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Why Vitamin C Gets A's from the Experts‏
PostPosted: Thu Mar 25, 2010 7:11 pm  Reply with quote
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Why Vitamin C Gets A's from the Experts

Practically everyone "knows" vitamin C is good for you... but I'm not sure many really understand how good. Identification of its import dates back to early explorers crossing the ocean by ship who suffered from something called scurvy -- caused by a deficiency of vitamin C.

For a long time now, the recommended daily allowance of vitamin C has been at levels that prevent such a deficiency -- but decades ago, some scientists, including Nobel Prize-winner Linus Pauling, began to argue that much higher doses of vitamin C are needed for optimal health. There is now a continual stream of research on vitamin C and its related health benefits -- which include antioxidant, anti-inflammatory and anti-aging properties, along with the fact that it has been shown to be a heart-health booster. I called naturopathic physician Mark Stengler, ND, author of Bottom Line Natural Healing newsletter for the latest thinking on the many positive attributes of vitamin C, along with guidelines on how much we need to reap its benefits.


Much of the new buzz on vitamin C relates to its value in reducing risk for cardiovascular disease, Dr. Stengler told me, citing numerous research studies showing its protective role in heart health. Among these is research based on the Nurses' Health Study which followed more than 85,000 women for up to 16 years, and that demonstrated that a higher intake (in this case, more than 359 mg/day from dietary sources and supplements) reduced cardiovascular risk by 27%... and an analysis of nine other studies tracking more than 290,000 adults that showed a 25% reduction in risk in those who took more than 700 mg of supplemental vitamin C, compared with those who took none.

In addition, a Finnish study examining the health of middle-aged men who had no evidence of pre-existing heart disease found that those who were deficient in vitamin C were 3.5 times more likely to suffer heart attack.

Not only has vitamin C been shown to decrease risk for heart attacks, it also seems to reduce damage following one. In a study called the Myocardial Infarction and Vitamins (MIVIT) trial, researchers found that patients who suffered an acute heart attack and then supplemented for one month with 1,200 mg of vitamin C (along with 600 mg of vitamin E) after an initial IV infusion of vitamin C had a reduced rate of complications from the heart attack. The supplemented group also had fewer additional heart attacks and deaths, reducing by nearly 20% the combined rate of death, new heart attack and other severe complications. "This doesn't surprise me," Dr. Stengler told me, "since vitamin C has so many protective functions, including increasing blood vessel flexibility (so they do not rupture as easily) and preventing the oxidation of LDL cholesterol." Readers may recall from previous stories that cholesterol becomes problematic when it oxidizes -- and vitamin C helps prevent that, he said.


In addition to acting as a powerful antioxidant and helping protect the body from free radical damage, vitamin C also supports immune function. It enhances the activity of white blood cells, the body's first defense against pathogens. And it improves immune response partly by activating an antiviral chemical produced by the body called interferon.

Additionally, vitamin C helps to regenerate other antioxidants, including vitamin E, by acting as a "recycling service" for antioxidants in the body, causing them to re-circulate in the bloodstream and thus delivering "double duty" protective action.

Inflammation is a component of major degenerative diseases and other conditions including diabetes, Alzheimer's, obesity and heart disease -- and C-reactive protein is one effective measure of inflammation levels. "Vitamin C as a supplement has been shown in studies to reduce C-reactive protein," Dr. Stengler said.


"Vitamin C has powerful healing effects on many other systems in the body as well," Dr. Stengler added. "I'd say it's one of the most versatile, multi-factorial nutrients for our bodies."

In particular, vitamin C is...

a.. A collagen builder. Collagen is an important structural component of bones and tissues -- and Dr. Stengler notes that vitamin C plays a critical role in the human body's synthesis of collagen, helping replace what is degraded by normal wear and tear.

b.. A detoxifier. "Vitamin C is involved in the production of bile acids, which carry toxins out of the liver," Dr. Stengler explained.

c.. An agent for longevity. Two major studies have associated vitamin C status with longevity. In a study of more than 19,000 adults, those with the highest blood levels of vitamin C had about half the risk for mortality compared with those with the lowest levels of vitamin C in their blood. Also, a decade-long study from UCLA of more than 11,000 adults showed that men with high vitamin C intake (at least 50 mg daily from their diet and regular vitamin C supplement) had a total death rate that was 41% lower than the rate among the men with low intake (less than 50 mg daily).

