Ascorbic acid

Ascorbic acid, commonly known as vitamin C, is a water-soluble vitamin that plays a key role in a number of vital functions in the human body. It is essential for the synthesis of collagen, neurotransmitters, steroid hormones, and is also involved in protein metabolism. Vitamin C is also a powerful antioxidant, protecting cells from free radical damage and supporting the immune system.

Vitamin C is not synthesized in the human body, so it must be obtained regularly from food or in the form of supplements. Sources of ascorbic acid include fresh fruits and vegetables, especially citrus fruits, kiwi, strawberries, broccoli, bell peppers and black currants.

Functions of ascorbic acid:

1. Collagen Synthesis: Vitamin C is essential for the production of collagen, an important component of connective tissue that supports skin, blood vessels, bones and cartilage.
2. Antioxidant: Protects cellular structures from free radical damage, promotes the repair of other antioxidants such as vitamin E.
3. Immune Support: Strengthens the body's defenses, helping to prevent and quickly recover from colds and other infectious diseases.
4. Iron absorption: Improves the absorption of iron from plant sources, helping to prevent anemia.
5. Protection against chronic diseases: Consuming adequate amounts of vitamin C may reduce the risk of developing certain chronic diseases, including cardiovascular disease, certain cancers, and cataracts.

Recommended daily allowance

The recommended daily intake of vitamin C varies according to age, gender and health status. It is about 90 mg per day for adult men and about 75 mg per day for adult women. Pregnant and lactating women require more vitamin C.

Side effects and cautions

When taken in normal doses, vitamin C is considered safe for most people. However, taking very high doses (over 2,000 mg per day) can lead to side effects such as stomach upset, diarrhea and kidney stones.

Indications Ascorbic acid

1. Prevention and treatment of vitamin C hypo- and avitaminosis:

   • To prevent and treat conditions associated with vitamin C deficiency, such as scurvy.

2. Immune Enhancement:

   • Increasing the body's resistance to infections, especially during periods of increased incidence of colds and viral infections.

3. Recovery from illness:

   • Acceleration of recovery processes after various diseases and surgeries due to the ability of vitamin C to stimulate the synthesis of collagen, necessary for tissue healing.

4. As an antioxidant:

   • Protecting cells from free radical damage, preventing oxidative stress, which can contribute to chronic diseases including cardiovascular disease and cancer.

5. Improved iron absorption:

   • Increasing the bioavailability of iron from plant-based food sources, which may prevent the development of iron deficiency anemia.

6. Prevention of cardiovascular disease:

   • Vitamin C may help reduce the risk of atherosclerosis by improving vascular wall health and lowering levels of "bad" LDL cholesterol.

7. Supporting skin health:

   • It promotes collagen synthesis, which is essential for maintaining skin elasticity and health, and may also prevent premature skin aging.

8. Involvement in metabolism:

   • Vitamin C is important for the metabolism of phenylalanine, tyrosine, folacin, iron, carbohydrates and lipids.

Release form

1. Pills

• Oral tablets: This is the most common form. Tablets can contain from 25 mg to 1,000 mg of vitamin C. They can be plain or chewable, which is especially convenient for children.

2. Powder

• Powder for dissolving in water: Ascorbic acid powder can be dissolved in water or added to smoothies and other drinks. This form makes it easy to adjust the dosage and is ideal for people who have difficulty swallowing tablets.

3. Chewable tablets

• Chewable tablets: Popular with children and adults who prefer a pleasant taste. Chewable tablets typically contain 100 mg to 500 mg of vitamin C and are available in a variety of flavors (orange, lemon, etc.).

4. Capsules

• Ascorbic acid capsules: Offer precise dosage and convenience, especially for adults who prefer capsules to tablets. Dosages range from 250 mg to 1,000 mg.

5. Liquid forms

• Concentrated liquid forms: These forms are ideal for children and adults who have difficulty taking solid or powdered forms of the vitamin. Liquid vitamin C can be added to drinks or food.

6. Vitaminized candies and lollipops

• Vitamin C Lollipops and Candies: Offer a fun and tasty way to get your daily allowance of ascorbic acid, and are especially popular with children.

7. Injections

• Solutions for injection: Used in health care facilities to rapidly replenish vitamin C deficiency, especially in critical and emergency cases.

Pharmacodynamics

1. Antioxidant activity:

   • Vitamin C is a powerful antioxidant that helps neutralize free radicals in the body. Free radicals are chemically active molecules that can damage cells, contributing to chronic diseases and accelerating the aging process. Ascorbic acid prevents oxidation of lipids, proteins, and DNA, which helps protect cellular structures and maintain health.

