Photos above and on the left: Albert von Szent-Györgyi

Vitamin C

Important information about vitamin C 1,2

Vitamin C was first discovered in 1928 by a Nobel Prize winner Albert von Szent-Györgyi.

Vitamin C is the most well-known and popular vitamin needed for the proper course of many life processes. The largest amounts are found in organs with high metabolic acitvity, including in the adrenal glands, brain, pancreas, stomach and lungs.

The minimum daily requirement for vitamin C is the largest of all the vitamins. It is about 1 mg/kg of body weight in an adult, and approximately 2 mg/kg of body weight in infants and children. The daily requirement for vitamin C increases in pregnant and breastfeeding women (to about 1.5 mg/kg of body weight) and in various medical conditions (arterial hypertension, diabetes mellitus, in patients on renal dialysis), as well as in smokers and in people who are under stress. It is also increased after strenuous, long-lasting physical activity, and in the case of vomiting, lack of appetite and abnormal bowel function.

Due to lack of enzyme L-gulonolactone oxidase, the human body is unable to produce vitamin C on its own and must get it from food and/or supplementation.

VITAMIN C

Vitamin C can be used:

  • in order to contribute to maintain the normal function of the immune system,
  • in order to contribute to normal collagen formation-for the normal function of blood vessels, cartilage and bones,
  • to protect the cells from oxidative stress- cause by, e.g.:

-stress,

-stimulants,

-intense, regular physical effort,

-improper diet,

-environmental pollution (e.g. pesticides, heavy metals),

-excessive exposure to sunlight,

-age. 21-23

  • in dentistry- vitamin C participates inthe  formation of collagen present in dentine, gums and bones, supporting their proper functioning, hence it can play a significant  role in e.g. implantology, orthognathic surgery, 18, 24, 25
  • as the vitamin of beauty- vitamin C helps in the normal formation of collagen, which is the main building component of the dermis,16
  • to increase iron absorption.

It is a very good antioxidant that effectively “sweeps away” free radicals, reducing the amount of damage at the DNA level, but also damage to proteins and lipids. 1,2

  • It takes part in the regeneration of vitamin E, thus strengthening the antioxidant effect.
  • Thanks to antioxidant properties, it protect cells of the immune system (including neutrophil cells, lymphocytes, macrophages) against oxidative stress, significantly increased during infection due to the production of endogenous radicals. 26
  • The decreased level of vitamin C is observed in patients:

- with an improper diet, poor in fruits and vegetables,

- hospitalized, 26,27

- in a critical condition. 28

 

It may demonstrate protective properties against many toxic substances, e.g. carcinogenic effects of N-nitroso compounds.2,12

It also stimulates the synthesis of norepinephrine and L-carnitine which help to maintain low level of fat tissue. Therefore, vitamin C may be helpful in regulating body weight.2,20

It plays a significant role in the proper functioning of the immune system, stimulates the proliferation of T-cells in response to infections, affects the function of neutrophils. It has antiviral and antibacterial effects, reduces the severity and duration of cold symptoms. 15,19

Thanks to its antioxidant properties, vitamin C plays a crucial role in prevention of atherosclerosis, by inhibiting the oxidation of LDL (Low Density Lipoprotein) and by reducing leukocyte adhesion to the vascular endothelium. 5, 7

It is worth to know that unused vitamin C is eliminated from the body. Therefore, it is important to take vitamin C regularly in order to maintain its adequate levels.

What are the symptoms of vitamin C deficiency? 2, 17

  • reduced immunity,
  • increased susceptibility to infections,
  • decreased physical performance,
  • impaired wound healing,
  • impaired collagen formation,
  • gingival bleeding,
  • impairment of all other processes which require and involve vitamin C,
  • scurvy.
 

In addition, long-term vitamin C deficiency may intensify the formation of canceorus and atherosclerotic changes, as well as increase blood pressure.

Elderly people, alcoholics, smokers and people on certain medication (e.g. aspirin, sulfonamides, barbiturates) are at risk of vitamin C deficiency.

Increased demand for vitamin C is observed 17

  • in pregnant and breastfeeding women,
  • under stress,
  • in smokers, people who abuse alcohol,
  • when using contraceptive pills, tetracyclines, barbiturates, corticosteroids,
  • in city dwellers (due to omnipresent pollutants and toxins),
  • during febrile states, infectious diseases, peptic ulcer disease,
  • with regular intake of acetylsalicylic acid or other salicylates,
  • in the elderly, surgical patients, people with tissue injuries,
  • in people leading very intensive lifestyle.

