Plasma Vitamin C Concentrations Were Negatively Associated with Tingling, Prickling or Pins and Needles Sensation in Patients with Postherpetic Neuralgia

Vitamin C deficiency increases the risk of postherpetic neuralgia (PHN). In this cross-sectional study, the relationships among plasma vitamin C concentrations, pain and Leeds assessment of neuropathic symptoms and signs (LANSS) items were investigated during their first pain clinic visit of 120 PHN patients. The factors associated with vitamin C deficiency were determined. Independent predictors of vitamin C deficiency were presented as adjusted odds ratios (AOR) and 95% confidence intervals (CI). The patients had a high prevalence (52.5%) of vitamin C deficiency. Their plasma vitamin C concentrations were negatively associated with spontaneous pain and tingling, prickling or pins and needles sensation according to the LANSS questionnaire. Based on the receiver operator characteristic curve, the cutoffs for plasma vitamin C to predict moderate-to-severe and severe symptoms of sharp sensation were <7.05 and <5.68 mg/L, respectively. By comparison, the patients well-nourished with vitamin C had lower incidences of sharp sensations, sharp pain, and reddish skin. Multivariate analyses revealed that vitamin C deficiency was associated with the low intake of fruit/vegetables (AOR 2.66, 95% CI 1.09–6.48, p = 0.032), peptic ulcer disease (AOR 3.25, 95% CI 1.28–8.28, p = 0.014), and smoking (AOR 3.60, 95% CI 1.33–9.77, p = 0.010). Future studies are needed to substantiate these findings.

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Hypovitaminosis Din Postherpetic Neuralgia—High Prevalence and Inverse Association with Pain: A Retrospective Study

Nutrients ◽

10.3390/nu11112787 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2787 ◽

Cited By ~ 3

Author(s):

Jen-Yin Chen ◽

Yao-Tsung Lin ◽

Li-Kai Wang ◽

Kuo-Chuan Hung ◽

Kuo-Mao Lan ◽

...

Keyword(s):

Postherpetic Neuralgia ◽

Characteristic Curve ◽

Hypovitaminosis D ◽

Pain Clinic ◽

Spontaneous Pain ◽

Inverse Association ◽

Cross Sectional ◽

Prospective Longitudinal Study ◽

First Pain ◽

Prospective Longitudinal

Hypovitaminosis D (25-hydroxyvitamin D (25(OH)D) <75 nmol/L) is associated with neuropathic pain and varicella-zoster virus (VZV) immunity. A two-part retrospective hospital-based study was conducted. Part I (a case-control study): To investigate the prevalence and risk of hypovitaminosis D in postherpetic neuralgia (PHN) patients compared to those in gender/index-month/age-auto matched controls who underwent health examinations. Patients aged ≥50 years were automatically selected by ICD-9 codes for shingle/PHN. Charts were reviewed. Part II (a cross-sectional study): To determine associations between 25(OH)D, VZV IgG/M, pain and items in the DN4 questionnaire at the first pain clinic visit of patients. Independent predictors of PHN were presented as adjusted odds ratios(AOR) and 95% confidence intervals (CI). Prevalence (73.9%) of hypovitaminosis D in 88 patients was high. In conditional logistic regressions, independent predictors for PHN were hypovitaminosis D (AOR3.12, 95% CI1.73–5.61), malignancy (AOR3.21, 95% CI 1.38–7.48) and Helicobacter pylori-related peptic ulcer disease (AOR3.47, 95% CI 1.71–7.03). 25(OH)D was inversely correlated to spontaneous/brush-evoked pain. Spontaneous pain was positively correlated to VZV IgM. Based on the receiver operator characteristic curve, cutoffs for 25(OH)D to predict spontaneous and brush-evoked pain were 67.0 and 169.0 nmol/L, respectively. A prospective, longitudinal study is needed to elucidate the findings.

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Plasma Vitamin C Is Lower in Postherpetic Neuralgia Patients and Administration of Vitamin C Reduces Spontaneous Pain but Not Brush-evoked Pain

Clinical Journal of Pain ◽

10.1097/ajp.0b013e318193cf32 ◽

2009 ◽

Vol 25 (7) ◽

pp. 562-569 ◽

Cited By ~ 49

Author(s):

Jen-Yin Chen ◽

Chia-Yu Chang ◽

Ping-Hsun Feng ◽

Chin-Chen Chu ◽

Edmund Cheng So ◽

...

