Excess Vitamin C May Worsen Osteoarthritis
Researchers Say Dietary Intake Should Not Be Above the RDA Recommendation
June 3, 2004 — It may be possible to get too much of a good thing when it comes to vitamin C and your health.
Although heralded as a powerful antioxidant that fights everything from the common cold to cancer, a new study shows that over a long period of time high doses of vitamin C is associated with worsening of one of the most common forms of arthritis — osteoarthritis of the knee.
The study showed long-term use of vitamin C supplements worsened the severity of osteoarthritis of the knee in guinea pigs. In these animals, osteoarthritis of the knees is similar to the cartilage damaging disease in humans, the authors write.
Previous short-term studies in humans and guinea pigs have shown that vitamin C might protect against osteoarthritis of the knees. In contrast, this new study shows prolonged use of vitamin C supplements may aggravate osteoarthritis.
Osteoarthritis causes the progressive breakdown of joint cartilage — a cushioning tissue layer that helps bone move against each other without causing friction and destruction of bone.
Researchers say the study highlights the potential drawbacks of long-term use of high-dose vitamin C supplements on joint health.
The study appears in the June issue of Arthritis& Rheumatism.
Vitamin C Linked To Lower Rheumatoid Arthritis Risks
In this study, published in the current issue of Annals of Rheumatic Diseases, researchers looked at the link between fruit and vegetable and dietary antioxidant intake and the development of inflammatory arthritis and rheumatoid arthritis in a group of 23,000 men and women who entered a large cancer study in the U.K. between 1993 and 1997. As a part of that study, the participants kept track of what they ate in a weekly food diary.
Between 1993 and 2001, 73 people developed inflammatory arthritis affecting two or more painfully swollen joints for at least a month, and 40% of them met the criteria for having rheumatoid arthritis.
Compared with those who did not develop the disease, researchers found that those with arthritis ate fewer fruits and vegetables. Specifically, people who ate the least amount of fruits and vegetables had double the risk of developing inflammatory arthritis.
The study also showed that there was a major difference in the amount of vitamin C that the people with arthritis consumed vs. those who did not develop the disease. People who got the least vitamin C in their diet had three times the risk of developing inflammatory arthritis than those who got the most.
Researchers found that lower intakes of other antioxidants were mildly associated with higher arthritis risks, but the link was not nearly as strong as the one with vitamin C intake.
Annals of Rheumatic Diseases
Vitamin D Supplements Linked To Less Cartilage Joint Loss In Knee Oa
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Among patients with knee osteoarthritis, higher intake with both vitamins C and D is associated with less cartilage degeneration, while supplementation with vitamin D alone over 4 years is linked with significantly less progression of knee joint abnormalities, according to data published in Arthritis Care & Research.
Various vitamin deficiencies have been identified in subjects with OA, including decreased vitamin C and D serum levels,Gabby B. Joseph, PhD, of the University of California, San Francisco, and colleagues wrote. One study found that the odds of having hip OA was 1.9 times lower in subjects with recommended or higher vitamin C intake and another study reported that 24% of patients with advanced OA were vitamin D deficient . Thus, understanding the impact of vitamin deficiency on knee joint health, and the value of nutritional supplements to prevent or treat OA is of significant scientific and clinical interest.
To analyze the links between vitamin C and D supplementation and MRI measures of cartilage composition and joint structure, Joseph and colleagues studied data from the Osteoarthritis Initiative. Joseph and colleagues included 1,785 participants from the initiative with radiographic Kellgren Lawrence knee grades of 0 to 3 in the right knee.
Disclosure: The researchers report funding from the NIH.
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Different Types Of Kidney Stones
There is a considerable variety of kidney stones. Here are five well-known ones:
1. Calcium phosphate stones are common and easily dissolve in urine acidified by vitamin C.
2. Calcium oxalate stones are also common but they do not dissolve in acid urine. We will discuss this type further below.
3. Magnesium ammonium phosphate stones are much less common, often appearing after an infection. They dissolve in urine acidified by vitamin C.
4. Uric acid stones result from a problem metabolizing purines . They may form in a condition such as gout.
5. Cystine stones result from an hereditary inability to reabsorb cystine. Most children’s stones are this type, and these are rare.
Benefits Of Vitamin C
Vitamin C plays an important role in immune function and improves your absorption of iron. It helps to protect cells and keep them healthy. It also helps maintain healthy skin, blood vessels, bones, and cartilage. Studies show a positive link between vitamin C and bone density.
Vitamin C is an antioxidant that blocks damage caused by free radicals, which are oxygen-containing molecules released when your body breaks down food or when you are exposed to tobacco smoke or radiation. A buildup of free radicals contributes to the aging process and the development of certain conditions, including:
- Atherosclerosis, a buildup of fatty deposits in the walls of arteries
Vitamin C is a necessary element for the body to make collagena key component of cartilage. It also plays an important role in the immune system, by regulating the production of cytokines and decreasing histamines levels that are triggered by allergens.
