Eleanor Food Stuff

Boots No 7 Vitamin C

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Boots No 7 Vitamin C

Photo Courtesy: The Good Brigade/DigitalVision/Getty Images

Hepatitis is a condition that causes inflammation of your liver. Currently, there are an estimated 6 million people living with hepatitis in the United States, and more than 50,000 people are diagnosed with this disease every year. There are three primary types of hepatitis, and while their symptoms can be similar, they vary largely in the ways they're transmitted. Learning more about each type of hepatitis can help you better understand the condition as a whole.

Hepatitis A is the most easily transmitted of the three viruses. It affects approximately 2,500 people every year in the United States. It typically spreads through feces-contaminated food or water and is found in the feces of people who have the virus. Hepatitis A causes a short-term, acute sickness that most people heal from without treatment. However, it can cause serious illness in some people. This virus is more common in places with underdeveloped sanitation systems.

While doctors can't treat hepatitis A with medication, people who get this virus can manage its symptoms with fluids, rest and good nutrition. There's also a safe and effective vaccine available to protect you against hepatitis A.

What Is Hepatitis B?

Hepatitis B can occur both acutely (meaning it develops quickly and lasts a short time) and chronically (meaning it develops slowly over time and worsens over months or years). According to the Centers for Disease Control and Prevention, up to 2 million people in the United States are chronically affected with hepatitis B. Hepatitis B can be transmitted through sexual activity and exposure to infected blood. It can also be passed from a parent to their newborn child during birth.

Hepatitis B usually causes short-term discomfort that many people recover from completely after about four to eight weeks. However, it can turn into a chronic condition that lasts for years; this is more likely in older adults. Doctors can treat severe chronic hepatitis B with antiviral medications. However, in most cases, treatments focus on proper hydration and nutrition. There's a safe vaccine available to protect you against hepatitis B, too.

What Is Hepatitis C?

Approximately 4 million people in the United States are affected with hepatitis C. This form of hepatitis causes a chronic illness in over 50% of people who get this type of the virus. It's the least transmissible of the three viruses and can spread through contact with infected blood.

Hepatitis C occurs more commonly in people who engage in intravenous drug use. If you received a blood transfusion before 1992, you should also get tested for hepatitis C if you haven't previously. Hepatitis C can spread through unprotected sexual intercourse, but this is a less common way to transmit it. While there's no vaccine for chronic hepatitis C, treatments that are available today offer a 95% cure rate.

Chronic hepatitis C can significantly affect how your liver works. It can cause cirrhosis, which means that your normal liver tissue is replaced with scar tissue. It can also cause liver cancer. However, there are medications that can help keep this disease in check. Making lifestyle changes, such as reducing or eliminating alcohol from your diet, can also decrease your chances of experiencing complications. In severe cases, hepatitis C may require a liver transplant.

The varying forms of viral hepatitis affect millions of people in the United States. Chronic hepatitis often has few symptoms in its early stages, so recognizing the associated dangers and getting tested if you've been exposed may save your life. Although there are five types of viral hepatitis, only A, B and C are the forms commonly found in the United States.

Resource Links:

"Hepatitis A, B, and C: Learn the Differences," Immunization Action Coalition

"What's the Difference Between Hepatitis A, B and C?," UNC Health Talk

"The ABCs of Hepatitis," Centers for Disease Control and Prevention

"What's the Difference: Hepatitis B vs Hepatitis C?," Hepatitis B Foundation

Benadryl And Vitamin C

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Benadryl And Vitamin C

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People with allergies may find relief by using natural plant extracts and foods that act as antihistamines.

Antihistamines are substances that block histamine activity in the body. Histamine is a protein that triggers allergy symptoms, such as sneezing, itchy eyes, and a scratchy throat.

Over-the-counter (OTC) and prescription antihistamine medications are effective for symptom relief, but they can cause side effects, such as drowsiness and nausea. As a result, some people wish to try natural alternatives.

In this article, we describe the five best natural antihistamines, and we take a look at the science behind them.

man standing by flowers and sneezing — There are a number of natural antihistamines that may help relieve allergy symptoms.

Vitamin C boosts the immune system. It also acts as a natural antihistamine.

According to a 2018 study on vitamin C in the treatment of allergies, oxidative stress plays a key role in allergic diseases. As vitamin C is a powerful antioxidant and anti-inflammatory, it may act as a treatment for allergies.

The researchers observed that high doses of intravenous vitamin C reduced allergy symptoms. They also reported that a deficiency in vitamin C might lead to allergy-related diseases.

Another study from 2000 suggests taking 2 grams (g) of vitamin C daily to act as an antihistamine.

The vitamin is present in many fruits and vegetables, including:

bell peppers
broccoli
cantaloupe melon
cauliflower
citrus fruits
kiwifruit
strawberries
tomatoes and tomato juice
winter squash

Vitamin C supplements, with and without bioflavonoids, are available in health stores, drug stores, and online.

Butterbur is a plant extract from a shrub that grows in Asia, Europe, and some parts of North America. People often use butterbur to treat migraines and hay fever, also known as allergic rhinitis.

According to the National Center for Complementary and Integrative Health (NCCIH), butterbur may have antihistamine effects.

A 2007 review of 16 randomized controlled trials, testing 10 herbal products, suggests that butterbur could be an effective herbal treatment for hay fever.

This review suggested that butterbur was better than a placebo, or as effective as antihistamine medications, for relieving allergy symptoms.

However, the authors of the review point out that some large studies received funding from industry manufacturers, and so further independent research is needed.

