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Unlike most minerals, vitamins are already in an organic form. This is not to say that all purified vitamins are in as bioavailable a form as they are in foods. However, a purified vitamin will be much closer to a food form than most minerals as found in the earth's crust. Having noted this distinction, it is nevertheless important to also find vitamins in forms as close to food forms as possible.

Many vitamins can be overdosed relatively easily. The main reason for this is that vitamins, while vital to proper bodily function, are needed in only the tiniest of amounts, as a general rule. When dealing with supplementation of any kind, you simply cannot assume that if a little is good, more must be better. Always remember that EVERYTHING is toxic in a high enough dose. No exceptions. And this includes many things that your body requires for survival. Everything in the biological sciences needs balance, and too much of something good should be avoided just as diligently as too little of it.

Vitamins comprise a very diverse group of organic substances. For the most part, these substances are not related at all in their chemical structures or physiological roles. Nevertheless, they are divided into two broad categories, based on how they are absorbed into the body: water-soluble vitamins and fat-soluble vitamins.

There are four fat-soluble vitamins:

1. Vitamin A. Essential for vision, for the immune system, and for functions associated with proper growth; also an antioxi-

dant. Probably best supplemented as beta-carotene, which converts to vitamin A and minimizes the possibility of overdosage. Melhus et al. have shown that too much vitamin A is associated with reduced bone mineral density and increased risk for hip fracture.6

Common dietary sources: beef liver, sweet potatoes, carrots, spinach, butternut squash.

2. Vitamin D. Essential for good skeletal growth and strong bones. Only minimal exposure to sunlight is necessary to meet the daily requirement. Vitamin D is easily overdosed and can promote abnormal calcification throughout the body, since it increases calcium absorption from the gut; the increased calcium absorbed does not necessarily seek out the bones, however. Schwartzman and Franck demonstrated that pharmacological doses of vitamin D will worsen osteoporosis.7 Consider not supplementing this vitamin at all, unless you do so in close coordination with your health care provider, making sure that the desired clinical effects are being accomplished.

Common dietary sources: few natural dietary sources; present in fortified milk, but this is not recommended.

3. Vitamin E. Helps to maintain the integrity of cell membranes; also an antioxidant. Try to take preparations with as much d-alpha-tocopherol content as possible. In general, do not exceed 800 IU per day; 400 IU per day would probably be advisable for most.

Common dietary sources: vegetable seed oils, peanuts. Lesser amounts in many different fresh vegetables and fruits.

4. Vitamin K. Necessary for proper blood clotting. Does not generally need supplementation unless some form of malabsorption exists in the gut, or if the bacteria in the gut that manufacture this vitamin have been destroyed.

Common dietary sources: green leafy vegetables, soybeans, beef liver.

Rapola et al. found that beta-carotene significantly increased the number of fatal heart attacks among men with previous heart attack who smoked.8 Without a good explanation of why this effect has been observed, it would be safest to advise smoking patients who have known heart disease to avoid beta-carotene and other vitamin A supplementation completely for the time being. However, an epidemiological study suggests that a diet rich in beta-carotene may lower a woman's risk of breast cancer after menopause, so a complete avoidance of beta-carotene supplementation for everyone is certainly not being recommended at this time.9 Further research may be needed to determine if supplemented beta-carotene is significantly less desirable than dietary beta-carotene. Certainly, as a general rule, supplemented nutrients can never be as desirable as dietary nutrients.

The fat-soluble vitamins are absorbed along with dietary fats. Normally, these vitamins are not excreted in the urine, but are stored in the body in moderate amounts. Conversely, the water-soluble vitamins are more numerous, are excreted in the urine, and are not stored in the body in appreciable quantities. Most authorities consider that there are nine water-soluble vitamins:

1. Vitamin B1 (thiamin). Helps to generate cellular energy, promote fatty acid synthesis, and support normal membrane and nerve conduction. Little toxicity has been observed with high oral intakes; unless a deficiency exists, consider supplementing with 5 to 25 milligrams daily.

Common dietary sources: yeast, sunflower seeds, peas, beans.

