These, together with a general anti-oxidant recommendation which included vitamin A and E, were his specific recommendation for the prevention and treatment of cardiovascular disease. *Source of intake should be from foods or formula only. (PubMed), 159. Such symptoms appear to be related to the weakening of blood vessels, connective tissue, and bone, which all contain collagen. Vitamin C/Professional handout/Interactions with drugs. In this case, vitamin C is esterified to the saturated fatty acid, palmitic acid, resulting in a fat-soluble form of vitamin C. Ascorbyl palmitate has been added to a number of skin creams due to interest in its antioxidant properties, as well as its importance in collagen synthesis (see the separate article, Vitamin C and Skin Health) (188). Despite conflicting results, it may be prudent for individuals predisposed to oxalate kidney stone formation to avoid high-dose vitamin C supplementation. Pfister R, Sharp SJ, Luben R, Wareham NJ, Khaw KT. Over years of buildup and accumulated damage to the coronary arteries, CHD may culminate in a myocardial infarction or heart attack. Early Hum Dev. "Vitamin C" Vitamin C and Cancer - Dr. Linus Pauling - How To Live Longer and Feel Better - Vitamin C Dr. Linus Pauling and Dr. Abram HofferVitamin C, Vita. Oregon State University, Updated in January 2006 by: Of note, it is possible that genetic differences among diabetic patients influence the effect of vitamin C supplementation on cardiovascular risk. The mechanisms underlying differential sensitivity to vitamin C are under investigation. Nutrients. Pauling L. The immune system. Although the analysis adjusted for several lifestyle and known risk factors, the authors noted that other healthy behaviors and/or folate intake may have confounded the association. Lee SH, Oe T, Blair IA. Wang L, Sesso HD, Glynn RJ, et al. 2015;122(13):1740-1747. Vitamin C is also a cofactor in numerous enzymatic reactions involved in the making of collagen, L-carnitine, and several neurotransmitters, and in the regulation of gene expression. Freeman; 1970. Overall, evidence suggesting specific drugs can lower blood vitamin C concentrations in humans is limited. South Med J. (PubMed), 191. (PubMed), 147. J Transl Med. The Linus Pauling Institute's Micronutrient Information Center provides scientific information on the health aspects of dietary factors and supplements, food, and beverages for the general public. Flavonoids are a class of water-soluble plant pigments that are often found in vitamin C-rich fruit and vegetables, especially citrus fruit and berries (see the article on Flavonoids). (PubMed), 168. Ascorbyl palmitate is a vitamin C ester (i.e., ascorbic acid linked to a fatty acid). In this latter trial, a greater decline in the Mini Mental State Examination (MMSE) score was observed in the supplemented group, however, the significance of this observation remains unclear. By pooling data from 13 prospective cohort studies comprising 676,141 participants, it was determined that dietary intake of vitamin C was not associated with colon cancer, while total intake of vitamin C (i.e., from food and supplements) was associated with a 19% reduced risk of colon cancer (79). Arch Intern Med. (PubMed), 84. Dosage is a key factor: low doses are ineffective. 22. Present Knowledge in Nutrition. 14. Am J Clin Nutr. Impaired blood-brain barrier integrity may affect the brains ability to retain vitamin C and thus to maintain a high CSF-to-plasma vitamin C ratio. One hundred percent absorption efficiency is observed when ingesting vitamin C at doses up to 200 mg at a time. Am J Clin Nutr. 2011;162(2):246-253. Vitamin C deficiency in the brain impairs cognition, increases amyloid accumulation and deposition, and oxidative stress in APP/PSEN1 and normally aging mice. Studies in the 1970s and 1980s conducted by Linus Pauling, Ewan Cameron, and colleagues suggested that large doses of vitamin C (10 g/day infused intravenously for 10 days followed by at least 10 g/day orally indefinitely) were helpful in increasing the survival time and improving the quality of life of terminal cancer patients (158). People with impaired kidney function may be at risk for aluminum toxicity when supplemental vitamin C is taken at the same time as these compounds (200, 201). Arlt S, Muller-Thomsen T, Beisiegel U, Kontush A. Phagocytic leukocytes also produce and release cytokines, including interferons, which have antiviral activity (16). 2004;140(7):533-537. 