Vitamin C worsening symptoms (sodium ascorbate)

[Nostos89]

Hello,

Does anyone experience worsening fatigue and other symptoms from vitamin c supplementation? I started taking around 1500 mg in May, and I've been having really bad fatigue all summer. I've continued to take it because I find it hard to believe it's the vitamin c. I have low-normal blood pressure so it's not due to the sodium. I suspect I have autoimmunity, so I wonder if it's stimulated my immune system too much?

 

[Wishful]

I don't notice it now, but I used to have worsening from VitC. There are a variety of mechanisms by which it could worsen ME symptoms. I consider it a case of 'if it makes you feel worse, don't take it' even if you don't know precisely why it's doing that.

 

[Nostos89]

Thank you for your response. I'm going to stop taking it and see if I have any improvement. I wonder if it's actually thinning my blood and lowering my blood pressure too much. Although, I believe I was 110/something at the doctor's the other day, which isn't too low. I've been at 90 for the first number in the past.

 

[PatJ]

worsening fatigue

According to WiseGeek:

The relationship between vitamin C and calcium is an important one. Vitamin C can support calcium absorption...

So this is what might be happening:
1. The vitamin C is increasing your calcium absorption
2. Excess calcium can disrupt your body's calcium/magnesium balance leading to lower (or not enough) magnesium.
3. Low magnesium can lead to fatigue (sometimes extreme fatigue). People with ME/CFS are often already low in magnesium.

The same thing can happen with a vitamin D supplement (or even when getting a lot of vitamin D from sun exposure) since vitamin D increases calcium absorption. This is why vitamin D supplements and magnesium should be taken together.

A magnesium supplement might help to relieve the fatigue.

 

[Nostos89]

According to WiseGeek:


So this is what might be happening:
1. The vitamin C is increasing your calcium absorption
2. Excess calcium can disrupt your body's calcium/magnesium balance leading to lower (or not enough) magnesium.
3. Low magnesium can lead to fatigue (sometimes extreme fatigue). People with ME/CFS are often already low in magnesium.

The same thing can happen with a vitamin D supplement (or even when getting a lot of vitamin D from sun exposure) since vitamin D increases calcium absorption. This is why vitamin D supplements and magnesium should be taken together.

A magnesium supplement might help to relieve the fatigue.

Thank you- this is really interesting. I suspect there is something off about my calcium levels because I've had elevated bone and intestinal specific alkaline phosphatase for 10 years. The doctors were never able to determine a cause.

I do take magnesium already- 400 mg a day. Maybe I need more? I took 200 mg of magnesium glycinate for years, and I start taking 400 mg a couple months ago (after the worsening of my fatigue).

 

[Learner1]

Have you looked into oxalates? Vitamin C can convert to oxalates and affect calcium. An OAT test or urine oxalic acid might tell you. A lot of "healthy foods" are high in oxalates and/or if your microbiome is missing oxalate degrading bacteria, you could be susceptible.

 

[PatJ]

I do take magnesium already- 400 mg a day. Maybe I need more?

Maybe more, or the same dose but split into multiple servings throughout the day. Magnesium is a supplement where the body is limited in how much it can absorb in one dose so split doses are usually better absorbed.

"There are diminishing returns associated with higher doses of magnesium — if you take 100% of your daily intake all at once, you won’t actually absorb as much compared to taking 25% at four different times throughout the day." (https://bodynutrition.org/magnesium/) (study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC295344/)

I take magnesium every day, but when taking vitamin D I need to take more magnesium to avoid lower energy (especially mental energy) and increased constipation.

 

[PatJ]

Here's another thought: Stomach acid is required to react with magnesium which turns it into an absorbable salt that the body can use. Low stomach acid can lead to magnesium deficiency.

 

[sue1234]

I have gotten that same response for a couple of years trying Vitamin C. I finally read a few places that Vitamin C lowers cortisol(or clears it faster from the body), so I am assuming that is why I get so fatigued. I am already on the lower-normal range for cortisol when tested to begin with.

 

[pamojja]

I finally read a few places that Vitamin C lowers cortisol(or clears it faster from the body), so I am assuming that is why I get so fatigued.

Though we are all different, I rather had too high cortisol on about 24 g per day of pure ascorbic acid powder for the last 10 years.

