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Vitamin C and the Goldilocks Theory of Medicine

Posted Feb 09 2013 3:00am
You remember Goldilocks, right?  She of the 3 bears fame?  The picky eater who didn't like her porridge either too hot or too cold?  As I've alluded to in many posts, medicine is like Goldilocks.  You want things just right, neither too high nor too low.  Case in point is vitamin C .  If you don't have enough, you run the risk of developing scurvy , which afflicted many sailors in the days of English supremacy over the seas.  And just why were the English so good?  Partly because Dr. James Lind figured out that limes were full of something that prevented scurvy while other nations had filled their ships with non-citrus consumables.

What I find amazing is that to this day, we still argue over the merits of vitamin C.   Nobel Prize winner, Dr. Linus Pauling, advocated for large daily doses of vitamin C , much higher than recommended by most other health care professionals.  However, others have warned of potential issues w/chronic "overdosage".  In a 
population-based prospective cohort study published in JAMA Internal Medicine earlier this week , the authors reported a link between high dose vitamin C supplementation and development of kidney stones in men.
Of note, the authors followed 23,355 Swedish men for an average of 11 years, of whom the vast majority were not supplement users and only 907 used vitamin C regularly.  However, those who regularly consumed vitamin C supplements (typically 1,000mg) had twice the risk of developing kidney stones compared to those who took no supplements or just a regular multivitamin.

Bottom line: eat your citrus fruits rather than drinking them as juice; then you can avoid the risk elevated risk of kidney stones while partaking of a healthy nutritional regimen.  WWGD? What would Goldilocks do?  Get just the right amount of vitamin C, not too little (scurvy) and not too much (kidney stones).

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