Three out of thousands had a light rash which cleared with subsequent doses. It was difficult to evaluate the cause of this because of concomitant infections. Several patients had discoloration of the skin under jewelry of certain metals. A few patients complaining of small sores in the mouth with the taking of small doses of ascorbate had them clear with bowel tolerance doses.
Patients with hidden peptic ulcers may have pain, but some are benefited. Mineral ascorbates can be used for maintenance doses in these cases. Two patients who had mild epigastric discomfort with maintenance doses of ascorbic acid who after being given ascorbate by vein for several days were then able to tolerate the acid orally.
It is my experience that high maintenance doses reduce the incidence of gouty arthritis. I have not seen difficulties with giving large amounts of ascorbic acid to patients with gout. Almost all my patients have been Caucasian, so I have no comment an the report that ascorbate can cause certain blood problems in certain non-white groups (30).
There has been no clinical evidence as Herbert and Jacob (31) suspected that ascorbic acid destroys vitamin B12.
If maintenance doses of ascorbic acid in solution are used over very long periods of time I would rinse the teeth after each dose. I would not brush my teeth with calcium ascorbate.
There is a certain dependency on ascorbic acid that a patient acquires over a long period of time when he takes large maintenance doses. Apparently, certain metabolic reactions are facilitated by large amounts of ascorbate and if the substance is suddenly withdrawn certain, problems result such as a cold, return of allergy, fatigue, etc. Mostly, these problems are a return of problems the patient had before taking the ascorbic acid. Patients have by this time become so adjusted to feeling better that they refuse to go without ascorbic acid. Patients do not seem to acquire this dependency in the short time they take doses to bowel tolerance to treat an acute disease. Maintenance doses of 4 grams per day do not seem to create a noticeable dependency. The majority of patients who take over 10-15 grams of ascorbic acid per day probably have certain metabolic needs for ascorbate which exceed the universal human species need. Patients with chronic allergies often take large maintenance doses.
The major problem feared by patients benefiting from these large maintenance doses of ascorbic acid in that they may be forced into a position where their body is deprived of ascorbate during a period of great stress such as emergency hospitalization. Physicians should recognize the consequences of suddenly withdrawing ascorbate under these circumstances and be prepared to meet these increased metabolic needs for ascorbate in even an unconscious patient. These consequences of ascorbate depletion which may include shock, heart attack, phlebitis, pneumonia, allergic reactions, increased susceptibility to infection, etc., may be averted only by ascorbate. Patients unable to take large oral doses should be given intravenous ascorbate. All hospitals should have supplies of large amounts of ascorbate for intravenous use to meet this need. The millions of people taking ascorbic acid makes this an urgent priority. Patients should carry warnings of these needs in a card prominently displayed in their wallets or have a Medic Alert type bracelet engraved with this warning.