These are the most basic function of ascorbic acid from a textbook of vitamins:

Vitamin C Basic Functions

• Collagen synthesis. Vitamin C is an essential coenzyme in collagen synthesis. Cofactor in the hydroxylation of lysine and proline, stimulation of gene-expression in fibroblasts; development, maturation and repair of connective tissue such as skin, bone, tendons ligaments, scar tissue, blood vessels and cartilage (anti-scurvy effect = ascorbic). Lack of ascorbic acid results in poorly formed connective tissue in the skin, joints, muscles, and bones.
• Hormone production. Glucocorticoids synthesis in adrenal cortex (stress-response), and Vitamin D-hormone (calcitriol synthesis). Production of epinephrine and norepinephrine, (the hormones released by the adrenal gland in response to stress) are dependent on adequate vitamin C status.
• Neurotransmitter metabolism. Ascorbic acid is essential for the production of norepinephrine and serotonin, two important neurotransmitters in the brain. Conversion of tryptophan in 5-hydrotryptophan (=precursor of serotonin), hydroxylation of dopamine into noradrenalin, synthesis of L-dopa.
• Amidation of neuro-endocrinic hormones. Gastrin, CRH (corticotropin-releasing- hormone and TRH (tyreotropin-releasing-hormone).
• Bile acid synthesis and cholesterol breakdown and excretion. The first key step in the degradation of cholesterol (also tyrosine; bile-acid-synthesis, cholesterol-7-hydroxylasis, HMG-CoA-recductasis) depends on vitamin C. Cholesterol levels in the liver and blood increase if vitamin C status is impaired.
• Carnitine synthesis. Ascorbic acid - together with cofactors niacin, vitamin B6, lysine and methione - is essential for the formation of carnitine, an amino acid required for breakdown of fats for energy. Lack of ascorbic acid lowers levels of carnitine and reduces energy production, producing fatigue and muscle weakness.
• Tyrosine metabolism. Synthesis and catabolism.
• Iron absorbtion and metabolism. Vitamin C sharply increases non-heme iron absorption from diet or supplements. Raising iron transference from transferritin (transport protein) to ferritin (storage protein)-
• Folic acid activation. To tetrahydrofolate (THF).
• Antioxidant function. Vitamin C is the body’s primary water-soluble antioxidant. It is present in the blood, body fluids, and inside all cells and helps protect against oxidative damage by free radicals of lipids (lipid-peroxidation), proteins, nucleic acid and cell membranes. (anti-inflammatory and anti-degenerative effects, e.g. in cancers, diabetes, arthritis, cataracts and cardiovascular diseases..). Vitamin C is also important in the conversion (reduction) of iron and copper to the form in which they function as cofactors in many enzyme systems, such as reduced copper in superoxide dismutase (another antioxidant).
• Antioxidant regeneration. Central building-block in the redox-chain of vitamin C, vitamin E, coenzym Q10 and lipoic acid and/or glutathione, Regeneration of glutathion-disulfide into glutathione.
• Vitamin E sparing effect. Regeneration of tocopherol radicals (vitamin E radical) into the reduced, anti-oxidative active alpha-tocopherol (vitamin E).
• Protection of folate and vitamin E from oxidation. Ascorbic acid protects folate and vitamin E from oxidation and helps maintain these vitamins in their active forms.
• Endothelial cell protection. Raising of NO-bioavailability. (anti thrombotic and blood-lowering effect)
• Detoxification and excretion of drugs and chemicals. Ascorbic acid helps maintain the enzyme systems in the liver that detoxify and excrete drugs and toxic environmental chemicals (such as pesticides and heavy metals). Detoxification of xenobiotika (synthesis/anti-oxidative protection of CYP 450) in the liver, excretion of toxins.
• Antiviral and antibacterial effect. Vitamin C is important for healthy immune function. It is essential for optimum activity of white blood cells and production of the chemical mediators that direct the immune response. Lack of vitamin C sharply increases vulnerability to infection (Immunocompetence). Stimulation of the cellular (antibodies) and hormonal immune system (interferon), protection of phagocytic membranes from oxidative self-destruction (prolonged function-time of immune cells), activation of complementary systems and of chemotaxis.
• Anti-glycation. Inhibition of protein glycosylation and AGE-formation (e.g. HbA1C).
• Anti-allergic. Vitamin C plays a role in controlling body and blood histamine levels (histamine degradation and mast cell stabilization), and blood histamine levels increase when vitamin C status is poor. High levels of histamine can aggravate allergies, asthma, stomach ulcers, and certain psychiatric disorders.
• Anti-carcinogenic. Inhibition of the formation of carcinogenic nitrosamines from nitrites and secondary amins (especially of the digestive system), protection of DNA from oxidative damage.