2. Collagen synthesis:

   • Vitamin C is essential for the hydroxylation of proline and lysine during the synthesis of collagen, a key structural protein that is essential for maintaining the integrity of skin, blood vessels, bones and cartilage. This makes ascorbic acid critical for wound healing, tissue repair, and maintaining healthy connective tissue.

3. Iron absorption:

   • Vitamin C improves the absorption of iron from food sources by converting iron from the less absorbable ferritin form to the more absorbable ferrous form. This prevents anemia and promotes better oxygenation of the blood.

4. Immune function:

   • Ascorbic acid stimulates the function of leukocytes (white blood cells), increases phagocytosis and interferon production, thereby strengthening the immune system and increasing the body's resistance to infectious diseases.

5. Neurotransmitter biosynthesis:

   • Vitamin C is involved in the synthesis of norepinephrine from dopamine in the brain and adrenal glands, which is important in regulating mood and stress response.

6. Anti-inflammatory action:

   • Vitamin C reduces the levels and activity of inflammatory molecules such as C-reactive protein and interleukins, which helps reduce symptoms of inflammation in the body.

7. Detoxification:

   • Promotes neutralization of toxins in the liver, also involved in the metabolism of tyrosine, phenobarbital and other substances.

Ascorbic acid may also have a protective effect against certain cancers through its ability to prevent DNA mutations associated with carcinogenesis. Because of these multiple functions, vitamin C is an important part of dietary recommendations and is often used as a dietary supplement to support overall health and prevent various diseases.

Pharmacokinetics

1. Absorption: Ascorbic acid is absorbed in the small intestine, mainly in the upper intestine, through active transport by a specific sodium-dependent vitamin C-transport protein. High doses may saturate this absorption mechanism and result in a slight increase in the absorption rate due to a passive diffusion mechanism.
2. Distribution: Ascorbic acid is widely distributed in the tissues of the body. It actively penetrates cell membranes where it can fulfill its biological functions.
3. Metabolism: Ascorbic acid is metabolized in the liver and other body tissues to form dehydroascorbic acid and further to other metabolites.
4. Excretion: The main route of excretion of ascorbic acid from the body is by renal mechanism. High doses of vitamin C can lead to oxalate formation in the kidneys, which increases the risk of stone formation.

Dosing and administration

Method of Application:

1. Oral Acceptance:

   • Ascorbic acid can be taken orally as tablets, chewable tablets, powder, or capsules.
   • The tablets should be swallowed whole with water.
   • Chewable tablets should be chewed thoroughly before swallowing.
   • The powder can be dissolved in water or added to food.

2. Injections:

   • Ascorbic acid can be given intravenously or intramuscularly as prescribed by your doctor. This method is used to quickly replenish vitamin C deficiency.

Dosage:

For adults:

• Prevention of vitamin C deficiency:
  • The usual dose is 75-90 mg per day for adult women and men, respectively.
• Treatment of vitamin C deficiency:
  • The recommended dose can range from 500 mg to 1,000 mg per day, divided into several doses.

For the kids:

• Prevention:
  • Dosage for children 1 year to 14 years of age ranges from 25 mg to 45 mg daily, depending on age.
• Treatment of deficiency:
  • The dosage may be increased to 100-300 mg per day, divided into several doses, depending on the degree of deficiency and the age of the child.

During pregnancy and lactation:

• Prevention and Treatment:
  • Recommended intake is 85 mg to 120 mg per day for pregnant and lactating women, respectively.

Special Instructions:

• Do not exceed the recommended daily dose, as excessive vitamin C intake can lead to side effects such as gastrointestinal upset and kidney stone formation.
• Vitamin C should be taken with caution by people with hemochromatosis, thalassemia, and elevated blood iron levels.
• Taking vitamin C may affect the effectiveness of some medications, including anticoagulants and antidepressants.

Use Ascorbic acid during pregnancy

Ascorbic acid (vitamin C) is an important nutrient during pregnancy, supporting the health of both the mother and the developing baby. However, its use must be balanced, as both deficiency and excess of this vitamin can lead to undesirable effects.

The importance of vitamin C during pregnancy

1. Collagen synthesis:

   • Vitamin C is critical for the production of collagen, which is essential for healthy skin, blood vessels, cartilage, and bones, as well as normal placental development.

2. Antioxidant defense:

   • Vitamin C helps protect cells from free radical damage, especially important when pregnancy increases oxidative stress.

3. Iron absorption:

   • Increases absorption of iron from food, preventing the development of iron deficiency anemia, a common condition during pregnancy.

4. Immune support:

   • Vitamin C strengthens the immune system, which is important for preventing infections during pregnancy.

