Frequently Asked Questions
Moderated By Owen R. Fonorow
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#1: What is the best form of vitamin C to take?
According to the late Dr. Robert Cathcart, twice as much vitamin C is required for the same therapeutic effect when ascorbates are already bound to minerals.
All forms of vitamin C cure scurvy. Various experts prefer mineral ascorbates (e.g. sodium ascorbate) orally to ascorbic acid, perhaps because it doesn't aggravate the throat (lower esophagus.) However, these alkaline forms of vitamin C do not enter the blood stream as rapidly, and they are less effective fighting infection. Many people take a combination of both ascorbic acid and sodium ascorbate.
#2: Is the "natural C complex" the same as vitamin C?
Vitamin C is defined as the substance that cures the deficiency disease scurvy. Vitamin C has a well defined chemical structure (C6H8O6). This separates it from the ill-defined "natural vitamin C complex."
This Natural Complex rumor has taken hold, even in books, and the claim is that vitamin C (ascorbic acid) isn't vitamin C!? This is why we wrote the Foundation's Position Paper on Natural Vitamin C, to answer this question.
#3: Is there a difference between "natural" and "synthetic" vitamin C? (C6H8O6)
Synthetic (L-ascorbates (C6H8O6) made in a factory, and the molecules made by plants and animals are identical.
Vitamin C is the ascorbate ion C6H8O6, and there is no way an organism can distinguish between the bioidentical ("synthetic") molecule and that which is produced by nature in plants and animals. See our vitamin C basics page for more details.
In our view, the most "natural" form of vitamin C is ascorbic acid - the form made in the kidneys and livers of most other mammals, in fact all species. (Note: Animal livers do not make bioflavonoids or rose hips.)
We have checked and note that almost all vitamin C in virtually every product over 200 mg, from any company, is "synthetic" vitamin C. (Some claim to be extracts but may cost over 1000 times the cost of synthetic vitamin C. If you really want "natural" vitamin C, be sure to eat plenty of organic oranges and uncooked red and green peppers.)
#4: Won't Taking Vitamin C Just Make Expensive Urine?
Drs. Hickey and Robert's Dynamic Flow theory, as put forth in their book Ascorbate: The Science of Vitamin C, explains that vitamin C in humans, and probably all animals, is short lived in the blood and supplies must be replenished all the time. Vitamin C is ever present in the urine for this reason.
The theory is an important scientific achievement because it accounts for all known experimental data regarding vitamin C, without exception. Until another theory which explains all the data is put forth, or until repeatable experiments are run that refutes Dynamic Flow, in our opinion, the scientific controversy is resolved.
Vitamin C in the urine is the way we were designed.
Doctors keep making this argument because the communication link to physicians regarding therapeutic nutrients and nutrition is broken. Drug firms have thousands of sales reps promoting the use of pharmaceuticals. Vitamin C has few, if any.
#5: I've read different advice on the Internet about taking vitamin C during pregnancy, what is the evidence?
The Foundation strongly advocates that pregnant women ingest sufficient (at least 6000 mg) vitamin C during pregnancy.
An early pioneer, Fred Klenner, MD, has stated that Vitamin C has definite "Primary and lasting benefits in pregnancy."
"Observations made on over 300 consecutive obstetrical cases using supplemental ascorbic acid, by mouth, convinced me that failure to use this agent in sufficient amounts in pregnancy borders on malpractice.
The lowest amount of ascorbic acid used was 4 grams and the highest amount 15 grams each day. (Remember the rat-no stress manufactures equivalent "C" up to 4 grams, and with stress up to 15.2 grams). Requirements were, roughly, 4 grams first trimester, 6 grams second trimester and 10 grams third trimester. Approximately 20 percent required 15 grams, each day, during last trimester. Eighty percent of this series received a booster injection of 10 grams, intravenously, on admission to the hospital. Hemoglobin levels were much easier to maintain." - Fred Klenner, MD
More than 99.99% of animal species synthesize vitamin C (ascorbic acid) on average, adjusted for body weight, 5400 mg daily. In animals, their ascorbic acid (vitamin C) is transmitted directly into the blood stream. They also obtain a little more in their diets.
Irwin Stone believed that most humans are born with scurvy. Stone is not alone in blaming Sudden Infant Death Syndrome (SIDS) on the lack of vitamin C in baby diets.
In our personal experience, Owen's wife took 6000 to 8000 mg vitamin C daily during pregnancy, more than the 3000-6000 she was taking. More during lactation. Mom was healthy. Our son was born notably healthy, and remains that way (illness free) to this day, 25 years later.
