Thirty years ago, Nobel Prize-winning chemist Linus Pauling, Ph.D., shook the health community with his book Vitamin C and the Common Cold, in which he proposed that large doses of C, or “megadoses,” could cut the duration of the common cold in half. The book sparked a continuing controversy over the doses and benefits of vitamin C, and helped spawn a multi-billion-dollar industry.
Less known is the pioneering work of Fredrick R. Klenner, M.D., who in the late 1940s was said to have cured more than 60 cases of polio and other types of life-threatening viral infections with megadoses of ascorbic acid. His work was well-documented in a number of peer-reviewed medical journals. Contemporary M.D.s such as Abram Hoffer, Robert Cathcart, Hugh Riordan and others continue this research and use megadoses of vitamin C as integral parts of effective treatment for health conditions as mild as seasonal allergies or as serious as advanced cancer, and in the prevention of diseases as disparate as sudden infant death syndrome in the beginning stages of life and Alzheimer’s toward the end.
In 1968, Pauling coined the term “orthomolecular” medicine to describe a nutrition-based approach to health intended to balance elements naturally present in the human body. While there is universal agreement among orthomolecular physicians that people must supplement their diets with vitamin C to remain healthy—and that the USRDA standards, developed by the U.S. Academy of Sciences, are far too low—there is considerable disagreement over what levels need to be maintained, and what forms of vitamin C are most beneficial.
A quick trip to a natural food store reveals that vitamin C is available in an overwhelming number of forms. There are capsules and powders, time-release pills and chewables. Pill potencies range from 100 mg to ten times that amount. Vitamin C can come as simple ascorbic acid or in “buffered” forms of mineral ascorbates, such as calcium ascorbate, magnesium ascorbate and so on. There are also dozens of different C-based supplement formulas, with added minerals, other vitamins or naturally occurring cofactors such as bioflavonoids. And the range of prices for vitamin C products is as great as the number of forms they come in.
To treat life-threatening illnesses, many alternative physicians administer vitamin C intravenously in order to achieve extremely high levels in the blood plasma and tissues (although they often combine this with an oral product regimen). The reason for this is that when vitamin C is ingested orally, the body regulates how much can be absorbed from the gastrointestinal tract into the bloodstream and utilized by cells. These are issues of bowel tolerance (a limiting factor for absorption) and bioavailability (how much is actually used by the cells, as opposed to how much is simply excreted through the kidneys). The differences among all the available vitamin C products are primarily focused on improving these two factors.
When individuals take more than a certain amount of vitamin C within a short period of time, it can cause diarrhea. The basic mechanism of bowel tolerance seems to be a function of the acidity of ascorbic acid, or simple vitamin C. Like any acidic food, when we ingest ascorbic acid, the body neutralizes it by combining the acid with minerals—in this case, most commonly with potassium or sodium. The ascorbic acid becomes a salt—potassium ascorbate or sodium ascorbate—which attracts water into the colon, creating loose bowels to expel it from the body.
The amount of vitamin C it takes to reach the threshold of bowel tolerance varies tremendously from individual to individual, and even within the same individual, depending on his or her condition. Many studies indicate that the sicker a person is, the more vitamin C he or she will naturally tolerate, by an astounding factor of ten or more.
Doses for Daily Health
It seems that everyone has a different opinion on how much vitamin C adults should take. At the most conservative end are the USRDA recommendations, which now advise 90 mg per day for healthy adult men and 75 mg for women, while urging smokers of both genders to add 35 mg to those amounts.
Other medical authorities contend that 90 mg only starts to meet our biological needs. Recent studies at the National Institutes of Health have found that a dose of 150 mg to 200 mg is optimal for raising the vitamin to full capacity in the bloodstream of healthy, nonsmoking adults. Above that, researchers contend, people simply excrete the rest in what is sometimes referred to as “expensive urine.”
The natural health community generally suggests much higher doses, in part because it recognizes that most of us aren’t as healthy as the 22-year-old men in the studies. At the high end of the spectrum is Owen Fonorow, who in 1995 co-founded the Vitamin C Foundation in Texas. Fonorow sticks by Pauling’s recommendation of 3 gm per day for healthy adults, although he, like Pauling, routinely takes 18 grams. Fonorow says the federal recommendations are aimed at the wrong target. “Everybody agrees [the USRDA has] done a good job eliminating clinical scurvy,” he says. “Where it’s missed the boat is determining the optimal level of vitamin C for good health.”
Many health advisers and scientists operate in the middle ground between the government’s 90 mg and Pauling’s 18,000 mg. The Linus Pauling Institute recommends that healthy adults consume at least 200 mg each day of vitamin C. Interestingly for a foundation named for a man who consumed 90 times this amount an a daily basis, the Institute says that 200 mg can be provided by five servings of most fruits and vegetables, and recommends additional supplementation only for vitamin E, selenium and, in some cases, calcium.
