\s=b\ High doses of vitamin C, popularly used as a home remedy against the common cold, destroy substantial amounts of vitamin B when ingested with food. Because this undesirable effect is unequivocal when measured in vitro, while the value of ascorbic acid in preventing the common cold is highly equivocal, daily ingestion of 0.5 gm or more of ascorbic acid without regular evaluation of vitamin B12 status is probably unwise. (JAMA 230:241-242, 1974) PAULING12 has suggested that amounts of ascorbic acid in the gram range be taken daily as protection against the common cold. Recent studies3,4 suggest that such doses do not prevent the appearance of the common cold, but do reduce symp¬ toms of each individual cold. Despite possible adverse effects of large doses of ascorbate5 "the public literally swallowed it whole, and sales of vita¬ min C have remained healthily high ever since" (Newsweek, Jan 21,1974, p 56).Recently, we observed6 that four of nine paraplegic veterans taking 1 gm of ascorbic acid daily by prescription to keep their urine acid (since the an¬ tibiotic they were taking was most effective at acid pH), had low serum vitamin B12 levels. Preliminary stud¬ ies suggested that these low levels were partly an artifact related to the radioassay procedure employed.7 However, prior studies showed that ascorbate also reduces serum vitamin B12 as measured microbiologically.8 Additionally, a destructive effect of ascorbate on crystalline vitamin B12 was reported two decades ago,9 and reduced (monovalent cobalt) vitamin B12 is less stable than oxidized (trivalent cobalt) vitamin Bl2.lou For these reasons, we investigated the effect of 0.1-, 0.25-, and 0.5-gm doses of ascorbic acid on the vitamin B12 content of meals served at the Bronx Veterans Administration Hos¬ pital.
Materials and MethodsTo mimic most closely the situation in which an individual eats a meal and then takes a tablet of ascorbic acid, the following protocol was adopted.Two sets of four identical meals of each menu to be studied were set up on trays as if for delivery to individ¬ ual patients. The food content of each tray was poured into a 1-gal (4-liter) food blender and homogenized for five minutes to mimic both the masti¬ cation of food by the teeth and the further homogenization that occurs in the stomach. Each pair of sample meals was then allowed to incubate for 30 minutes at 37 C to mimic the gastric environment, after addition of 0.1 gm of ascorbic acid to sample 2, 0.25 gm to sample 3, and 0.5 gm to sample 4. After incubation, vitamin B12 content was determined by radio-assay1213 against a series of intrinsic factor concentrate standards to which had been added sufficient ascorbic acid to equal the amount in the as¬ sayed aliquots of each meal, to correct for any artifact effect of ascorbate on vitamin B12 radioassay.7The "modest vitamin B12-content meal" consisted of 177 ml of cream of potato soup; a fruit plate of 100 gm of cottage cheese, 10 gm of lettuce, and 360 gm of canned peaches; 6 gm of crackers; 25 gm of bread; 5 gm of but¬...