Here's some interesting reading regarding antioxidant supplenentation that I came across a while back:

http://lpi.oregonstate.edu/s-s00/recommend.html

"With respect to the UL, we agree with the Panel that there is no scientific evidence that even very large amounts of vitamin C are toxic or exert adverse health effects. Specifically, in healthy individuals vitamin C does not cause mutations, cancer, birth defects, hardening of the arteries (atherosclerosis), kidney stones, pro-oxidant effects, "rebound scurvy," excess iron absorption, vitamin B12 deficiency, allergic response, or erosion of dental enamel. The Panel used osmotic diarrhea and gastrointestinal disturbances as criteria to determine the UL for vitamin C and arrived at a level of 2 grams/day. We disagree with this conclusion because it is based primarily on data from uncontrolled case reports. Some studies have reported no gastrointestinal disturbances or diarrhea at up to 6 grams/day of vitamin C, and gastrointestinal disturbances have been observed at widely differing threshold levels (from 3 grams/day up to 10 grams/day). More importantly, we believe that diarrhea and gastrointestinal disturbances are not toxic or severe enough effects to justify a UL based on these criteria. Thus, the side effects of vitamin C are generally not serious, and individuals experiencing these effects may easily eliminate them by reducing vitamin C intakes.

Based on our review of the literature, we conclude that the RDA for vitamin C should be 120 mg/day for optimum risk reduction of heart disease, stroke, and cancer in healthy individuals. Special populations, such as older adults and individuals with disease, may require substantially larger amounts of vitamin C to achieve optimum body levels and derive therapeutic benefits. Furthermore, we conclude that there is currently no consistent and compelling data for serious adverse effects of vitamin C in humans, and a UL can therefore not be established."

I think in order to take vitamin C in that volume (20 grams a day) you'd definitely want to take it in a buffered form (ester-C, e-mergen-c, or with rosehips, etc...) that much straight up, unbuffered vitamin C can really make the old stomach hurt.

My Chiro/Applied Kinesiologist (Basically who regards everyone but himself with disdain for how they nourish themselves) recommended to me, once upon a time, that I should ingest Vitamin "C" in increasing doses until I reached a point that I believe Molina described as "sublime evacuation". He (chiro) said it was a good way to detoxify the bod. I think I was fighting a cold or some such at the time?

Who knows, he does this voodoo thing where you hold your arm up and then he mentions a laundry list of whatnot while pushing on your arm. If your arm drops it means something. PFM (Pure F'ing Magic) if you ask me but he's bandaged up myself and a couple of my buddies so I humor him.

FWIW



John

I'm also a chiro but am very skeptical of any chiro that holds himself up as a nutrition expert. I'm also very skeptical of A.K.

One of the earlier pioneers in high dose Vitamin C was Linus Pauling. He was a Nobel Prize winner but his work on Vitamin C was always contraversial. My master's degree was in biochemistry/nutrition and I remember studying some of his work albiet quite a while ago.

Here is an interesting site.

http://lpi.oregonstate.edu/...r/vitamins/vitaminC/

try reading "Optimum Sports Nutrition" by Colgan. He has a newer book,"Sports Nutrition Guide" which overlaps the content, but they both are needed to get his info.

Recommends 2 to as much as 12 grams/day, and gives suggestions as to decide what is right for you as we are all different. Furthermore, I have found by following those recommendations that I need more some days and LESS other days. So my base amt is 2 grams, and if I had perhaps too hard a workout I will take more in the evening. Then, if I begin to have problems breathing because of a lung infection or sinus problems, I take more. For example I took 5 grams the next morning and then 5 grams at lunch and 5 grams in the afternoon and then 5 grams before bed. The very next day I took only 5 grams 3x for a total of 15 grams. All calcium ascorbate, straight ascorbic acid does not work well for me.

Just curious, danb, as to what scientific evidence he gives for recommending such high doses of vit C.

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If it's research you want, search on Linus Pauling. He is a Nobel Prize winner in Chemistry who went on to study Vitamin C. Most recommendation for high doses come from this research...

- Dennis

Well, I am not trying to fight, but how do I take your question? Let's see, you don't even want to consider looking at the book?

