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Vitamin C, Ascorbic Acid, Ascorbate


Ascorbic Acid

Chemistry
glucose -> gluconolactone -> ascorbic acid
L-ascorbic acid -> dehydro-L-ascorbic acid + 2H+ + 2e-
L-gulonolactone oxidase is absent in humans
Under stress animals with this enzyme produce significant amounts of C

Biochemistry
coenzyme of dopamine B-oxidase:
tyrosine -> dopamine -> NE -> EPI
coenzyme for
proline -> hydroxy proline (collagen synthesis)
hydroxy phenyl pyruvate -> homogenistate (precursor of fumarate)

Functions
Ascorbic acid aids in the absorption of iron, antioxidant, anti-inflammatory
Ascorbic acid is involved in drug metabolism and detoxification
Ascorbic acid regulates cellular humoral immune function
Ascorbic acid involved in degradation of cholesterol and steroid hormone synthesis
Collagen synthesis
absence leads to impairment of peptidyl hydroxylation of procollagen
nonhydroxylated collagen cannot form the required triple helix
the synthesis of both proteoglycan and collagen is decreased in ascorbic acid deficiency,
possibly due to inhibition of insulin-like growth factor I

Requirements
RDA - 60 mg, Optimal - 1-9 g

Sources
acerola berries, orange juice, guava, peppers, grapefruit juice

Toxicity
abdominal pain and diarrhea in large doses
increases uric acid excretion which may precipitate gout
can raise oxalic acid levels in urine causing kidney stones (controversial)
increases iron absorption possibly causing iron overload
very high doses may deplete copper

Interactions
aspirin and tobacco reduce absorption
large doses can cause a false negative hemoccult test

Deficiency
Scurvy
Many features result from these defects in collagen synthesis
capillary fragility and hemorrhage, poor healing of wounds,
bony abnormalities of children.
listlessness, fatigue, weakness, SOB
muscle cramps, aching bones, joints and muscles, anemia
EENT
gum involvement with swelling, friability, bleeding, secondary infection
loosening of the teeth
Dermatology
dry skin, fever, hemorrhage, easy bruising, secondary infections
perifollicular hyperkeratotic papules with fragmented and buried hairs
perifollicular hemorrhages
purpura beginning on the backs of the lower extremities
splinter hemorrhages in the nail beds
petechial hemorrhages in the viscera
Musculoskeletal
hemorrhage into the muscles of the arms and legs
hemorrhages into joints
Symptoms resembling those of Sjogren's syndrome may occur.
Hematology
Normochromic, normocytic anemia due to bleeding into tissues.
Macrocytic and/or megaloblastic anemia


Therapeutics
EENT
glaucoma - lowers intraoccular pressure
cataracts
Respiratory
asthma - anti-histamine effects, phosphodiesterase inhibitor
Cardiology
cholesterol - prevents oxidation of LDL, raises HDL
coronary artery disease - inhibits platelet aggregration
decreased triglycerides
Liver
heavy metal detox - chelates lead, copper and other metals
Andrology
impotence - prevents agglutination of sperm
Endocrinology
diabetes - decreases sorbitol in RBC's
prevents glycosylation of tissues
Urology
gout - lowers uric acid levels, increases urinary excretion
Immunology
allergies - anti-histamine effects
infections - increases macrophage activity, anti-viral in vitro
wound healing - hydroxylation of proline for collagen synthesis
Oncology
cancer prevention - inhibits hyaluronidase used by cancer cells
Musculoskeletal
low back pain - anti-inflammatory
Psychology
schizophrenia
Obstetrics
premature rupture of placentia

 

 

 

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