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Which Form Of Vitamin C Is The Best
If you want to supplement your dog with vitamin C, the best form is the salt forms of vitamin C, known as mineral ascorbates .
Ascorbates are easily absorbed anywhere in the dog’s intestinal tract. They are also considered to be the most gentle forms of vitamin C and cause fewer side effects such as diarrhea or heartburn.
Calcium ascorbate is pH-neutral, and has a slightly bitter taste. It is widely considered to be able to give the best results in relieving symptoms of arthritis.
Sodium ascorbate is also pH-neutral. It has a slightly saline taste. According to Dr. Wendell Belfield , sodium ascorbate is the most effective form of vitamin C for dogs.
Vitamin C And Alcohol
There are a lot of myths regarding Vitamin C when it comes to alcohol and hangovers.
Firstly Vitamin C is not involved in alcohol metabolism and, therefore, will not speed up how fast alcohol is broken down.
Secondly, for the healthy individual who drinks socially, alcohol does not deplete Vitamin C levels.
On the other hand, chronic alcohol use is a risk factor for Vitamin C deficiency. The cause for this is not fully understood but its thought to be from a combination of poor nutrition, liver inflammation and reduced absorption from the gut.
Vitamin C does not speed up alcohol metablism.
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Foods That Can Help Relieve Joint Pain
Inflammation aggravates arthritis pain. Your diet contributes a lot to inflammation — eat lots of refined sugars, alcohol, and saturated fat and you may make your arthritis pain more severe.
Instead, include foods rich in antioxidants, omega-3 fatty acids, and specific vitamins — such as vitamins C and A — to fight inflammation and encourage your bodys immune system to function optimally.
Here are 10 foods to include in your diet every week to help relieve joint pain, including some you may choose to have every day.
What Does Vitamin C Do
Vitamin C is an essential nutrient that is obtained purely through your diet. This means your body is unable to produce Vitamin C and you can become deficient if you dont eat enough.
Citrus fruits, berries, tomatoes, potatoes, and green leafy vegetables are excellent sources of vitamin C.
When you mention Vitamin C, most people immediately think of the immune system. And although it is important for immune health, its other major function includes collagen synthesis and antioxidation.
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The Dangers Of Too Much Vitamin C
In 2004, Duke researchers found that when patients with osteoarthritis consumed high amounts of vitamin C, they were more at risk for developing bone spurs and joint damage. This was due to a protein in the blood triggered by vitamin C. Because a vitamin C deficiency can put you at a higher risk of developing arthritis, its important to find the right balance.
Vitamin C For Psoriatic Arthritis
Psoriatic arthritis is an inflammatory form of arthritis that develops in some people with psoriasis, an autoimmune disease that causes skin cells to build up and form plaques, dry, inflamed raised lesions on the skin. The cause of psoriatic arthritis is unclear, but researchers think it includes both environmental and genetic factors.
In one case review, a 36-year-old woman with severe psoriasis since the age of 22 had been prescribed topical anti-steroid cream during that 14-year period. Doctors suggested a diet rich in fruits and vegetable and the addition of several supplements, including vitamin C. After six months on the diet and supplements, the patient’s psoriasis completely cleared up.
Both animal and human studies have shown the positive effects of vitamin C on cartilage, as well. One study in rats showed that vitamin C reduced cartilage loss and prevented the progression of osteoarthritis . In another study, researchers discovered that high levels of vitamin C intake helped reduce cartilage and joint damage.
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Gout And The Influence Of Ascorbic Acid
Several studies have shown that vitamin C significantly altered the levels of uric acid in the blood of gout patients. A study published in 2009 suggests that vitamin C may also help to protect against the development of gout.
Choi and colleagues studied 46,994 male subjects with no history of gout at the start of the program4. In the period between 1986 and 2006, the men completed questionnaires that queried any symptoms of the disease. In addition, vitamin C intake was also recorded.
The results of the study found that men who took a higher amount of vitamin C had less risk of developing gout. A total of 1,317 subjects showed signs of gout in the course of the 20-year-long study. The researchers concluded that a vitamin C supplement could potentially help prevent gout.
Studies On The Use Of Vitamin C In Arthritis Management
Vitamin C can be quite helpful in the treatment of different forms of arthritis. It has been shown to improve pain due to gout arthritis because vitamin C reduces the serum level of uric acid.
Other studies show that the ability of vitamin C to reduce the risk of gout and joint pain due to this form of arthritis increases with increasing doses of the vitamin.
However, vitamin C can also reduce other kinds of joint pain not associated with arthritis. In a 2007 paper published in the American volume of The Journal of Bone and Joint Surgery, the effectiveness of vitamin C for treating complex, regional pain syndrome was evaluated.
The prospective, randomized, multicenter study recruited 416 patients who reported 427 wrist fractures were treated with one of 200 mg, 500 mg, 1500 mg of vitamin C or placebo daily for 50 days.
The result showed that all doses of vitamin C reduced wrist joint pain and that even though 1500 mg produced a better pain reduction, it was only slightly better than 500 mg daily doses of the vitamin.
