HAY FEVER AND VITAMIN C 1942

During the past four years one of us made occasional observations indicating a lowering of the body level of vitamin C during hay-fever attacks.

Histamine Theory

Other workers developed the interesting theory that histamine, C₅H₆N₉, although a normal constituent of the blood, is thrown into the blood stream in excessive amounts during allergic attacks and that this excess histamine is responsible for some of the unpleasant symptoms. On the assumption that histamine might react with vitamin C, or ascorbic acid, we mixed water solutions of the two substances but observed no reaction in absence of free oxygen. Upon bubbling a slow stream of air through the solution it was easy to detect evolution of ammonia. Titration with 2,6-dichlorophenol-indophenol showed loss of vitamin C. Later we learned that this reaction was already known. Since there is a little dissolved oxygen in blood serum, the body furnishes the proper conditions for very slow reaction.

TABLE 1 The Results Given in Table 1 are Significant. The sign “—” Means There Was No Determination or Dosage for That Column
Patient Number	Vitamin C in 24-hour urine before dosage	Excretion of C after one week of 100 mg daily	Symptoms after one week of 100 mg daily	Symptoms after week of 200 mg daily	Symptoms after dosage of 500 mg daily
1	49 mg	—	—	“Immense improvement.” Gain after two days	—
2	8 mg	218 mg ? (after dose of 200 mg daily)	No relief	Distinct gain	“No hay fever” after 3 days
3	8 mg	1-6 mg (after 2 days of 600 mg rose to 96 mg)	No relief	—	“Much better” after 2 days
4	42 mg	90 mg	No relief	Slight gain	“Almost no hay fever” after 4 days
5	20 mg	35 mg	Some relief	Decided relief	“Almost no hay fever” after 2 days
6	11 mg	73 mg	No relief	No relief	“Hay fever practically gone” after 3 days
7	6 mg	1-6 mg (after 3 days of 500 mg rose to 102 mg)	Some relief	—	Great relief after 3 days
8	16 mg	(after 12 days rose to 221 mg)	—	Great relief	—
9	—	—	Little relief	Great relief	—
10	—	—	Little relief	Great relief	—
11	—	—	Little relief	“Felt fine”	—
12	—	—	—	“Better physical condition”	“Highly favorable reaction. More refreshing sleep” after 2 days
13	16 mg	106 mg ?	No relief	—	“Distinctly better” after 3 days
14	—	—	—	Great relief in few days	—
15	—	—	—	“Much less tired”	—
16	—	—	Definitely improved	—	—
17	9.5 mg	105 mg	Some relief	—	—
18	—	—	“It helped”	—	—
19	—	—	—	Began in July. “No hay fever at all—after years of suffering”	—
20	0-5 mg	67 mg (after 10 days of 200 mg daily)	—	Vast improvement. From weakness to vigor	—
21	—	—	—	—	(Invalid from asthma.) After 1 week became astonishingly vigorous and healthy
22	High	Higher	No relief	No relief	Little relief
23	63 mg	118 mg ?	No relief	—	No relief after 3 days
24	10 mg	—	Broke out in rash and quit	—	—
25	—	—	—	—	1000 mg gave great relief the next day

Required Replacement of Vitamin C

A low level of vitamin C in the body causes weakness as well as other ills, so it is apparent that losses due to hay fever should be made good by a diet extremely rich in this vitamin, or even, in severe attacks, by administration of the pure synthetic product.

Many tests of this idea have been made by others, but there has been much confusion as to the ascorbic acid required for relief.

We therefore experimented ¹ with twenty-five hayfever sufferers in Oberlin at three levels of vitamin intake; 100 mg, 200 mg and 500 mg daily, administered during the ragweed season from August 15 to September 15.

URINARY EXCRETION

In most instances we were able to determine the 24-hour urinary excretion ² of vitamin C before giving first dose. Whenever possible we determined the excretion again after one week. It is the general opinion that a healthy individual of average weight excretes from 30 to 50 mg of vitamin C daily in the urine.

With ordinary methods of collection we have observed considerable loss by oxidation, so we used the very simple but effective method previously devised by Holmes and Campbell. ³

The maximum pollen count in Cleveland, thirty-five miles from Oberlin, averaged about 87 for the last half of August and about 80 for the first half of September. “Sneezing begins at 15.” Oberlin, away from Lake Erie, has more pollen than Cleveland.

The initial daily vitamin C excretion of twelve (including three not charted) averaged only 10 mg, indicating a very low level, due to destruction or inactivation of the vitamin. One excreted 20 mg, three were satisfactory and the others were not measured.

Usually, after a week of treatment the excretion rose to excellent levels, in some instances indicating body saturation. Strangely enough, patients No. 1 and No. 4 showed very good vitamin C levels before starting treatment, yet they were greatly benefited by adequate dosage.

It is evident from the table that only five sufferers made a noticeable gain in health after a week of 100 mg daily dosage, while twelve gained decidedly after a similar period of 200 mg dosage and eight reported improvement after three or four days at the 500 mg level. One got almost immediate relief after a single dose of 1,000 mg. Apparently there was distinct gain with 88 per cent of the patients.

TREATMENT

We strongly recommend that pharmaceutical firms prepare 250 mg tablets of vitamin C (or capsules to be emptied on the tongue) in order to lower the cost and to simplify dosage. The patient (after consulting the family physician, as was done in our own recorded experiments) would do well to begin with a daily 250 mg dose and, if no decided improvement results after one week, to try 500 mg daily until satisfactory progress is observed. After that he might get along comfortably on 250 mg or less during the season.

Since excess vitamin C is excreted rapidly in the urine, it is impossible to go beyond body saturation. Rarely are any irritating effects observed, yet one of our patients reported development of a rash.

REDUCING ACIDITY FOR SENSITIVE PATIENTS

Patients objecting to the acidity of ascorbic acid are advised to mix with the vitamin an amount of baking soda nearly equivalent chemically. If the vitamin is visibly crystalline, equal volumes of vitamin and sodium bicarbonate are used; if the vitamin is in a fluffy powder form, about one third that volume of sodium bicarbonate will serve. It is a mistake to mix water solutions to be kept for days, as oxidation occurs rapidly in the neutralized vitamin solution. We proved, by tests on several people, that after keeping a mixture of the dry powders eight hours and then administering there was no apparent loss of the vitamin. Patients with gastric ulcer, usually on a diet low in vitamin C because of difficulty with the roughage of vegetables and the acidity of fruits, may profit by the observation above.

HAY FEVER AND VITAMIN C

Histamine Theory

Required Replacement of Vitamin C

URINARY EXCRETION

TREATMENT

REDUCING ACIDITY FOR SENSITIVE PATIENTS

(References)