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Don’t ignore Vitamin C

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People in the low-carb community tend to ignore vitamin-C. I think this is incorrect and I am now of the opinion that we all need to supplement with higher doses of Vitamin-C. That includes people that eat fruit and vegetables on a regular basis.

Here’s why.
Vitamin-C is a key evolutionary mechanism to keep our heart healthy and safe from heart attacks. So please don’t ignore Vitamin-C.

Let’s deep dive into the world of vitamin-C, shall we? It is indeed a fascinating story.

The low-carb basics

Low-carbers argue that eating less carbohydrate results in needing less vitamin C. This is because glucose competes with Vitamin C for access to the same metabolic pathways in the body, which is true.

So if your carbohydrate intake is high, you will have to increase your intake of vitamin C containing foods or natural supplements to get enough vitamin C to overcome the high blood sugar. It’s only when eating the so called standard American diet which is high in carbohydrates and grain consumption that vitamin C needs are higher. Lowering your carb intake lowers the need to supplement with Vitamin C.

On the other side people doing keto can get enough vitamin-c by eating many fresh, low carb vegetables such as peppers and dark leafy greens like kale and broccoli that have loads of vitamin C. This type of eating will probably help you meet your RDA of 80mg and avoid scurvy which is a typical symptom of low vitamin-C and will result into bleeding gums.
 
As we will see further down, this is hardly enough when we are talking about how we approach longevity today and living into our 90s.
 

The history

Where history comes into play is that animals are able to make vitamin C. In fact, we’re one of the only mammals that can’t. Unfortunately, we lost that ability a few million years ago.  This means that we need to get 100% of the Vitamin C our bodies need from our diets. 

Most animals are able to synthesize a significant amount of the vitamin on their own, while humans are deprived of this capability due to a series of mutations of the key gene in the vitamin C biosynthesis.  Probably from one of natures few mistakes. This actually led to issues as we will see further down as lack of vitamin-c leads to issues of the artery wall integrity. As a result of lack of vitamin-c during certain periods of the year there was a mutation created which led to apo(a) and lp(a) to protect us from excess bleeding by forming clots.

Animals synthesize it from glucose, in four steps. Humans have retained the first three steps but lack the fourth. We lost this fourth step about forty million years ago. Perhaps because we learned to re-cycle vitamin C within our red blood cells, so we need far less of it. This is called ‘electron transfer hypothesis.’ If making Vitamin C uses up resources that we need for other thing, just eat it, there is plenty about.

Summary

  • Humans lost the ability to synthesize vitamin C, millions of years ago. As an evolutionary step a genetic mutation gave birth to another mechanism to protect us from bleeding. Welcome lipoprotein(a) and Lp(a). These molecules are protective but also very sticky and difficult to dissolve and are contributing to thrombosis.

Benefits of vitamin-C

Although Vitamin C is a widely recognized, powerful antioxidant it also plays an important role in the many functions in the body.
  • Vitamin-C helps the gut absorb iron (increases absorption up to 4 times).
  • Vitamin-C has been recognized as a valuable factor in skin health, especially given its role in collagen synthesis. Vitamin-C has great potential when it comes to photoprotection, skin dryness, protection against environmental pollutants, as well as wrinkling and other signs of aging.
  • Since vitamin-c is competing with glucose it makes sense that supplementation of Vitamin C can help lower fasting and after-meals (post-prandial) blood sugars.
  • Vitamin-c is also key for our immune system. And because our body requires dietary vitamin C for the immediate defensive response that occurs as soon as we are exposed to germs, as well as the long-lasting, highly-specific response that allows us to develop immunity to certain infections over time. And vitamin C deficiency impairs immunity and increases infection risk.
  • Vitamin-C is also required for the production of L-carnitine and certain neurotransmitters, and it is also an important factor in protein metabolism. 
  • Furthermore, vitamin C is known for its protective role in the body as a physiological antioxidant which has been found to aid in the regeneration of other antioxidants, including vitamin E. What’s more, given its role as a potent antioxidant, vitamin C also appears to combat the free radicals produced by normal metabolic respiration. Moreover, vitamin C has been associated with the proliferation of white blood cells, crucial in the body’s defence against infections, therefore greatly benefiting the immune system.
  • Vitamin C promotes wound healing and shorten healing time. In addition, low levels of vitamin C have been linked to signs of cognitive impairment affecting memory and thinking.
  • Vitamin-C is used to produce collagen. This is key for the health of our heart. One of the primary roles of vitamin C concerns collagen synthesis, as without it the natural production of collagen in the body would not be possible, and we would be lacking this main structural protein. 

