[rosacea] vitamin C, retin A

Patti,

See now this is excellent communication.  I love Dr. Weil.  He is one
of the few that actually knows both naturopathic and allopathic
medicine.  I believe that he is a Harvard grad.  Anyway, he has to keep
up to date with every aspect of human health (heart, lungs, kidney,
brain, skin etc) and in both disciplines (allopathic and naturopathic).
 This makes it impossible to research every area -- one cannot be an
expert in all fields.  I am not perfect -- far from it.  However, I am
an expert on blood vessel function in normal and diseased states.  So,
I have to know everything pertaining to blood vessels.  In addition, I
have to be 2 to 3 years ahead of physicians and other PhDs in order to
get funded -- it has to be cutting edge stuff or we perish.  My area of
expertise is actually in both diabetes and hypertension (I have a 2
year grant from the American Heart Association right now also).  

Physicians can now supplement their patients (titrate the dose
upwards)to determine the best dosage to use for their patients
respective vascular disease.  They can then test vascular function in
the body (responses of blood vessels to medications that test vascular
function inside the body) and also out of the body (take blood vessels
out of the patient and compare them to pre-vitamin c treatment)to
determine what minimal dose has the best effect.  They usually always
find that under 2 to 3 grams per day has very little effect on reversal
of vascular abnormalities.  However, when they increase up to 6 to 10
grams, vascular function is helped in many cases and biopsies of these
vessels shows normalization of the muscular wall of the blood vessels. 
In addition, we are not only interested in incorporating Vitamin C into
the human body, but we want it constantly perfusing our blood stream to
scavenge free radical formation (free radicals are like little pac mans
that grab onto the inside of blood vessels and cause death to the cells
that it grabs). Another important point, and probably the most
relevant, is that Dr. Weil said that in order to PREVENT certain
diseases then smaller amounts are needed -- this is absolutely the
case.  However, once the damage has incurred (functional and structural
vascular damage), then it is a different ball game.   This is true for
all diseases and this is why prevention is much easier then reversing a
disease once it has set in.  Once you see rosacea on the face, you have
the disease.

Patty, you seem very interested in learning and reading medical
literature. That is great.  But, do not take physicians or biomedical
research scientist's (me) word for everything -- assimilate information
from many different sources (find the experts and ask them to present
all the sides to the story).  Let me give you an example.  Have you
ever heard of Dr. Albert Klingman.  He is probably one of the most
famous dermatologists in the world.  He has done as much for the field
in dermatology as any physician.  He is amazing.  However, in one of
his famous articles, he stated that  rosacea was purely a solar
dermatose and that retin A is an excellent treatment for the disease. 
He then mentions that this is because retin A reverses sun damage
(increases collagen support of skin and therefore supports blood
vessels), and therefore, retin a is the best treatment for the disease.
Now, I am not a dermatologist and I could not hold up his jock strap in
the field of dermatology (in fact, I dont even know what a cancerous
mole looks like), however, I will go toe to toe with him in the boxing
ring and shred him apart on his theory and treatment of rosacea with
retin A.  First, he is correct that retin A is an anti-inflammatory in
the skin -- however, retin A is also a powerful inflammatory stimuli
directly on blood vessels (irritates blood vessels causing increase
blood flow to the area of trauma) -- this is bad for us.  Second, and
most importantly, although retin A does indeed enhance collagen
synthesis in the superficial dermis, it does not lend support for
damaged blood vessels.  85% of the strength of the blood vessel comes
from within its muscular walls and not from the surrounding skin.  For
example, I could take the damaged facial blood vessels out of a
rosacean and put them in a 13 year old teen with perfect skin and
collagen -- she would develop rosacea very very quickly.  Conversely, I
could take perfectly strong blood vessels from a 14 year old boy and
put them into the facial skin of a  98 year old (with extensive
collagen damage to the dermis) and she would probably never develop one
rosacea symptom.  The key is the blood vessel itself.  If you are
getting rid of inflammation within the dermis with azelex, and retin A,
while you are aggravating the blood vessels (the real beast), then it
is extremely hard to ever break through this disease. Concerning Retin
A, if one were to do further research, one would find that John Wilkin,
a rosacea expert (now in the FDA) strongly recommends against retin A
use in several key articles.  He states that a physician should "first
do no harm' when it comes to the treatment of rosacea-sensitive skin. 

Sun damage can play a role in rosacea (UV induced damage to vascular
smooth muscle contractile proteins, endothelial cells and DNA
modification of cellular 'cement' in blood vessel), however, it is
never the sole cause of rosacea.

So, as you can see, always be a little bit cautious -- especially of my
hot wind.

Thank you for your response.