Most people tolerate butterbur well, according to the NCCIH, but it may cause side effects such as:

breathing difficulties
diarrhea
drowsiness
fatigue
a headache
itchy eyes

Raw butterbur extracts contain certain compounds called alkaloids that can cause liver damage and cancer. Extracts of butterbur that do not contain these substances are available. However, no studies have looked into the long-term effects of using these products.

The plant extract can also cause allergic reactions in people with sensitivities to ragweed, chrysanthemums, marigolds, and daisies.

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Pineapple juice contains the anti-inflammatory enzyme bromelain.

Bromelain is an enzyme found in the core and juice of pineapples and is also available as a supplement.

Bromelain is a popular natural remedy for swelling or inflammation, especially of the sinuses and following injury or surgery.

Research on mice suggests that bromelain can reduce allergic sensitization and allergic airway disease thanks to its anti-inflammatory and anti-allergic properties.

In some people, oral supplementation of bromelain may cause adverse reactions such as:

changes in menstruation
digestive upset
an increased heart rate

People who are allergic to pineapple should avoid bromelain.

Bromelain supplements are available at health stores and online.

Probiotics are microorganisms that might offer health benefits by helping the body maintain a healthful balance of gut bacteria.

Probiotics may boost a person's immune system, which can help the body fight off allergies.

The NCCIH say that the evidence for probiotics is mixed and that some probiotics may help while others may not.

Quercetin is an antioxidant flavonoid found in many plants and foods. Research suggests that adding quercetin to the diet may help to relieve allergy symptoms.

Research reports that quercetin can have anti-allergic and antihistamine properties.

In one animal study, researchers found that quercetin could reduce the respiratory effects of allergies in mice by lowering airway inflammation.

However, the evidence for its effectiveness is mixed, and according to the NCCIH, there is not enough evidence to suggest that quercetin can relieve allergic rhinitis.

Quercetin is naturally present in many foods and herbs, including:

apples
berries
black tea
broccoli
buckwheat tea
grapes
Ginkgo biloba
green tea
peppers
red onions
red wine

However, taking supplements of quercetin will work better in the treatment of allergies than eating foods that contain it. This is because foods contain significantly lower levels of the flavonoid.

Quercetin is generally safe for most people. It may cause headaches and tingling in the arms and legs of some people. Very high doses, especially when taken long-term, may cause kidney damage.

People can buy quercetin supplements at health stores or online.

Other natural remedies

The NCCIH state that there is not enough evidence to suggest that the following natural products can help with the symptoms of allergic rhinitis:

astragalus
grape seed extract
omega-3 fatty acids
stinging nettle
French maritime pine bark extract
spirulina

If natural antihistamines do not reduce a person's allergy symptoms, they may need to seek alternatives.

Other methods to treat and prevent allergy symptoms include:

Avoiding the allergen

Allergy avoidance is typically the first line of defense against symptoms. Try to identify the allergen, which might be pollen, pet dander, or mold spores, and reduce exposure to it as much as possible.

Medications

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Allergy shots may be helpful for people with severe allergies.

Allergy medicines can cause the immune system's reaction to the allergen to calm down. Antihistamines work by breaking down histamine in the body.

Antihistamine medications can reduce symptoms such as sneezing, itchy eyes, and sinus pressure.

Medications for allergies are available OTC or by prescription and include:

oral medications
liquids
nasal sprays
eye drops

Immunotherapy

People with severe allergies may benefit from immunotherapy. This treatment is also suitable if allergy medications do not relieve symptoms.

During immunotherapy, a healthcare professional will give a person a series of injections that contain tiny amounts of the allergen. This treatment may take place over several years and aims to desensitize the body to the allergen.

For people with pollen allergies, doctors may recommend sublingual immunotherapy. This involves placing a tablet under the tongue until it dissolves.

Epinephrine treatment

Those with severe allergies may need to carry an emergency epinephrine shot (Auvi-Q, EpiPen) with them at all times. Giving this treatment at the onset of an allergic reaction can reduce symptoms and may save a person's life.

Living with allergies can be challenging, especially when symptoms are at their worst. Seek help and advice from a doctor when dealing with allergy symptoms.

Some natural substances can have antihistamine properties, meaning they can break down the chemicals that cause allergy symptoms. More evidence is needed to find out how effective these natural remedies are.

For the best chance of relief, try to limit or avoid exposure to the allergen. Practice good self-care techniques and consider using natural antihistamines.

As the United States Food and Drug Administration (FDA) do not regulate supplements, and natural remedies can interfere with certain medications, it is essential to speak to a doctor before beginning any new supplement or herbal remedy.

Read the article in Spanish.

Benadryl And Vitamin C

Source: https://www.medicalnewstoday.com/articles/323276

All About Vitamin C

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All About Vitamin C

A Guide to Vitamin C Serums

leonori/Shutterstock

For 70 years Vitamin C has been one of the biggest weapons in the skin care industry. It's used to make cleansers, moisturizers, lotions, masks, and serums. So what is this powerful vitamin? How can it benefit you? Why should you use serums that contain Vitamin C? We're here to answer all of those burning questions in this complete guide and reveal the many benefits Vitamin C serums offer for your skin.

What Are Vitamin C Serums?

There are many variations of Vitamin C, but the most popular is ascorbic acid, a common ingredient in skincare products. However, all the variations of Vitamin C have anti-inflammatory benefits.

Vitamin C Serums are products that contain a high level of Vitamin C. They're used to treat wrinkles, sagging skin, lighten dark or red spots, prevent breakouts and even your skin tone. Basically, they battle all of those annoying skin issues. There are loads of products out there that claim they'll save your skin, but some can cause damage. Vitamin C is one of the most revered ingredients and conclusive research has shown how effective it can be.