Dr. Colgan seems like a careful man, who claims to have coached thousands of athletes. He cites 4 studies on high doses of C, in the bibliography to Ch17,one is his own so it can be discounted if you wish. According to him, I have not read the source materials, the range of C doses indicated do not show negative effects.

The rational for recommending high doses is based on more than 18 years experience helping athletes. In the second book the higher average recommendation for C is lowered to 4 grams. Referenced too but more scattered in the biblio.

I read both books and benefited. Then shared this with the reader who posed a question. What have you to offer? Suggest a book that supports your growth and/or rehabilitation as an athlete and I WILL GLADLY read it as soon as I can obtain it.

Dan

20 grams LOLOLOL. Molina peed 15 grams of vitamin C on that day, if not more. that makes a extremely expensive urine!!

Sergio Marques

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S�rgio Marques
When it hurts is when it feels good ;-)
Sergio-Marques.com

i may be the antithesis to this whole discussion. i'm a GP and i never recommend vitamin supplementation to normal patients--normal meaning their illnesses are not directly related to a vitamin deficiency such as scurvy, osteoporosis, pernicious anemia and neuropathies due to vitamin b deficiencies, etc. If have rarely found that in patients with no predilection to deficiency (anatomic, biochemical, disease states, malutrition) is there a need to supplement anything other than what you would get from a healthy diet of high carbs, moderate protein, low-fat,lots of veggies and fruits. The literature simply does not support the common lay man's belief that more is better. No conclusive evidence that it prolongs life, or lowers risk for heart disease, and certainly nothing to say that it helpe enduranec sport performance. In most cases--vit c for example, side effects are uncommon and not really threatening as the kidney just excretes the excess. In other cases--such as vit. e, serious complications may arise with overdosing.

as a triathlete--I have never found the need to supplement with anything as I have a typically asian diet. high carbs, lo-fat, modest protein. I have never had symptoms of vitamin deficiency. does this affect performance in terms of possible benefit that i might not be getting? I seriously doubt because again the body just gets rid of the excess.

over the years, people have been brainwashed by pharmaceutical companies to believe that they need supplements. it is a billion-dollar industry. in my 3rd world practice in the Philippines, it is so frustrating to hear patient's questions about what vitamins to buy for their cough and in the same breath they'll tell you they can't afford anti-TB meds.

at least for me, it is my personal crusade to debunk the pharmaceutical myths that my patients beleive surrounding vitamin supplementation.

Kim

More than what, the RDA? There is plenty of literature that supports doses of some vitamins and minerals above the RDA. You have access to Medline I assume so just do a search and see what comes up. Do you understand how the RDA is arrived at? Do you think ultra-endurance athletes have the same nutritional requirements as the general population?

I'm not trying to advocate mega-dosing and I understand your frustration with supplementation that, in the best case gets pissed out, but that doesn't mean taking the extreme opposite stance is correct either.

Not trying to fight either dan. I just wondered since advocating such high doses is not common practice... I don't know any MD who recommends anything higher than 400-500mg/day - still well above the RDA which many folks believe is too low.

I guess I should try and find some of these studies. (I'm not opposed to looking at the book, but don't really want to buy it) But for me to take 10X my normal Vitamin C (that's with supplmentation!), I'd need some pretty strong convincing.

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I just found this on the web - I'm making the assumption that the Colgan quote is accurate:

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But aren't you simply making expensive urine when you take large amounts of supplements?

Dr. Michael Colgan investigated this often made rebuttal. He investigated how much vitamin C we use by giving increasing daily doses and measuring excretion. "Only a quarter of our subjects reached their vitamin C maximum at 1,500 mg a day. More than half required over 2,500 mg a day to reach a level where their bodies could use no more. Four subjects did not reach their maximum at 5,000 mg." Increasing vitamin C intake from 50 mg to 500 mg tends to double serum vitamin C levels.

