Vitamin C and Stroke Prevention
by Jeffrey Dach MD
One of my friends was hospitalized recently after a sudden paralysis of his right arm and leg which was found to be a stroke on his CAT scan. He is about my age and was previously healthy with none of the usual risk factors of high blood pressure, smoking or obesity. Thankfully, he recovered quickly, and was soon back to normal at home.
Image at Left: CAT Scan of severe hemorrhagic stroke. White material (red arrow) is blood ruptured into the brain. This patient did not survive.
What is a Stroke?
Why did my friend get a stroke? What is a stroke and how can it be prevented? There are two kinds of stroke, the first kind is the ischemic stroke, in which blood flow is blocked off by a clot or small plug, and the second kind is the hemorrhagic stroke (image above), in which a small crack in the artery leaks blood into the surrounding brain. Stroke is quite common with about 700,000 strokes annually in the United States. Both heart attacks and strokes are caused by atherosclerotic vascular disease.
Stroke prevention treatment offered by our medical system usually consists of blood thinners such as coumadin and aspirin, usually started after the first stroke in hopes of preventing a second stroke. An often ignored, yet more important preventive measure is Vitamin C in stroke prevention. Vitamin C is cheap, pennies a day, so there is no financial incentive to anyone to recommend it.
Vitamin C Beneficial for Stroke Prevention
Here are two of many recent studies published in the medical literature showing Vitamin C to be beneficial in reducing the risk of stroke
Image at left: Oranges rich in Vitamin C courtesy of Wikipedia.
This first study was carried out in rural Japan, and those people with the highest blood levels of Vitamin C had 70 per cent fewer strokes.(1) A second study done in Finland in 2002 showed the same findings (2). Those people with the lowest vitamin C blood levels had 2.4 times greater risk of stroke. If high blood pressure and obesity were added factors, there was even higher risk for stroke.
How Does Vitamin C Work? - Collagen Synthesis
How does Vitamin C work to make our arteries stronger? The arteries are made of a connective tissue substance called Collagen, and vitamin C is the key nutrient for collagen synthesis. In addition,Vitamin C is a major player as an anti-oxidant, important for quenching free radicals which result from oxidative metabolism.
Vitamin C Deficiency
Now that you are convinced that Vitamin C is beneficial in preventing stroke, perhaps you might think that we all get enough vitamin C in our diets. Well, a new study of 15,769 people aged 12 to 74 years in the American Journal of Public Health says otherwise. This study found a distressing 10 percent of women and 14 percent of men to be deficient in Vitamin C.(3)
Is the Recommended Dietary Allowance for Vitamin C Too Low? How much Vitamin C is Enough?
These are the different recommendations depending on the source:
Daily Vitamin C........Source of Recommendation
60-95 mg................U.S. Government RDA (15)
200 mg...................Levin/NIH (16)
400 mg...................Linus Pauling Institute (7)
2500 mg.................Hickey/Roberts (12)
4000 mg.................Robert Cathcart MD III (4)
6-12 g...................Thomas E Levy, MD, PHD (6)
All Animals Convert Glucose into Vitamin C
Below Images Courtesy of Wikipedia
Notice the 6 carbons and the ring structure of glucose, a common sugar (lower left). All animals convert the glucose into the L-ascorbate (vitamin C) with the use of three enzymes located in the liver of all animals (lower right). Note the similarity in the two ring structures of glucose and L-ascorbate with the Oxygen at the top.(5)
glucose vitamin C (ascorbate)
All Humans Have a Genetic Mutation, and Cannot Make Vitamin C
We humans had a mutation 40 million years ago, and lack the final enzyme step needed to make our own Vitamin C. This last enzyme is called GLO (gulano lactone oxidase).(13)(14) You might ask the question: how much vitamin C would we make every day if the GLO enzyme was present and doing its job to convert glucose into vitamin C ? Perhaps the best answer comes from studying how much vitamin C animals produce. Based on animal vitamin C data, estimates are that healthy adult humans would produce about 2 to 4 grams (2,000 to 4,000 milligrams) of vitamin C daily. Other primates (gorillas, Orangutans, chimpanzees) cannot make their own vitamin C, and they typically consume 3 to 4 grams of vitamin C daily (calculated on a "human-weight basis").(6)
Determining how much supplemental vitamin C will meet your individual requirements is fairly easy using a tolerance-test technique developed by Dr. Cathcart.(4) The tolerance test starts with a dose of 2 grams of vitamin C per day. Then, slowly increase your Vitamin C dose each day until you start experiencing excess gas or loose bowels. At that point, your body isn't absorbing or able to use that much vitamin C, so you should scale back to the largest amount that doesn't produce these symptoms.
