Vitamin C

Vitamin C - is she sinner or saint?  Probably a better description would be that of a fallen starlet.  Vitamin C just ten years ago was supposed to the panacea for every issue from cancer to heart disease to aging.  Now the research is showing that megadosing Vitamin C over 500 mg/day is, with one exception, a waste of money.  However, that exception is important as I will point out below.  Finally, I want to highlight when and how Vitamin C supplementation can actually be dangerous. 

In fact, before I go on, let me point out that you can get a nice dose of Vitamin C from fruits and vegetables.  Furthermore, many fruits and vegetables will actually protect the Vitamin C that you do have and, in many cases, provide phytochemically the same benefits as Vitamin C.

Let's start by looking at Vitamin C and heart disease, which is the #1 killer of men and the underlying cause of most erectile dysfunction issues.  Here the studies have been decidedly mixed. In its favor, Vitamin C, and Vitamin E as well, were examined in a controlled study by Danish researchers in 2000.  Participants were given 250 mg and 91 mg twice daily of Vitamins C and E, respectively.  This study found that those on the Vitamins C and E had decreased arterial thickness, i.e. less plaque buildup from arteriosclerosis. [1] The researchers commented that "taking either vitamin separately also resulted in a reduction in plaque buildup but the combination of vitamins worked best..." Similarly, a large meta-analysis of nine cohorts found that those who took supplemental Vitamin C at megadose levels (> 700 mg) had significantly reduced (25%) cardiovascular issues compared to those who did not take Vitamin C. [2] 

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So everything sounds like a "green light", right?  Well, unfortunately, there have been a number of studies that have found that Vitamin C has no significant heart benefit.  One of the biggest was The Physicians Health Study II of 14,000 male physicians run by a Harvard professor.  In this study physicians were put on 500 mg Vitamin C and 400 IU Vitamin E daily.  The researchers found that neither vitamin decreased cardiovascular events whatsoever.  So here you have one of the biggest and best run studies showing that Vitamin C is anything but a miracle worker and very possibly a waste of money when it comes to heart disease.

This may have been partially explained when researchers discovered that Vitamin C megadosing overly dampens a key oxidant, peroxide, that is responsible for supplying blood flow to the muscles and expanding arteries. [15]  Although more research needs to be done, not only does this mean Vitamin C could be a negative for the heart, but it could also be deleterious for both muscle building and erectile strength. (That's why I always recommend getting improving your health, sex life and erections through exercise, diet and sleep.)

I should also mention that Vitamin C received a real black eye from one study of arterial thickness.  This study reported that those who took Vitamin C had 2.5 times the thickening of the arteries compared with those who took none. [3]  This study has been criticized for being relatively small and one can't help but ask the question, "If Vitamin C causes such accelerated hardening of the arteries, why aren't its proponents dropping dead like flies?"  Personally, I doubt that Vitamin C causes arterial thickness, but caution may be in order.

NOTE:  Contrast this with Pomegranate Juice which has been shown to improve the entire lipid profile, lower blood pressure and decrease arterial plaque!  Again, food has a clinical effect...

Another researcher, Rory Collins, looked at not just heart disease during a huge five year study involving 20,000 people who took daily 600mg of vitamin E, 250mg of vitamin C and 20mg of beta-carotene.  This study [7] in the prestigious journal Lancet found that there was no improvement in heart disease or cancer rates.  Once again, Vitamin C looked like a questionable use of one's money.  Some have criticized this study for only supplementing with 250 mg of Vitamin, but keep in mind that is roughly the Vitamin C found in five oranges.

One can't help but wonder why Vitamin C does not fight cancer more effectively.  After all, it is one of our body's most important antioxidants and it is used extensively throughout the immune system.  It only stands to reason that it should help with cancer outcomes. The reason is very likely that Vitamin C very likely has a dark side:  the journal Gut simulated conditions in the stomach and found that Vitamin C, when fat levels are low, actually inhibits the carcinogenic nitrosamine production but promotes nitrosamines when fat is present. [8] I'm not talking about fat as in overweight:  I'm talking about fat in your meal.  If you eat any fat in your meal - which almost every one in a modern society does - megadosing with Vitamin C will lead to a flood of carcinogenic nitrosamines and this may explain some of Vitamin C's questionable cancer results.