2. Vitamin B2 (riboflavin). Important for the cellular reactions that transfer energy from one chemical substance to another; also serves as an antioxidant; helps in the formation of energy from food fats and proteins. Deficiency syndrome has not been clearly characterized; consider supplementing with 5 to 15 milligrams daily.

Common dietary sources: beef liver, meat, oysters.

3. Vitamin B3 (niacin). Important for the proper function of numerous enzymes and of the brain and nervous system; important for the synthesis of many hormones. Deficiency causes a syndrome called pellagra. A supplement of 5 to 20 milligrams daily is probably acceptable for most people. Niacin can excessively accelerate detoxification in susceptible individuals, especially in those who have their dental toxicity removed.

Common dietary sources: beef and beef liver, poultry, fish.

4. Vitamin B6 (pyridoxine). Important for the proper function of many enzymes involved in amino acid metabolism. Consider supplementing with 5 to 15 milligrams daily. Common dietary sources: meat, beans, potatoes, bananas.

5. Folic acid. Important for the synthesis of DNA and for the metabolism of amino acids and histidine. Consider supplementing with 200 to 400 micrograms daily.

Common dietary sources: brewer's yeast, spinach, asparagus, turnip greens, lima beans, beef liver.

6. Vitamin C (ascorbic acid). Believed to be important for fat metabolism, immune function and healing, endocrine function, and neutralization of toxicity; also an antioxidant. Important to take adequate doses on a regular basis; many individuals will do best on 10 to 15 grams of sodium ascorbate daily, taken under the direction of their health care provider. Common dietary sources: papaya, orange, cantaloupe, broccoli, brussels sprouts, green peppers, grapefruit, strawberries.

7. Vitamin B12 (cobalamine). Important for the maintenance of proper nerve function and blood synthesis. Unless a clear deficiency syndrome exists (pernicious anemia and/or markedly low blood levels of the vitamin), consider avoiding any supplementation, since supplement forms of B12

can promote the methylation of inorganic mercury in the body, making it much more toxic and causing clinical compromise.

Common dietary sources: meat, seafood, poultry.

8. Biotin. Important for energy metabolism. Consider supplementing with 100 to 200 micrograms daily.

Common dietary sources: yeast, liver, kidney.

9. Pantothenic acid. A precursor to the body's synthesis of its own coenzyme A; important for the metabolism of carbohydrates and fats. Consider supplementing with 10 to 20 milligrams daily.

Common dietary sources: widespread; especially high in egg yolk, liver, kidney, yeast.

Vitamin c

Vitamin C is such an important supplement that it deserves its own special section. Vitamin C is usually supplemented in one of three forms: ascorbic acid, calcium ascorbate, or sodium ascorbate. The ascorbate anion can be supplemented as part of many different mineral chelates, but these three forms are the major sources of supplemented vitamin C.

In the amounts that I recommend, the best form of vitamin C to take is sodium ascorbate. Calcium ascorbate supplies too much calcium, which is undesirable for reasons that I explained earlier. Ascorbic acid can impair digestion by decreasing enzyme and acid production in the stomach when it is taken close to a meal. It can also erode tooth enamel if it is frequently in contact with the tooth surfaces.

Except when taking only a couple of grams (1 gram = 1,000 milligrams) or less of vitamin C, the preparations that add rutin and other bioflavonoids should be avoided. Megadoses of vitamin C are being promoted here, but the effects of megadose rutin and other bioflavonoids, compounds felt by some to enhance the effects of vitamin C, are unknown.

You may be concerned about taking in too much sodium if you take megadoses of sodium ascorbate. After all, doesn't sodium raise the blood pressure and make high blood pressure (hypertension) even more difficult to control? Actually, I have never observed this problem in any patient to whom I have given sodium ascorbate by mouth or vein. In fact, some very good clinical research indicates that it is the chloride in common table salt, not simply the sodium, that elevates blood pressure. But sodium and table salt have come to be considered the same substance, even though this is not true. Sodium is only a part of table salt, not the entire compound. Kurtz et al. showed that sodium chloride raised the blood pressure of men with high blood pressure, while sodium citrate did not.10 Kurtz and Morris also showed in animal studies that sodium expanded plasma volume and elevated blood pressure only when it was given as sodium chloride.11 Neither the blood volume nor the blood pressure was increased when sodium was given with bicarbonate, phosphate, glutamate, glycinate, aspartate, or ascorbate (vitamin C). The time-honored concept of "sodium-dependent" hypertension needs to be replaced by a new concept of "sodium chloride-dependent" hypertension.

