The Dosage Controversy
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There is an extreme difference between the 45-60 mg
Recommended Daily Allowance (RDA)(179) and the 10, 20 or more GRAMS of
Vitamin C suggested to therapeutically treat various illnesses(46). The
very low RDAs are the amounts of Vitamin C which have been shown to
prevent overt scurvy, and without this low amount of Vitamin C, humans
will die.
It is very difficult to calculate or even measure our state of health,
because it is in constant fluctuation, according to a number of
parameters: exposure to pathogens (viruses, bacteria); exposure to
allergens; physical and emotional stresses, dietary abuse (too much sugar,
caffeine, alcohol, etc.). Also, our emotional and psychological sense of
well-being affects so many of the body's metabolic processes.
The myth that almost everybody believes, even in the face of extensive
clinical evidence to the contrary, is that the body can only store a
limited amount of Vitamin C, and it is a waste of money to take any more
than this amount, since it will only be excreted in the urine. The truth
is that our bodily reserves of Vitamin C fluctuate according to how much
is needed to buttress the immune system, scavenge free radicals, regulate
cholesterol and sugar metabolism, repair wounds, etc. etc.
Accordingly to Dr. Robert Cathcart, a well-nourished person would
normally have more than 5 grams of Vitamin C in their body(46). Most
individuals' Vitamin C levels are far below this level, placing them at
substantial "risk for many problems related to failure of metabolic
processes dependent upon ascorbate". In fact, the list of problems Dr.
Cathcart suggests may become exascerbated with "severe depletion of
ascorbate" is considerable: immune disorders; rheumatoid arthritis;
allergic reactions; chronic infections; scarlet fever; blood coagulation
processes; heart and blood pressure conditions; stress-coping mechanisms
of the adrenals; impaired wound healing of conditions such as bed sores,
hernias; spinal disc degeneration; nervous system and even psychiatric
disorders; cancers.
Thus, in an optimal state of health, lack of stress, etc., an
individual's bodily requirement for Vitamin C could be in balance with his
dietary and supplementary intake. However, if this person suffered from
hay fever and was exposed to rag weed, or if (s)he came down with a nasty
cold, his/her immune system would require many times more Vitamin C in
order to restore his/her good health. In other words, when under severe
stress, the body can literally "soak up" Vitamin C, which at other times
it wouldn't need.
While it is clear that there can be NO hard and fast rule about exactly
how much Vitamin C to take for your particular momentary state of health,
Drs. Linus Pauling(166), Emanuel Cheraskin(54) and others give APPROXIMATE
guidelines in advising the intake of 1-3-5 g per day. But really the
ABSOLUTE BEST way to know how much Vitamin C you need is to ASK YOUR BODY!
And this is what the "Bowel Tolerance Technique" is about: titrating
your individual body chemistry at any particular moment in time to
ascertain how much Vitamin C you need. This method was developed by Dr.
Robert Cathcart(46), who has extensive clinical experience with Vitamin C,
(more than 13,000 patients), and who has used Vitamin C to therapeutically
treat a large list of conditions including colds, hepatitis,
mononucleosis, cancer and AIDS.
The Bowel Tolerance Technique
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This method takes advantage of the body's way of showing you when you
have taken enough Vitamin C, i.e. diarrhoea occurs. This is because when
there is a concentrated solution (say of Vitamin C) in the intestinal
cells, this pulls water in from the surrounding cells, loosening the stool
and producing diarrhoea(28). Diarrhoea only occurs in response to the
excess Vitamin C that reaches the intestines and is not absorbed by the
body(46). In other words, when you have exceeded the level of how much
Vitamin C you need at a particular time, your body lets you know by
producing diarrhoea. Therefore, the optimum level of Vitamin C to take is
just short of this "bowel tolerance" or diarrhoea causing level.
The bowel tolerance level of your body will shift quite dramatically,
depending upon how stressed your body is. It may range from 1 g or less
when you are perfectly healthy to 20 or even 50 g when you have a very bad
cold or influenza, or even 150-200 g for mononucleosus. It would be
difficult to orally take 200 g; these high doses are achieved with both
oral and intravenous doses of Vitamin C, administered by physicians such
as Dr. Cathcart. Table 8 lists various conditions and their Vitamin C
doses recommended by Dr. Cathcart:
Table 8: Usual Bowel Tolerance Doses
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Grams Vitamin C No. of Doses
Condition per 24 hours per 24 hours
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Normal 4-15 4
Mild Cold 30-60 6-10
Severe Cold 60-100 8-15
Influenza 100-150 8-20
ECHO, coxsackievirus 100-150 8-20
Mononucleosis 150-200 12-25
Viral Pneumonia 100-200 12-25
Hay Fever, Asthma 15-50 4-8
Environmental & Food Allergy 0.5-50 4-8
Burn, Injury, Surgery 25-150 6-20
Anxiety, Exercise, Mild Stresses 15-25 4-6
Cancer 15-100 4-15
Ankylosing Spondylitis 15-100 4-15
Reiter's Syndrome 15-60 4-10
Acute Anterior Uveitis 30-100 4-15
Rheumatoid Arthritis 15-100 4-15
Bacterial Infections 30-200 10-25
Infectious Hepatitis 30-100 6-15
Candida Infections 15-200 6-25
From Cathcart: "Vitamin C, Titrating to Bowel Tolerance, Anascorbemia
and Acute Induced Scurvy". Medical Hypotheses: 7: 1359-76. 1981(46) .