Vitamin C - Advantages

Your Brain. So is there anywhere where megadoses of Vitamin C seem justified?  One good example is in the brain.  As I frequently point out, the brain is a huge energy and nutrient hog and Vitamin C is no exception. Several studies have shown Vitamin C intake correlated with improved cognitive function [4] and neuroprotection. [5]  But it should be noted that there are other studies that show no correlation between Vitamin C intake and cognitive function.  Researchers examining the Rotterdam Study, for example, concluded that "there was no association between cognitive function and intake of vitamins C and E". [6]  Again, though, the majority of studies show some advantage to Vitamin C supplementation.

Weight Loss. I can hear the inner screams from some of you that are taking Vitamin C for weight loss, since researchers found that "Vitamin C status is inversely related to body mass. Individuals with adequate vitamin C status oxidize 30% more fat during a moderate exercise bout than individuals with low vitamin C status; thus, vitamin C depleted individuals may be more resistant to fat mass loss". [9] But remember this is only for Vitamin C deficient individuals and does not justify megadosing.  You can get plenty of Vitamin C from food to overcome these kind of deficits.

Cortisol and Stress Reduction. Vitamin C has been shown in a number studies to reduce cortisol during times of stress.  For example, one study of ultramarathoners [10] showed decreases in cortisol from those given megadoses of Vitamin C.  Another (almost humorous) study induced stress by forcing subjects into public speaking and mathematical test-taking situations and found that 3000 mg reduced cortisol levels significantly.  [11]  More recent research found that 1,000 mg of Vitamin C reduced cortisol levels in weight lifters for 24 hours after lifting. [12]  Animal studies have shown the same thing on animals under stress. [13] 

Skin. Vitamin C protects your collagen, a key component to any anti-aging regimen for your Skin and Appearance.  Now I know of no study that shows that oral Vitamin C supplementation reduces wrinkling and sagging.  However, it is very likely that Vitamin C does reduce or at least protect your skin from wrinkling on a small scale. In fact, researchers just found that Vitamin C protects skin cell DNA through fibroblast stimulation [14] and think it may help to actually heal the skin. NOTE:  Vitamin C definitely can reduce wrinkling if applied topically.  See this link on Skin and Topical Vitamin C for more details. 

Vitamin C - Strategy

My strategy is to take 250-500 mg per day on a normal basis and megadose with 1500-2000 mg when under stress, i.e. low sleep, demanding job schedule, etc.  And I always take Vitamin C with no fat in my stomach.  Of course, this is no problem for me as I almost always consume a Low Fat Diet anyway.

NOTE:  Regular Vitamin C is very acidic and hard on the stomach:  you may want to consider the Ester-C form for just that reason if you do decide to take it.  Here is the exact brand I take for about the same price as I get it at Walmart: Ester-C Vitamin C - 500 mg, 300 Coated Tablets.

REFERENCES:

1) Journal of Internal Medicine, 2000; 248 (5), 377-386

2)  American Journal of Clinical Nutrition, Dec 2004, 80(6):1508-1520, December 2004 Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts Paul Knekt, et al

3)  Reported on March 2, 2000, by Dr. James Dwyer at an American Heart Association meeting in San Diego

4) Eur J of Clin Nutr, 2003, 57(Suppl1):S54–S57

5) J. Amer Geriatr Soc, 2000, 48:1285–1291

6) Am J Epidemiol, 1996, 144:275–80

7) The Lancet, 2002, 360(9347):1781-1782

8) Gut, 2007;56:1678-1684, Published Online First: 4 September 2007

9) J Am Coll Nutr, 2005 Jun, 24(3):158-65

10) Int J Sports Med, 2001 Oct, 22(7):537-43, Peters EM, Anderson R, Nieman DC, Fickl H, Jogessar V., "Vitamin C supplementation attenuates the increases in circulating cortisol, adrenaline and anti-inflammatory polypeptides following ultramarathon running."

11) Psychopharmacology (Berl),Jan 2002,159(3):319-24

12) J Strength and Conditioning Res,1998,12(3):179-184

13) http://www.sciencedaily.com/releases/1999/08/990823072615.htm

14) http://esciencenews.com/articles/2009/09/09/ study.reveals.new.role.vitamin.c.skin.protection

15) Experimental Physiology, Published Online: 21 Jul 2009, 94(9):961-971, "The effects of antioxidants on microvascular oxygenation and blood flow in skeletal muscle of young rats"