Increasing intake to 5,000 mg a day will double serum levels again. Expensive urine? Vitamin C protects the bowel, kidneys and bladder on the way out. As Dr. Michael Colgan points out the average victim of bowel or bladder cancer spends $26,000 for treatment - mostly to no avail.
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So if I read this right, 25% of people that he has looked at max out at 1.5g/day. >50% maxed out at 2.5g/day. Given this, a dose of 4g seems a little silly and 20g seems riduculous. Also, since I take 500mg/day, I'm probably doubling my serunm vitamin C levels compared to diet only. Super. But to double it again I'd have to increase my supplmentation 10X... thats a lot of money and a good possibility for GI distress.

Here's my disclaimer: if Colgan really has evidence that athletes need more vitamin C and don;t max out betwen 1.5 and 2.5g, I'll take it back.

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Here's Colgan's website

http://www.colganinstitute.com/index.htm

Check it out, and decide for yourself if he's truly being objective and unbiased in his mega-dose reccomendations. And if you think he is, feel free to order some vitamin C ($14.25 for 45g - that will last Molina a little more than 2 days)

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http://www.ncbi.nlm.nih.gov/...26&dopt=Abstract

http://www.ncbi.nlm.nih.gov/...22&dopt=Abstract

http://www.ncbi.nlm.nih.gov/...74&dopt=Abstract

http://www.ncbi.nlm.nih.gov/...84&dopt=Abstract

Just some of the things I could find. I know there is a general and very recent consensus statement from the NIH regarding a whole host of vitamins/minerals and their RDAs which I can no longer find in my files. I do remember though that again there was no evidence to support mega-dosing. The first one I cited here is particularly interesting as it does say that there is no evidence yet to suggest that taking in more than the RDA does anything beneficial. And I also believe that the RDA can be achieved with the proper diet w/o the need for supplements. Supplementation was only recommended for special populations--notably children, elderly, pregnant women, and smokers. I could not find any articles that would relate to endurance athletes. There was sufficient evidence though that vitamin C in particular is safe even in very high doses, so if anybody wants to down 20g/day go ahead, but practicing evidence-based medicine is not just about eliminating practices which are harmful but also eliminating practices which are not proven to work because of the cost to society that it entails.

Kim

1) And I thought my C was expensive at 1/3 the price of yours. Sometimes I buy it in bulk powder, even cheaper. I think the power tastes bad like a grassy taste, so I do not use it all the time. The tablets are swallowed so no taste.

2) Normally, I am using Nature'sLife c-1000Ascorbate tablets, that is a calcium ascorbate formula. Or almost any other NON ascorbic acid C.

3) as I said I normally take smaller amounts, just take more when I feel I need it.

4) In addition to the effects I mentioned above, I have found that normal black-and-blue bruising and swelling do not occur with injuries if I have enough C. Nor does out and out pain after exercise. I have repeated this experiment many times. These effects seem to be related to my low saturated fat diet too. FLAME ON.....

5) back to cost.... If I AVERAGE 5gm/day max then I look at all the complaints I have w/o supplementation and look at the scary cost of those KNOW-it-all doctors ( a visit to the clinic will cost $100.00 easy even if there is no resolution of any problem and if they are not open then wait in the emergency room for 5 hours to be seen and pay $300.00 for 2 minutes maximum of the docs time and no other service ..... hummm), I say the cost is worth it. Look guys, a cup of espresso costs at least $2.00, I'm spending 65 cents per day on C.

4) As w/ most books, Colgan's are not perfect, but do require reading more than a sentence or two to understand why he makes his statements. OTOH, I was experimenting on myself before I read his book plus some others and found the reasons why what I had found worked.

5) I have trained on and off for 35 years and never felt as good as in the last 7 since I changed my diet and supplementation.

6) Do doctors now actually learn anything abt exercise or diet in their MD training? They did not in the past. Has this changed? If it has, I would like to see the curriculum. Give a web link to the courses and textbooks. I'll read them with pleasure. Prove I should listen to them.

7) Oh screw you guys why should I help you by telling me what helps me.