Keyword(s):

Vitamin C ◽

Postherpetic Neuralgia ◽

Plasma Vitamin ◽

Spontaneous Pain

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Plasma Vitamin C Levels: Risk Factors for Deficiency and Association with Self-Reported Functional Health in the European Prospective Investigation into Cancer-Norfolk

Nutrients ◽

10.3390/nu11071552 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1552 ◽

Cited By ~ 6

Author(s):

Stephen J. McCall ◽

Allan B. Clark ◽

Robert N. Luben ◽

Nicholas J. Wareham ◽

Kay-Tee Khaw ◽

...

Keyword(s):

Risk Factors ◽

Vitamin C ◽

Short Form ◽

Bodily Pain ◽

Functional Health ◽

Plasma Vitamin ◽

Cross Sectional ◽

Vitamin C Deficiency ◽

Sf 36 ◽

Prospective Investigation

Background: To investigate the demographic and lifestyles factors associated with vitamin C deficiency and to examine the association between plasma vitamin C level and self-reported physical functional health. Methods: A population-based cross-sectional study using the European Prospective Investigation into Cancer-Norfolk study. Plasma vitamin C level < 11 µmol/L indicated vitamin C deficiency. Unconditional logistic regression models assessed the association between vitamin C deficiency and potential risk factors. Associations between quartiles of vitamin C and self-reported functional health measured by the 36-item short-form questionnaire (SF-36) were assessed. Results: After adjustment, vitamin C deficiency was associated with older age, being male, lower physical activity, smoking, more socially deprived area (Townsend index) and a lower educational attainment. Compared to the highest, those in the lowest quartile of vitamin C were more likely to score in the lowest decile of physical function (adjusted odds ratio (aOR): 1.43 (95%CI: 1.21–1.70)), bodily pain (aOR: 1.29 (95% CI: 1.07–1.56)), general health (aOR: 1.4 (95%CI: 1.18–1.66)), and vitality (aOR: 1.23 (95%CI: 1.04–1.45)) SF-36 scores. Conclusions: Simple public health interventions should be aimed at populations with risk factors for vitamin C deficiency. Poor self-reported functional health was associated with lower plasma vitamin C levels, which may reflect symptoms of latent scurvy.

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Prevalence of Hypovitaminosis C and its Relationship with Frailty in Older Hospitalised Patients: A Cross-Sectional Study

Nutrients ◽

10.3390/nu13062117 ◽

2021 ◽

Vol 13 (6) ◽

pp. 2117

Author(s):

Yogesh Sharma ◽

Alexandra Popescu ◽

Chris Horwood ◽

Paul Hakendorf ◽

Campbell Thompson

Keyword(s):

Vitamin C ◽

Cross Sectional Study ◽

Multivariate Logistic Regression Model ◽

Cross Sectional ◽

Vitamin C Deficiency ◽

Frailty Assessment ◽

Geriatric Unit ◽

Hospitalised Patients ◽

Micronutrient Malnutrition ◽

The Relationship

Frailty is common in older hospitalised patients and may be associated with micronutrient malnutrition. Only limited studies have explored the relationship between frailty and vitamin C deficiency. This study investigated the prevalence of vitamin C deficiency and its association with frailty severity in patients ≥75 years admitted under a geriatric unit. Patients (n = 160) with a mean age of 84.4 ± 6.4 years were recruited and underwent frailty assessment by use of the Edmonton Frail Scale (EFS). Patients with an EFS score <10 were classified as non-frail/vulnerable/mildly frail and those with ≥10 as moderate–severely frail. Patients with vitamin C levels between 11–28 μmol/L were classified as vitamin C depleted while those with levels <11 μmol/L were classified as vitamin C deficient. A multivariate logistic regression model determined the relationship between vitamin C deficiency and frailty severity after adjustment for various co-variates. Fifty-seven (35.6%) patients were vitamin C depleted, while 42 (26.3%) had vitamin C deficiency. Vitamin C levels were significantly lower among patients who were moderate–severely frail when compared to those who were non-frail/vulnerable/mildly frail (p < 0.05). After adjusted analysis, vitamin C deficiency was 4.3-fold more likely to be associated with moderate–severe frailty (aOR 4.30, 95% CI 1.33-13.86, p = 0.015). Vitamin C deficiency is common and is associated with a greater severity of frailty in older hospitalised patients.