1982;47(3):473-482. A 2012 review of nine randomized controlled trials found no substantial effect of -carotene, vitamin C, and vitamin E, administered individually or in combination over 2.1 to 12 years, on the risk of cataracts or cataract surgery (112). Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice. 2012;95(5):1079-1088. Carr AC, Maggini S. Vitamin C and immune function. (PubMed), 51. 21. Similarly, the EPIC-Norfolk study, a 10-year prospective cohort study in 20,649 adults, found that individuals with plasma vitamin C concentrations in the top quartile (25%) had a 42% lower risk of stroke compared to those in the lowest quartile (66 mol/L vs. <41 mol/L) (58). 2014;15:192. (PubMed), 173. Vitamin C requirements are likely to be increased in this population due to the hypermetabolic response driven by the systemic inflammatory reaction (152, 153). (PubMed), 199. N Engl J Med. McEvoy CT, Milner KF, Scherman AJ, et al. (PubMed), 69. Vitamin C and the Common Cold. Atherosclerosis. Moran JP, Cohen L, Greene JM, et al. 2009;90(5):1252-1263. New York: Garland Publishing, Inc.; 1994:1139-1193. 2000;31(10):2287-2294. The Linus Pauling Institute's Micronutrient Information Center provides scientific information on the health aspects of dietary factors and supplements, food, and beverages for the general public. (PubMed), 3 Camarena V, Wang G. The epigenetic role of vitamin C in health and disease. After five years of follow-up, vitamin C supplement use was associated with a small decreased risk of total mortality, although no association was found with cardiovascular disease- or cancer-specific mortality. 1999;69(6):1086-1107. Aspirin can impair vitamin C status if taken frequently (201). Vissers MCM, Das AB. 1990;265(5):2584-2587. Nonetheless, vitamin C supplementation led to a 36% lower risk of placental abruption and to a significant increase in gestational age at birth (88). Jane Higdon, Ph.D. Chen GC, Lu DB, Pang Z, Liu QF. Am J Obstet Gynecol. (PubMed), 29. 2004;80(6):1508-1520. Chuang CH, Sheu BS, Kao AW, et al. Tsugane S, Sasazuki S. Diet and the risk of gastric cancer: review of epidemiological evidence. *Monooxygenases catalyze the hydroxylation of one substrate, whereas dioxygenases catalyze a reaction that couples the hydroxylation of a specific substrate with the conversion (decarboxylation) of -ketoglutarate into succinate. (PubMed), 57. (PubMed), 123. Notably, intravenous administration of vitamin C bypasses absorptive control in the intestine such that very high concentrations of vitamin C can be achieved in the plasma; within a few hours, renal excretion restores vitamin C to baseline plasma concentrations (see Cancer Treatment) (25). 1999;281(24):2289-2293. 2012;37(12):2706-2714. In an observational study that included 1,387 men, higher intakes of vitamin C were associated with lower serum concentrations of uric acid (117). Vitamin C also participates in redox recycling of other important antioxidants; for example, vitamin C is known to regenerate vitamin E from its oxidized form (see the article on Vitamin E). Authors' perspective: What is the optimum intake of vitamin C in humans? A meta-analysis of 29 small randomized controlled trials of short durations (median duration, 8 weeks) in 1,407 participants (10 to 120 subjects per trial; including both normotensive and hypertensive subjects) found that daily supplementation with 60 to 4,000 mg of vitamin C (median dose, 500 mg) reduced systolic blood pressure by 3.84 mm Hg and diastolic blood pressure by 1.48 mm Hg (45). Modern Nutrition in Health and Disease, 11th ed. Periprocedural myocardial injury: Coronary angioplasty (also called percutaneous transluminal coronary angioplasty) is a nonsurgical procedure for treating obstructive coronary heart disease (CHD), including unstable angina pectoris, acute myocardial infarction, and multivessel CHD. Calcium in this form appears to be reasonably well absorbed. Exercise-induced bronchoconstriction is a transient narrowing of the airways that occurs after exercise and is indicated by a 10% decline in Forced Expiratory Volume in 1 second (FEV1). Diabetes Care. 2007;10(2):75-83. Lysine also prevents collagen-digesting enzymes from destroying collagen. Pauling L. Vitamin C therapy and advanced cancer (letter). The effects of increasing weekly doses of ascorbate on certain cellular and humoral immune functions in normal volunteers. Improved endothelial function was observed with daily vitamin C doses above 500 mg (39). J Am Heart Assoc. Due to the pharmacokinetics and tight regulation of plasma vitamin C, supplementation with vitamin C will have variable effects in vitamin C-replete (plasma concentrations near saturation) versus sub-optimal (plasma concentrations <50 mol/L), marginally deficient (plasma concentrations <23 mol/L), or severely deficient (plasma concentrations <11 mol/L) individuals (28). Although the use of lead paint and leaded gasoline has been discontinued in the US, lead toxicity continues to be a significant health problem, especially in children living in urban areas. 