What Is The Function Of Vitamin C In The Body – As we all know that raw fruits and vegetables are the richest sources of nutrients. Eating a variety of these nutritious foods can help people meet their daily needs.
Vitamin C, also called ascorbic acid, plays many important roles in the body. In particular, it is key to the immune system, which helps prevent infections and fight disease.
What Is The Function Of Vitamin C In The Body
The human body does not store vitamin C, so people need to get this nutrient from their diet every day. It dissolves in water, and any excess leaves the body in the urine.
Let’s Be Familiar With Vitamin C
According to the Office of Dietary Supplements (ODS), the recommended daily allowance of vitamin C for adults is:
Some experts believe that people should consume more than the recommended daily allowance for good health. A scientific editorial suggests that 200 mg per day is an optimal amount for most adults.
One serving of any of the foods below contains more than 20 percent of the recommended daily value of vitamin C. This makes these foods “good” sources of the vitamin, according to the Food and Drug Administration (FDA).
Cooking can reduce the amount of vitamins in fruits and vegetables. To lose some of the vitamin C, ODS recommends steaming or microwaving these foods
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Vitamin C is an antioxidant. It protects the body’s cells from damage caused by free radicals. Free radicals can cause changes in cells and DNA that can lead to diseases, including cancer.
This vitamin also plays an important role in almost all tissues of the body. Without vitamin C, the body cannot produce collagen, a protein necessary for building and maintaining:
Vitamin C is an important part of the immune system, which defends against viruses, bacteria, and other pathogens. Studies show that low levels of vitamin C lead to problems with the immune system and other diseases. Many critically ill patients are deficient in vitamin D and vitamin C and current international guidelines state that hypovitaminoses should be compensated. However, uncertainty about the optimal dose, timing and indication exists in clinical practice, mainly due to conflicting evidence. This narrative review discusses both micronutrients with regard to pathophysiology, clinical evidence of benefits, potential risks, and guideline recommendations. Evidence generated from the latest clinical trials is summarized and discussed. In addition, practical tips for the use of these vitamins in clinical work are provided. Vitamin D and C supplements represent cost-effective and simple interventions with excellent safety profiles. Regarding vitamin D, critically ill individuals require a loading dose to improve 25(OH)D levels over several days, followed by daily or weekly maintenance doses, usually more higher doses than healthy individuals need. For vitamin C, doses of 100–200 mg/d are recommended for patients receiving parenteral nutrition, but needs may be as high as 2–3 g/d in critically ill patients.
Medical Nutrition Therapy (MNT) is an important part of the complex care needed for patients in the intensive care unit (ICU). This is especially important for patients at high nutritional risk, for example chronically malnourished or sarcopenic patients, or for patients staying in the ICU for long periods of time. MNT covers the administration of macronutrients (carbohydrates, proteins, and fats), as well as the supplementation of micronutrients, for example vitamins and trace elements.
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MNT in the ICU is not trivial, the optimal management strategy often remains controversial due to inconclusive evidence. This is especially true for micronutrients, as many of them have been studied in heterogeneous ICU populations at different doses, routes, and durations of administration at different perioperative and/or ICU times. In addition, reported outcomes differ from trial to trial, preventing rigorous synthesis of evidence, for example in the forms of well-conducted meta-analyses. Therefore, uncertainty remains about what needs to be considered and implemented in daily ICU clinical practice.
This article reviews the current evidence and controversy regarding two different micronutrients—vitamin D and vitamin C—in a narrative fashion. Both vitamins are discussed with regard to pathophysiology, clinical evidence of benefits, potential risks, and guideline recommendations. Summarizes the evidence generated from the latest clinical trials. In addition, practical tips for the use of these vitamins in clinical work are provided.
Contrary to popular belief, vitamin D is not a vitamin but a steroid hormone with a wide range of cellular, anti-inflammatory, and immunomodulatory effects. It is one of the main regulators of calcium and phosphate balance, and therefore, plays an important role in maintaining a healthy bone metabolism. Moreover, the immunomodulatory features of this hormone are of particular interest for the critically ill patient.
The body obtains vitamin D from fungi-based food (vitamin D2) or animal sources (vitamin D3), through endogenous synthesis in skin exposed to the sun (vitamin D3) or through supplements. After that, the liver metabolizes any of these to 25(OH)D, which is further hydroxylated to the active form 1, 25(OH)2D in the kidneys. The active form of vitamin D has a half-life of approximately 1 h and exerts its multiple effects by binding to the vitamin D-receptor (VDR), which is expressed by many tissues (1–3). (Table 1).
