Vitamin C – The Revisit

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I have had to come back to discuss vitamin c following the August 2017 article Vitamin C – What else does it do for us? as a result of consultation queries which warrants a universal response and obviously, restriction in word limitation given for my last vitamin c topic.

In this article, I will try to further emphasize and keep in mind the relevant clinical outcome instead of the biological explanations behind vitamin c’s effectiveness on health. Whilst there isn’t a surge in vitamin c deficiency in the United Kingdom, it is worth appreciating its influence or response when one is unwell.  

The 4 most common questions I have come across in our clinic since August 2017:

  1. What is the maximum dose of vitamin c I can take in a day?

  2. When is it important to consume vitamin c?

  3. Do I have to get intravenous injections all the time to acquire more vitamin c?

  4. Does vitamin c treat common colds?

These answers to the above questions exist, but I feel that we need a legislated update for the good of mankind. My responses are:

  1. The UK recommendation is 80 mg per day, which is about an orange and a half. However, some cases of chronically ill patients have taken doses up to 50 grams safely, under the supervision of trained clinicians.

  2. It is a daily recommendation, therefore, its recommended you take that minimum a day. When unwell, I would like to suggest that more should be added to one’s diet.

  3. No, you don’t necessarily have to have injections all the time. You can acquire more through eating foods with vitamin c, particularly fruits and vegetables. Unless there is a clinical diagnosis of malnourishment/deficiency, inadequate or unsafe oral intake, food can’t pass through the intestines or there is malabsorption syndrome.

  4. As it stands, the answer is unclear, however, what we currently know is that vitamin c does not decrease the average incidence of colds in the general population, yet it halves the number of colds in physically active people.

I feel vitamin c is just as an important nutrient as the others and contributes to one’s wellbeing. In an ill patient, it has an important role to play and clearly, the traditional “low doses” are useful, but to what degree? Some controlled trials have found statistical dose-response for the duration of the common cold symptoms, with up to 6 – 8g/day of vitamin c. Other studies have even found that vitamin c prevented and benefitted patients with pneumonia and may alleviate respiratory symptoms caused by exercise. This doesn’t mean it treats it, but obviously warrants further investigations and possibly changes in recommendations of vitamin c intake.

10 Little Known Vitamin D Facts

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To commemorate this day, I thought I’d share some interesting Vitamin D facts that are not so commonly known…

 

  1. Vitamin D is not technically a vitamin. Vitamins have to be consumed as they cannot be created in the body. It is better classified as a hormone. Or more accurately, a pre-hormone which has to be converted to its active, hormonal component

  2. It regulates the activity of over 200 different genes

  3. You don’t get much Vitamin D from dairy. The main reason is because animals, just like people, need sunlight to make Vitamin D. So if you eat mainly intensely farmed animals and their milk products, it won’t be high in Vitamin D. Look out for free range, grass fed animals. One good example is Kerrygold butter which claims to be from grass fed animals

  4. Lower fat foods fortified with vitamin D won’t be as good as full fat products. Its a fat soluble vitamin and as such, being delivered in a fattier format aids absorption

  5. Obesity is associated with lower Vitamin D levels. The hypothesis here is that the Vitamin hides out in the fat cells. Would be interesting to see more research here

  6. Most Vitamin D rich foods are from an animal source. Hence, vegetarians and vegans need to pay extra attention to supplementing with Vitamin D

  7. Tanning beds can help raise Vitamin D levels- but we are not advocating it!

  8. Darker skin tones or skin that tans easily make less vitamin D compared to paler skin. This is probably a necessary adaptation due to migration of our ancestors into colder regions with less sunshine. In fact, darker skin tones may require 3-6 times more time in the sun to make the same amount of Vitamin D compared to paler skin tones

  9. Older people make less Vitamin D. There may be a few reasons for this. Its believed that absorption may be poorer in older skins. The body also is less efficient in converting it to its active form. Another reason could also be that older people don’t go outdoors as much

  10. Sunscreen with SPF of 30 effectively blocks out UVB rays, hence indirectly reducing Vitamin D production by up to 95%. This piece of info was gleaned from the Journal of Clinical Endocrinology and Metabolism 2011.