2008;300(18):2123-2133. 2011;26(3):309-318. (PubMed), 44. 2018;9:809. (PubMed), 104. Indeed, research has recently uncovered the crucial role played by enzymes, such as the TET dioxygenases and Jumonji domain-containing histone demethylases, in the fate of cells and tissues (seeTable 1). Vitamin C also prevented the rise of Sequential Organ Failure Assessment (SOFA) and Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II scoresused to assess severity of illness and risk of mortalityobserved in placebo-treated patients (154). [Your name] is not affiliated or endorsed by the Linus Pauling Institute or Oregon State University. One small placebo-controlled, cross-over trial in 11 men showed that the oral administration of 4 g of vitamin C resulted in a greater vitamin C concentration in plasma over a four-hour period when vitamin C was encapsulated in liposomes compared to unencapsulated vitamin C (190). Lykkesfeldt J, Christen S, Wallock LM, Chang HH, Jacob RA, Ames BN. ACS Chem Neurosci. These products are all Lp (a) binding inhibitors. Pharmacol Rep. 2010;62(4):751-756. Conde-Agudelo A, Althabe F, Belizan JM, Kafury-Goeta AC. A small randomized controlled trial performed in 60 ischemic stroke patients showed that intravenous vitamin C administration (500 mg/day for 10 days, initiated day 1 post-stroke) had no effect on serum markers of oxidative stress or neurological outcomes compared to placebo(143). The confirming scientific experiments of Dr. Pauling were published in the Proceedings of the National Academy of Science (1990, Vol 87, pgs 6204-6207) and Dr. Pauling was . 307 Linus Pauling Science Center Neutrophils, mononuclear phagocytes, and lymphocytes accumulate vitamin C to high concentrations, which can protect these cell types from oxidative damage(12-14). 2013;32(12):1508-1517. Jacobs C, Hutton B, Ng T, Shorr R, Clemons M. Is there a role for oral or intravenous ascorbate (vitamin C) in treating patients with cancer? Pauling's therapeutic dosage of vitamin C for those diagnosed with cardiovascular disease is from 6,000 mg up to 18,000 mg (or bowel tolerance). 2018;20(2):145-166. In this context, it is important to note that data from the National Institutes of Health (NIH) have indicated that vitamin C levels in plasma and circulating cells become fully saturated at intakes of about 400 mg/day in young, healthy nonsmokers. However, cases have occurred in children and the elderly on very restricted diets (33, 34). (PubMed), 166. Abramovici A, Gandley RE, Clifton RG, et al. Cigarette smoking during pregnancy causes intrauterine growth restriction and preterm birth, among other pregnancy complications (90, 91), and is the primary cause of childhood respiratory illness (92). Int J Vitam Nutr Res. HIF-dependent antitumorigenic effect of antioxidants in vivo. The role of vitamin C as a cofactor is also related to its redox potential. The work of Linus Pauling stimulated public interest in the use of doses greater than 1 g/day of vitamin C to prevent the common cold (177). With respect to vitamin C and cerebrovascular disease, a prospective cohort study that followed more than 2,000 residents of a rural Japanese community for 20 years found that the risk of stroke in those with the highest serum concentrations of vitamin C was 29% lower than in those with the lowest serum concentrations of vitamin C (57). Higher doses (>500 mg) result in fractionally less vitamin C being absorbed as the dose increases. Vitamin C supplementation in pregnancy. Linus Pauling's Recommendations for Vitamin C and Lysine - The Ezekiel Diet Files Linus Pauling's Recommendations for Vitamin C and Lysine by EzekielDiet.com Posted on Sep 22, 2021 Pauling's Vitamin C and Lysine dosage recommendations from his Unified Theory Lecture on Heart Disease. After 14 years of follow-up, it was found that men who consumed 1,000 mg/day of vitamin C had a 41% higher risk of kidney stones compared to men consuming <90 mg of vitamin C daily. (PubMed). Myint PK, Luben RN, Wareham NJ, Khaw KT. Calcium ascorbate: Calcium ascorbate generally provides 90-110 mg of calcium (890-910 mg of ascorbic acid) per 1,000 mg of calcium ascorbate. A three-year randomized controlled