The Best Form of Vitamin C
Of course, your daily Vitamin C requirement can be obtained from citrus fruits such as oranges, lemons and limes, etc. And if you wish to use a Vitamin C supplement, I would recommend a buffered, 100% pure L-ascorbate also called Vitamin C. Our office provides this item to all our clients as a convenience, and the cost is about 5 cents a day. In terms of medical prevention bang for the buck, you can’t beat it.
Articles of related interest:
Heart Disease, Ascorbate, Lysine and Linus Pauling
Jeffrey Dach MD
7450 Griffin Rd Suite 180/190
Davie, FL 33314
References and Links
(1 ) http://stroke.ahajournals.org/cgi/content/full/31/10/2287
Stroke. 2000;31:2287. Serum Vitamin C Concentration Was Inversely Associated With Subsequent 20-Year Incidence of Stroke in a Japanese Rural Community The Shibata Study Full text
(2 ) http://stroke.ahajournals.org/cgi/reprint/33/6/1568.pdf
Plasma Vitamin C Modifies the Association Between Hypertension and Risk of Stroke. Stroke, 2002;33:1568-1573 S. Kurl, MD; T.P. Tuomainen, MD; J.A. Laukkanen, MD; K. Nyyssönen, PhD;
Hampl JS, Taylor CA, Johnston CS. "Vitamin C deficiency and depletion in the United States: the Third National Health and Nutrition Examination Survey, 1988 to 1994." Am J Public Health 2004; 94(5): 870-875
Cathcart RF. Vitamin C, Titrating To Bowel Tolerance, Anascorbemia, and Acute Induced Scurvy. Medical Hypotheses 1981; 7: 1,359-1,376
Vitamin C, the L and R isomers: Wikipedia
Thomas Levy MD on Vitamin C
Linus Pauling Institute References for Vitamin C
Knekt P, et al. "Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts." Am J Clin Nutr 2004; 80(6): 1,508-1,520.
(9) http://www.seanet.com/~alexs/ascorbate/194x/klenner-fr-southern_med_surg-1949-v111-n7-p209.htm Klenner FR. “The Treatment of Poliomyelitis and Other Virus Diseases with Vitamin C.” Southern Medicine & Surgery 1949: 209
Ascorbic Acid and Some Other Modern Analogs of the Germ Theory. Journal of Orthomolecular Medicine, 1999; Vol 14 (3): 143-56. John T. A. Ely, Ph.D.Radiation Studies, Box 351310 University of WashingtonSeattle, WA 98195
Publications by Robert F. Cathcart MD
Is the Recommended Dietary Allowance for Vitamin C Too Low? by Bill Sardi
Dr. Hickey and Roberts Vitamin C recommendations
American Society for Nutrition J. Nutr. 137:2171-2184, October 2007
Critical Review New Developments and Novel Therapeutic Perspectives for Vitamin C
Yi Li and Herb E. Schellhorn. Vitamin C is an essential nutrient for the biosynthesis of collagen, L-carnitine, and the conversion of dopamine to norepinephrine (1). Under physiological conditions, it functions as a potent reducing agent that efficiently quenches potentially damaging free radicals produced by normal metabolic respiration of the body. Though most animals are able to synthesize large quantities of vitamin C endogenously, humans lost this capability as a result of a series of inactivating mutations of the gene encoding gulonolactone oxidase (GULO)3, a key enzyme in the vitamin C biosynthetic pathway. These mutational events were estimated to have occurred about 40 million years ago, rendering all descending species, including humans, ascorbic acid deficient. Acute lack of vitamin C leads to scurvy, manifest by blood vessel fragility, connective tissue damage, fatigue, and, ultimately, death.
J. Biol. Chem., Vol. 269, Issue 18, 13685-13688, 05, 1994
Cloning and chromosomal mapping of the human nonfunctional gene for L- gulono-gamma-lactone oxidase, the enzyme for L-ascorbic acid biosynthesis missing in man
M Nishikimi, R Fukuyama, S Minoshima, N Shimizu and K Yagi
Institute of Applied Biochemistry, Yagi Memorial Park, Gifu, Japan.
These findings indicate that the human nonfunctional L-gulono-gamma-lactone oxidase gene has accumulated a large number of mutations without selective pressure since it ceased to function during evolution.
Proc Natl Acad Sci U S A. 2001 August 14; 98(17): 9842–9846. A new recommended dietary allowance of vitamin C for healthy young women-90 mg. Mark Levine, Yaohui Wang, Sebastian J. Padayatty, and Jason Morrow
NIH Research Shows 100 to 200 Mg of Vitamin C Daily May Benefit Healthy Adults. Research from the National Institutes of Health (NIH) shows that healthy adults may benefit from daily intake of 100 to 200 milligrams of vitamin C, the Journal of the American Medical Association reports in its April 21 issue. The conclusion is based on recent findings about the mechanisms and action of vitamin C by Mark Levine, M.D. Levine says adults need about 200 mg of vitamin C daily,
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