Many alternative-thinking scientists now frequently recommend a range of 500 mg to 1,000 mg per day—preferably in two or three doses with meals. But that’s when you’re healthy. While studies do not prove that vitamin C prevents the common cold, scientists have found that large doses taken at the onset of a cold can shorten its duration by 23%, on average. Those studies recommend taking between 1,000 mg and 8,000 mg daily at the first signs of a cold, in doses of up to 1,000 mg apiece. With regard to cancer, Riordan’s research indicates that some cancer patients are approaching clinical scurvy (a side effect of chemotherapy treatments), and therefore need far higher doses. A common recommendation is 20,000 mg of oral vitamin C supplements per day for cancer patients, or whatever their bodies can handle.
How Much Is Too Much?
In the estimated 20,000 studies conducted on vitamin C over the last six decades, there are no indications that higher doses are toxic. An excess simply produces diarrhea.
“There are some people who, when they’re sick, can take orders of magnitude more than 3 grams per day with no intolerance,” says Fonorow. He follows the bowel tolerance guidelines codified by Dr. Cathcart: Keep taking approximately a gram every hour until you have to go to the bathroom—at which point you’ve reached your limit.
“If you’ve got diarrhea, you’ve gotten too much,” says Fonorow. “What you’re trying to figure out is, whether this is a 30-gram cold or a 100-gram cold. If you take 100 grams for a 30-gram cold, you’ll be on the pot all day.”
People do need to be aware that if they have been taking large doses of vitamin C to ward off a cold or to fight a serious illness, they should avoid going abruptly from, say, 8 grams a day down to one gram. This can cause what is called the “rebound effect,” leading to symptoms of scurvy. It is thus important for people to wean themselves off megadoses gradually by reducing the amount they’re taking over a period of a week or so.
While there are serious unresolved controversies among experts as to how much and what kind of vitamin C to take, there is no disagreement that an adequate supply of vitamin C is essential to good health. But this begs the question: If vitamin C is so critical to our daily body functions, why don’t our bodies make it naturally? Interestingly, most animals, except guinea pigs and primates, do. Animals produce it naturally in the liver, in quantities proportionate to body weight—the equivalent for a human of 10 to 12 grams per day when healthy and 5 to 10 times or more than that when stressed. But humans lack the enzyme to turn glucose into vitamin C. In the 1960s, Irwin Stone, Ph.D., developed the theory that some 65 million years ago, our tropical ancestors ate enough fruits and leafy vegetables that were high in vitamin C that we “successfully” mutated away from producing it. This was actually an evolutionary advantage while we lived in trees and gorged on fruit—our bodies were relieved of the necessity of turning glucose into ascorbic acid. But it has turned into a disaster now that we live in a polluted world, eating diets low in C. Stone, and others, view vitamin C supplementation not as simply a matter of addressing an accidental dietary deficiency, but of attempting to correct a species-wide genetic defect that has a most profound impact on our health.
Why do we need vitamin C?
Vitamin C in any of its natural formsis believed to be involved in more biochemical reactions in the body than any other vitamin. In his book, Vitamin C: Its Molecular Biology and Medical Potential, Sherry Lewin, Ph.D., says that vitamin C is necessary for some 300 functions in the body. It protects the cardiovascular system and prevents heart disease, balances cholesterol levels and plays an important role in the body’s production of collagen. As the protein constituent of our connective tissue, collagen literally holds us together—maintaining our skin, muscles, bones and blood vessels—and aids in the healing of wounds. Vitamin C is necessary for the operation of our immune systems; our white blood cells cannot function properly without an adequate supply. Vitamin C also plays a key role in the synthesis of neurotransmitters, steroid hormones and metal ion metabolism. It is most widely known, however, as an antioxidant—preventing and repairing cellular damage caused by toxic metabolic byproducts that many scientists think are the major cause of many diseases and aging.
Beets vs. Corn
For many years, the only source of vitamin C was food or a synthetic vitamin derived from corn sugar. Recently, though, beet-derived C has caused a buzz in the alternative health community. Critics of beet superiority point out that laboratory analysis shows no difference in structure or action between the two, and that all previous studies on the benefits of vitamin C used corn-derived products. However, a number of well-known M.D.s, including W. Lee Cowden and Douglas Brodie, say they see better results using beet-derived vitamin C for their intravenous use in cancer therapies. With that in mind, some vitamin suppliers, including NutriCology, specify which forms of their vitamin C are derived from beets and which are from corn.