 

Hope this has given you some food for thought. I personally recommend a Vitamin D shot into the muscle 4-6 times/year for paler skins and 6-8/year for darker skin tones; spaced out more during summer months. Some people prefer taking higher dose Vitamin D orally. I personally prefer injections as they are easy to administer and receive. Plus I don’t have the hassle of having to remember to consume them. For me, I always know when I’m running low on Vitamin D when my temperature regulation goes out the door. Cold feels too cold and hot feels too hot.

 

This reminds me, I think I’m due for my winter shot now….

Resources:

  1. Ghorbani, Zeinab, et al. “Vitamin D in Migraine Headache: a Comprehensive Review on Literature.” Neurological Sciences, 2019, doi:10.1007/s10072-019-04021-z.

  2. Guo, Jing et al. “A Narrative Review of The Role of Foods as Dietary Sources of Vitamin D of Ethnic Minority Populations with Darker Skin: The Underestimated Challenge.” Nutrients vol. 11,1 81. 3 Jan. 2019, doi:10.3390/nu11010081

  3. Hanel, Andrea, and Carsten Carlberg. “Vitamin D and Evolution: Pharmacologic Implications.” Biochemical Pharmacology, 2019, doi:10.1016/j.bcp.2019.07.024.

  4. Krysiak, Robert, et al. “The Effect of Vitamin D on Thyroid Autoimmunity in Euthyroid Men with Autoimmune Thyroiditis and Testosterone Deficiency.” Pharmacological Reports, vol. 71, no. 5, 2019, pp. 798–803., doi:10.1016/j.pharep.2019.04.010.

  5. Libon, Florence, et al. “Sunscreens Block Cutaneous Vitamin D Production with Only a Minimal Effect on Circulating 25-Hydroxyvitamin D.” Archives of Osteoporosis, vol. 12, no. 1, 2017, doi:10.1007/s11657-017-0361-0.

  6. Piccolo, Brian D et al. “Circulating 25-Hydroxyvitamin D Concentrations in Overweight and Obese Adults Are Explained by Sun Exposure, Skin Reflectance, and Body Composition.” Current developments in nutrition vol. 3,7 nzz065. 27 May. 2019, doi:10.1093/cdn/nzz065

  7. Webb, Ann R et al. “Colour Counts: Sunlight and Skin Type as Drivers of Vitamin D Deficiency at UK Latitudes.” Nutrients vol. 10,4 457. 7 Apr. 2018, doi:10.3390/nu10040457

Vitamin C – What else does it do for us?

 
 

It has been 7 weeks since my last blog and the clinic has been casually mannered, meaning nothing unorthodox as per patient related issues. The Harpal Clinic Team has a new addition to the team, a copied version of Harpal, whom you may see when you pay us a visit.

Once again, I have been encouraged to write about this vitamin c topic by the new intravenous therapy clients, whom have the basic understanding of this essential nutrient.

By the end of this article, like vitamin c, I hope you find this fruitful to your immune system, to support and simplify recent understandings behind it.

Without consciously thinking, the food of choice for vitamin c intake is an orange, for me at least. Possibly, the most popular amongst the huge variety of fruits and vegetables we can source from. Again without determinedly thinking the benefits of this nutrient, it is necessary for growth and our immune system. As basic as that sounds, this does not explain it all, because every other micronutrient we eat does almost the same job, therefore, a bit more insight into it feels relevant.

Vitamin c is important and chronic deficiency in it can result in scurvy. Fortunately, scurvy is rare and almost exclusively associated with malnutrition, malabsorption or psychiatric disease. Since we can almost entirely defend ourselves from this disease, which has not been epidemic for a very long time, at least in the United Kingdom, little attention has been highlighted on it’s supporting role.