How Are Vitamin C Serums Made?

Well so far we've talked about how incredible Vitamin C is and it sounds like a dream come true doesn't it? It's not all good. In fact, the mighty vitamin is unstable when it's exposed to air and light. Other ingredients need to be used to stabilize it and allow it to deliver amazing results. The serums are combined with ferulic acid and Vitamin E. According to researchers the perfect mixture is 15% Vitamin C with 1% Vitamin E and 0.5% ferulic acid. This makes Vitamin C perform to the best of its abilities, without damaging your skin.

What Does Vitamin C Serum Do for Your Face?

Boosts Collagen Production: Collagen keeps your skin firm and prevents sagging. Environmental factors such as lifestyle choices and pollution can increase the elasticity of your skin, so it's important you try to increase your collagen production.

Hydrates Your Skin: Dry skin is a common issue, but Vitamin C can help to give your skin that much-needed moisture boost. Remember, it doesn't work immediately so you need to keep applying the serum to see results.

Brightens Your Complexion: Dark spots on your skin are caused by the overproduction of melanin. Vitamin C decreases the production and lightens the dark spots to even out your complexion.

Reduces Redness and Inflammation: Conditions such as Rosacea leave many people searching for a magic cure. Vitamin C helps facial redness and inflammation by reducing the appearance of broken capillaries.

Why Should You Be Using Vitamin C Serum?

Don't think Vitamin C serums are just beneficial for your face. They can also shield you from sun damage and reduce stretch marks.

Saves You From The Sun: Prolonged exposure to UV rays can cause long-term damage to your skin. Luckily, Vitamin C is a powerful antioxidant that reduces red sports and prevents sunburn from spreading.

Fades Acne Scars: Acne plagues most of us at some point and we look forward to being free. Most of us get stuck with some scars but Vitamin C helps to fade scars and even out any discoloration.

Reduces Stretch Marks: Yes, Vitamin C serum can even help prevent those unsightly stretch marks by tightening your skin.

Are you ready to change your skin? Add a Vitamin C serum to your beauty regimen and enjoy a glowing complexion.

All About Vitamin C

Source: https://www.bloglines.com/article/a-guide-to-vitamin-c-serums?utm_content=params%3Ao%3D740010%26ad%3DdirN%26qo%3DserpIndex

What Drink Has The Most Vitamin C

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What Drink Has The Most Vitamin C

5 Effective Vitamin C Drinks You Can Add To Your Immunity-Boosting Diet

Vitamin C Benefits: It's important to replenish our body with Vit C as often as possible

It is an established fact that vitamin C makes a significant contribution in boosting our immunity. But, this is not the only reason you should consume it in ample amounts. The nutrient plays a big role in maintaining the strength of bones and teeth, improving metabolism, healing wounds, and keeping skin and hair in good condition. You should also know that vitamin C is a water-soluble compound and gets washed away easily by our system, so it's important to replenish our body with it as often as possible.

While there are lots of foods that can fuel vitamin C in our body, juicing or brewing certain foods and drinking them on a daily basis is the quickest way to refill lots of vitamin C. Here are some drinks that you can add to your diet for your daily vitamin C fix.

Vitamin C drinks for strong immunity:

1. Lemonade

Having lemon water daily is a great way to rev up your metabolism and boost immunity along the way. Just squeeze lemon in warm water, add some honey and black pepper and have it the first thing in the morning. You can also make refreshing lemonade in cold water with soda, black salt and sugar and have it any time of the day. Or just add freshly-squeezed lemon juice in a glass of water and gulp it down to quench your thirst.

(Also Read: 9 Fruits And Vegetables That Have More Vitamin C Than Orange)

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^{Drinking lemon water is an effective way of improving immunity.}

2. Fruit Juice

Pick any fruit with high vitamin C content, juice it and drink it. Orange, litchi, pineapple, watermelon, cherries are some fruits you can juice to make a healthy, immunity-boosting drink.

3. Herbal Tea

Ditch your regular tea laced with caffeine and replace it with herbal tea at least once a day. Choose from antioxidants-rich herbs like coriander, basil, mint, thyme and rosemary.

4. Milk Shake Or Smoothie

Strawberry shake, mango shake, apple shake, kiwi smoothie and papaya smoothie are some interesting options when you feel like having a creamy and tasty drink. The fact that they are also rich in vitamin C makes these a great option too.

(Also Read: Immunity-Boosting Summer Foods You Must Include In Your Daily Diet)

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^{Strawberry shake gives you a good amount of vitamin C.}

5. Vegetable Juice Or Soup

Make vegetable juice with green leafy and cruciferous vegetables like spinach, spinach, broccoli, cabbage, cauliflower, kale, or make hot soups with them. Tomato and cucumbers are also great options to include in your cooling juice or warming soup.

Face seasonal infections and other health risks on a healthy diet with these effective vitamin C-rich drinks.

About Neha GroverLove for reading roused her writing instincts. Neha is guilty of having a deep-set fixation with anything caffeinated. When she is not pouring out her nest of thoughts onto the screen, you can see her reading while sipping on coffee.

What Drink Has The Most Vitamin C

Source: https://food.ndtv.com/food-drinks/5-effective-vitamin-c-drinks-you-can-add-to-your-immunity-boosting-diet-2256657

Vitamin C In Renal Failure

BrettDesember 03, 2021 Tidak ada komentar

Vitamin C In Renal Failure

Review
Open Access
Published: 12 February 2020

Dosing vitamin C in critically ill patients with special attention to renal replacement therapy: a narrative review

Annals of Intensive Care volume 10, Article number:23 (2020) Cite this article

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Abstract

Rationale/methods

The primary aim of the present contribution is to find a literature-based agreement on dose adjustments of vitamin C in critically ill patients undergoing renal replacement therapy (RRT).