In my own case when starting high dose vitamin C, a for years persisting skin-rush on my back cleared first. Together with lysine and all other nutrients recommended by Linus Pauling - pain-free walking distance from a PAD improved from mere 3-400 meters up to 2 hours. But only once I exceeded the in his view minimal therapeutic dose of 6 g/d each (by now in remission). Rhinitis symptoms recurring every spring since 15 years got alleviated. A cystitis circumscripta of the bladder disappeared. Blood pressure stayed consitently at 110/72 throughout the last 10 years.

The first 3 years of those my serum calcium was consistently below, but since came up right in the middle of normal with normalization of vitamin D serum levels without suplementing calcium. I did however experience a very severe magnesium deficiency, which even very high oral magnesium supplementation could only alleviate somewhat (up to 2.4 g of elemental oral magnesium), but whole-blood Mg levels declined further. Only been able to bring whole-blood magnesium up with almost monthly Mg-sulfate IVs since 2 years.

Personally in retrospect I still believe that normalized vitamin D levels pushed a subclinical Mg-deficiency into a very severe, by using up its co-factor magnesium far beyond whats available.

 

[Learner1]

Too much vitamin C can convert to oxalates, which can create many unplesant symptoms.

 

[pamojja]

Not in my case. And not in the case of 25 000 patients of Dr. Cathcart.

Robert F. Cathcart II, M.D. writes on “Why Don’t Massive Doses of Ascorbate Produce Kidney Stones?”

“Years ago when Linus Pauling wrote his book "Vitamin C and the Common Cold", the critics immediately labeled the taking of large doses of vitamin C dangerous because it would produce calcium oxalate kidney stones. This practice of telling people that vitamin C caused kidney stones continues today by the critics of vitamin C despite the lack of clinical evidence of kidney stones in people taking vitamin C.

“It was hypothesized that since a significant percentage of ascorbate was metabolized into and excreted as oxalic acid that this oxalic acid should combine with calcium in the urine and deposit as calcium oxalate kidney stones. It is true that those of us who take large doses of ascorbate have elevated oxalic acid in our urine but no kidney stones. With the millions of people in the world taking vitamin C, if vitamin C caused kidney stones there would have been a massive epidemic of kidney stones noticed by this time. There has been none.

“I started using vitamin C in massive doses in-patients in 1969. By the time I read that ascorbate should cause kidney stones, I had clinical evidence that it did not cause kidney stones, so I continued prescribing massive doses to patients. To this day (2006) I estimate that I have put 25,000 patients on massive doses of vitamin C and none have developed kidney stones. Two patients who had dropped their doses to 500 mg a day developed calcium oxalate kidney stones. I raised their doses back up to the more massive doses and added magnesium and B6 to their program and no more kidney stones. I think that the low doses had no effect and they, by coincidence, developed the kidney stones because they were not taking enough vitamin C.”

Maybe exactly because excretion increases.

 

[Learner1]

It's not just kidney stones. It's oxalates in thyroid, it's oxalates binding metals so one becomes depleted and then things don't work, its oxalates causing osteoporosis, it's oxalates in your liver, your joints, your brain, your eyes....

Not in my case. And not in the case of 25 000 patients of Dr. Cathcart

Perhaps not in your case. But, unfortunately, the answer can be yes. (And I actually had high dose IV C as a part of my cancer treatment...so I do understand where you and Dr. Cathcart are coming from...)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946963/

 

[pamojja]

...so I do understand where you and Dr. Cathcart are coming from...)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946963/

This review only confirms that oxalates-excretion increases with possibly beneficial effects, and the epidemiological increase of kidney-stones with too low vitamin C intake by Dr. Cathcart. We both come from having experienced too many beneficial effects over too many years (as already outlined above: reversal of a walking-disabilty in my case), and only one slighty inconvenient bad-effect whenever I have to go above 30 g/d (for beneficial effects for example with rhinitis) of flatulence.

It's oxalates in thyroid, it's oxalates binding metals so one becomes depleted and then things don't work, its oxalates causing osteoporosis, it's oxalates in your liver, your joints, your brain, your eyes....

I monitored metals, liver, eyes - everything improved with propper supplementation - and have no pain in bones or joints.

The problem of course is, that each one is one's own lab-rat. No one ever studies the details of multi-systems benefits, or risk of real high dose vitamin C supplementation. The only study which did test at least one marker of glycation beside serum levels, found amazing benefits (now behind a paywall). If it would be a patentable drug, it would be the next blog-buster drug:

Journal of the New Zealand Medical Association, 23-August-2002, Vol 115 No 1160

Glycohaemoglobin and ascorbic acid

Copplestone et al1 (http://www.nzma.org....al/115-1157/25/) identified misleading glycohaemoglobin (GHb) results due to a haemoglobin variant (Hb D Punjab) and listed a number of other possible causes for such false results (ie, haemolytic anaemia, uraemia, lead poisoning, alcoholism, high-dose salicylates and hereditary persistence of foetal haemoglobin).