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Cross-sectional and prospective associations between dietary and plasma vitamin C, heel bone ultrasound, and fracture risk in men and women in the European Prospective Investigation into Cancer in Norfolk cohort

American Journal of Clinical Nutrition ◽

10.3945/ajcn.115.111971 ◽

2015 ◽

Vol 102 (6) ◽

pp. 1416-1424 ◽

Cited By ~ 14

Author(s):

Henriette Finck ◽

Andrew R Hart ◽

Marleen AH Lentjes ◽

Amy Jennings ◽

Robert N Luben ◽

...

Keyword(s):

Vitamin C ◽

Fracture Risk ◽

Plasma Vitamin ◽

Cross Sectional ◽

Bone Ultrasound ◽

Men And Women ◽

Heel Bone ◽

Prospective Investigation

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Nutrient deficiencies as a risk factor in Taiwanese patients with postherpetic neuralgia

British Journal Of Nutrition ◽

10.1017/s0007114511000481 ◽

2011 ◽

Vol 106 (5) ◽

pp. 700-707 ◽

Cited By ~ 19

Author(s):

Jen-Yin Chen ◽

Chin-Chen Chu ◽

Yung-Song Lin ◽

Edmund Cheng So ◽

Ja-Ping Shieh ◽

...

Keyword(s):

Risk Factor ◽

Folic Acid ◽

Vitamin C ◽

Postherpetic Neuralgia ◽

Multivariate Logistic Regression Analysis ◽

Cross Sectional Study ◽

Vitamin B ◽

Healthy Controls ◽

Nutrient Deficiencies ◽

Cross Sectional

Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ). The aim of the present study was to compare the nutritional status of PHN patients with that of healthy controls, and then to identify risk factors for PHN using multivariate multiple logistic regressions. In the present cross-sectional study, we prospectively enrolled fifty PHN patients for at least 3 months and fifty healthy controls. We selected nine circulating nutrients including ionised Ca, Zn, retinol, folic acid, vitamin B12, vitamin C, α-tocopherol, γ-tocopherol and lycopene associated with both immunity and the modulation of neuropathic pain, and measured their concentrations in plasma/serum. Concentrations of ionised Ca, Zn, vitamin C and vitamin B12were significantly lower in PHN patients than in controls after excluding those patients receiving supplements since the outbreak of HZ. The prevalence of either mild/marginal or severe deficiencies for any of the nine selected circulating nutrients in PHN patients (92 %) was much higher than that in controls (46 %) (P < 0·001). Lower concentrations of vitamin C ( ≤ 45·0 μmol/l), ionised Ca ( ≤ 1·05 mmol/l) and Zn ( ≤ 0·91 g/l) were found to increase independently the risk of PHN using binary variable (dichotomy) analyses with both PHN patients and controls in a multivariate logistic regression analysis. No significant correlations existed between the risks of PHN and the concentrations of retinol, folic acid, vitamin B12, lycopene or α:γ-tocopherol ratios. Thus, lower concentrations of circulating nutrients, namely vitamin C, ionised Ca or Zn, are probably a risk factor in Taiwanese patients with PHN.

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Gender Differences in Plasma Vitamin C Concentrations and Cognitive Function: A Pilot Cross-Sectional Study in Healthy Adults

Current Developments in Nutrition ◽

10.1093/cdn/nzaa038 ◽

2020 ◽

Vol 4 (4) ◽

Cited By ~ 1

Author(s):

Nikolaj Travica ◽

Karin Ried ◽

Irene Hudson ◽

Avni Sali ◽

Andrew Scholey ◽

...

Keyword(s):