Available data/study results

Critical illness is frequently accompanied by severe vitamin C deficiency. High-dose supplementation beneficially affects clinical outcome in small cohorts of patients with sepsis, burn injury, and trauma. There are no specific data on clinical outcomes in patients receiving renal replacement therapy (RRT). Vitamin C plasma concentrations in patients on RRT are comparable to critically ill patients not receiving RRT. Vitamin C is cleared from the circulation during RRT at a rate dependent on the plasma concentration, dose and duration of RRT. Sieving coefficient is about 1. While the dose of RRT is lower than normal renal function, tubular reabsorption is absent. Sparse evidence suggests that vitamin C dosing during continuous RRT should not exceed the dose administered to critically ill patients not receiving continuous RRT. Low plasma concentrations are expected during prolonged RRT because of persistent extracorporeal removal, absent renal reabsorption and enhanced metabolic loss due to circuit-induced oxidative stress. A dosage of twice 1 g vitamin C daily may be necessary to achieve normal plasma concentrations during RRT, but more studies are needed. There is no available evidence that high doses of vitamin C administered over a short period can induce oxalate stones or has pro-oxidant effects.

Conclusions

Supplementing vitamin C 1 g twice daily to critically ill patients has a solid pathophysiological rationale and a good safety profile. Patients on RRT probably need similar doses as critically ill patients not receiving RRT. Intravenous vitamin C in a dose of 2 g/day may be necessary to achieve normal plasma concentrations during RRT. However, data on dose adjustment of vitamin C during intermittent or chronic RRT are sparse and require more thorough pharmacokinetic and dose–response studies.

Rationale for supplementing vitamin C in critically ill patients

Vitamin C has anti-oxidant, anti-inflammatory, and immune-enhancing capacities, and acts as a cofactor for the synthesis of collagen, cortisol, catecholamines, and vasopressin [1]. Plasma vitamin C concentrations frequently flirt with scurvy levels in septic, trauma, and burn patients, after major surgery, and in any condition characterized by overwhelming systemic oxidative and inflammatory stress [2]. Diminished intake, increased consumption, and reduced recycling all contribute to this vitamin C deficiency. In line with its biological modulator functions and continued depletion in severe disease, restoring normal circulating vitamin C levels is thought to improve hemodynamics [3], limit organ failure, and benefit survival of critically ill patients. Promising results have been reported in small cohorts of patients receiving a repletion dose of vitamin C in combination with vitamin E. High-dose intravenous (IV) vitamin C significantly reduced fluid requirements, weight gain, and wound edema and improved renal and pulmonary function in the acute phase after burn injury [4]. Vitamin C infusion, alone [5,6,7] or in combination with thiamine and hydrocortisone [8], reduced biomarkers of inflammation and endothelial injury and had a positive impact on shock reversal, recovery from organ failure, and survival in severe sepsis and septic shock in a landmark before after trial [8], but not in the most recent vitamins trial which randomized septic shock patients to the above-mentioned cocktail or to hydrocortisone alone [9]. Apart from the hydrocortisone in all control patients, the vitamins trial differs from the before–after trial by a later timing of vitamin C (median more than 24 h after admission), and by less comorbidity. The value of early high-dose IV vitamin C treatment in ischemia/reperfusion injury has been extensively documented in animal experiments [10], but requires confirmation in clinical trials. Altogether, evidence on vitamin C supplementation is still fragmentary or inconclusive and does not support a widespread use in critically ill patients [11, 12]. For instance, regarding the CITRUS-ALI study which is widely quoted and promoted as a negative study; in actuality it is a double-positive study [13]. Indeed, the authors have recalculated the Sequential Organ Failure Assessment (SOFA) score as several errors did occur like for instance imputing the SOFA score prior to death in those patients who died prior to 96 h [5]. This reanalysis demonstrates a significant difference in SOFA scores between the two groups at 96 h and this reanalysis should be published soon [13]. Nevertheless, adjuvant vitamin C therapy holds particular promise in sepsis because of its apparent involvement in sepsis-related pathophysiological processes and the remarkably positive results in small clinical studies. A large number of randomized controlled trials (RCTs) are currently recruiting patients with sepsis and septic shock [14] to assess the benefit of vitamin C alone or in combination with hydrocortisone and thiamine.

Considerations on dosing of vitamin C in critical illness

The recommended daily dietary intake of vitamin C in healthy individuals is approximately 100 mg and produces plasma vitamin C levels between 60 and 100 µmol/L [15]. Vitamin C dosing in critically ill patients, however, is still an issue under debate. Also, it is unclear whether the dosing strategy should attempt to achieve normal or supraphysiologic (up to 1000 µmol/L) plasma vitamin C levels.