It is commonly known that, to provide antioxidant protection, a Recommended Dietary Allowance (RDA) of 90 mg/day for adult men and 75 mg/day for adult women is set based on the vitamin C intake to maintain near-maximal neutrophil concentration with minimal urinary excretion of vitamin c. Despite this RDA, several studies have also reported the benefits of “intravenous high doses” which can be adequately taken without any health implications, interestingly; these doses support our health.

Benefits:

  • Biosynthesis of collagen

  • Regulation of HIF-1α, which plays an integral role in the body’s response to low oxygen

  • Confers mitochondrial protection against oxidative injury.

  • Activation of the B vitamin, folic acid

  • Conversion of cholesterol to bile acids

  • Conversion of the amino acid, tryptophan to the neurotransmitter, serotonin

  • Reduces the severity of allergic reactions

  • Protects body from deleterious effects of free radicals, pollutants and toxins

  • Tissue healing

Most recently, research has shown it to be a key antioxidant of the Central Nervous System, as multiple evidence links oxidative stress with neurodegeneration, positioning redox imbalance and reactive oxygen species as a cause of neurodegeneration.

Having explained the goodness of vitamin c, which I have only written a tenth about, it is only fair to highlight the potential side effects. The side effects are, ingesting a large dose may cause gastrointestinal distress and diarrhoea. On it’s own it works well but is effective as an adjunct supplement. Also, there have been isolated cases of allergic reactions with eczema, urticaria and asthma. Otherwise, the benefits here outweigh the risk, in this article, the risk being the benefits.

Why Some Vegetarians or Vegans Thrive and Others Fail

I’ve started seeing more and more people coming in for injectables and intravenous drips like Vitamin B12, B Complex, high dose Vitamin C, glutathione, Magnesium, amino acids and D amongst others. However, new Vitamin B12 patients far outnumber the rest and many of them are vegetarians or vegans. Many of these patients have also chosen to eat this way later in life ie teens or later. There is a great deal of awareness within this community and they choose to eat this way, accepting that they need to do more to counter the potential nutritional shortfalls.

Surprisingly, I don’t see many who are born into vegetarian families (due to religion or culture) where they have eaten this way for generations. This suggests that they either are relatively unaware (I somehow don’t think that this is the issue), or that they are more ‘adapted’ to this way of eating. My believe is that epigenetics is at play here.

 

Coming from a culture where I’m familiar with vegetarianism for religion purposes, and knowing what I do now about some problems that vegetarianism brings about; this article that I’m about to share has always been a question in my mind and something that I’ve been meaning to explore. It’s so well written and researched that I don’t need to add much to it besides introducing you to the writer of that blog post and giving you my 2 cents about it.

 

The article discusses 4 points and is written by Denise Minger. Denise’s blog site https://rawfoodsos.com/  went viral after she published her findings regarding the China Study, which is possibly the most famous pro-vegan study out there. Her quest started when her usually perfect teeth was found to be full of cavities despite doing everything by the book to stay ‘healthy’. Being a naturally curious sort, she delved into the China Study and actually took the trouble to analyse the data. There she found many discrepancies which sadly enough does happen in the scientific world where data is ‘tweaked’ to fit in with the original hypothesis. Her work is relevant and needs to be read.

 

My personal opinion:

  • Veganism does not suit everyone

  • If this is how you choose to eat, do take extra care to ensure that you are getting all the relevant nutrition (possible from plant sources eg seaweed, natto, marmite etc) and constantly be on the lookout for symptoms of deficiencies

  • If you have indigestion, increased acid reflux, gas and bloating or prone towards soft or hard stools, you probably have some gut issues. This means that absorption of nutrients won’t be as good

  • If you constantly take antibiotics or have done so in the past, your gut bacteria may be deficient; again potentially leading to problems with gut nutrient absorption

  • Every so often, consider injectables as it won’t get lost in the gut.