Kindest Regards,

Geoffrey 

<7o8e26$5uj-@egroups.com> wrote: 
original article:http://www.egroups.com/group/rosacea-support/?start=68

92
> Dr. Nase:
> 
> Yikes!  Thats a lot of vitamin C information to swallow (no pun
> intended).  I got the news about the JAMA articles from a health
> newsletter I get monthly.  It is written by Andrew Weil M.D., N.D.  He
> has alway been big on taking large doses of vitamin C, so I was
> suprised he wrote this.  Here is the statement:
> 
> "For several years I have recommended that everyone supplement with
> 2,000 to 6,000 mg of vitamin C a day..... However, a recent study done
> at the Lunus Pauling Institute has convinced me that much lower levels
> of ascorbic acid are sufficient to protect against cancer, heart
> disease, and other chronic diseases.  In addition, there's now
evidence
> that 200 to 500 mg of vitamin C a day is more than enough to saturate
> the body's tissues....A review of clinical trials published in the
> April 21st journal of the american Medical Association found that two
> 100-mg doses of vitamin C a day are about as much as human cells can
> absorb.  A similar dosage (120 to 200 mg a day) was reported to be
> optimal for reducing the risk of cardiovascular disease, cancer,
> cataracts, and other chronic ailments by researchers at the Linus
> Pauling Institute in the June issue of the American Journal of
Clinical
> Nutrition.....  Incidentally, I've learned that the National Academy
of
> Sciences is now revising the RDA for vitamin C, and for the first time
> will recommend an amount that is intended to prevent not only
> deficiency disease, but chronic disease as well.  The new RDA, to be
> released later this year, is expected to be somewhere between 100 and
> 200 mg."
> 
> I did not realize SO much research has been done on vitamin C.  Let us
> know if you think the studies are actually proof that more than 200 mg
> per day does no good.  I will certainly take more vitamin C if there
is
> even the smallest chance it may help.  
> 
> I will be sending you my quote soon.
> Thanks again to you and Dr. Sy for all the help.
> 
> Patty
> 
> <7o8bem$s5d-@egroups.com> wrote: 
> original article:http://www.egroups.com/group/rosacea-support/?start=

> > Hi Patty,
> > 
> > I am very interested in seeing that article about Vitamin C.  In the
> > last 2 years alone, over 100,000 peer reviewed, top-of-the-line
> medical
> > articles in Science, Hypertension, Diabetes, New England Journal of
> > Medicine, Cancer, American Journal of Physiology, Biochemistry,
> > Pharmacology Therapeutics, Free radicals and Disease....etc have
> > demonstrated that the human body can handle large concentrations of
> > vitamin C.  Most state that the minimum required for normal living
is
> > 1,000 mg.  The average starting dose for a human with disease --
> > diabetic retinopathy, diabetic nerve damage, phlebitis (inflammation
> of
> > veins), vasculitis, edema, vasculopathy, collagen disorders, various
> > skin disorders,  venular disorders is 3,000 mg per day.  Physicians
> can
> > measure incorporation of vitamin c into plasma membranes,
> intracellular
> > organelles, collagen incorporation, inhibition of collagenase
activity
> > (breaks down collagen) etc and find that 3,000 mg for a human of 150
> > pounds is a sub average dose.  Tens of thousands of peer-reviewed
> > double blinded studies have demonstrated much greater efficacy of 8
to
> > 10,000 mg per day in human patients with various diseases
(especially
> > vascular mediated).  They can measure antioxidant status and free
> > radical scavenging in the body with high tech equipment.  In
recently
> > published cancer studies, physicians start their patients out on
> 15,000
> > mg per day and move upwards -- they measure every possible parameter
> > known to man kind to be thorough -- in divided doses, 95% of the
> > patients can handle this massive quantity -- meaning that all
medical
> > parameters have not been saturated and the body can utilize the
active
> > vitamin c as well as the important metabolites.  In fact, the FDA is
> > now contemplating moving up the daily minimum dose of 60 mg of
vitamin
> > c a day to 1,000 mg.  This coming from the very conservative FDA. 
60
> > mg of  vitamin c a day is the bare minimum that a healthy person
needs
> > to take in order to not get scurvy -- bare minimum needed in order
to
> > not get a disease!   At the medical vascular meetings that I have
> > attended over the last couple of years (with thousands of
> presentations
> > and patient care seminars), approximately 35% of them deal with the
> > benefits of Vitamin c -- doses in between 3,000 and 10,000 grams per
> > day.  Physicians and myself have done thorough reviews on this
subject
> > because I work in a medical university with physicians and
diabetics. 
> > This is my livelihood and I currently have a large 4 year NIH grant
> > (National Institutes of Health) dealing with diabetes, vascular
> > dysfunction and vitamin C supplementation.  If you go back 10 years
in
> > the best medical journals, you will find 500,000 to 600,000 articles
> on
> > the benefits of high dosage vitamin C -- from the laboratory to
human
> > patients. 
> > 
> > Patty, I usually don't respond personally to statements, however, I
> > wanted to make sure that people understood all the medical
literature
> > that was out there.  Sometimes a little bit of information is very
> > misleading.
> > 
> > However, communication like this is often very productive and
> > stimulates great conversation.  I will be happy to discuss more with
> > you in the future.
> > 
> > Geoffrey 
> > ========
> > Dr. Geoffrey Nase, Ph.D.
> > 
> > <7o87rs$5ss-@egroups.com> wrote: 
> > original article:http://www.egroups.com/group/rosacea-support/?star

> > > Hey!!
> > > 
> > > I just found some good news.  The Journal of the American Medical
> > > Association April 21st issue revealed some trials that showed that
> 200
> > > mg of vitamin C per day is about all the human body can absorb. 
> This
> > > definately puts all the controversy to rest.  So, I'm going to
start
> > > taking only half of one of my 500 mg Ester C tablets each day. 
This
> > > will definately save money in the vitamin department!!!!
> > > 
> > > Patty