Some items pertaining to vitamin C dosing are known. First, intravenous (IV) dosing is crucial. Enteral uptake is unpredictable and may be seriously limited because the enteral transporter is satiable [1] and gut function often is impaired during critical illness. Second, high vitamin C doses (2–3 g/day) must be administered to restore plasma concentrations to normal [16, 17] and sustained therapy is needed to prevent reoccurrence of hypovitaminosis [17]. Third, a very high dose (100–200 mg/kg/day) is required to obtain supranormal plasma concentrations [4, 17]. Studies which showed beneficial effects on biological and clinical outcome parameters used very high vitamin C doses (66 mg/kg/h or 1584 mg/kg/day) on the first day of admission in burn patients [4] and 3 g, 6 g or 200 mg/kg daily in septic or trauma patients [5,6,7,8].

a. Pharmacokinetics of vitamin C

Vitamin C pharmacokinetics are best described by a two-compartment model with body weight and creatinine clearance as independent covariates [17]. In normal kidneys, vitamin C is filtered in the glomerulus and (partly) reabsorbed in the proximal convoluted tubule and the descending loop of Henle (see Fig. 1). Like enteral absorption, tubular reabsorption is satiable which accounts for a higher loss when plasma concentrations are high. Although the kidneys excrete about half of the administered vitamin C dose, the dose–concentration relationship is linear, implying that an x-times higher dose results in x-times higher plasma concentration [17]. Plasma concentrations following IV administration are expected to be significantly higher in anuric patients. Nearly half of critically ill patients have or develop acute kidney injury (AKI), and more than 20% need renal replacement therapy (RRT) within the first week of intensive care stay [18].

b. Pharmacokinetics of vitamin C during RRT

As a small (176 Da) water-soluble molecule, vitamin C concentration in ultrafiltrate or dialysate is equal to plasma (sieving coefficient around 1) [18]. Vitamin C removal during RRT, therefore, depends on the dose and duration of RRT, and on plasma concentrations (see Fig. 1) [19, 20]. During RRT, clearance is less than by glomerular filtration because the dose of standard RRT is lower than normal renal function. However, as vitamin C is not reabsorbed during CRRT, losses persist even in case of overt deficiency due to absent reabsorption. Furthermore, the decline in vitamin C plasma concentration during RRT is higher than expected when based on loss by filtration or dialysis, probably because of consumption related to substantial oxidative stress induced by the extracorporeal circuit [21], which leads to insufficient recycling of the oxidized vitamin C.

c. Clinical studies on plasma concentrations and loss of vitamin C during RRT

We have summarized the data of the five studies on vitamin C during RRT in Table 1. Vitamin C plasma concentrations in patients on RRT were found to be lower than in healthy controls, but comparable to critically ill patients not receiving RRT (see Table 1). Story et al. reported a daily median loss of 93 (range: 0–372) mg vitamin C in patients on continuous veno-venous hemofiltration (CVVH) [22]. Plasma vitamin C levels were reduced by 50% during a single intermittent hemodialysis session [19, 20]. Morena et al. observed a mean loss of 66 (range 8–230) mg vitamin C per session (200 mg/week) of intermittent chronic hemodiafiltration [19]. Pronounced vitamin C deficiency was reported in 80% of patients receiving continuous RRT (CRRT) for a mean duration of 2 weeks despite a daily IV dose of 500–1.000 mg supplemented for 7 days prior to vitamin C sampling [22].

Table 1 Table describing the pertinent studies examining vitamin C dosing in RRT

Full size table

Supplementing vitamin C during RRT by giving 1 g twice daily

Optimal plasma concentrations of vitamin C in critically ill patients on RRT are not known. Furthermore, symptoms of deficiency are difficult to diagnose during critical illness and are probably different from classical scurvy. The dose for supplementation of vitamin C during RRT to prevent scurvy or scurvy-like plasma concentrations of vitamin C is much lower as compared to pharmacological dosing. Apparently, doses of 1000 mg were not enough to avoid low plasma concentrations during RRT in a retrospective study [22]. The plasma vitamin C concentrations of the above described patient on CVVH receiving twice 1 g daily were within the normal range [22], suggesting that a twice daily dose of 1 g vitamin C may be sufficient to maintain normal plasma concentrations during CVVH [23]. However, more pharmacokinetic data are needed for an evidence-based recommendation of vitamin C to prevent deficiency. Plasma vitamin C concentrations in a patient on CVVH receiving 2 g/day were also similar to patients not on CRRT. In this case, the estimated daily effluent loss was 830 mg/day or 41% of the administered dose, which tended to be less than by the native kidney [23].

d. Pharmacological dosing of vitamin C to manipulate severe oxidative stress during RRT

Dosages of vitamin C should be higher if the goal is to influence redox homeostasis and enzyme function in sepsis and other conditions as severe burns [24]. A recent small case series reported plasma concentrations in CRRT patients supplemented with 6-g vitamin C daily [24]. Trough and peak concentrations were intentionally high (263 and 461 μmol/L resp.), but comparable to patients not receiving CRRT. Estimated effluent losses were 1680 mg/day or 28% of the administered dose. Plasma concentrations in patients with chronic renal insufficiency on intermittent hemodialysis were even higher [24]. Thus, based on the sparse available evidences, vitamin C dosing during CRRT should not exceed the dose administered to critically ill patients not on CRRT. Obviously, more pharmacokinetic data and dose–response studies are needed to settle this issue and randomized controlled trials (RCTs) are needed to evaluate clinical effects in septic AKI needing RRT.

e. Should a patient on RRT receive IV supplementation if they are on full enteral nutrition?