  • If you already have symptoms, consider a course of injectables initially more frequently (eg weekly or fortnightly depending on which nutrient) before you taper it off. This is to allow your body to heal to a point where you won’t go back to ‘baseline’ so quickly. There’s also the problem of getting used to a certain level of energy. Most people with very low energy levels can never figure out how others go on. They also tend to be very happy with every little uplift in energy; forgetting what its like to have full functional energy. I just don’t think it makes good sense when cumulative additional changes make such a huge change in a person’s health. The time to stop would be when you start seeing negligible results. That usually means that you’re either optimised or if you’re still tired, that there is another reason for it.

 

I hope that you will enjoy this article…..

https://authoritynutrition.com/4-reasons-some-do-well-as-vegans/

 

Vit D- My Unbelievable Labs

This is a slightly more personal blog post as I’m still a little flustered about it.

 

I’ve been taking patient’s bloods and interpreting their labs for a long time now. My personal health, alongside my patients, has increased leaps and bounds (I do take a bit of my own advice!!). I have good hair and glowing, clear skin, good gut and good energy levels. On the whole, I’m in a pretty good place. Recently, I had the opportunity to get my blood drawn and decided to see what my labs look like.

 

Results came back and most things were as expected, except for my Vit D which was below normal. This annoyed me that the labs would make a mistake. So we called them up and asked them to retest it. I had had a Vit D injection, the whole 300,000 IU of it, just a couple weeks before. The results were clearly a lab error.

 

They retested it and it came back still in the red- very, very low, but a different number to before. This got me thinking. I’ve been raving about the benefits of Vitamin D to all my patients. I’ve asked them all to get an injection as I’d personally seen the benefits in myself and my patients. What was going on?

 

In 2015/2016, I’ve probably had 4-5 injections of Ergocalciferol, or Vit D2. Each time 300,000 IU. I haven’t taken any extra supplements at home. I went on a 2 week outdoorsy holiday in July/August and still have the tan from it now (November). The first injection was a life changer. I was extremely hot the night of the injection. Next day, I was bouncing. Similar but not as dramatic improvements with the next few injections. I needed very few clothes compared to others, could handle cold more than others (no coat in summer and only lightweight coats in autumn versus others who needed much more). In fact, I still go out with bare legs now.

 

My symptoms which made me think that I may be low in D again:

 

  • Energy levels were good but I started to find it slipping

  • I wasn’t recovering from night outs as well as usual

  • I also started noticing quite significant hair loss

  • My skin was simply not as smooth and blemish free as before. It was also duller

  • More importantly, I felt colder than I thought I should be feeling

  • I was feeling too hot or too cold suddenly- temperature regulation wasn’t right. This was a classic red flag for my own body and I recognised it

 

After my last injection, once again I didn’t feel the cold that much and temperature regulation improved. Energy levels came back but I was still more tired than usual. Yesterday- after the shock of my horrendous results- I had another D shot. I slept very well at night. Hands and feet are still cool but not cold. I feel good and fresh. I’ve had a birthday since with wonderful friends and parties for most nights of the week last week. And I’m still up and raring to go.

 

What hits me is that despite doing this for a living, I was oblivious to how low my own levels were. It must have been dangerously low when I first did a D shot. I come across as being bouncier and more energetic than most people. Even I realise that I’ve higher energy levels than others. So where does that put others? I think personally, because I make sure I’m balanced in other ways, it has not been obvious that I was so deficient. But its a cautionary tale nevertheless and I know that I will be making much more efforts to get myself tested more regularly and to make sure that I’m optimised nutritionally. Since my body cannot seem to make enough from all the sun I get (more than many others and usually without SPF on my body). I will also look into simpler and more cost effective ways to test for it so that patients can get themselves tested without too much effort. Watch this space…..

FYI, we have now introduced many more injectable services like our B cocktail (B12+B Complex), C, Magnesium, Glutathione etc as an injection or an intravenous push (for larger volumes). Do check our website more for info. My patients seem to love it as they keep coming back, despite the slight ouch!