Vitamin C, Volume III

279 Pages·1989·28.51 MB·English

by  C. Alan B. Clemetson

Vitamin C
Volume III
Author
C. Alan B. Clemetson
Professor
Tulane University School of Medicine
New Orleans, Louisiana
Boca Raton London New York
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Library of Congress Cataloging-in-Publication Data
Clemetson, C. Alan B.
Vitamin C / C Alan B. Clemetson.
p. cm.
Includes bibliographies and index.
ISBN 0-8493-4841-2 (v. 1)
ISBN 0-8493-4842-0 (v. 2)
ISBN 0-8493-4843-9 (v. 3)
1. Vitamin C deficiency. 2.Vitamin C--Metabolism. I. Title.
RC627.S36C53 1989
616.3’9--dc19 88-14735
A Library of Congress record exists under LC control number: 88014735
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ISBN 13: 978-1-351-07758-3 (ebk)
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FOREWORD
While frank scurvy is rare nowadays, subclinical vitamin C deficiency is common and is
now known to be associated with elevated blood histamine levels, which rapidly return to
normal when ascorbic acid is administered. Epidemiological and experimental evidence
suggests that our common metabolic defect, the inability to synthesize ascorbic acid from
simple sugars, may be largely responsible for the development of subendothelial hemorrhage,
thrombosis, atheroma, and degenerative vascular disease. This book is more concerned with
factors affecting ascorbic acid metabolism, such as aging, smoking, infection, trauma,
surgery, hormone administration, heavy metals, pregnancy, hemolysis, ionizing radiation,
aspirin, alcohol, and other drugs which cause a disturbance of ascorbic acid metabolism and
may thereby lead to vascular disease, than it is with simple dietary deficiency of ascorbic
acid. The clinical, pathological, and chemical changes observed in ascorbic acid deficiency
are discussed in detail; several diseases and disorders associated with abnormalities of
ascorbic acid metabolism are described. Possible toxic effects resulting from the oxidation
of ascorbic acid are noted, and reasons for the use of D-catechin or other chelating fiber to
prevent or minimize the release of ascorbate free radical are detailed.
PREFACE
About 60 years ago, and before the isolation of ascorbic acid, Mme. L. Randoin (1923)*
found the number of research studies on the antiscorbutic vitamin so great as to make it
impossible for her to review them all.
"Jm maintenant a parler de,s recherches de toute Now I must speak of all kinds of studies of the
naturefmtes sur lefacteur antiscorbutlque. La tache antiscorbutic factor. It IS a thankless task because
est bien ingrate, car /e nombre de ces recherches the number of research studies is so great that 1t IS
est si grand qu'il m'est eVldemment zmposszble de clearly impossible to review them all; moreover, by
les passer toutes en revue et, au surplus, elles pre- failure of agreement, they present such gaps that It
sentent, par defaut de convergence, de telles la- is truly difficult to present a consistent thesis.
cunes, qu' zl est vraiment difficile d' en donner une
idee d'ensemble."
Today, the profusion of the literature on this subject is even more overwhelming. It is
growing so fast that it is impossible to do justice to all the work that had been done in this
field. Moreover, having written 57 chapters in 36 months, it is inevitable that the chapters
written first will not be as up-to-date as those written last.
Undoubtedly, some important works have been omitted, either because they have
escaped my notice or because they were written in a language that I cannot read. Any workers
whose contributions have been omitted must accept my assurance that it was not by intent.
It is hoped that this book presents a consistent thesis and that its main message is clear.
It does not so much concern the amount of vitamin C in the diet, as it does the factors
affecting ascorbic acid metabolism, the diseases that may result from abnormalities of
ascorbic acid metabolism, and some suggestions as to what we may be able to do to prevent
them.
Although the title of this book is Vitamin C, it could equally well have been entitled
Vitamin C. Heavy Metals, and Chelating Fiber.
C. Alan B. Clemetson, M.D.
Pineville, Louisiana
February, 1987
THE AUTHOR
C. Alan B. Clemetson, M.D., was born in England. He attended the King's School,
Canterbury, Magdalen College, Oxford, and Oxford University School of Medicine, grad-
uating as a physician (B.M., B.Ch.) in 1948. He is an obstetrician and gynecologist, with
fellowships in British, Canadian, and American colleges (F.R.C.O.G., F.R.C.S.C., and
F.A.C.O.G.), but he has devoted most of his life to research and has published papers on
many diverse subjects.
His career has included academic positions at London University, the University of Sas-
katchewan, the University of California at San Francisco, the State University of New York,
and at Tulane University in Louisiana, where he is currently Professor at the School of
Medicine.
He has challenged many conventional ideas and believes that, "certainty of knowledge
is the antithesis of progress." Thus, every statement in this book is backed by reference to
experiments and observations in the literature; contrary findings are cited, weighed, and
given due credence.
VITAMIN C
Volume I
Vitamin C Deficiency
Classical Scurvy: A Historical Review
Chronic Subclinical Ascorbic Acid Deficiency
Factors Affecting the Economy of Ascorbic Acid
Inadequate Ascorbic Acid Intake
Smoking
Aging
Sex
Menstrual Cycle, Estrus Cycle, Ovulation
Infection
Trauma, Surgery, and Bums
Heavy Metals, Water Supplies: Copper, Iron, Manganese,
Mercury, and Cobalt
Bioflavonoids
Dietary Protein
Hormone Administration: Birth Control Pills
Pregnancy
Hemolysis
Stress and the Pituitary-Adrenal System
Lack of Sleep
Time of Day
Season
Achlorhydria
Ionizing Radiation
Aspirin and Salicylates
Alcohol
Other Factors Affecting Ascorbic Acid Needs
Volume II
Clinical and Pathological Findings in Ascorbic Acid Deficiency
Vascular Changes
Diabetes Mellitus
Anemia
Defective Wound Healing
Bone Changes
Joint Lesions
Dental and Periodontal Changes
Atherosclerosis
Mental Depression
Amyloid
Venous Thrombosis
Decreased Resistance to Infection
Liver, Bile, and Gallstones
Volume III
Chemical Changes Associated with Vitamin C Deficiency
Histamine Metabolism
Proline and Lysine Metabolism
Carbohydrate Metabolism
Folic Acid Metabolism
Cholesterol Metabolism
Tyrosine and Phenylalanine Metabolism
Tryptophan Metabolism
Adrenal Corticoid Metabolism
Uric Acid Clearance
Clinical Conditions Associated with Disorders of Ascorbic Acid Metabolism
Rheumatic Fever
Menorrhagia
Wound Dehiscence
