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Why A Sick Body Needs So Much Vitamin C |
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Megadoses: Why?
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Copyright (C), 1994 and
prior years by Dr. Robert F. Cathcart. Dr. Cathcart gave his permission "to distribute
via the internet as long as material is distributed in its entirety
and not modified." ABSTRACT Keywords: vitamin C,
ascorbate, acute induced scurvy, bowel tolerance, titrating to bowel
tolerance, the ascorbate effect, free radical scavengers, reducing
equivalents. INTRODUCTION I have found vitamin C
exceptionally useful in a very high dose range. Its usefulness is in three
such distinct realms that I will describe them as the three faces of vitamin
C.
1. vitamin C to prevent scurvy
One might criticize the
wisdom of my use of these massive doses but Klenner had successfully utilized
them previously. The works of Irwin Stone, Linus Pauling, and Archie
Kalokerinos have supported many of my observations. It was apparent that in
all the studies yielding negative or equivocal results, inadequate doses were
used. In some studies, doses barely bordering on adequate, tease the
investigator with statistically significant but not very impressive
beneficial results. My early discovery was
that the bowel tolerance to ascorbic acid of a person with a healthy GI tract
was somewhat proportional to the toxicity of their disease. Bowel tolerance
doses are the amounts of ascorbic acid tolerated orally that almost, but not
quite, cause diarrhea. A patient who could tolerate orally 10 to 15 grams of
ascorbic acid per 24 hours when well, might be able to tolerate 30 to 60
grams per 24 hours if he had a mild cold, 100 grams with a severe cold, 150
grams with influenza, and 200 grams or more per 24 hours with mononucleosis
or viral pneumonia (1, 2). Marked clinical benefits in these conditions occur
only at the bowel tolerance or higher levels. I named the process whereby the
patient determined the proper dose as titrating to bowel tolerance. These
increases in bowel tolerance in the vast majority of patients normally
tolerant to ascorbic acid (perhaps 80% of patients) are invariable. The
marked clinical benefits are noted only when a threshold dose, usually close
to the bowel tolerance dose, is consumed. I call this benefit the ascorbate
effect. Most patients are started
at first with hourly doses of ascorbic acid powder dissolved in small amounts
of water. Later, after the patient has learned to accurately estimate the
dose necessary to achieve the ascorbate effect, comparable doses of tablets
or capsules are also used. Where patients are intolerant to adequate amounts
of ascorbic acid orally and the severity of the disease warrants it,
intravenous sodium ascorbate is used. Failures are related
to individual difficulties in taking the proper adequate doses. I now have
had 22 years (1994) to gather clinical experience and to reflect on this
phenomenon. I want to emphasize
the importance of this increasing bowel tolerance with increasing toxicities
of diseases. The sensation of detoxification one experiences at these doses
is unmistakable. The effect is so
reliable and dramatic in the tolerant patient as to make obvious the fact
that something very important, that has not been widely appreciated before,
is going on. THE THREE FACES At a second level (the
second face) vitamin C is still used as a vitamin but larger doses are
necessary to maintain its basic vitamin C functions because the vitamin is
destroyed rapidly in diseased or injured tissues where there is an
overabundance of free radicals. I described the resulting state of
deficiency, if the vitamin C is not replaced, as acute induced scurvy (1, 2).
There is ample evidence of this depletion of vitamin C by stress and disease
as recently reviewed in the literature. Additionally, the recent
extensive research on vitamin C has concerned itself with certain functions
that may be augmented by higher than minimal doses of vitamin C (20).
Strangely, any usefulness of these larger than minimal doses of vitamin C
remain mostly neglected by clinicians. This level is from about 1 to 20 grams
a day. Benefits vary from person to person. At this second level, as
in studies reviewed by Pauling (11) and more recently by Hemil (20), there
may be expected a slight decrease in the incidence of colds but a more
significant reduction in the complications and the duration of colds.
Personally, I am impressed by the number of patients (but certainly not all)
who tell me that they have not had a cold for years since reading Pauling's
book and taking vitamin C. Patients with chronic infections frequently have
those infections cured for the first time. Antibiotics work synergistically
with these doses. A surprising number of elderly persons benefit from doses
of this magnitude and may indeed have what Irwin Stone described as chronic
subclinical scurvy (10). The third level of doses
(the third face) is virtually undiscussed in the literature but is the most
interesting. These doses range usually from 30 to 200 grams or more per 24
hours. The most important concept to understand is that while incidentally at
these dose levels the vitamin C performs all the functions of levels one and
two, it is mostly thrown away for the reducing equivalents it carries (3).
