A model that makes sense of opposing views about vitamin C has the following “tenets” (by definition, tenets are tentatively held ideas, modifiable with every piece of data that does not fit the model):
- Pauling focused on the high rate of synthesis of vitamin C in animals that make it. He focused on the fact that if we ingest grams of vitamin C, we absorb grams of vitamin C. He noted that we absorb even more vitamin C when we are ill. Pauling focused on the proven utility of high dose vitamin C in the work of Dr. Frederick Klenner. He more or less ignored the high rate of urinary excretion of vitamin C.
- The US government focused on the high rate of urinary excretion and the fact that total body pools of vitamin C cannot be increased stably beyond about 1500-3000 mg. The government scientists ignored the fact that animals of our size make 200 times our RDA and that we absorb grams of vitamin C before we excrete all but about 100 mg of it per day and that we absorb more vitamin C when we are sick.
- As a rule, animals make about what they need of various nutrients. Exception: we make less choline than we need. As a consequence, animals do not make 200 times what they need.
- Both Pauling and the government scientists are making valid points. What is the explanation of these contradictory viewpoints?
- A possible explanation of the paradox is that vitamin C is accidentally absorbed (for example, oxidized vitamin C is absorbed by a glucose receptor) and deliberately excreted. This fails to explain why vitamin C is absorbed better when we are ill.
- Optimal tissue levels of vitamin C are at or near SL (saturating or near saturating levels). This explains why goats make 13 grams of vitamin C a day and why we absorb grams per day even though we need but 100 mg or so to replace losses of vitamin C (at 2-4% loss per day with a total body pool size of 1500-3000 mg).
- Supersaturating levels in serum and tissues occur for a short period of time following injection with high levels of sodium ascorbate.
- Chosen properly, an injection that achieves a therapeutic window of proper supersaturating levels of serum and tissue vitamin C, which I will call SSL1 (supersaturating level 1), avoids most of the toxicity and allows some antitumor, antiviral, antibacterial, and antifungal action, as well as some high level chelating of heavy metals. This explains the effectiveness of the use of injectable vitamin C as an adjunct cancer therapy and the many anecdotal results (more than 30 diseases treated) of Dr. Frederick Klenner re injection of high doses of vitamin C followed by high oral doses. Before even getting a diagnosis, Dr. Klenner treated everyone prophylactically with a high dose of injectable vitamin C, followed by multiple oral high dose vitamin C. When they came back for their diagnosis and treatment, they were in many cases on the road to recovery.
- Chosen improperly, there is a level of serum and tissue super-saturation, SSL2 (supersaturating level 2), at which there could be heavy damage to normal cells, especially if the kidneys are compromised. Possible mechanism: a catalytic cycle in which vitamin C binds regions in the genome in which copper is bound to cellular DNA, and creates single and double stand breaks. Vitamin C can be regenerated by various cellular antioxidants like glutathione (at 5-10 mM, glutathione is many times higher in concentration than cellular vitamin C), making this a highly destructive catalytic event.
- This toxic reaction or something like it or both explains why evolution has favored those animals whose kidneys excrete vitamin C so well and so rapidly, and this rapid excretion explains why vitamin C cannot ordinarily be driven to still higher concentrations in tissues (>=SSL2), given reasonably healthy kidney function.
- This explains the US government’s position – why take more than about 100 mg a day if it is all going to be excreted? Well yes, after tissue saturation has been achieved. I doubt that 100 mg a day can always maintain saturation in all tissues. When we are sick we absorb more vitamin C (as evidenced by higher bowel tolerance) and we consume more vitamin C when we are sick. When goats are sick they make twice as much vitamin C as when they are healthy.
- Nature’s program is to overdose the vitamin, thus achieving tissue saturation, and then excrete the excess as rapidly as possible to sidestep the toxic side reaction(s).
- Because of the toxic reaction(s) at SSL2, at inappropriately high supersaturating concentrations of vitamin C, no one with impaired kidney function should take Pauling type doses (18 grams a day).
- Re the government’s position: I would argue that vitamin C passing through the bowel may be doing us a world of good in keeping stools somewhat looser rather than too hard. I would also argue that vitamin C in urine is definitely doing us a world of good. First, in solubilizing substances like calcium (calcium oxalate and calcium phosphate stones are much less likely in someone taking high dose vitamin C). Second, and this is more speculative, in reducing the likelihood of UTI – the acidity of urine with lots of vitamin C likely makes it very uncomfortable for fimbriated bacteria trying to colonize the urinary tract.
- Also, re the government’s position: the total requirement for vitamin C cannot be deduced merely from mass balance studies. Two reasons – vitamin C is likely a member in a number of other nutrients’ ADME networks, and it will have an optimal dose for functioning there that is in addition to its own optimal dose (since a vitamin C molecule cannot be in two places at once). In addition, we need to write the total requirement of any nutrient as the sum of at least 4 independent parts: 1. the requirements of the entire gut. 2. the requirements of the blood stream and lymphatic systems. 3. the sum of the requirements of all tissues. 4. the requirements of the urinary system.
How general is this model? Might the same not be true of selenium and other nutrients in which the therapeutic window is rather narrow?
Nature plays with fire – it has to; life would never have come to be without doing so – and avoids getting burned most of the time thanks to many rounds of selective pressure that was at times so great that scientists estimate that ~90% of all species were extinguished. That is how nature comes up with such nearly flawless solutions to working with substances that can be as beneficial at one set of doses, between SL and SSL1, and so harmful at another set of doses, that is, >=SSL2.