8) ok, I'll take that back a little. But why so negative? I did not give abolutes. I just told what works for ME, why I think it is so, and some biblio. Just a suggestion. Not that I attribute speed or anything to it, just that it works for me. Of course if you don't have problems you do not need help, and if you do need help then Colgan's approach might work. Are you afraid to spend $1.00 or $2.00/day to find out?

danb,

i know you weren't replying to me but i just wanted to add a little more. your attitude to supplementation is so similar to a typical patient's response--hey, it works for me so leave me alone. which is perfectly fine too. if i was your doctor i wouldn't stop you just so you wouldn't think i was a prick and never come back to my clinic. but again, if i was your doctor, i do have the responsibility to tell you that to the best of my knowledge what you're doing is not gonna do jack-shit. for too long, medicine has been bogged down by treatments that by logic ought to work but when finally tested do not. there is no longer a place in medicine for anecdotal evidence because it can be dangerous (what if years from now research comes out that vit. c megadosing causes cancer, or impotence, or zits, etc?) and because useless treatments take money away from more worthwhile endeavors--i.e. if the marketing money used on you to convince you to buy vit. c was used to subsidize your healthcare instead then you wouldn't be bitching about exorbitant MD fees.

Kim

P.S. i don't know about the american curriculum, but admittedly there is a lack of training in med school here in the Philippines with regards to the endurance athlete subpopulation. it is a very small and insiginificant population, especially when you consider more pressing concerns such as infectious disease, cancer, malnutrition, etc. and, even if someone were so inclined (as I am) to learn more regarding the special needs of athletes, there is precious little material to find out there. so, personally, i take the view that athletes (who are already so much healthier than the population at large) just need to eat more to meet caloric and nutrient requirments. In my 7 years of triathlon, I have never had symptoms of a vitamin deficiency.

finally found what i was looking for--warning this is looong!

Routine Vitamin Supplementation to Prevent Cancer and Cardiovascular Disease

The U.S. Preventive Services Task Force concludes the evidence is insufficient to recommend for or against the use of vitamin supplements A, C, or E; multivitamins with folic acid; or antioxidant combinations for the prevention of cancer or heart disease. (I recommendation.)

The Task Force found poor evidence to determine whether supplementation with these vitamins reduces the risk for heart disease or cancer. The available evidence from randomized trials is either inadequate or conflicting, and the influence of confounding variables on observed outcomes in observational studies cannot be determined. As a result, the Task Force could not determine the balance of benefits and harms of routine use of vitamin supplements A, C or E; multivitamins with folic acid; or antioxidant combinations for the prevention of cancer or heart disease.

The Task Force recommends against the use of beta-carotene supplements, either alone or in combination, for the prevention of cancer or heart disease. (D recommendation.)

The Task Force found good evidence that beta-carotene supplementation provides no benefit in the prevention of cancer or heart disease in middle-aged and older adults. In 2 trials restricted to heavy smokers, beta-carotene supplementation was associated with higher incidence of lung cancer and higher all-cause mortality. The Task Force concludes that beta-carotene supplements are unlikely to provide important benefits and might cause harm in some groups.

- The Task Force did not review evidence regarding vitamin supplementation for patients with known or potential nutritional deficiencies, including pregnant and lactating women, children, the elderly, and people with chronic illnesses. Dietary supplements may be appropriate for people whose diet does not provide the recommended dietary intake of specific vitamins. Individuals may wish to consult a health care provider to discuss whether dietary supplements are appropriate.

- With the exception of vitamins for which there is compelling evidence of net harm, there is little reason to discourage people from taking vitamin supplements. Patients should be reminded that taking vitamins does not replace the need to eat a healthy diet. All patients should receive information about the benefits of a diet high in fruits and vegetables, as well as information on other foods and nutrients that should be emphasized or avoided in their diet.

- Patients who choose to take vitamins should be encouraged to adhere to the dosages recommended in the Dietary Reference Intakes of the Institute of Medicine. Some vitamins, such as A and D, may be harmful in higher doses; therefore, doses greatly exceeding the Recommended Dietary Allowance or Adequate Intake should be taken with care while considering whether potential harms outweigh potential benefits. Vitamins and minerals sold in the United States are classified as "dietary supplements," and there is a degree of quality control over content if they have a U.S. Pharmacopeia (USP) seal. Nevertheless, imprecision in the content and concentration of ingredients could pose a theoretical risk not reflected in clinical trials using calibrated compounds.