When vitamin C is in short supply during pregnancy, nature favors the baby. So taking extra vitamin C is important for Mom.
Dr. A. Hoffer, MD, Ph.D.
#6: What is the rebound effect?
The "rebound effect" is a temporary condition. When one begins taking adequate replacement vitamin C (amounts that mimic what animal make) the blood concentrations increase. Ascorbate dependent enzyme reactions begin and the body uses the now-plentiful ascorbate for other metabolic functions.
Stopping vitamin C too quickly cause blood levels to drop from active enzymes that are using up what little vitamin C now enters the blood stream.
Most humans exist in a state of sub clinical scurvy (vitamin C deprivation), and "non critical" body functions (ascorbate-dependent enzyme systems) that rapidly use up vitamin C are "switched off" - for survival.
Linus Pauling explained that with vitamin C in the blood, these enzymes reactions have numerous health benefits, including possible anti-cancer effects.
The "rebound or discontinuation effect" caused by suddenly discontinuation high dose vitamin C may last a day or two. The ascorbate-dependent enzyme reactions continue for 24-48 hours, and use up the dwindling vitamin C in the blood. This effectively lowers your serum vitamin C blood concentration below normal for a few days.
During this short period, cells may be deprived of vitamin C and people may experience the onset of a cold, fatigue, or other temporary unpleasant feelings. This has been called the discontinuation or "rebound" effect. It can be completely avoided by a continuous vitamin C intake.
After returning to a normal low-vitamin C diet, the ascorbate-dependent enzyme system turns off. The individual returns to the "normal" subchronic, scorbutic state that allows humans survive with less then optimal vitamin C.
#7: I purchased 1000 mg of Vitamin C in a pill form. The label states the pill contains "Rose Hips". Question: Is vitamin C with rose hips fine?
Linus Pauling mentioned in his book HOW TO LIVE LONGER AND FEEL BETTER (1986) that:
Page 15, 1986 paperback.
#8: The directions state one pill per day, is this how I should start and then up the level to two pills a day?
The Foundation now recommends gradually increasing vitamin C up to our RDA of 3000 mg daily, e.g. 1000 milligrams (1 gram) with meals.
Many people will be healthier with a higher daily amount of vitamin C than our RDA.
And based on Dr. Hickey/Robert's Dynamic Flow theory, at least 500 mg of vitamin C every 4 waking hours is probably optimal. (This frequency may not be convenient, so higher doses less frequently are the norm with "megadosers.")
If the amount that produces runny stools is very low, you may want to consider a better absorbed liposomal vitamin C.
#9: When is the best time to take? Morning and/or night or both?
The amount animals produce is around 5 to 6 grams, on average and adjusted for body weight. Species that can, produce more when under stress, (and while sleeping.)
The Hickey/Roberts Dynamic Flow findings indicated that the half-life of vitamin C in the blood stream is 30 minutes, so roughly 500 mg every 4 hours keeps the blood at the highest concentrations all day long in people who are not sick or under stress.
However, other than taking Cardio-C (vitamin C and lysine) twenty minutes prior to meals, we don't think it matters what time of day.
#10: Also, I was told if I stop taking Vitamin C once I've started, I'm likely to get very sick..... Is this true?
Generally, the more vitamin C you consume, the less sickness you will suffer. The people who told you this are probably thinking of the so-called "rebound effect" that is described in Pauling's HOW TO LIVE LONGER AND FEEL BETTER book and is temporary. In fact, Linus Pauling wrote,
#11: Why does the Linus Pauling Institute recommend only 200 mg (now 400mg) vitamin C?
Apparently the new leaders of the institute do not have the knowledge and experience of a scientist of the caliber of Linus Pauling.
It seems as if the new leadership has not bothered to read Linus Pauling's 1986 book HOW TO LIVE LONGER AND FEEL BETTER, or they do not understand it.
The Institute now makes the same mistake Pauling chastised "old fashioned" nutritionists for making. By focusing on "tissue saturation" as an indicator of optimal vitamin C intake, they miss the value of intakes recommended by Cathcart, Jaffe, Pauling and Stone, etc.
The tissue saturation argument cannot account for the 9000 mg of vitamin C that is *NOT* lost in the feces or urine at the daily intake of 18,000 mg.
Linus Pauling explained that vitamin C, unlike a coenzyme vitamin, is used up making collagen, the most abundant protein in the human body. Pauling also told us that ascorbate is changed or lost during the manufacturing other substances as well. These reactions do not occur at low or minimal intakes, and once they begin, the rebound effect occurs if vitamin C is suddenly stopped, until the body adjusts. Pauling thought many of these reactions and substances produced at high vitamin C intakes have anti-cancer properties.