With these doses it is possible to saturate the body with reducing
equivalents, neutralize the excessive free radicals, and drive a reducing
redox potential into involved tissues. Inflammations mediated by free
radicals can be eliminated or markedly reduced. In many instances patients
with allergies or autoimmune disease have their humeral immunity controlled
while their cellular immunity is augmented (19). To the extent that free
radicals are either essential to the perpetuation of a disease or just part
of the cause of symptoms, the disease will be cured or just
ameliorated. The list of diseases
involving free radicals continue to grow. Infections, cardiovascular
diseases, cancer, trauma, burns both thermal and radiation, surgeries,
allergies, autoimmune diseases and aging are now included. It is more
difficult to think of a disease that does not involve free radicals.
Progressive nutritionists routinely give vitamin C, vitamin E, beta carotene,
selenium, NAC, etc. to counter free radicals. I certainly agree with this
practice. However, there is one important concept neglected. In the spirit that if you
throw a bucket of water on a fire, it is the water that puts the fire out,
not the bucket; it is the reducing equivalents carried by the free radical
scavengers that quench the free radicals, not the free radical scavenger
itself. Most of the reducing
equivalents utilized by non enzymatic free radical scavengers do not come
from the ingested free radical scavengers but come through glycolysis, the
citric acid cycle, NADPH, FADH2, glutathione, etc. Dietary free radical
scavengers carry in on ingestion only a small percentage of the total
reducing equivalents carried by those scavengers during their lifetime in the
body. After their first pass neutralizing free radicals, the free radical
scavenger must be recharged with reducing equivalents made available in the
mitochondria. Consider the following:
Early in this study a 23-year-old, 98-pound librarian with severe
mononucleosis claimed to have taken 2 heaping tablespoons every 2 hours,
consuming a full pound of ascorbic acid in 2 days without it producing
diarrhea. She felt mostly well in 3 to 4 days, although she had to continue
about 20 to 30 grams a day for about 2 months. Subsequently, all my young
mononucleosis patients with excellent GI tracts have responded similarly and
have had equivalent increases in bowel tolerance during the acute stage of
the disease. I believe that the loose
stools caused by excessive doses of ascorbic acid orally ingested is due to a
resulting hypertonicity of ascorbate in the rectum. Water is attracted into
the rectum by the increased osmotic pressure and results in a benign
diarrhea. With toxic illnesses, the ascorbate is destroyed rapidly in the
involved tissues resulting in a rapid absorption from the gut. Of the
ascorbate, what does not reach the rectum, does not cause diarrhea.
Intravenous sodium ascorbate does not cause diarrhea and, in fact, increases
bowel tolerance to orally ingested ascorbic acid while the IV is running.
With hypertonicity of the ascorbate both in the blood and in the rectum, the
osmotic pressure of the ascorbate is more equal on both sides of the bowel
wall so no diarrhea results. If the diarrhea was cause by other metabolic
processes, diarrhea would be caused by intravenous ascorbate. It should be noted that
in some cases of pathological diarrhea, ascorbic acid stops the diarrhea.
