How much and what type of Vitamin C should

be taken daily?

Question of the Week:

January 10, 2002

"How much and what type of Vitamin C should be taken daily? I am a 48 year old female thinly built but noticing lately my muscle tone is atrophying because I do not get much time to exercise the way I used to . I eat very little red meat but lot of fish and vegetables, do not smoke or drink even my facial muscles are becoming lax what do you suggest. "

Dear Questioner:

Here is a question I have chosen to answer because it illustrates a number of different points about anti-aging medicine.

The questioner asks about the proper dose and type of vitamin C. This is a resonable inquiry. We generally recommend about 500 mg twice a day, which is about 15 times the RDA, but is much lower than the mega doses of 10,000 to 20, 000 mg Linus Pauling and others have proposed. This is because ascorbic acid (vitamin C) can also function as a pro-oxidant if in excess. It is better to balance it with adequate levels of vitamin E and alpha lipoic acid, the natural regenerators of reduced vitamin C so that it can act as a free radical quencher and not a pro-oxidant. We recommend 400 to 800 IU of E and 50 mg twice a day of alpha lipoic acid. This keeps the antioxidant network of both lipid soluble and water soluble fractions of the cell functioning smoothly as described by Dr. Lester Packer in his excellent book, The Antioxidant Miracle. We generally recommend ascorbic acid as the replacement form, although ascorbyl palmitate is also acceptable. As usual, if you can eat enough fruits and vegetables to bring your intake to this level, so much the better.

But this is most likely not the cause of her muscle atrophy and laxity. Vitamin C is important for maintaining the integrity of collagen and elastin, but its effect is mostly seen in the skin not the muscles. As a 48 year old woman, she is very likely perimenopausal (or possibly menopausal, though I'd think she'd mention it) and experiencing significant declines in estradiol, testosterone, and DHEAS and by now had at least a 50% drop in her growth hormone levels. The last would be exacerbated by her discontinuation of exercise, a known GH releaser. These hormones are important for protein synthesis in the muscle and have been shown to correlate with muscle mass. Therefore, while vitamin C in the right doses would certainly be beneficial, she should consider having her hormones of aging levels tested, and if deficient, replaced.

A final point to be emphasized. People age at different rates and in different ways. Therefore, it is important to have an objective assessment of the which aspects of your antioxidant and hormone systems are waning and replace only those that are lacking. For example, I've had a 60 y.o. male patient with an IGF-I of a 25 y.o. (304 ng/ml) and a testosterone levels of an 80 y.o. (250 ng/dl). Does he need replacement of his GH just because the average IGF-I level of a 60 y.o. is 140? NO! Similarly, I've seen women with low testosterone levels in their thirties, and women in their sixties with no estradiol, but normal healthy levels of testosterone. A balanced and individually tailored program is absolutely necessary.

Joseph M. Raffaele, MD