We have observed a significant "false" lowering of GHb in animals and humans supplementing ascorbic acid (AA) at multigram levels. Mice receiving ~7.5 mg/d (equivalent to > 10 g/day in a 70 kg human) exhibited no decrease in plasma glucose, but a 23% reduction in GHb.2 In humans, supplementation of AA for several months did not lower fasting plasma glucose.3,4 We studied 139 consecutive consenting non-diabetic patients in an oncology clinic. The patients had been encouraged as part of their treatment to supplement AA. Self-reported daily intake varied from 0 to 20 g/day. The plasma AA levels ranged from 11.4 to 517 µmol/L and correlated well with the reported intake. Regression analysis of their GHb and plasma AA values showed a statistically significant inverse association (eg, each 30 µmol/L increase in plasma AA concentration resulted in a decrease of 0.1 in GHb).

A 1 g oral dose of AA can raise plasma AA to 130 µmol/L within an hour and such doses at intervals of about two hours throughout the day can maintain ~230 µmol AA/L.5 Similar levels could also be achieved by use of sustained-release AA tablets. This AA concentration would induce an approximate 0.7 depression in GHb. The GHb assay used in our study, affinity chromatography, is not affected by the presence of AA.3 Thus, unlike the case with Hb D Punjab, our results were not caused by analytical method artifact. More likely, the decreased GHb associated with AA supplementation appears related to an in vivo inhibition of glycation by the elevated plasma AA levels, and not a decrease in average plasma glucose.3 If this is true, the effect has implications not only for interpretation of GHb but also for human ageing, in which glycation of proteins plays a prominent role in age-related degenerative changes.

No existing antiglycation drug can do that - ie. decreasing HbA1c a whooping 1% with 20 g/d intake. Therefore all these low dose studies which a lot of hypothesized bad effects. But god forbit, never actually really testing high vitamin C intake for multisystem benefits.

 

[dannybex]

@pamojja Just curious if you slowly ramped up your vitamin C initially? Also, did you ever get to the point where you experienced diarrhea with such astronomical dosages?

 

[pamojja]

you slowly ramped up your vitamin C initially?

Yes, I started with lower doses and increased over the years. The limit where I got diarrhea I found experimentally is at 50 g of ascorbic acid spread throughout the day

 

[dannybex]

Wow. That's truly incredible.

 

[iwillwin1day]

Yes, I started with lower doses and increased over the years. The limit where I got diarrhea I found experimentally is at 50 g of ascorbic acid spread throughout the day

How much vitamin c do you take every day? I cannot go above 6 gram per day sodium ascorbate. I am taking it from last 3 months. Still cannot go above 6 grams.

 

[pamojja]

Wow. That's truly incredible.

Not that much, if one considers that vitamin C needs do go up in any kind of conditions burning through one's body stores at an deleterious rate. See titration of ascorbic acid, where my rhinitis alone would explain my limit of need at 50 g per day:

          TABLE I - USUAL BOWEL TOLERANCE DOSES

                               GRAMS ASCORBIC ACID      NUMBER OF DOSES    
CONDITION                  PER 24 HOURS           PER 24 HOURS
normal                       4 -  15              4 -  6
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 and                                      
food allergy              0.5 -  50              4 -  8
burn, injury, surgery       25 - 150+             6 - 20
anxiety, exercise and                                  
other 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
candidiasis                 15 - 200+             6 - 25

How much vitamin c do you take every day? I cannot go above 6 gram per day sodium ascorbate. I am taking it from last 3 months. Still cannot go above 6 grams.

In average took about 24 g/d spread-out in about 4 doses on empty stomach for the last 10 years. But as you can see in above table, bowel-tolerance can be very individual, and as low as even 1g per day in some rare individuals. For increasing tolerance spreading out small tolerated doses throughout the day is essential. Liposomal beside mineral-ascorbate (you're already taking) could also increase your tolerance.

 

[dannybex]

That's my issue, very, very low tolerance.

I've been dealing with diarrhea for probably 8 months now. Stool tests come back negative, etc., etc.. It might be a little bit better in the last few days, but that's happened off and on during the 8 months only to return. In the meantime I've basically got subclinical, if not clinical scurvy, which of course the doctors deny -- even the classic corkscrew hairs -- which I've had for probably six or seven years now.