The answer is yes. Patients on RRT have similar plasma concentrations to critically ill patients not on RRT [23]. Critically ill patients exhibit hypovitaminosis C and vitamin C deficiency despite recommended enteral and parenteral intakes along with nutrition [25, 26]. Based on the scarce clinical data, a twice 1 g dose of intravenous vitamin C is needed to maintain normal plasma concentrations in critically ill patients with or without RRT on full nutrition [23], whereas 1 g/day seems insufficient [21].

f. Vitamin C dosing during peritoneal dialysis (PD)

Vitamin C deficiency is common in patients undergoing maintenance hemodialysis (MHD) and continuous ambulatory peritoneal dialysis (CAPD). Vitamin C losses are lower in CAPD than in MHD [27]. Patients with chronic kidney disease (CKD) undergoing CAPD, however, are prone to increased oxidative stress (OS) which is associated with enhanced cardiovascular risk, peritoneal membrane changes, and ultrafiltration failure. Supplementation of vitamin C and E in CAPD patients significantly attenuated OS as reflected by an increase in erythrocyte antioxidant enzyme activity and total antioxidant capacity (TAC) and lower MDA and carbonyl compound concentrations [28].

g. Dosing considerations for patients with renal failure who are not on RRT

Removal of vitamin C by the kidney depends on plasma concentration. In case of hypovitaminosis tubular reabsorption is maximal and removal is minimal while losses are higher when plasma concentrations are high. In patients with severe AKI, plasma concentrations following IV administration are expected to be significantly higher, especially in anuric patients. Thus, dose reduction is needed in patients with renal failure who do not require RRT. Since no guidelines are found in the literature, dosing 1–2 g/day vitamin C dosing seems to be most appropriate to avoid overdosing in this population.

Renoprotective effects of vitamin C

In a recent animal study, 24 adult male Wistar rats were randomly distributed into three groups: Group I received sevoflurane only, whereas Groups II and III additionally received moderate (150 mg/kg) and high (300 mg/kg) doses of ascorbic acid. The study found a dose-dependent reduction of acute tubular necrosis in the ascorbic acid group [29]. In patients with severe sepsis and septic shock treated with colistin according to a modified pharmacokinetics–pharmacodynamics (PK/PD)-based dosing strategy, Dalfino et al. identified baseline renal impairment and older age as strong predictors of AKI occurrence. Concomitant administration of ascorbic acid markedly reduced AKI risk [30]. In the before–after study of Marik, less patients received RRT for AKI in the group receiving ascorbic acid (in combination with hydrocortisone and thiamine) [8].

Possible side-effects of treatment with vitamin C

Significant toxicity of high-dose vitamin C has not been reported in published clinical trials. However, in view of a potential increase in vitamin C supplementation in critical illness, vigilance remains imperative.

Some potential side-effects must be emphasized:

(A) Oxalate stones and nephropathy

High-dose vitamin C increases oxalate excretion [17] and may cause oxalate crystallization, stone formation and nephropathy in susceptible patients. Several cases have been reported in patients receiving vitamin C supplements [31, 32]. Gender is a risk factor for dose-dependent oxalate stone formation [32]. A vitamin C dose above 1000 mg/day was not associated with renal stone formation in women, yet 700 mg/day sufficed to induce stones in men [33]. Apart from primary hyperoxaluria, a rare inborn error of metabolism, risk factors include fat malabsorption due to small bowel resection, inflammatory bowel disease, chronic pancreatitis or gastric bypass (decreasing fecal oxalate excretion), underlying chronic kidney disease, urinary outflow obstruction [34]. However, in a recent prospective case series exploring high-dose vitamin C (up to 100 g IV thrice weekly), no renal stones or kidney injury were reported [35].

(B) Pro-oxidant effects

Theoretical concerns exist that high-dose vitamin C may exert pro-oxidant effects. By donating an electron during radical scavenging, vitamin C is converted to the ascorbate radical and after a further electron donation to dehydroascorbic acid (DHA). During this process, a more aggressive radical (i.e., superoxide) is converted to the less aggressive ascorbate radical which predominantly reacts with itself, thereby dismutating to DHA and ascorbate [1]. In addition, electrons from ascorbate can reduce copper and iron, and generate superoxide and hydrogen peroxide (H₂O₂). This pro-oxidant effect occurs when large doses are infused. Some cancers are susceptible to H₂O₂, while human cells are less so possibly because of the large reducing capacity of erythrocytes [1]. Significant toxicity of high-dose vitamin C has not been reported in published clinical trials. However, given that relatively few patients have been enrolled to date, additional side-effects cannot be excluded.

(C) Incorrect glucose readings

Amongst other factors, high concentration of ascorbic acid interfere with glucose readings from finger stick blood glucose (FSBG) meters [36]. A classic case of marked interference with FSBG readings is due to intravenous ascorbic acid, because the devices recognized ascorbic acid as glucose and erroneously detects hyperglycemia if ascorbic acid levels are high. Factitious hyperglycemia may expose the patient to unwarranted insulin dosing errors. Spectrophotometric methods can be used to avoid unnecessary insulin with the risk of hypoglycemia.

(D) Hemolysis in G6PD deficiency

Several cases of hemolysis induced by pharmacological doses of IV ascorbic acid (> 60 g) in patients with G6PD deficiency have been published [36]. However, as recently reported low–moderate dose IV vitamin C may be the treatment of choice for drug-induced hemolysis in patients with G6PD deficiency [36]. Extrapolated from in vitro data, a dose of up to 6 g/day is not contraindicated in patients with G6PD deficiency [37]. Higher doses should be avoided in these patients [38].

Safety

Important side-effects of vitamin C are not reported in any of the mentioned controlled trials, also not in the most recent VITAMIN randomized trial [9]. Furthermore, vitamin C has been evaluated for treating atrial fibrillation in RCTs after cardiac surgery [39]. Meta-analyses also evaluated adverse events. They concluded that vitamin C was safe [40], although meta-analyses upon vitamin C should be taken with caution as recently shown [41].

