It also proved to be difficult, despite the enormous attention devoted to it, because of medicine's poor understanding of the disease. Today we know that the answer turned out to be Vitamin C, a simple substance that not only cures and prevents scurvy but also has other potential therapeutic effects, which are still being discovered today.
Vitamin C is a generic term used to describe all ascorbate compounds, including ascorbic acid, dehydroascorbic acid and ascorbate salts. (The term "vitamin" comes from "vital amine," a term coined in the early 20th century. This is somewhat of a misnomer because these we know now that these compounds do not have any amino groups. However, the term "vitamin" has gained such popularity that it has stuck.)
Because of its effect against an array of diseases, vitamin C has been credited with almost magical properties. Although using it to treat diseases such as cancer and heart disease remains controversial, the importance of vitamin C in human health is universally recognized. As one authority rightly put it, "Nothing emphasizes the importance of vitamin C to human beings more than the effect of being without it for a relatively short time."
'Nothing emphasizes the importance of vitamin C to human beings more than the effect of being without it for a relatively short time.'
The fact that this mutation spread throughout the human population raises the question of whether or not this "nutritional defect" is associated with certain evolutionary advantages. While the answer to this question is unknown, several hypotheses have been proposed. For example, some scientists speculate that the ultimate cause was a prehistoric viral infection that caused genetic damage which knocked out our ability to manufacture vitamin C. But because our ancestors lived in warm climates that were extremely rich in foods containing vitamin C, the nutritional consequences of this defect didn't really show up. As this theory has it, this inability to produce vitamin C internally likely caused an accumulation of free radicals within the body (as discussed below), which, in turn, resulted in an increase in the mutation rate of bodily cells, which, in turn, sped up the evolutionary transition to modern day Homo sapiens.
This idea of ascorbic acid influencing the rate of mutation and, consequently, evolution is supported by the fact that increased levels of free radicals are known to promote HIV replication, whereas ascorbic acid slows down the replication cycle.6 This could be one reason why natural selection favored the loss of our ability to synthesize vitamin C, especially when vitamin C is available from diet. By reducing human longevity, the loss of vitamin C producing-ability may also have selected against aging populations and made more food available for younger and more fertile individuals within early human populations, perhaps in a time of food shortages — in effect, thinning the human herd to the ultimate benefit of the survival of the species.
Vitamin C affects mood and energy levels. Depression and hypochondria are common symptoms of vitamin C deficiency. These are caused by norepinephrine deficiency, which results from the inadequate conversion of dopamine to norepinephrine in the absence of ascorbic acid. Vitamin C deprivation often also leads to a condition that impairs fatty acid metabolism and produces fatigue and lethargy.
Vitamin C is also essential for the absorption of iron by our bodies. Lack of vitamin C can lead to iron deficiency anemia, which is characterized by pallor, fatigue and weakness.
There are limits, however, to the amount of vitamin C that the body can process. Excess vitamin C, as a water-soluble vitamin, is simply excreted into the urine. For this reason, taking large quantities of vitamin C orally cannot raise and maintain ascorbic acid levels in the blood. The bottom line is that vitamin C cannot be stored for long periods in our bodies. We need to take in a consistent supply of vitamin C through our diet.
The current recommended daily allowance (RDA) for vitamin C, set by the Food and Nutrition Board of the U.S. National Academy of Sciences, is 75 mg per day for adult women and 90 mg per day for adult men. This value is derived from the estimated average requirement or vitamin C, which is the amount of vitamin C required by half of the healthy population at a certain life stage.
Another RDA, however, based on the adequate intake (AI) value, has also been proposed. The AI value is calculated from a group of healthy individuals and so is more useful for establishing the best levels of nutrient intake for individuals. Based on this value, it is recommended that 200 mg of vitamin C should be taken per day. This equals about 5 servings of fruits and vegetables. At this level, our bodily tissues will soon absorb the maximum amount of vitamin C that is possible. Although vitamin C can come from a variety of sources, including dietary supplements, the best way to get vitamin C is directly from the food we eat. Therefore, 5 servings of fruits and vegetables are recommended for all healthy individuals under normal conditions ).
People who smoke and those who are exposed to cigarette smoking need more vitamin C than those who don't smoke or are not exposed. Cigarette smoke contains free radicals which deplete vitamin C.
|Source (Size)||Vitamin C, mg|
|Strawberries (1 Cup, sliced)||95|
|Kiwi fruit (1 medium)||75|
|Orange (1 medium)||70|
|Cantaloupe (1/4 medium)||60|
|Mango (1 Cup, sliced)||45|
|Watermelon (1 Cup)||15|
|Orange (1 Cup)||100|
|Grapefruit (1 Cup)||70|
|Grape (1 Cup)||240|
|Apple (1 Cup)||100|
|Cranberry cocktail (1 Cup)||90|
|Pepper, red or green
Raw (1 Cup)
Cooked (1 Cup)
|Broccoli, cooked (1 Cup)||120|
|Brussels sprouts, cooked (1 Cup)||100|
Red, raw (1 Cup)
White, raw (1 Cup)
|Cauliflower (1 Cup)||50|
|Potato, baked (1 Medium)||25|
Some of the difference in these findings may be attributable, at least in part, to the difference in how the vitamin C was given. In the 1974 study, vitamin C was delivered by mouth and intravenously, whereas in the Mayo Clinic study it was administered by mouth only. As we have said, there is a limit to how much vitamin C can reach the bloodstream when it is taken orally. Much higher levels can be achieved, however, if the vitamin C is administered intravenously. Therefore, it is likely that higher effective vitamin C concentration was achieved in the earlier study than in the Mayo Clinic study.
