliomyelitis therapy with ascorbic acid]. Helv Med Acta. 1952 Oct;19(4-5):470-4. PMID: [’13021801’]
[40] Dalton WL. Massive doses of vitamin C in the treatment of viral diseases. J Indiana State Med Assoc. 1962 Aug; 55:1151-4. PMID: [’13883259’]
[41] Cathcart RF. Vitamin C, titrating to bowel tolerance, anascorbemia, and acute induced scurvy. Med Hypotheses. 1981 Nov;7(11):1359-76. PMID: [’7321921’]
[42] [Orens. Hepatitis B--a ten day "cure". A personal history. Bull Phila Cty Dent Soc. 1983 Mar;48(6):4-5.] PMID: [’6573223’]
[43] [Klenner 1974. Significance of high daily intake of ascorbic acid in preventive medicine. Journal of the International Academy of Preventive Medicine 1: 45-69.
[44] https://www.youtube.com/watch?v=VrhkoFcOMII.
[45] Ling SS, Magosso E, Khan NA, Yuen KH, Barker SA. Enhanced oral bioavailability and intestinal lymphatic transport of a hydrophilic drug using liposomes. Drug Dev Ind Pharm. 2006 Mar;32(3):335-45. PMID: [’16556538’]
[46] Yamada Y, Harashima H. Mitochondrial drug delivery systems for macromolecule and their therapeutic application to mitochondrial diseases. Adv Drug Deliv Rev. 2008 Oct-Nov;60(13-14):1439-62. Epub 2008 Jul 4. PMID: [’18655816’]
[47] Rawat A, Vaidya B, Khatri K, Goyal AK, Gupta PN, Mahor S, Paliwal R, Rai S, Vyas SP. Targeted intracellular delivery of therapeutics: an overview. Pharmazie. 2007 Sep;62(9):643-58.
PMID: [’17944316’]
[48] Goldenberg H, Schweinzer E. Transport of vitamin C in animal and human cells. J Bioenerg Biomembr. 1994 Aug;26(4):359-67. PMID: [’7844110’]
[49] Liang WJ, Johnson D, Jarvis SM. Vitamin C transport systems of mammalian cells. Mol Membr Biol. 2001 Jan-Mar;18(1):87-95. PMID: [’11396616’]
[50] Meister A. Glutathione-ascorbic acid antioxidant system in animals. J Biol Chem. 1994 Apr 1;269(13):9397-400. PMID: [’8144521’]
[51] [Klenner FR. The treatment of poliomyelitis and other virus diseases with vitamin C.
South Med Surg. 1949 Jul;111(7):209-14.] PMID: [’18147027’]
[52] 2. (April 1951) Klenner FR. Massive doses of vitamin C and the virus diseases. South Med Surg. 1951 Apr;113(4):101-7. PMID: [’14855098’]
[53] 3. (1953) Klenner FR. The use of vitamin C as an antibiotic. Journal of Applied
Nutrition 6: 274-278.
[54] (1971) Klenner FR. Observations of the dose and administration of ascorbic acid when employed beyond the range of a vitamin in human pathology Journal of Applied Nutrition 23: 61-88.
[55] [Lotze H. Clinical experimental investigations in benign tertian malaria. Tropical Diseases Bulletin 35 733]
[56] [(1937) Strangeways W. Observations on the trypanocidal action in vitro of solutions of glutathione and ascorbic acid. Annals of Tropical Medicine and Parasitology 31 405]
[57] Jahan K, Ahmad K, Ali MA. Effect of ascorbic acid in the treatment of tetanus. Bangladesh Med Res Counc Bull. 1984 Jun;10(1):24-8. PMID: [‘6466264’]
[58] Levy T. (2002) Curing the incurable, pp. 267 - 271.