Dosage recommendations

• General recommendations:
  • The recommended daily allowance of vitamin C for pregnant women is about 85 mg per day, which is slightly higher than for non-pregnant adult women (75 mg per day).
• Upper safe limit:
  • The upper acceptable intake level for pregnant women is 2000 mg per day. Exceeding this limit may lead to side effects such as diarrhea and gastric disturbances.

Potential risks of overdose

• Osmotic diarrhea and gastric upset can develop with too high doses of vitamin C.
• Kidney Stones: Although rare, there may be an increased risk of oxalate kidney stone formation if recommended doses of vitamin C are significantly exceeded.

Contraindications

1. Hypersensitivity: People with known hypersensitivity to ascorbic acid or any other components of the drug should avoid its use.
2. Elevated iron levels in the body (hemochromatosis): Patients with hemochromatosis, or other conditions characterized by elevated iron levels in the body, may not be advised to use high doses of ascorbic acid, as vitamin C enhances iron absorption.
3. Urolithiasis: Use of high doses of ascorbic acid may increase the risk of kidney stones (oxalate stones).
4. Hemophilia and other clotting disorders: Patients with hemophilia or other clotting disorders may require caution when using ascorbic acid because of its property of increasing blood coagulation.
5. Diabetes:Diabetic patients should use ascorbic acid with caution, as high doses may raise blood sugar levels.
6. Renal insufficiency: In patients with renal insufficiency, caution may be required with ascorbic acid due to the potential for accumulation of metabolites in the body.
7. Pregnancy and lactation: Use of ascorbic acid in high doses during pregnancy and lactation may require medical advice.
8. Pediatric:Pediatricians often recommend the use of ascorbic acid in children, but the dosage should be adjusted to the child's age and weight.

Side effects Ascorbic acid

1. Gastrointestinal disorders:

   • Diarrhea and stomach cramps often occur when vitamin C is consumed in high doses (usually over 2000 mg per day), which can cause osmotic effects and gastric irritation.
   • Heartburn or nausea can also result from high doses of vitamin C, especially if taken on an empty stomach.

2. Increased risk of kidney stones:

   • Excessive dosages may increase oxalate levels in the urine, which contributes to the formation of oxalate kidney stones, especially in predisposed individuals.

3. Disruption of vitamin and mineral absorption:

   • High doses of vitamin C may interfere with the absorption of vitamin B12 and copper, which is important to consider for long-term use.

4. Allergic Reactions:

   • Although rare, allergic reactions, including skin rash, itching or other hypersensitivity manifestations, may occur.

5. Insulin response:

   • Vitamin C in high doses can raise blood sugar levels, which requires caution in people with diabetes.

6. Hemolytic anemia:

   • People with glucose-6-phosphate dehydrogenase enzyme deficiency may experience hemolysis of red blood cells when taking large doses of ascorbic acid.

Overdose

An overdose of ascorbic acid can lead to a number of side effects and negative health consequences. Although ascorbic acid (vitamin C) is widely used for its antioxidant properties and its role in a variety of physiological processes, it is important to be aware of its potential toxicity when consumed in excess.

Key findings from the research:

• Ascorbic acid in high doses can cause side effects such as acidosis, oxaluria, kidney stones, glucosuria, kidney disease, gastrointestinal disorders, allergic reactions, blood clotting and cholesterol disorders, destruction of vitamin B12, fatigue and sterility. It is also known that ascorbate intake can affect the results of some laboratory tests (Barness, 1975).
• In a study of the effect of ascorbic acid on withdrawal in addicts, it was shown that high-dose vitamin C supplementation can alleviate withdrawal symptoms in addicts, indicating the potential usefulness of ascorbic acid in the treatment of addiction (Evangelou et al., 2000).
• Ascorbic acid plays an important role in many metabolic reactions, including collagen production, and can exert both antioxidant and pro-oxidant effects depending on the conditions. For example, it can inhibit angiogenesis, which is of interest for further studies of its non-toxic antitumor effects (Mikirova et al., 2008).

Interactions with other drugs

1. Salicylates and aspirin: Prolonged administration of high doses of ascorbic acid may reduce excretion of salicylates and aspirin, which may lead to an increase in their toxicity.
2. Iron: Ascorbic acid improves the absorption of iron from food, so its concomitant use with iron-containing drugs may increase their effectiveness.
3. Cholesterol-lowering drugs: Some studies have shown that ascorbic acid can reduce blood cholesterol levels, especially in patients with hypercholesterolemia, while reducing the need for cholesterol-lowering drugs.
4. Diuretics: Ascorbic acid may increase the acidity of urine, which may increase the rate of excretion of some diuretics.
5. Drugs metabolized in the liver: Interactions with drugs metabolized in the liver may be possible due to the influence of ascorbic acid on metabolic processes.