Despite extensive research and public attention over the years, vitamin C has not yet been proven effective in treating cancer.
Recent research has, however, identified mechanisms that may explain whatever anti-cancer properties vitamin C may have. As a potent antioxidant, vitamin C protects cells from oxidative DNA damage, a known cause of cancer. In addition to its direct antioxidant effects, vitamin C makes cancerous cells more susceptible to apoptosis, or programmed cell death. Vitamin C also helps prevent uncontrolled cell proliferation, which contributes to cancer growth.
This research shows how vitamin C could function as an anti-cancer agent. In light of these new developments, an interventional study using high-dose intravenous vitamin C in the treatment of cancer in human subjects was approved by the FDA and entered phase I trial in 2007. This is the first officially-conducted interventional study examining the anti-cancer] effect of vitamin C and its findings, which are expected in 2009, should yield information that will help determine the value of this vitamin as a cancer fighter.
As with cancer, in recent years scientists have changed their focus from trying to find a "cure" to identifying possible mechanisms by which ascorbic acid might interfere with heart disease-inducing processes.
Epidemiological studies have confirmed that eating vitamin C-rich foods such as fresh fruits and vegetables is associated with a reduced risk of cardiovascular disease.
Cardiovascular disease often begins with oxidative damage from naturally- occurring substances such as reactive oxygen (ROS) or reactive nitrogen species (RNS). Accumulation of these substances in the body has several detrimental effects on the cardiovascular system. First, they modify low density lipoprotein (LDL), leading to the formation of highly reactive oxidized LDL (oxLDL) cells, which are more likely to clog blood vessels, promote inflammation, and cause the death of cells lining the blood vessels. These events are the precursors of artery-clogging atherosclerotic lesions.
Vitamin C interferes with these processes in a number of ways. For example, ascorbic acid reduces the amount of ROS and RNS in the blood. It makes LDL more resistant to oxidation and thus slows the formation of oxLDL. Vitamin C also counteracts oxLDL-induced inflammation and cell death, preventing the formation of lesions within the blood vessels.
The anti-atherosclerotic properties of ascorbic acid are significantly increased when it is combined with vitamin E. The cooperative interactions between these two vitamins form the basis for co-antioxidant therapy in the treatment of heart disease, which is becoming increasingly accepted by the medical community.
In addition, completely unexpected functions of vitamin C that may have important medical implications have recently been discovered. For example, ascorbic acid stimulated transformation of mouse embryonic stem cells into cardiac muscle cells, which may ultimately result in cardiac tissue regeneration for heart transplantation. While in the early stages, the applications of this new knowledge regarding vitamin C hold great promise.
- Golde,D.W. Vitamin C in cancer. Integr Cancer Ther 2, 158-159 (2003). Gonzalez,M.J. et al. Orthomolecular oncology: a mechanistic view of intravenous ascorbate's chemotherapeutic activity. P R Health Sci J 21, 39-41 (2002).
- Gonzalez,M.J. et al. Orthomolecular oncology review: ascorbic acid and cancer 25 years later. Integr Cancer Ther 4, 32-44 (2005).
- Li,Y. & Schellhorn,H.E. Can ageing-related degenerative diseases be ameliorated through administration of vitamin C at pharmacological levels? Med Hypotheses (2006).
- Li,Y. & Schellhorn,H.E. New developments and novel therapeutic perspectives for vitamin C. J. Nutr. 137, 2171-2184 (2007).
- Levine,M., Rumsey,S.C., Daruwala,R., Park,J.B. & Wang,Y.H. Criteria and recommendations for vitamin C intake. JAMA 281, 1415-1423 (1999).
- Levine,M. et al. Vitamin C pharmacokinetics in healthy volunteers: Evidence for a recommended dietary allowance. Proc Natl Acad Sci USA 93, 3704-3709 (1996).
- Wilson,J.X. Regulation of vitamin C Transport. Annual Review of Nutrition 25, 105-125 (2005).
- Bown, S.R. Scurvy : How a Surgeon, a Mariner and a Gentleman Solved the Greatest Medical Mystery of the Age of Sail. (Chichester : Summersdale Publishers Ltd., 2004.)
- Davies,M., Austin,J. & Partridge,D.A. Vitamin C: Its Chemistry and Biochemistry. (Royal Society of Chemistry, Letchworth, 1991).