WHAT YOU NEED TO KNOW ABOUT VITAMIN C SUPPLEMENTATION Recently, there's been reason to worry about the safety of food and other products imported from China, and I was personally distressed to hear that about 80% of the ascorbic acid -- vitamin C -- made in the world originates in that country. I asked Dr. Stengler if we should be concerned. He noted that there is little reason to fear toxicity. "American companies import the raw ingredients but the reliable manufacturers verify quality," he said. "They're doing their own tests before putting their labels on the products. If you stick with the big name brands when buying vitamin C, you have very little to worry about."

Though the current recommended dietary allowance (RDA) for vitamin C is only 90 mg for men and 75 mg for women (add an extra 35 mg for smokers), Dr. Stengler believes a far higher intake is beneficial. "For general prevention and overall health, studies suggest 400 to 500 mg daily," he said. For those with heart disease he recommends 500 mg to 1,500 mg daily. "For my patients with existing disease, such as cancer, I prescribe oral (or sometimes intravenous) doses that are much higher. These should be taken only under supervision -- especially when undergoing chemotherapy or radiation."

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New Relief for Migraine Sufferers

Understandably, migraine patients are always hoping for new and better drugs. For many people with severe migraines, the most effective pain medications have been the "triptans" -- in particular, sumatriptan (Imitrex), the most popular version. Now research shows that many patients may soon be able to benefit from a "new" drug that actually turns out to be not so new after all. Trexima, a new drug with sumatriptan, awaiting FDA approval, is a combination of Imitrex and naproxen sodium -- yes, naproxen is the active ingredient in Aleve and other over-the-counter pain relievers.

"Drug combining" is one way the pharmaceutical industry can introduce "new" medications in hopes of FDA approval. Once such a newly combined formulation gets a thumbs-up, it means, in effect, that an old drug regains patent protection in the new form (and, of course, the potential to bring in handsome profits). You may not be surprised to learn, then, that GlaxoSmithKline's drug Imitrex will go off patent in 2009. This is news that can bring on a headache -- but when I looked into it I learned that maybe Trexima (a drug by GlaxoSmithKline and Pozen) actually is more effective against the debilitating pain of migraine.

There is research, of course, published in the Journal of the American Medical Association saying it's so. Two parallel studies totaling close to 3,000 patients show the combined formulation to be more effective then either single remedy alone or a placebo. Though neither study looked at the difference in efficacy between the single tablet combining both medications and swallowing both a triptan pill and over-the-counter analgesic at the same time, in trials sponsored by Pozen, researchers said there appears to be increased serum drug levels of sumatriptan and a prolonged half-life for naproxen sodium when combining both drugs compared to their administration as monotherapy.

To find out about this from an unbiased source, I called neurologist Alan C. Carver, MD, director of headache and pain management in the department of neurology at the Mount Sinai School of Medicine in New York City. Interestingly, Dr. Carver tells me he is excited about the possible approval for Trexima. He said some of his patients have told him that Imitrex works "better" when they take it with naproxen, not realizing that it is the naproxen itself that adds to migraine relief.

We now know, he told me, that along with a great deal of pain, migraines also cause a lot of inflammation. The combination pill addresses both problems -- easing the pain while also helping to rid the body of excess inflammation. Many patients do not require the extra boost of an anti-inflammatory, says Dr. Carver, but those who do might benefit from having an all-in-one drug -- i.e. Trexima -- available to them. In response to the obvious question -- why not simply take Imitrex with Aleve -- Dr. Carver says that Trexima may be more effective than taking the drugs singly, although he advises that more research is needed to answer that question. The single drug also assures the proper dosages of each drug in combination.

Of course my preference is to offer advice on avoiding problems like migraine altogether, rather than just telling readers about new-and-improved drugs. So I asked Dr. Carver whether migraine patients would benefit from taking natural anti-inflammatories such as omega-3s, feverfew and other remedies. He responded that, while there is not enough significant data from clinical trials about this, given what we know about inflammation and migraines, it makes sense to consider targeting the problem of migraine with different avenues.

Daily Health News contributing editor Andrew L. Rubman, ND, says the best way to address the problem is to improve function first, often with natural interventions, and suppress unresponsive symptoms second. And in my view, that's a "combination therapy" that really makes sense.

Be well,
Carole Jackson
Bottom Line's Daily Health News

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New Relief for Migraine Sufferers

Alan C. Carver, MD, director of headache and pain management in the department of neurology, Mount Sinai School of Medicine in New York City.

Why Vitamin C Gets A's from the Experts

Mark A. Stengler, ND, a naturopathic physician and leading authority on the practice of alternative and integrated medicine. He is director of the La Jolla Whole Health Clinic, La Jolla, California, and associate clinical professor at the National College of Naturopathic Medicine, Portland, Oregon. He is author of the newsletter Bottom Line Natural Healing, www.DrStengler.com.

"When there is only one dreaming, it is just a dream.
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