Importantly, if Pauling's Unified Theory of Cardiovascular Disease is correct, the great problem of heart disease is a chronic vitamin C deficiency! The Linus Pauling Institute's meager vitamin C recommendation completely ignores this discovery!
#12: My doctor warned me that at USC study showed vitamin C clogs arteries. Does vitamin C cause atherosclerosis or heart disease?
This widely placed report sprung from a meeting of the American Heart Association before any paper was published, and was contrary to the earlier published findings of the same researcher (Dwyer.)
Dr. Dwyer was studying arterial thickness in heart disease and reported that patients who supplement vitamin C had "thicker" arteries. Apparently, vitamin C's role in collagen was unknown to these researchers who found no adverse effects, i.e. no narrowing or blockage.
Life Extension Foundation commissioned its own study to check the USC results and found no evidence what-so-ever of heart disease in subjects with high vitamin C intake.
It is our understanding that Dr. Dwyer has not published this paper and has retracted his concerns. See this link for more information. And Linus Pauling's theory that chronic low vitamin C intake causes heart disease.
#13: I've heard that the science implicates high vitamin C intake with DNA damage and cancer. True or false?
Contrary to widely published reports, most of which were based on papers or comments that have since been retracted. There is no evidence that vitamin C damages DNA or contributes to cancer.
#14: How often does vitamin C cause kidney stones?
Factors such as dehydration, lack of magnesium, and sometimes the form of vitamin C may contribute to stone formation. Sometimes changing the form of vitamin C will counteract the propensity of certain people to form stones.
Linus Pauling addressed this issue in his 1986 book HOW TO LIVE LONGER AND FEEL BETTER. There are generally two classes of kidney stones; one type forms in acidic urine and another type forms in alkaline urine.
No Kidney Stones During Robert Cathcart's Practice
After he cured a lingering childhood illness, doctor Robert Cathcart changed his practice of medicine from surgery to treating infectious diseases with vitamin C. He wrote that he had not seen a single case of kidney stones in his 14,000+ patient experience.
Large Harvard Study Finds No Link Between Vitamin C and Kidney Stones
Harvard looked at the issue and did not find a correlation between vitamin C and kidney stones, but they did find a correlation between low vitamin B6 and the propensity to form stones.
Experts generally agree that stones will not form if the urine pH is neutral, and experts tell us that high magnesium intake will prevent the formation of kidney stones.
So the first step for any person forming kidney stones is to measure their urine pH upon waking. If the urine is acidic - add sodium ascorbate (or baking powder) to his daily vitamin C, until his morning urine is pH neutral,
People forming kidney stones should also drink more water, add magnesium and a good Super-B complex vitamin (with vitamin B6).
#15: How do you avoid etching teeth with ascorbic acid?
The vitamin C is acidic enough to etch the surface of teeth, and can get to be a problem if I am taking several doses per day. Of course, the pure L-ascorbic acid is the strongest, but even the Cardio-C has this problem in my mouth. I am currently loading the Cardio-C into capsules. I am hoping that in the future, you will consider offering the Cardio-C in capsules.
Daniel Cobb DOM
Making your own capsules is a good idea, and we will explore providing our vitamin C in capsules. Thank you for this report.
Orthodox medicine advises people with Hemochromatosis (congenital iron overload in tissues) to avoid vitamin C? What is the foundation's opinion?
People with hemochromatosis can take steps to reduce iron in the digestive tract at the same time they are taking vitamin C orally.
Opinion of Robert Cathcart, III, MD (orthomed.com)
This theoretical difficulty concerning C is typical of how the orthodoxy will expand a theory into a fact without any evidence.
One example is my nurse 86 years mother with ischemic heart and heart valve defect, I give her same IV vitamin C over the last two years, still well, her ferritin remains below 300 mg/dl.
Quite a number of "heart patient" have elevated ferritin levels unless we check for it.
My experience with ferritin is in cancer patients, those with high baseline ferritin and IV vitamin C given (up to 120 grams per day) if the ferritin increases, the patient usually succumbed to their cancer, this is true for those with chemo or radiation.
I read a very good article on haemachromatosis and I will forward to you because that article made me decide to continue high oral and injection vitamin C despite the orthodox advice.
I give advice to those patients, avoid high iron containing diet and take oral vitamin C separately from food.
Dr. Mercola also wrote a good article on iron, he believes in giving phytates to reduce absorption.
Paper recommended by Dr. Selva ANTIOXIDANTS FOR HAEMOCHROMATOSIS...