In another study published in Annals of Rheumatic Diseases, 23,000 participants in a large-scale cancer study in which their diets were recorded over a period of 8 years. The study result showed that participants who ate more vitamin C-rich fruits and vegetables had lower risks of developing rheumatoid arthritis.
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Arthritis And Vitamin C: The History Of Scurvy
During early centuries when sailors where exploring the oceans, many suffered from a deficiency in vitamin C during long periods at sea. Known as scurvy, this nutrient deficiency caused connective tissue to breakdown. Sailors experienced malaise and lethargy.
This was often followed by the weakening of the gums and skin spots. Left untreated, scurvy can lead to death. Sailors were prone to scurvy due to a lack of fresh fruit and vegetables.
Although scurvy is rare in developed countries, there are cases seen in children with severely restricted diets. These situations are often associated with developmental or psychiatric problems. Vitale and colleagues reported on two cases of vitamin C deficiency, where the children were misdiagnosed with rheumatologic diseases2. However, once the children were treated with vitamin C, their arthritic symptoms were resolved.
Although the researchers only examined two cases, the authors point out that a vitamin C deficiency can cause quite severe arthritis. This is because degradation of articular cartilage occurs in conjunction with a deficiency in vitamin C. The researchers warn that if rheumatic symptoms are presented in childhood, a deficiency in vitamin C could be the underlying trigger.
What Is Apple Cider Vinegar
Apple cider vinegar is the product of fermentationthe process in which sugars in food are broken down by bacteria and yeast. In stage one of fermentation, the sugars are turned into alcohol. Stage two, if the alcohol ferments further, you get vinegar. While vinegar can be made from all sorts of thingsfruits, vegetables, and grains ACV, is, unsurprisingly, made from pulverized apples. The main ingredient of apple cider vinegar, or any vinegar, is acetic acid. It also has other acids, vitamins, mineral salts, and amino acids.
It sounds like a relatively innocuous substance more likely to be found in a salad dressing or used as a preservative, but because of its unique properties, ACV has a huge range of uses.
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Vitamin And Mineral Guide For Arthritis
Learn about key vitamins and minerals and which ones are especially important when you have arthritis.
Vitamins and minerals play a critical role in staying healthy, but getting enough of certain nutrients is even more important when you have arthritis. This guide provides thorough research of key vitamins and minerals to help you figure out what you may be missing. But remember: While some supplements may help arthritis symptoms, nothing can substitute doctor-prescribed medications, a healthy diet and exercise. Always talk to your doctor before adding a new supplement, vitamin or mineral to your regimen. Just because something is natural doesnt mean it cant cause side effects or interact with medications. For more tips on choosing safe supplements, read this article.
What it does: Calcium is an essential mineral thatmaintains strong bones and teeth regulates muscle contractions transmits nerve impulses and helps release essential hormones and enzymes. It also helps prevent osteoporosis and fractures, which are higher risks among people with rheumatoid arthritis and those taking corticosteroids.
How much:Experts recommend 1,200 mg a day for healthy adults, but people with inflammatory arthritis may need more up to 1,500 mg for men and postmenopausal women. Recent research has debunked the claim that calcium supplements raise heart attack risk.
Too much:Tolerable upper limit = 2,500 mg.
Too much:No tolerable upper limit has been determined.
Vitamin D And Your Health
Vitamin D is called the sunshine vitamin for good reason. Not only does your body make vitamin D when your skin is exposed to the sun, but we also know vitamin D can ward off many health problems.
Vitamin D is a naturally occurring compound that regulates the bodys use of calcium and phosphorus. Its crucial for the formation of bone and teeth.
Because vitamin D is so important to bone growth, some researchers have wondered if supplements can help joint pain.
One study found that patients living with chronic pain who were deficient in vitamin D were the most likely to benefit from taking vitamin D supplements. However, more information is needed to determine whether vitamin D supplements can help everyone living with chronic pain.
Another study predicted that adults with a vitamin D deficiency who are older than 50 are more likely to develop pain in their hip and knee joints. The study also noted that the pain is more likely to get worse if the deficiency isnt treated.
A looked at vitamin D levels in people who have rheumatoid arthritis , an autoimmune condition that causes the body to attack its joints. The study found that most of the participants had low vitamin D levels.
The researchers concluded that the low vitamin D levels were a complication of RA. Other have concluded that people with RA have low vitamin D levels from their corticosteroid medications.
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Persistent Iron Deficiency Anemia
Vitamin C and iron deficiency anemia often occur together.
Signs of iron deficiency anemia include paleness, fatigue, trouble breathing during exercise, dry skin and hair, headache and spoon-shaped fingernails .
Low levels of vitamin C may contribute to iron deficiency anemia by reducing the absorption of iron from plant-based foods and negatively affecting iron metabolism (
While fatigue and irritability may be some of the first symptoms to appear, they typically resolve after just a few days of adequate intake or within 24 hours of high-dose supplementation .
Summary Signs of fatigue and poor mood can appear even with low-to-normal levels of vitamin C, but they quickly turn around with adequate vitamin C intake.