trial in 160 patients with documented coronary heart disease and low blood HDL concentrations found that a combination of simvastatin (Zocor) and niacin increased HDL concentration, inhibited the progression of coronary artery stenosis (narrowing), and decreased the frequency of cardiovascular events, such as myocardial infarction and stroke(202). I've never used his regimen in this regard, but it should help. BMJ. Arch Intern Med. 1996;173(6):1502-1505. (PubMed), 67. In vitro experiments performed using 11 different cancer cell lines demonstrated that sensitivity to vitamin C correlated with the expression of catalase, an enzyme involved in the decomposition of hydrogen peroxide (172). Although two intervention studies failed to show a reduction in stomach cancer incidence with vitamin C supplementation(35), some research suggests that vitamin C supplementation may be a useful addition to standard H. pylori eradication therapy in reducing the risk of gastric cancer (76). (PubMed), 108. (PubMed). (PubMed), 129. Linus Pauling is a hard guy to argue with. 2016;9:25-30. Pauling, two-time Nobel laureate and the world's foremost vitamin C proponent, entertained an overflow crowd in the Bldg. Although CSF vitamin C is maintained at concentrations several-fold higher than plasma vitamin C, the precise function of vitamin C in cognitive function and AD etiology is not yet fully understood (102). In response to invading microorganisms, phagocytic leukocytes release non-specific toxins, such as superoxide radicals, hypochlorous acid ("bleach"), and peroxynitrite; these reactive oxygen species kill pathogens and, in the process, can damage the leukocytes themselves (15). Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. Comparison of mortality associated with sepsis in the burn, trauma, and general intensive care unit patient: a systematic review of the literature. Br Med J. No association between dietary or supplemental intake of vitamin C and mortality was found after approximately 14 years of follow-up. Ye Z, Song H. Antioxidant vitamins intake and the risk of coronary heart disease: meta-analysis of cohort studies. Davis JL, Paris HL, Beals JW, et al. Age-related changes to the lens (thickening, loss of flexibility) and oxidative damage contribute to the formation of cataract, i.e., cloudiness or opacity in the lens that interferes with the clear focusing of images on the retina. 2013;5(11):4284-4304. (PubMed), 181. Intakes of vitamins A, C, and E and use of multiple vitamin supplements and risk of colon cancer: a pooled analysis of prospective cohort studies. Carr AC, Frei B. (PubMed), 126. 1. (PubMed). Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. J Am Soc Nephrol. However, no difference in the infarct size between antioxidant vitamin treatment and placebo was seen (138). (PubMed), 157. Carr AC, Bozonet SM, Pullar JM, Simcock JW, Vissers MC. (PubMed), 52. Oregon State University, Copyright 2000-2023 Linus Pauling Institute. Hemorrhagic stroke occurs when a weakened blood vessel ruptures and bleeds into the surrounding brain tissue. In another randomized, double-blind, controlled trial in 28 critically ill patients with septic shock, infusion of 25 mg of vitamin C per kg every six hours for 72 hours significantly limited the requirement to vasopressor norepinephrinedecreasing both the dose and duration of treatmentand dramatically improved the 28-day survival rate (155). 1995;59(6):1519-1523. The lens of the eye focuses light, producing a clear, sharp image on the retina, a layer of tissue on the inside back wall of the eyeball. Science. Of note, because intravenous administration of 80 g of vitamin C precipitated hemolytic anemia in two subjects with glucose-6-phosphate dehydrogenase deficiency, patients due to receive high-dose vitamin C infusion are systematically screened for this genetic disorder (166). Oregon State University, Updated in September 2003 by: Vol. Eur J Cancer. Is vitamin C supplementation beneficial? Hammoud AO, Bujold E, Sorokin Y, Schild C, Krapp M, Baumann P. Smoking in pregnancy revisited: findings from a large population-based study. Linus Pauling Recommendations 1. (PubMed), 30. (PubMed), 189. Years later, Dr. Linus Pauling, two-time Nobel Prize winner, is ignored for reporting that large amounts of vitamin C and lysine are needed to prevent coronary attacks. (PubMed), 58. Breast Cancer Res Treat. Adults. Amelioration of persistent left ventricular function impairment through increased plasma ascorbate levels following myocardial infarction. For some still unclear reasons, smoking has