References

  1. Maćkowiak K., Torliński L.: „Współczesne poglądy na rolę witaminy C w fizjologii i patologii człowieka”; Nowiny Lekarskie 2007, 76, 4, 349–356.
  2. Janda K., Kasprzak M., Wolska J.: „Witamina C – budowa, właściwości, funkcje i występowanie”; Pomeranian Journal Life Sciences 2015, 61,4, 419–425.
  3. Zielinska-Pisklak M., Szeleszczuk Ł., Kuras M.: Rola witaminy C i cynku we wspomaganiu układu odpornościowego. lekwpolsce.pl, vol. 23, nr 11–12’13 (271–272).
  4. Hacisevki A.: ,,An overview of ascorbic acid biochemistry”; Ankara Ecz. Fak. Derg. 2009; 38(3): 233–255.
  5. Naidu K.A.: “ Vitamin C in human health and disease is still a mystery? An overview”; Nutrition Journal, 2003, 2:7.
  6. Sorice A. et al.: “Ascorbic Acid: Its Role in Immune System and Chronic Inflammation Diseases”; Mini-Reviews in Medicinal Chemistry 2014, 14(5):444–52.
  7. Iqbal K. et al.:,,Biological significance of Ascorbic Acid (Vitamin C) in human health – A review”; Pakistan Journal of Nutrition, 2004; 3(1): 5–13
  8. Aghajanian P. et al.: ,,The roles and mechanisms of actions of vitamin C in bone: new developments”; Journal of Bone and Mineral Research 2015; 30(11):1945–55.
  9. Desai C. K.. et al.:"The Role of Vitamin Supplementation in the Prevention of Cardiovascular Disease Events”; Clinical Cardiology 2014; 37(9):576–81.
  10. Grosso G. et al.: ,,Effects of Vitamin C on health: a review of evidence”; Frontiers in Bioscience (Landmark Ed). 2013 Jun 1;18:1017–29.
  11. May J. M. et al.:,,Ascorbic Acid Efficiently Enhances Neuronal Synthesis of Norepinephrine from Dopamine”; Brain Research Bulletin 2013; 90:35–42.
  12. Szymańska-Pasternak J. et al.: ,,Witamina C jako oręż w walce z rakiem”; Onkologia w Praktyce Klinicznej 2011, 7(1): 9–23.
  13. Ellulu M.S. et al.: ,,Effect of vitamin C on inflammation and metabolic markers in hypertensive and/or diabetic obese adults: a randomized controlled trial”; Drug Design, Development and Therapy 2015; 1,9:3405–12. doi: 10.2147/DDDT.S83144.
  14. Kulbacka J., Saczko J., Chwiłkowska A.; „Stres oksydacyjny w procesach uszkodzenia komórek”; Pol. Merk. Lek., 2009; 27, 157, 44–47.
  15. Chambial S. et al.: “Vitamin C in Disease Prevention and Cure: An Overview”; Indian J Clin. Biochem.;2013; 28(4): 314–328.
  16. Pullar J.M. et a..: The Roles of Vitamin C in Skin Health. Nutrients 2017; 9, 866; doi:10.3390/nu9080866.
  17. Miktus M.: Witaminy – część II: ogólna charakterystyka witaminy C. Nutrition&Health 2000, 3, 1 (12), 1–4.
  18. Winkler S.: Extraordinary implant failure. Journal of Oral Implantology 2010, 36(5): 391–400.
  19. Jariwalla R.J., Harakeh S.: Antiviral and immunomodulatory activities of ascorbic acid. Sub-cellular biochemistry 1996; 25, 213–231.
  20. Johnston C.S. et al.: Marginal vitamin C status is associated with reduced fat oxidation during submaximal exercise in young adults. Nutrition & Metabolism 2006; 3:35 doi:10.1186/1743–7075–3–35.
  21. Birben E. et al.: Oxidative Stress and Antioxidant Defense. World Allergy Organization 2012; 5:9–19.
  22. Pham-Huy L.A. et al.: Free radicals, antioxidants in disease and health. Int J Biomed Sci 2008; 4 (2): 89–96.
  23. Rahal A. et al.: Oxidative stress, prooxidants, and antioxidants: the interplay. BioMed Research International 2014; 2014: 761264.
  24. Abrahmsohn G.M. et al..: Vitamin C and dental healing: testing and placebo effect. General dentistry 1993; 41 (6): 523–527.
  25. Bsoul S.A., Terezhalmy G.T.: Vitamin C in health and disease. Journal of Contemporary Dental Practise 2004; (5)2:001–013.
  26. Robitaille L., Hoffer J.: A simple method for plasma total vitamin C analysis suitable for routine clinical. Nutrition Journal 2016; 15:40.
  27. Wang Y. et al.: Effects of vitamin C and vitamin D administration on mood and distress in acutely hospitalized patients. Am J Clin Nutr 2013; 98:705–11.
  28. Schorah C.J. et al.: Total vitamin C, ascorbic acid, and dehydroascorbic acid concentrations in plasma of critically ill patients. Am J Clin Nutr 1996; 63:760–5.
  29. Schonberger K., Cabezas-Wallscheid N.: Vitamin C: C-ing a new way to fight leukemia. Cell Stem Cell. 2017; 21(5):561–563.
  30. Miller P.G., Ebert B.L.: Vitamin C regulates stem cells and cancer. Nature 2017; 549:462–464.
  31. Gillberg L. et al..: Vitamin C – A new player in regulation of the cancer epigenome, Semin Cancer Biol. 2018; 51:59–67.

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