Conclusions and future directions

Vitamin C is closely involved in pathophysiological processes related to ischemia–reperfusion, immunomodulation, and inflammation. Critical illness leads to a rapid exhaustion of vitamin C stores. Adjuvant therapy with vitamin C has been shown to mitigate organ injury in burn, sepsis, and post-cardiac surgery patients. The optimal dosing strategy in critically ill patients is unknown and a most effective or specific pathology-related dosing schedule remains to be established. However, at least 2–3 g IV vitamin C must be supplemented daily during the acute phase to normalize plasma concentrations. Preliminary clinical experience suggests that high-dose vitamin C therapy (≥ 6 g daily) in the acute phase is associated with better outcome and no significant toxicity. The promising results of adjuvant high-dose vitamin C alone or in combination with thiamine and hydrocortisone are currently being evaluated in large RCTs.

Scarce available data remain inconclusive regarding dose adjustments during RRT. However, vitamin C dosing during CRRT should probably not exceed the dose administered to critically ill patients not on CRRT, though this hypothesis needs to be confirmed in RCTs. Low plasma concentration can be expected during RRT for a prolonged time period due to persistent extracorporeal removal and metabolic loss due to circuit-induced oxidative stress accentuating the need for further pharmacokinetic and dose–response studies in the setting of CRRT. However, a dosage of about 1 g twice daily may be needed to obtain normal plasma concentration during RRT.

Availability of data and materials

Not applicable.

Abbreviations

IV:: Intravenous
SOFA Score:: Sequential Organ Failure Assessment Score
RCTs:: Randomized controlled trials
RRT:: Renal replacement therapy
CRRT:: Continuous renal replacement therapy
CVVH:: Continuous veno-venous hemofiltration
OS:: Oxidative stress
DHA:: Dehydroascorbic acid
H₂O₂ :: Hydrogen peroxide
MHD:: Maintenance hemodialysis
CAPD:: Continuous ambulatory peritoneal dialysis
PD:: Peritoneal dialysis
TAC:: Total antioxidant capacity
CKD:: Chronic kidney disease
PK/PD:: Pharmacokinetic/pharmacodynamics

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Author information

Affiliations

ICU Dept, Centre Hospitalier Universitaire Brugmann/Brugmann University Hospîtal, Place Van Gehuchtenplein, 4, 1020, Brussels, Belgium

Patrick M. Honore
Development, Ageing & Pathology Research Department, Vrije Universiteit Brussel, Brussels, Belgium

Herbert D. Spapen
Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, 825 Fairfax Av, Suite 410, Norfolk, VA, 23507, USA

Paul Marik
Dept. of Anesthesiology, Intensive Care Medicine, Emergency Medicine & Pain Medicine, Ziekenhuis Oost-Limburg Genk, Genk, Belgium

Willem Boer
Department of Intensive Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands

Heleen Oudemans-van Straaten

Contributions

PMH, HDS, PM, WB, and HOVS designed the paper and participated in drafting and reviewing. All authors read and approved the final manuscript.

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Correspondence to Patrick M. Honore.

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Honore, P.M., Spapen, H.D., Marik, P. et al. Dosing vitamin C in critically ill patients with special attention to renal replacement therapy: a narrative review. Ann. Intensive Care 10, 23 (2020). https://doi.org/10.1186/s13613-020-0640-6

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Received: 27 August 2019
Accepted: 06 February 2020
Published: 12 February 2020
DOI : https://doi.org/10.1186/s13613-020-0640-6

Keywords

Vitamin C
Renal replacement therapy
Sepsis
Burns
Trauma
High-dose vitamin C
Peritoneal dialysis
Prevention of acute kidney injury

Vitamin C In Renal Failure

Source: https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-020-0640-6

How Much Vitamin C Do Guinea Pigs Need Everyday

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How Much Vitamin C Do Guinea Pigs Need Everyday

A Guide to Vitamin C Serums

leonori/Shutterstock

What Are Vitamin C Serums?

There are many variations of Vitamin C, but the most popular is ascorbic acid, a common ingredient in skincare products. However, all the variations of Vitamin C have anti-inflammatory benefits.

How Are Vitamin C Serums Made?

What Does Vitamin C Serum Do for Your Face?

Brightens Your Complexion: Dark spots on your skin are caused by the overproduction of melanin. Vitamin C decreases the production and lightens the dark spots to even out your complexion.

Why Should You Be Using Vitamin C Serum?

Don't think Vitamin C serums are just beneficial for your face. They can also shield you from sun damage and reduce stretch marks.

Fades Acne Scars: Acne plagues most of us at some point and we look forward to being free. Most of us get stuck with some scars but Vitamin C helps to fade scars and even out any discoloration.

Reduces Stretch Marks: Yes, Vitamin C serum can even help prevent those unsightly stretch marks by tightening your skin.

Are you ready to change your skin? Add a Vitamin C serum to your beauty regimen and enjoy a glowing complexion.

How Much Vitamin C Do Guinea Pigs Need Everyday

Source: https://www.bloglines.com/article/a-guide-to-vitamin-c-serums?utm_content=params%3Ao%3D740010%26ad%3DdirN%26qo%3DserpIndex

Colã¡Geno Con Vitamina C Efectos Secundarios

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Colã¡Geno Con Vitamina C Efectos Secundarios

Descripción general

La vitamina C (ácido ascórbico) es un nutriente que el cuerpo necesita para formar vasos sanguíneos, cartílagos, músculos y colágeno en los huesos. La vitamina C también es vital para el proceso de curación del cuerpo.

La vitamina C es un antioxidante que protege las células contra los efectos de los radicales libres, las moléculas que se producen cuando el cuerpo descompone los alimentos o se expone al humo del tabaco y la radiación del sol, rayos X u otras fuentes. Los radicales libres pueden desempeñar un papel en las enfermedades cardíacas, el cáncer y otras enfermedades. La vitamina C también ayuda al cuerpo a absorber y almacenar el hierro.