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How to Achieve Bowel Tolerance
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Bowel tolerance level is that level where "maximum relief of symptoms
which can be expected with oral doses of ascorbic acid is obtained at a
point just short of the amount which produces diarrhoea". Dr. Cathcart
notes that effects upon acute symptoms do not occur until doses of 80-90%
of bowel tolerance are reached. This means that if you take less Vitamin C
than what your body actually needs, you may not notice dramatic or even
any effects upon your symptoms. The small doses prescribed in many of
clinical trials with colds did exert some effect, but probably not the
optimal effect which could have been achieved with subjects being "pushed"
to bowel tolerance.
It is relatively easy to determine your own bowel tolerance level. You
may need to start gradually and build up to this level. Many people can
absorb up to 10 g Vitamin C without diarrhoea; others have diarrhoea with
only 1 g. Start taking 1-2 g Vitamin C 3 times per day, for a total daily
dose of 3-6 g. After 1 week, slowly increase this amount to 4 daily doses,
then 5, until you reach the point when cramps and loose stools occur. This
will be very easy to notice. The amount that you have taken represents
your bowel tolerance of Vitamin C at that particular time. It is important
to take Vitamin C regularly throughout the day, at least 3 times daily.
When you are ill, it may be necessary to take 1-2 gm each hour to
experience relief. With some experience, you will be able to instinctively
know how much Vitamin C to take, somewhere in between the amount that
makes you feel good and the amount that causes diarrhoea. And you will
surely notice that this level will increase dramatically when you are
sick, and then return to normal when you are well. Taking Vitamin C to
bowel tolerance level will mean that you will always be giving your body
its optimum requirement of this vital nutrient.
The majority of people, perhaps 80-85%, tolerate Vitamin C without any
difficulties; however a significant minority do suffer gastrointestinal
upsets, including gas and diarrhoea. It should be borne in mind that often
the underlying problem behind such gastric upsets is an unbalanced
ecological flora, especially the overgrowth of organisms such as Candida
albicans. Attention to, and restoration of the correct balance of
intestinal flora will often enhance many aspects of a person's health, not
merely their tolerance of Vitamin C.
The producers of buffered mineral ascorbates, including Ester-CR
ascorbate, claim one of the advantages of their Vitamin C is that it
produces less stomach and intestinal upset than ascorbic acid due to its
buffered nature. The acidity of Vitamin C in the intestines, where
absorption occurs, causes Vitamin C to be pushed out rapidly due to
irritation of mucous membranes. Buffered Vitamin C does not produce this
effect, although it does produce CO2 gas. Ester-CR ascorbate does not
produce CO2 gas, since it has been bonded and pre-reacted during its
synthesis.
Dr. Cathcart uses ascorbic acid, rather than buffered Vitamin C,
initially in crystals rather than capsules, because he feels it has a
stronger "punch"(49). Once experienced with crystals, patients "graduate"
to capsules or tablets. Other physicians prefer buffered ascorbates such
as Ester-CR ascorbate because of these digestive attributes. Because of
the biochemical individuality, after trying various forms of Vitamin C,
each person can usually decide which suits him or herself.
If you are persuaded by the evidence that Vitamin C can positively
affect your health, you owe it to yourself to experience the optimum
effect, which means going all the way to bowel tolerance level.
Other Methods to Determine Vitamin C Levels
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Urine C-Strips
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There are a number of commercially available test papers which can
providea good approximation of the level of your urinary Vitamin C
concentration. With one of these, for example, C-StripsR (Wholesale
Nutrition), Vitamin C turns the blue strips white. The number of seconds
it takes for the strip to turn white can be converted to the concentration
of urinary Vitamin C by reference to tables provided. There are also
guidelines of optimum, borderline and "sick" ranges of Vitamin C urinary
levels.
Urinary excretion levels are subject to considerable variation, and are
thus
recommended as an APPROXIMATE rather than a PRECISE measure of body
Vitamin C levels(54). They are a most important alarm indicator if they
indicate NO detectable Vitamin C in the urine. This indicates that your
body reserve of Vitamin C has been depleted, and should be replenished to
afford you maximum health protection.
Laboratory Tests to Measure Plasma and Leukocyte Vitamin C Levels
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A reliable yet convenient indicator of Vitamin C levels is still being
sought(134). Plasma(98) is considered to indicate metabolic turnover
status of Vitamin C, while leukocyte concentrations are thought to provide
a better measure of tissue stores of Vitamin C. However, Vitamin C
utilization differs even within the different types of leukocyte cells
(Mononuclear and Polymorphonuclear), and there is no easy or reliable
correlation between plasma and leukocyte Vitamin C levels(26). It is more
technically difficult to prepare these different leukocyte fractions than
to simply assess plasma. Applications of techniques such as
High-Performance Liquid Chromatography (HPLC)(19,162) will doubtless
accelerate the development of a simple, easy and reliable test of Vitamin
C concentration.
Intradermal Test
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This somewhat painful, inconvenient and time-consuming procedure has
also been used to measure tissue levels of Vitamin C. It involves
injecting a dye solution to produce a wheal on the forearm, and timing how
long it takes to be completely decolorized. Twenty minutes or less is a
good result, from twenty to thirty minutes borderline, anything longer
than thirty minutes is unacceptable(54). Not exactly the most friendly
do-it-yourself technique; recommended only for those who enjoy sticking
themselves with needles.
Lingual Ascorbic-Acid Test (LAAT)
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This is a much more palatable measure of Vitamin C status. A drop (from
a 25 gauge needle) of blue dye (2,6, dichloroindophenol sodium salt
solution) is dropped onto the tip of the tongue. The time is takes for the
dye to disappear is again a measure of Vitamin C status. Less than twenty
seconds is good; between twenty to twenty-five seconds, marginal; longer
than twenty-five seconds represents depletion of Vitamin C levels(54,175).