A. Thomas E. Levy, MD, JD opinion
I cover this issue on pages 394 to 398 of my book VITAMIN C, INFECTIOUS DISEASES AND TOXINS. It's not as clear-cut as other issues, but high-dose vitamin C over the long run is probably as good for hemochromatosis as it is for other conditions.
Note: There are other prudent approaches to reducing iron overload according to health reporter and author Bill Sardi:
My First Case of Generalized Urticaria after IV Vit-C Slow Bolus!
Yesterday was a bad day. At 1430 hours a 30-year-old man (security guard) came with features of high fever for three days with chills and rigors. He had seen a day earlier another doctor who prescribe paracetamol, amoxycillin, buscopan tablets, to no relief.
I saw him, appeared toxic, flushed face, Bp 120/90, pulse 110, temperature 38'Celsius, complaining feeling cold, severe headache and mild flu. Hess test is negative, no petechie of Dengue (there is dengue cases here).
I prepared a 15 gram sodium ascorbate in 60 cc syringe and given slowly intravenously but after nearly 10 grams(40cc), he complained of generalized itching with hives developing and immediately I gave intramuscular 10 mg chlorpheniramine and oral cetirizine 10 mg. I observed him and did not continue the remaining IV C. Then he complained of severe chills and after another 15 mins the itchiness recurs and another 5 mg chlorpheniramine was given IM. He was really having rigors with 'goose pimples'! I kept observing him nearly 45 minutes in my consultation room before referring him to hospital but prescribe oral ascorbate powder for him.
I was not keen to give any adrenaline because he was not coughing/breathless and no wheezing or rhonchi noted and itchiness got better after the chlorpheniramine. I also withheld any steroids in case this was a viral condition.
I was kind of 'jolted' by this event because I have been giving IV C bolus every day, sometimes twice a day and also apart from IVC infusions. I have no explanation for the above.
I felt close to nearly using steroids and or adrenaline!
My earlier one and only allergy is a 78-year-old female with hypothyroidism, I give 30 grams sodium ascorbate and oral antihistamine prior to infusion, she gets slight itchiness midway through the drip but tolerable. I still give her oral C and almost monthly IV C infusion. Once he had a fall with ankle sprain and I notice if a IV C infusion is given on consecutive days, her itchiness/allergy is less (I gave her 5 I VC infusion over 10 days)
I did not give IVC infusion to the man because his medical billing is limited.
I would appreciate any advice???
Though I was slightly 'shaken' but this kind of incidence is very rare.
My IVC bolus is pure sodium ascorbate powder dissolves in sterile water prior to injection.
SIGNED: Dr. S.
Date: Tue, 2 Dec 2003 20:15:45 -0700
Your patient sounds sick enough to conclude that he had a very high titer of virus in his body. While it is not very common, there are times when a reaction like the one you described occurs. I think one of three explanations accounts for the reaction.
#1, When the vitamin C is of corn origin, a few people have an allergic reaction to the corn, and something like beet origin vitamin C is needed. Using short-term steroids for such a situation is certainly reasonable. Also, adrenaline, if life-threatening bronchspasm begins to appear.
#2, There are people who have a Herxheimer-like reaction when a large amount of virus is killed quickly. Giving large amounts of fluid is good with even more vitamin C.
#3, few people, I believe, have massive detoxifications when given vitamin C. When the dose is low enough, the release of toxins is in excess of the ability of vitamin C to neutralize them. The answer is often more vitamin C, or increased oral supplementation for days to weeks before going back to the intravenous administrations.
With the hives being involved, the first allergic reaction is probably most likely.
Keep up the good work.
Should I be worried about patients with a G6PD deficiency?
That is not to say it isn't a real problem. In our experience, only with high dose intravenous infusions, and apparently then in young (children). If the patient is sensitive to the problem, there will be blood in the urine, during and after the IV. (Our local alt. doc tests for this by only giving 10 g IV, then 20, etc. monitoring the urine in people who haven't had IV/C previously.)
According to doctor Levy, the specific problem created by the G6PD is a lack of glutathione (GSH) in red blood cells. The general answer is to load up on liposomal GSH prior to the IV to get more GSH into blood cells.
People who think they may have G6PD can start taking vitamin C slowly, and monitor the urine for blood. If there is none, you won't have a problem taking vitamin C. You can be extra careful by taking liposomal glutathione (regular glutathione does not generally enter cells when taken by mouth.)
The VITAMIN C FOUNDATION is a national nonprofit, charitable organization that has recently been assigned the IRS tax-exempt 501(c)(3) designation as a Texas non-profit corporation devoted to preserving the "lost knowledge" about ascorbic acid and its role in life. Dedicated to the memory of Linus C. Pauling, the foundation's activities are funded by charitable contributions.