Vitamin-C and heart health

It is now well established tha Lp(a) is a sticky type of LDL which helps when there are vascular damage by slowing down bleeding. Lp(a) is genetically coded and does not change much with diet. This process however contributes to arthrosclerosis, but it is an evolutionary protective method in the absense of vitamin-c. 

Here comes collagen into play. Think of collagen as being like the steel bars in concrete, providing support and strength for tissues around the body. Without collagen, things can start to break apart quite dramatically. Blood vessels, for example, need a lot of collagen, as they have to withstand a lot of pressure, and squeezing and bending.  So, one of the first clinical signs of scurvy (Vitamin C deficiency) is often bleeding gums. This is the same in our blood vessels.

  • Vitamin-C comes into play because as we have seen it is essential for collagen production which help keep the arteries strong but also flexible. The body then does not have a need to utililse Lp(a) for patching injuries. Vitamin-C has long been known to participate in several  important functions in the vascular bed in support of endothelial cells. These functions include increasing the synthesis and deposition of type IV collagen, stimulating endothelial proliferation, inhibiting apoptosis (endothelial cell death), scavenging radical species, and sparing endothelial cell-derived nitric oxide to help modulate blood flow. 
  • Vitamin-C also hides Lysine and proline from Lp(a) hydroxylation which are molecules that Lp(a) detects vessels damage and attaches to.

This theory is slowly taking some notice. You can read more about it by Dr Malcolm Kendrick in his recent book The Clot thickens but the notion is now new. Linus Pauling, a Nobel price winner has been talking about the importance of Vitamin-C as the cause of heart disease since 1930s.

A note of caution

  • Without vessel injury, Lp(a) is not deposited, arthrosclerosis is not initiated, there is no abnormal surface upon which thrombosis can occur and coronary artery disease will not happen.
  • Although vitamin-c may not be able to reverse inflammatory vascular diseases such as atherosclerosis, it may well play a role in preventing the endothelial dysfunction that is the earliest sign of many heart diseases.

A different way to look it

The heart disease story has been developing in two different directions. One side side of the coin is the intent to reduce the levels of cholesterol as much as possible which has not led to much success in my opinion. In 1976 the dietary guidelines limited cholesterol to <300 mg/dL and has the limit has been reduced since then with the 2018 guides suggesting that our total cholesterol level should be 200mg/dL or less. The result is still an increase on deaths from heart attacks and an explosion in the use of statins.

The other side of the coin is that slowly a changing trends when it comes to solutions regarding addressing CVD.

  1. Initially, it was only suggested that people need to lower their cholesterol.
  2. Later on, it was suggested to Lower LDL.
  3. Afterwards we gained an understanding that what is more impactful is to lower our oxidised LDL.
  4. Now, many are looking into addressing Lp(a) and getting appropriate vitamin-C doses (but not only of-course).

Summary

  • Both preclinical and clinical data available in the literature show that Vitamin C plays a pivotal role in a number of processes involved in the pathogenesis of CVD

Vitamin-C bioavailability

A bit of definition first. Ascorbic acid is usually referred to a vitamin-c and most vitamin-c supplements contain only ascorbic acid. However ascorbic acid is not the entirety of vitamin C, rather it can be described as the “antioxidant wrapper” that co-occurs with the other parts of vitamin C:  flavonoids, the enzyme tyrosinase, and several other factors that benefit blood vessel strength and the oxygen carrying capacity of red blood cells.  

When it comes to availability, it is important to note that the stability of the vitamin in vegetables and fruits is compromised by numerous factors – including metallic ions, heat, pH, and oxygen – which may lead to oxidation of vitamin C.

Pro Tip

  • When cooking, add lemon or other vitamin-C sources at the end of cooking to avoid destroying the vitamin-C. Same stands for tea. Let your tea cool down before adding lemon juice.

Approximately 70%–90% of vitamin C is absorbed at moderate intakes of 30–180 mg/day. However, at doses above 1 g/day, absorption falls to less than 50% and absorbed, unmetabolized ascorbic acid is excreted in the urine. This is is because normal ascorbic acid is water soluble, meaning it’s absorbed in water. Although our bodies contain a lot of water, the structure of our cells is made of lipids—fat. As we know, oil (fat) and water do not mix; they repel each other. This means that water soluble vitamin C is not absorbed very well into our cells where it is most needed. 

Liposomal vitamin C on the other hand, is encased in a liposomal form—surrounded by a lipid bilayer that allows for easier access into the cell. This means that it is far more absorbable and bioavailable in the body, ready to be used as needed. 