[59] [Zannoni VG, Brodfuehrer II, Smart RC, Susick RL Jr. Ascorbic acid, alcohol, and environmental chemicals. Ann N Y Acad Sci. 1987; 498:364-88. PMID: [’3304067’]
[60] [Kao H, Jai SD, Young YS. A study of the therapeutic effect of large dosage of injectio ascorbici acidi on the depression of the central nervous system as in acute poisoning due to barbiturates. Yao Xue Xue Bao. 1965 Nov;12(11):764-5.]. PMID: [’5899011’] [Article in Chinese]
[61] Laing MD. A cure for mushroom poisoning.S Afr Med J. 1984 Apr 14;65(15):590. PMID: [’6200941’]
[62] [Dey PK. Efficacy of vitamin C in counteracting tetanus toxin toxicity. Naturwissenschaften. 1966 Jun;53(12):310.] PMID: [’5986216’]
[63] Dey PK. Protective action of lemon juice and ascorbic acid against lethality and convulsive property of strychnine. Naturwissenschaften. 1965 Apr; 52:164. PMID: [’14291219’]
[64] Dey PK. Protective action of ascorbic acid & its precursors on the convulsive & lethal actions of strychnine. Indian J Exp Biol. 1967 Apr;5(2):110-2. PMID: [’4383547’]
[65] Ala-Ketola L, Varis R, Kiviniitty K. Effect of ascorbic acid on the survival of rats after whole body irradiation. Strahlentherapie. 1974 Dec; 148(6):643-4. PMID: [’4450227’]
[66] Kennedy M, Bruninga K, Mutlu EA, Losurdo J, Choudhary S, Keshavarzian A. Successful and sustained treatment of chronic radiation proctitis with antioxidant vitamins E and C. Am J Gastroenterol. 2001 Apr;96(4):1080-4. PMID: [’11316150’]
[73] full artikel: www.riordanclinic.org/research/articles/89023765jom.pdf
[74] Curhan GC, Willett WC, Speizer FE, Stampfer MJ. Intake of vitamins B6 and C and the risk of kidney stones in women. J Am Soc Nephrol. 1999 Apr;10(4):840-5. PMID: [’10203369’]
[75] Gerster H. No contribution of ascorbic acid to renal calcium oxalate stones. Ann Nutr Metab. 1997;41(5):269-82. PMID: [’9429689’]
[76] Casciari JJ, Riordan NH, Schmidt TL, Meng XL, Jackson JA, Riordan HD. Cytotoxicity of ascorbate, lipoic acid, and other antioxidants in hollow fibre in vitro tumours. Br J Cancer. 2001 Jun 1;84(11):1544-50. PMID: [’11384106’]
[77] Simon JA, Hudes ES. Relation of serum ascorbic acid to serum vitamin B12, serum ferritin, and kidney stones in US adults. Arch Intern Med. 1999 Mar 22; 159(6):619-24. PMID: [’10090119’]
[78] Maikranz P, Holley JL, Parks JH, Lindheimer MD, Nakagawa Y, Coe FL. Gestational hypercalciuria causes pathological urine calcium oxalate supersaturations. Kidney Int. 1989 Jul;36(1):108-13. PMID: [’2811052’]
[79] Padayatty SJ, Sun AY, Chen Q, Espey MG, Drisko J, Levine M. Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PLoS One. 2010 Jul 7;5(7):e11414. doi: 10.1371/journal.pone.0011414. PMID: [’20628650’]
[80] Hayashi T, Ishida Y, Miyashita T, Kiyokawa H, Kimura A, Kondo T. Fatal water intoxication in a schizophrenic patient--an autopsy case. J Clin Forensic Med. 2005 Jun;12(3):157-9. Epub 2005 Mar 16. PMID: [’15914312’]
Sture Blomberg, M.D., Ph. D. Assoc. Prof.
Anesthesiology & Intensive Care Medicine
Fig 1. Askorbic acid, Vitamin C, resembles fructose very much. It is synthezied from glucose in the liver in most species and exists in 5 different forms. First, the form which is displayed in the figure with the two hydroxyl groups intact at the bottom. When the Ascorbic acid functions as an antioxidant it will release two electrons and two protons (encircled in read) in three different steps. One electron is first donated to different biomolecules, which creates the second form, ascorbate-ion. In the second and third step it will donate a proton and an electron within nano-seconds, which seems that it actually donates one hydrogen atom, and is now named ”ascorbyl-radical”. When it in the fourth step donates the last proton it is called dehydro-ascorbate, it has lost two hydrogens and are now ready to be excreted. It seems that the Vitamin C is very valuable to oxidized biomolecules. It can provide one single electron, one hydrogen and one proton without doing any harm to itself or anything else. It is just very mild and generous.