Habitual Abortion
Abruptio Placentae
Prematurity and Premature Rupture of the Fetal Membranes
Megaloblastic Anemia of Infancy, Pregnancy, and Steatorrhea
Gastrointestinal Ulcers and Hemorrhage
Ocular Lesions
Cerebral Hemorrhage and Thrombosis
Coronary Thrombosis and Myocardial Infarction
TABLE OF CONTENTS
CHEMICAL CHANGES ASSOCIATED WITH VITAMIN C DEFICIENCY
Chapter I
Histamine Metabolism ................................................................. .
I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I
II. Guinea Pigs ....................................................................... I
III. Humans ........................................................................... 3
A. Pregnancy ................................................................. 4
B. Age ........................................................................ 4
C. Sex ........................................................................ 5
D. Subsequent Work .......................................................... 5
IV. Implications ...................................................................... II
References ............................................................................... II
Chapter 2
Proline and Lysine Metabolism ........................................................ 15
References ............................................................................... 29
Chapter 3
Carbohydrate Metabolism ............................................................. 33
References ............................................................................... 39
Chapter 4
Folic Acid Metabolism ................................................................. 43
References ............................................................................... 47
Chapter 5
Cholesterol Metabolism ................................................................ 49
I. Guinea Pig Studies ............................................................... 49
II. Other Animals ................................................................... 59
III. Human Studies ................................................................... 60
IV. Summary ........................................................................ 70
V. Conclusions ...................................................................... 70
References ............................................................................... 70
Chapter 6
Tyrosine and Phenylalanine Metabolism .............................................. 75
I. Introduction ...................................................................... 75
II. Hydroxyphenyluria ............................................................... 75
III. Dopa, Dopamine, Norepinephrine, and Epinephrine ............................. 84
IV. Tyrosine Oxidation to Dopa and Melanin ........................................ 87
V. Tyrosine Iodination and Conversion to Thyroxine ............................... 88
VI. Conclusions Concerning Clinical Relevance ..................................... 88
References ............................................................................... 89
Chapter 7
Tryptophan Metabolism ............................................................... 93
References ............................................................................... 99
Chapter 8
Adrenal Corticoid Metabolism ....................................................... 10 1
I. Introduction ..................................................................... 101
II. Human Observations ............................................................ 101
III. Guinea Pigs ..................................................................... 102
IV. Rats ............................................................................. 10 8
V. In Vitro Studies ................................................................. 108
References .............................................................................. 109
Chapter 9
Uric Acid Clearance .................................................................. 113
References .............................................................................. 114
CLINICAL CONDITIONS ASSOCIATED WITH DISORDERS OF ASCORBIC ACID
METABOLISM
Chapter 10
Rheumatic Fever ...................................................................... 117
I. Experimental Production in the Guinea Pig ..................................... 117
A. Controls ................................................................. 117
B. Infection ................................................................. 117
C. Scurvy ................................................................... 117
D. Combined Scurvy and Infection ......................................... 118
E. Scurvy and Exotoxin .................................................... 119
II. Rheumatic Purpura .............................................................. 120
III. Epidemiology of Rheumatic Fever .............................................. 121
IV. Ascorbate Status in Rheumatic Fever ........................................... 121
A. Urinary Excretion Tests ................................................. 122
B. Blood Values ............................................................ 123
V. Ascorbic Acid Supplements in Rheumatic Fever. ............................... 124
VI. Use of Ascorbic Acid in Prophylaxis Against Rheumatic Fever ................ 125
VII. Other Prophylactic and Therapeutic Measures .................................. 125
VIII. The Hyperimmune Response .................................................... 127
IX. The Effect of Cortisone on Ascorbic Acid Metabolism in Rheumatic
Fever ........................................................................... 127
X. Conclusions ..................................................................... 127
XI. Future Research ................................................................. 130
References .............................................................................. 130
Chapter 11
Menorrhagia ........................................................................... 133
References .............................................................................. 143
Chapter 12
Wound Dehiscence .................................................................... 145
References .............................................................................. 150
Chapter 13
Habitual Abortion ..................................................................... 151
References .............................................................................. 158