Vitamin C is one of the few supplements that are extremely difficult to overdose. Whether administered orally or intravenously, megadose vitamin C has been shown to be a superlative therapy for heavy-metal poisoning; carbon monoxide exposure and poisoning; pesticide exposure; allergic and toxic shock from snakebite or insect bite; and almost all viral diseases studied, including polio, hepatitis, and herpes. Frederick Klenner, M.D., published much of the significant work documenting these marvelous effects of megadose vitamin C.12-15 In many of the conditions listed above, Dr. Klenner would often report clinical cures, with return of blood tests to normal, after only a few days of therapy. However, the doses that he used, typically as sodium ascorbate administered intravenously, ranged from a few grams to a few hundred grams daily. No other modern study on vitamin C even approaches these doses, so Dr. Klenner's work still constitutes the only substantial published documentation of the effects of such very large doses.

Although Dr. Klenner's findings serve notice of the enormous utility of intravenous vitamin C, most people are not going to take an IV on a daily, or even a weekly, basis. However, for patients seeking a therapy to help neutralize toxicity and give their struggling immune systems a chance to recover, frequent 40- to 60-gram infusions of vitamin C can help achieve just that.

The more common way to take vitamin C is orally. Doses of 10 to 15 grams daily are advisable for most people, in my opinion. This would amount to a heaping teaspoon of sodium ascorbate taken twice daily in water or dilute juice. However, oral vitamin C will very quickly let you know when you have taken too much of it. Too much vitamin C will cause a loose diarrhea, usually lasting for a few hours. Some people will get diarrhea before they reach the recommended 10 grams, while many others won't get it until they reach 40 grams or more. For those who want further information on this topic, Cathcart published a method for determining the optimal dosage of vitamin C in different diseases based on bowel tolerance (that is, the point at which diarrhea begins).16

Once you have experimented a bit with oral sodium ascorbate to find out how much it takes to cause diarrhea, you can take just short of that dose on a daily basis, even if it is more than 15 grams. This will have a beneficial effect on your general health. When you decrease your bowel transit time with oral vitamin C, you can keep your colon fairly clear of feces most of the time. This accelerated emptying of the gut and colon can substantially decrease the toxicity that most of us face on a daily basis from poorly digested food, for reasons that I explained at length in chapter 2. Not only will shorter bowel transit time facilitate the elimination of toxins, but di rect contact with vitamin C will directly neutralize much of the bacterial toxicity in your gut before it gets absorbed. The direct contact with the vitamin C will inactivate or neutralize most bacterial toxins while facilitating their direct elimination with the shorter bowel transit time induced by the vitamin C. Of course, the high doses of oral vitamin C also allow the optimal absorption of vitamin C into the blood, where daily toxicity from all sources can also be neutralized as it appears in the blood. Periodically, for all of these reasons, it's also a good idea to take a "C-flush," taking enough vitamin C to deliberately induce this cleansing diarrhea. This is best done when you are not working and have easy access to a toilet. To minimize the buildup of uncomfortable gas, take a little powdered activated charcoal with the vitamin C. It is also extremely important to drink large amounts of water to prevent your body from becoming dehydrated once the diarrhea starts. For those who have schedules that can deal with the inconvenience of the self-limited diarrhea, doing a "C-flush" on a daily basis can be a very healthy habit.

Some medical authorities continue to advise against megadose vitamin C therapy, claiming that it increases the incidence of kidney stones and the potential for kidney failure. With the use of sodium ascorbate as the primary source of vitamin C, these concerns just do not seem to be justified. In fact, the ability of vitamin C to neutralize so many different toxins appears to benefit those with kidney disease as well. However, large doses of vitamin C should probably be avoided if you drink very little water. Optimal hydration is important in general, but you should avoid high doses of vitamin C (or anything else, for that matter) if you are chronically dehydrated.

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