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Table 1. Overview of available vitamin D preparations, adapted from Prietl B. et al. (4) indicated standard dose recommendations apply to non-ICU patients.
Vitamin D and its metabolites are important immunomodulators involved in many biological processes of the innate and adaptive immune system (4). Immune cells such as lymphocytes, monocytes, macrophages, and dendritic cells express VDR, explaining the key role of adequate vitamin D levels for infections and cancer, respectively (5–7). Another major action of vitamin D3 involves its potential to promote the killing of intracellular bacteria such as Mycobacteria tuberculosis and M. leprae in macrophages through toll-like-receptors 1 and 2, indicating a great ability for in critically ill patients (8, 9).
In addition, the VITAL study revealed that daily supplementation with 2,000 IU of vitamin D for 5 years appeared to reduce the incidence of autoimmune diseases (10), which may be explained by the tolerogenic effects of the hormone (4). Additionally, vitamin D exerts a protective effect on the intestinal mucosa and influences thyroid diseases (6, 11) (see overview—Figure 1).
Figure 1. Multiple effects of vitamin D and its deficiency on the body. ARDS, acute respiratory distress syndrome.
Zinc, Vitamin C Synergy And Immune Function » Magazine Science
Vitamin D3 acts through both genomic and non-genomic pathways. Basically, calcitriol is thought to exert its effects by interacting with the nuclear vitamin D receptor (nVDR). But there are also non-genomic actions that occur through the activation of signaling molecules for example phospholipases C and A2, second messengers, activation of protein kinases or opening of calcium or chloride channels. Another non-genomic action involves binding to target proteins, which provides the basis for the immunoregulatory effect of vitamin D (12).
The actions of vitamin D in a neuronal cell line and the neuroprotective non-genomic effects of vitamin D and its metabolites are still being investigated. Recent studies have shown a modulation of synaptic transmission in juvenile GnRH neurons by vitamin D3 and in addition, calcipotriol (a vitamin D analog) has been shown to act as a neuroprotective agent in neuroblastoma cells (13 , 14).
Furthermore, pharmacogenomics has a relevant impact on the pharmacokinetics and -dynamics of vitamins and influences the efficacy of any supplementation. Vitamin D production is highly dependent on renal 1a-hydroxylase, which can be up-regulated by parathyroid hormone (PTH) and inhibited by calcitriol itself. Genetic polymorphisms in the encoding enzymes CYP27B1 as well as CYP24A1 have shown a significant influence on the concentration of vitamin D metabolites in the circulation (15).
Also, genetic aberrations in vitamin D binding protein (VDBP) have been shown to be associated with an increased risk for Graves’ disease (16) and indicated a decreased risk for osteoporosis (17).
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Other genetic polymorphisms in different CYP-enzymes can lead to markedly reduced conversion to calcitriol, and genetic variations in the vitamin D receptor have been associated with an increased incidence of hip fracture, myocardial infarction, cancer and mortality in general. There is some indication that the VDR polymorphism specifically modifies the risk for prostate, breast, colorectal and skin cancer (15, 18, 19).
Vitamin D deficiency [defined as 25(OH)D levels below 20 ng/ml] is common and occurs in about half of the normal population and in approximately 70% of all intensive care patients (20, 21). Burn patients are particularly affected (22, 23). Vitamin D deficiency can be caused by low seasonal sun exposure or high air pollution (1), vegan diet (24), use of sunscreen, staying indoors, wearing protective clothing and reducing endogenous production of vitamin D from solar UVB in older age.
Also, the bioavailability of vitamin D decreases in patients with obesity (25). In addition, obesity involves systemic inflammation, which may increase the need for exogenous vitamin D.
However, vitamin D deficiency seems to occur in ICU patients worldwide regardless of latitude, i.e., UV exposure (26). Pre-existing conditions, malnutrition, liver, renal or parathyroid dysfunction can lead to decreased vitamin D levels, as well as therapeutic interventions and co-medications. Overall, this can result in increased mortality and poorer outcomes (1, 27).
Amazing Ways Vitamin C Benefits Your Health
A clear association between low vitamin D and poor clinical outcomes in critically ill adults and children has been repeatedly demonstrated in observational studies. There is a higher risk for sepsis, acute respiratory failure, acute renal failure, prolonged ICU
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