- The adverse effects of beta-carotene on smokers have been observed primarily in those taking large supplemental doses. There is no evidence to suggest that beta-carotene is harmful to smokers at levels occurring naturally in foods.

- The Task Force did not review evidence supporting folic acid supplementation among pregnant women to reduce neural tube defects.

- Clinicians and patients should discuss the possible need for vitamin supplementation when taking certain medications.

For more information, please visit http://www.ahrq.gov/clinic/3rduspstf/vitamins/vitrrpda.htm

Again, you are talking about the RDA. It is established based on statistical consumption of vitamins from a cross-section of the supposedly disease-free population. Do you really think this should be applied to the n% of the population that are (extreme) endurance athletes? Is the total oxidative stress the same between the sedentary and the extremely active?

For example:

http://www.ncbi.nlm.nih.gov/...13&dopt=Abstract

http://www.ncbi.nlm.nih.gov/...36&dopt=Abstract

I'm not saying that supplementation makes a big difference - just that the RDA is not a good standard for endurance athletes. Their nutritional needs are different. We wouldn't recommend the standard 2000 Calorie diet to someone training 20hrs/week, why would we recommend the standard levels of micronutrients?

- Dennis

well...you did a better search than me but as far as I can tell (which is not much since these are abtracts), positive effects of supplementation in both studies are only in biochemical substances posited to be involved in the immune system adn recovery. but how does this effect translate to the real world? were the subjects recovering faster? were the subjects getting less colds or other infections? experimentally the evidence is there but this is not evidence of clinical validity.

as an example--one of the earliest drugs for lowering blood cholesterol (a "statin") was thoroughly examined and it turned out that, despite lowering cholesterol to normal/optimal levels, cardiac deaths remained at the same level. also, when the cost to prevent mortality of only one patient from cardiac causes was calculated, the cost was deemed extremely exorbitant making use of this new wonder drug controversial to say the least.

i did correct myself though on the RDA. i accept that we are a special population with special needs. but until now the parameters of those special needs have not been reliably set. so, in my other post, i said that i would advise people to just eat more of a sensible diet instead of resorting to buying vit.c by the sack. eat more broccoli, eat more oranges, buy Philippine mangoes:-) with so many food choices out there to give you the same benefit as a tablet why do people insist on taking a pill? from a socio-economic stand point, it's better to do it the old-fashioned way.

Kim

Kim,

I suspect that I will get along with you famously when we meet sometime. I especially like your seemingly stubburn and suspicious nature. OTOH you seem pretty easygoing. I like that. My father was a doctor with those qualities. I am trained as a biologist and did not believe any of this supplementation stuff for many years and discovered it out of desperation after a particularly bad bout with mycoplasmal pneumonia that left me with the capacity to ride my bike for a maximum of 2 minutes at a walking pace. The doctors said that there was no evidence to suggest that I had any impairment of respiratory or other physical ability. What were they thinking?

Despite my education I prefer to live in a forest far from the city and make do with many kinds of work others would not want to have. This lifestyle gives me the opportunity to keenly oberve my body and even sometimes train on a regular basis. In addition I have the space for a nice large garden, I have clean water, air, and many things to be thankful for.

I have been to a few other countries so while I have not been to the Philippines, but I would ventue to say that the food there just might be fresher, taste better, more full of vitamins, and grown on better soil as it is in those other countries than much of the marginal produce sold here in the US. Even so called ORGANIC vegetables are often minimally nutritious here. Often noted is the lack of iron in vegetables and C in fruits that should have these in generous quantities.

I am not always able to do this but many years I grow much of my own vegetables and some fruits. I am the only one to blame if they do not measure up. Have not tested them in a lab, but those that have tested their own often say that taste tells the same story as the lab. The better it tastes, the more nutritious.

As to the negatives created by cost, as I said people barely notice the cost of coffee or espresso and then complain abt the cost of supplements that are often cheaper per day.

As to health care here....... Well let's just say it is going down the tubes and you need to recognise that even people who have held the same job for years have been losing the ABILITY to even get health insurance at all due to the changes in political climate. Furthermore, clinics and hospitals are being bought by large corporations and shut down or having the docs pressured in ways that many have simply quit leaving substantial communities w/o doctors at all.