been associated with a lower risk of preeclampsia during pregnancy (93). Relation between plasma ascorbic acid and mortality in men and women in EPIC-Norfolk prospective study: a prospective population study. Vitamin C in plasma is inversely related to blood pressure and change in blood pressure during the previous year in young Black and White women. Evans RM, Currie L, Campbell A. The Pauling therapy is a combination of the specific orthomolecular nutrients - ascorbic acid, lysine and proline - that are proven to combat coronary heart disease at the specific dosages recommended by Linus Pauling. It should also be noted that the Linus Pauling Institute's recommendation is strictly directed towards prevention of disease in healthy individuals, not treatment of disease. 2005;192(6):1856-1862; discussion 1862-1853. Vitamin C in Health and Disease. Carcinogenesis. (PubMed), 89. Additionally, several cross-sectional studies reported inverse associations between circulating vitamin C concentrations and markers of insulin resistance or glucose intolerance, such as glycated hemoglobin (HbA1c) concentration (50, 85, 86). Nutrients. Am J Clin Nutr. 1996;155(6):1847-1851. Effect of Helicobacter pylori and its eradication on gastric juice ascorbic acid. (PubMed), 116. Vitamin C intake, circulating vitamin C and risk of stroke: a meta-analysis of prospective studies. Specific measures of functions stimulated by vitamin C include cellular motility (10), chemotaxis(10, 11), and phagocytosis(11). Milei J, Forcada P, Fraga CG, et al. 2014;53(5):1255-1262. Science. Sodium ascorbate and calcium ascorbate are the most common forms, although a number of other mineral ascorbates are available. (PubMed), 43. Zhang ZW, Patchett SE, Perrett D, Katelaris PH, Domizio P, Farthing MJ. A meta-analysis of 10 trials that examined antioxidant vitamins, of which five included vitamin C, found no association between any antioxidant vitamin (vitamin C, vitamin E, or -carotene), administered alone or in combination, and risk of stroke (60). Atrial fibrillation:Atrial fibrillation is the most common type of cardiac arrhythmia. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. Nutrients. Zhu Y, Pandya BJ, Choi HK. Ascorbyl palmitate is marketed as "vitamin C ester," which should not be confused with Ester-C (see above). Banerjee S, Hawksby C, Miller S, Dahill S, Beattie AD, McColl KE. J Am Soc Nephrol. 2010;51(6):963-964. Ascorbic acid levels in the aqueous humor of nocturnal and diurnal mammals. Higher plasma concentrations achieved via intravenous vitamin C administration are comparable to those that are toxic to cancer cells in culture. Although observational studies suggested that supplemental vitamin C may be helpful to prevent incident and recurrent gout, this has not been demonstrated by intervention studies undertaken thus far. Because vitamin C can inactivate urease (an enzyme that facilitates H. pylori survival and colonization of the gastric mucosa at low pH) in vitro, vitamin C may be most effective as a prophylactic agent in those without achlorhydria(77, 78). Effect of antioxidant vitamin supplementation on cardiovascular outcomes: a meta-analysis of randomized controlled trials. SVCT-2 in breast cancer acts as an indicator for L-ascorbate treatment. 177. J Nutr. 2015;4(11). 2009;29(3):809-815. One supplement, Ester-C, contains mainly calcium ascorbate and includes small amounts of the vitamin C metabolites, dehydroascorbic acid (oxidized ascorbic acid), calcium threonate, and trace amounts of xylonate and lyxonate. Padayatty SJ, Sun H, Wang Y, et al. (PubMed), 180. Plasma vitamin C predicts incident heart failure in men and women in European Prospective Investigation into Cancer and Nutrition-Norfolk prospective study. A 2013 meta-analysis of 17 prospective cohort studies reported a 19% lower risk of stroke with the highest versus lowest dietary vitamin C intakes and a 38% lower risk with the highest versus lowest circulating vitamin C concentrations (59). It is not known whether supplemental vitamin C could improve markers of glycemic control in subjects at risk of diabetes. World J Crit Care Med. Arch Neurol. Intravenous vitamin C and cancer: a systematic review. Taylor EN, Stampfer MJ, Curhan GC. Cancer Chemother Pharmacol. Vitamin C affects several components of the human immune system in vitro; for example, vitamin C has been shown to stimulate both the production (5-9)and function (10, 11)of leukocytes (white blood cells), especially neutrophils, lymphocytes, and phagocytes.
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