Presumably in these cases some of the increased destruction of ascorbate is
from free radicals in the bowel. However, in most toxic systemic diseases
there is no reason to believe that the destruction of the additional
ascorbate occurs directly in the bowel, so it is a safe hypothesize that this
increased destruction occurs in the interior of the body. The increased tolerance
to ascorbic acid orally provides an interesting and somewhat useful measure
of the toxicity of a disease. Probably it is somewhat a measure of the free
radicals involved in a disease. I describe a cold that at its maximum makes
it possible for a patient to just tolerate 100 grams of ascorbic acid orally
without diarrhea, a "100 gram cold." Patients, appearing to be
well, who have a tolerance over 20 to 25 grams per 24 hours probably have
some subclinical condition which is being hidden by their own free radical
scavenging system. Patients with chronic
infections (and a normally strong stomach) can ingest enormous amounts of
ascorbic acid. One of my chronic fatigue patients is functional only because
of his ingestion of 65 pounds of ascorbic acid in the past 12 months. In 22
years, I, personally, have ingested approximately 361 kilos ( 797 lbs ) ( 4.3
times my body weight ) of ascorbic acid because of chronic allergies and
perhaps chronic EBV. Considering the reducing
equivalents carried by such amounts of ascorbic acid, one can only guess at
the turnover rate of the non enzymatic free radical scavengers in a patient
acutely ill with a 200 gram mononucleosis. However, one gains the impression
that all the non enzymatic free radical scavengers would have to be rereduced
many times a day. AN ANALOGY My use of ascorbate is
like thousands of neighbors coming from miles around, each with a bucketful
of their own water, throwing their own water on your fire once, and then
leaving. CONCLUSION The sudden marked benefit
in many disease processes which is achieved at doses near to the bowel
tolerance level suggests that a reducing redox potential is forced into the
affected tissues only at those dose levels. This ascorbate effect only at the
high dose levels is also suggestive that something other than classic
functions of vitamin C is involved. This ascorbate effect is more compatible
with principles of redox chemistry.
Only a small percentage
of the total reducing equivalents donated by non enzymatic free radical
scavengers to neutralize free radicals, come in on the ingested nutritional
free radical scavengers. Ascorbate is unique in that the body can tolerate
doses adequate to supply the necessary reducing equivalents to quench the
free radicals generated by severely toxic disease processes. The vitamin C is
thrown away for the reducing equivalents it carries. Only in this way can the
large amounts of free radicals generated by the most toxic disease processes
be rapidly quenched. REFERENCES 1. Cathcart RF. The
method of determining proper doses of vitamin C for the treatment of disease
by titrating to bowel tolerance. J Orthomolecular Psychiatry 1981; 10:125-32. 2. Cathcart RF.
Vitamin C: titrating to bowel tolerance, anascorbemia, and
acute induced scurvy. Medical Hypotheses 1981; 7:1359-76. 3. Cathcart RF. A
unique function for ascorbate. Medical Hypotheses 1991; 35: 32-7. 4. Klenner FR.
Virus pneumonia and its treatment with vitamin C. J. South. Med. and Surg.
1948; 110: 60-3. 5. Klenner FR. The
treatment of poliomyelitis and other virus diseases
with vitamin C. J. South. Med. and Surg. 1949; 111:210-4. 6. Klenner FR.
Observations on the dose and administration of ascorbic acid when employed
beyond the range of a vitamin in human pathology. J. App. Nutr.
1971; 23: 61-88. 7. Klenner FR.
Significance of high daily intake of ascorbic acid in
preventive medicine. J. Int. Acad. Prev. Med. 1974; 1:45-9. 8. Stone I. Studies
of a mammalian enzyme system for producing evolutionary evidence on
man. Am. J. Phys. Anthro. 1965; 23:83-6. 9. Stone 10. Stone I. The
Healing Factor: Vitamin C Against Disease. Grosset and 11. Pauling L. Vitamin C
and the Common Cold. W.H. Freeman and Company, 12. Pauling L.
Vitamin C, the Common Cold, and the Flu. W.H.Freeman and Company, 13. Pauling L. How
to Live Longer and Feel Better. W.H. Freeman and Company, 14. Kalokerinos A.
Every Second Child. Keats Publishing, Inc., 15. Cathcart RF.
Clinical trial of vitamin C. Letter to the Editor, Medical Tribune, June 25, 1975. 16. Cathcart RF. Vitamin
C in the treatment of acquired immunedeficiency syndrome
(AIDS). 17. Cathcart RF.
Vitamin C: the nontoxic, nonrate-limited,
antioxidant free
radical scavenger. 18. Cathcart RF.
HIV infection and glutathione (Letter to editor concerning
Vitamin C tolerance in AIDS). 19. Cathcart RF. The
vitamin C treatment of allergy and the normally unprimed state of
antibodies. 20. Hemil H. Vitamin C
and the common cold. Br J Nutr 1992; 67:3-16. Andrew Saul’s books are FIRE
YOUR DOCTOR! How to be Independently Healthy (reader reviews at
http://www.doctoryourself.com/review.html
) and DOCTOR YOURSELF: Natural Healing that Works (reviewed at http://www.doctoryourself.com/saulbooks.html
)
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