As to what my vitamin regime does for me, please read my posts more carefully. I did not say it relieves or protects me from cancer, or the zits. I said it helps me feel better after workout in specific ways. Those are ways that to my knowledge are not often acknowledged much less studied in the literature. None the less, they are very important to me as an athlete.

I feel so confident abt my statements that I dare you to propose a test of bruising on MY body that should produce a bruise without breaking a bone or the skin as I do not want to out of commision, but am willing to be a guinea pig. To give a little history, I have hit myself by accident with a hammer on the leg in the quads that did not leave a bruised black-and-blue mark even though tender to the touch for days. I work as a carpenter by choice and this happens quite often, so is something I can see the effects of being lax w/ the supplements or not. Thus, without supplements I bruise in this case and with supplements I do not.

In addition to the vitamin supplementation which I consider minimal, I do control my diet. In particular I find that I am sensitive to saturated fats. I have not done the exhaustive experiment of eliminating each type one by one. I have simply gone without or with saturated fats. I attribute to this regimine the lack of swelling and pain I used to associate with hard workouts and injury. Before when I had a hard workout I could barely walk, now I feel the usage or overusage, but not the pain I used to feel. I am not aware which fats are in Philippine diets, but here in the US there are all sorts of manufactured fats that many consider harmful. See the book by Udo Erasmus "Fats That Heal, Fats That Kill" This book is also provided with an abundant biblio. ( Basically you will find that I do not read books without credible biblios or at least do not believe them without.) I do not eat any fat from mammals at all, nor any polysaturated. So I limit my fats to unrefined sunflower oil, canola oil, olive oil, and the small amt of fat that I cannot remove from poultry ( can usually get rid of most of the fat there).

So as I hope you can see, we are talking more than apples and oranges here. We are talking across oceans of experience in many respects.

YMMV.

Sincerely
Dan

>1) And I thought my C was expensive at 1/3 the price of yours

That's the price that Colgan sells it at. I don't have a problem with people if they want to take large amounts of vitamin C. But considering that Colgan's income is dependent on 1) people buying his books and 2) people buying his supplements, I remain deeply skeptical about ihs recommendations.

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>I also believe that the RDA can be achieved with the proper diet w/o the need for supplements.

RDI (was RDA) is a bare minimum. ODI is the current thinking (See Balch: Prescription for Nutritional Healing. The "Blended Standard" outlines this well; http://www.deaddoctorsdontlie.com/resources/daily_compare.html (a google search will show other references). This is a consensus of what many doctors consider useful intakes.

For some things, like Vitamin C, it is possible to the R/ODI. For many other essential things, especially minerals, it is impossible. This is mostly due to over farming. See http://longevinst.org/nlt/newsletter16.htm for a good article and the government site the article refers to: http://www.nal.usda.gov/fnic/foodcomp/Data/SR16/wtrank/wt_rank.html.

Mega dosing on one nutrient is very bad. It's like adding too much sugar to a cake recipe. Vitamins and minerals need to be in balance in order to be of use. This is the reason why Calcium is almost always packaged with Magnesium in a certain proportion.

i'm sorry but your link doesn't mean anything to me because it's a resource provided by a company that sells supplements. and, the "bibliography" that they use to support it is not composed of published studies in credible medical journals but rather books published specifically for lay people (the one by Colgan is already presumed to be biased because he too sells supplements). the "consensus" that you speak of does not exist as of now. a true "consensus" in the scientific sense is one based on clinical trials and as i posted before there is still no scientific evidence available (as per your country's own health agencies).

you may be right about the state of US agriculture though. i don't know anything about that since i am from the Philippines.

Kim

And who will pay for these "objective" studies? The Government?

Drug companies will only provide studies if the drug they are making is patentable, which makes the drug very expensive and very profitable. This leaves the educational institutions and the government itself for nutritional supplement studies. As we all know, the government’s last attempt to preach good nutrition came in the form of the food pyramid which (as any farmer will tell you) is a great way to make people fat.

If you take a drug, then you are relying on the potentially bias studies the drug companies perform. As we all know, prescription drug can be dangerous and studies may not keep a prescription drug from killing someone.