Debido a que el cuerpo no produce vitamina C, necesita obtenerla de la dieta. La vitamina C se encuentra en las frutas cítricas, las bayas, las papas, los tomates, los pimientos, el repollo, las coles de Bruselas, el brócoli y las espinacas. La vitamina C también está disponible como suplemento oral, generalmente en forma de cápsulas y tabletas masticables.

La mayoría de las personas obtiene suficiente vitamina C con una dieta saludable. La deficiencia de vitamina C es más probable en personas que:

Fuman o están expuestas al tabaquismo pasivo
Tienen ciertas afecciones gastrointestinales o ciertos tipos de cáncer
Tienen una dieta limitada que no incluye frutas y verduras regularmente

La deficiencia grave de vitamina C puede provocar una enfermedad llamada escorbuto, que causa anemia, sangrado de las encías, hematomas y mala cicatrización de heridas.

Si tomas vitamina C por sus propiedades antioxidantes, ten en cuenta que es posible que el suplemento no ofrezca los mismos beneficios que los antioxidantes naturales presentes en los alimentos.

La cantidad diaria recomendada de vitamina C es de 90 miligramos para hombres adultos y 75 miligramos para mujeres adultas.

Evidencia

En la investigación sobre el uso de vitamina C para afecciones específicas, se ha demostrado lo siguiente:

Cáncer. Consumir una dieta rica en frutas y verduras podría reducir el riesgo de varios tipos de cáncer, como el cáncer de mama, de colon y de pulmón. Sin embargo, no está claro si este efecto protector está relacionado con el contenido de vitamina C en la comida. Tomar suplementos de vitamina C por vía oral no pareciera ofrecer el mismo beneficio.
Resfriado común. Tomar suplementos de vitamina C por vía oral no previene el resfriado común. Las pruebas también muestran que los beneficios de tomar suplementos de vitamina C en forma periódica para reducir la duración o intensidad de un resfriado son mínimos.
Enfermedades oculares. Tomar suplementos de vitamina C por vía oral en combinación con otras vitaminas y minerales parece prevenir el empeoramiento de la degeneración macular asociada a la edad (DMAE). Algunos estudios también indican que las personas que tienen mayores niveles de vitamina C en su alimentación tienen menor riesgo de desarrollar cataratas.

Nuestra recomendación

Luz verde: Generalmente seguro

En general es segura

La mayoría de las personas obtiene suficiente vitamina C con una alimentación equilibrada. Las personas que pueden ser susceptibles a la deficiencia de vitamina C pueden beneficiarse del uso de suplementos de vitamina C.

Seguridad y efectos secundarios

Si se toman en dosis adecuadas, los suplementos de vitamina C generalmente se consideran seguros. Tomar demasiada vitamina C puede causar efectos secundarios, entre ellos:

Náuseas, vómitos y diarrea
Acidez estomacal
Hinchazón o cólicos estomacales
Fatiga y somnolencia, o a veces insomnio
Dolor de cabeza
Enrojecimiento de la piel

En algunas personas, los suplementos de vitamina C pueden causar cálculos renales, en especial si se toman en altas dosis. El uso prolongado de suplementos de vitamina C por vía oral superiores a 2000 miligramos por día aumenta el riesgo de efectos secundarios significativos.

Dile al médico que estás tomando suplementos de vitamina C antes de hacerte análisis clínicos. Los altos niveles de vitamina C podrían interferir con los resultados de determinados análisis, como los análisis de las heces para detectar sangre oculta o los análisis de glucosa.

Interacciones

Estas son algunas de las posibles interacciones:

Aluminio. Tomar vitamina C puede aumentar la absorción de aluminio de medicamentos que contienen aluminio, como aglutinantes de fosfato. Puede ser dañino para las personas con problemas renales.
Quimioterapia. Existe la inquietud de que el uso de antioxidantes, como la vitamina C, durante la quimioterapia podría reducir el efecto de los medicamentos de quimioterapia.
Estrógeno. Tomar vitamina C con anticonceptivos orales o terapia de reemplazo hormonal podría aumentar los niveles de estrógeno.
Inhibidores de la proteasa. El uso oral de vitamina C podría reducir el efecto de estos medicamentos antivirales.
Estatinas y niacina. Cuando se toman con vitamina C, los efectos de la niacina y las estatinas, que podrían ser beneficiosas para las personas con colesterol alto, podrían verse reducidos.
Warfarina (Jantoven). La vitamina C en dosis altas podría reducir la respuesta a este anticoagulante.

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July 29, 2021

Vitamin C — Fact sheet for health professionals. Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/. Accessed Oct. 11, 2020.
Vitamin C — Fact sheet for consumers. Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminC-Consumer/. Accessed Oct. 11, 2020.
Vitamin C. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Oct. 11, 2020.
Pazirandeh S, et al. Overview of water-soluble vitamins. https://www.uptodate.com/contents/search. Accessed Oct. 11, 2020.
Quidel S, et al. What are the effects of vitamin C on the duration and severity of the common cold? Medwave. 2018; doi:10.5867/medwave.2018.06.7260.
Ascorbic acid oral. Facts & Comparisons eAnswers. https://www.wolterskluwercdi.com/facts-comparisons-online/. Accessed Oct. 11, 2020.
Ascorbic acid. IBM Micromedex. https://www.micromedexsolutions.com. Accessed Oct. 11, 2020.
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Colã¡Geno Con Vitamina C Efectos Secundarios

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