Final thoughts

There are many conclusions one can draw from this post. Here are my thoughts based on everything discussed in this post.

First of all, I generally argue that supplements should be used only as the word is intended to. Supplementing. Vitamin-C for example helps us absorb iron but also is critical for collagen production. So taking supplements in isolation is proven not to be useful in many cases. So we should include lemons and fruit in our daily life even if following a keto lifestyle. Berries and peppers are quite high in vitamin-C and low in sugar.

I also think that evolution does not make mistakes. The Lp(a) mutation was a protective mechanism to keep human race alive. Let’s not forget that the priority of the body is reproduction not longevity. So going back in time, this must have been a life saver. 

However, the way most of us lead our lives is full of stress, lack of connecting with nature and full of toxins. We may want to live until we 100 years old but we are not giving ourselves a chance to do so. So we need to consider tools, biohacks, that help us optimise certain processes in our body. Optimising Vitamin-C levels is one of the most powerful biohacks.

I have been recently been including more fruit and in my diet and have been supplementing with 1gr of a liposome vitamin-c from Altrient and I believe all of us can benefit from more vitamin-C.

Of-course, when it comes to keeping our heart healthy there are many more things to do, but these are for separate posts.

Further reading

  1. Check your iron status | ketOntrack
  2. Ascorbic Acid and the Immune System
  3. New Developments and Novel Therapeutic Perspectives for Vitamin C | The Journal of Nutrition | Oxford Academic (oup.com)
  4. Glut-1 explains the evolutionary advantage of the loss of endogenous vitamin C-synthesis | Evolution, Medicine, and Public Health | Oxford Academic (oup.com)
  5. Supplementation of Vitamin C Reduces Blood Glucose and Improves Glycosylated Hemoglobin in Type 2 Diabetes Mellitus: A Randomized, Double-Blind Study – PMC (nih.gov)
  6. Vitamin C and Immune Function – PubMed (nih.gov)
  7. Vitamin C and Skin Health | Linus Pauling Institute | Oregon State University
  8. Let’s talk about C – just you and me | Dr. Malcolm Kendrick (drmalcolmkendrick.org)
  9. Role of Vitamin C in the Function of the Vascular Endothelium – PMC (nih.gov)
  10. The Epidemiology of Coronary Heart Disease | Revista Española de Cardiología (revespcardiol.org)
  11. AHA Dietary Guidelines | Circulation (ahajournals.org)
  12. History of the Dietary Guidelines | Dietary Guidelines for Americans
  13. Dietary goals for the United States – NALDC (usda.gov)
  14. Vitamin C supplementation lowers serum low-density lipoprotein cholesterol and triglycerides: a meta-analysis of 13 randomized controlled trials – PMC (nih.gov)
  15. How Your Lipoprotein(a) Level Affects Your Risk of Heart Disease | RHR (chriskresser.com)
  16. Changes in lipoprotein(a), oxidized phospholipids, and LDL subclasses with a low-fat high-carbohydrate diet – PMC (nih.gov)
  17. Increased plasma concentrations of lipoprotein(a) during a low-fat, high-carbohydrate diet are associated with increased plasma concentrations of apolipoprotein C-III bound to apolipoprotein B-containing lipoproteins – PubMed (nih.gov)
  18. Modification of lipoproteins by very low-carbohydrate diets – PubMed (nih.gov)
  19. Efficacy of Vitamin C Supplementation on Collagen Synthesis and Oxidative Stress After Musculoskeletal Injuries: A Systematic Review – PMC (nih.gov)
  20. Vitamin C and Cardiovascular Disease: An Update – PMC (nih.gov)
  21. Vitamin C and Heart Health: A Review Based on Findings from Epidemiologic Studies – PMC (nih.gov)
  22. Antioxidant Vitamins and the Prevention of Coronary Heart Disease (aafp.org)
  23. Can Vitamins Help with Heart Disease? (aafp.org)
  24. Vitamin C and Ascorbic Acid Are Not the Same Thing — Arthur Haines
  25. Vitamin C – Health Professional Fact Sheet (nih.gov)
  26. Liposomal-encapsulated Ascorbic Acid: Influence on Vitamin C Bioavailability and Capacity to Protect Against Ischemia–Reperfusion Injury – PMC (nih.gov
  27. Vitamin C and Lipoprotein – YouTube
  28. Linus Pauling lectures on Vitamin C and Heart Disease (lbl.gov)
  29. Linus Pauling’s Vitamin C Therapy: A Personal Experience | OptimaEarth Labs

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