Cognitive Function ◽

Vitamin C ◽

Verbal Learning ◽

Cross Sectional Study ◽

Healthy Adults ◽

Plasma Vitamin ◽

Motor Speed ◽

Cognitive Assessments ◽

Cross Sectional ◽

And Gender

ABSTRACT Background A number of investigations have highlighted the importance of vitamin C in maintaining brain health. Biologically, vitamin C has exhibited roles in neuromodulation, neurodevelopment, vascular support, and neuroprotection. Vitamin C's contribution to cognitive function in both cognitively intact and impaired cohorts has previously been assessed, with little focus on gender variability. Objective The present study explored the interaction between gender and plasma vitamin C on cognitive performance, and the effect of different amounts of plasma vitamin C (adequate/inadequate) on various cognitive tasks by gender. Methods This retrospective analysis was conducted in healthy adults (n = 80, female = 52, male = 28, 24–96 y) with a range of blood plasma vitamin C concentrations. Cognitive assessments included the Swinburne University Computerized Cognitive Assessment Battery (SUCCAB) and 2 pen-and-paper tests, the Symbol Digits Modalities Test (SDMT) and the Hopkins Verbal Learning Test–Revised (HVLT-R). Food-frequency questionnaires were used to elucidate dietary consumption. Results After adjusting for a number of potential covariates such as age, number of prescribed medications and dose of vitamin C supplementation, results indicated a significant interaction (P < 0.001) between plasma vitamin C and gender on cognitive function, on both the computerized and pen-and-paper assessments. A novel finding was that the performance of males with inadequate plasma vitamin C was poorer on tasks involving components of memory (short/delayed), inhibition, and visual perception, whereas females presenting with inadequate vitamin C were more compromised on tasks involving psychomotor performance/motor speed. Additionally, females with adequate vitamin C concentrations exhibited higher performance than males on tasks involving recall, recognition, attention, and focus. Conclusions Further larger-scale investigations are required to establish a cause-and-effect relation and to elucidate whether differences in cognitive function between genders may be attributed to plasma vitamin C status. This trial was registered at https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369440&isReview=true as ACTRN12615001140549.

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Oral vitamin C supplementation to patients with myeloid cancer on azacitidine treatment: Normalization of plasma vitamin C induces epigenetic changes

Clinical Epigenetics ◽

10.1186/s13148-019-0739-5 ◽

2019 ◽

Vol 11 (1) ◽

Cited By ~ 7

Author(s):

Linn Gillberg ◽

Andreas D. Ørskov ◽

Ammar Nasif ◽

Hitoshi Ohtani ◽

Zachary Madaj ◽

...

Keyword(s):

Vitamin C ◽

Biological Effects ◽

Pilot Trial ◽

Dna Demethylation ◽

Controlled Clinical Trial ◽

Plasma Vitamin ◽

Oral Vitamin ◽

Oral Supplementation ◽

Vitamin C Deficiency ◽

Vitamin C Supplementation

Abstract Background Patients with haematological malignancies are often vitamin C deficient, and vitamin C is essential for the TET-induced conversion of 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC), the first step in active DNA demethylation. Here, we investigate whether oral vitamin C supplementation can correct vitamin C deficiency and affect the 5hmC/5mC ratio in patients with myeloid cancers treated with DNA methyltransferase inhibitors (DNMTis). Results We conducted a randomized, double-blinded, placebo-controlled pilot trial (NCT02877277) in Danish patients with myeloid cancers performed during 3 cycles of DNMTi-treatment (5-azacytidine, 100 mg/m2/d for 5 days in 28-day cycles) supplemented by oral dose of 500 mg vitamin C (n = 10) or placebo (n = 10) daily during the last 2 cycles. Fourteen patients (70%) were deficient in plasma vitamin C (< 23 μM) and four of the remaining six patients were taking vitamin supplements at inclusion. Global DNA methylation was significantly higher in patients with severe vitamin C deficiency (< 11.4 μM; 4.997 vs 4.656% 5mC relative to deoxyguanosine, 95% CI [0.126, 0.556], P = 0.004). Oral supplementation restored plasma vitamin C levels to the normal range in all patients in the vitamin C arm (mean increase 34.85 ± 7.94 μM, P = 0.0004). We show for the first time that global 5hmC/5mC levels were significantly increased in mononuclear myeloid cells from patients receiving oral vitamin C compared to placebo (0.037% vs − 0.029%, 95% CI [− 0.129, − 0.003], P = 0.041). Conclusions Normalization of plasma vitamin C by oral supplementation leads to an increase in the 5hmC/5mC ratio compared to placebo-treated patients and may enhance the biological effects of DNMTis. The clinical efficacy of oral vitamin C supplementation to DNMTis should be investigated in a large randomized, placebo-controlled clinical trial. Trial registration ClinicalTrials.gov, NCT02877277. Registered on 9 August 2016, retrospectively registered.

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Insufficient Vitamin C Levels among Adults in the United States: Results from the NHANES Surveys, 2003–2006

Nutrients ◽

10.3390/nu13113910 ◽

2021 ◽

Vol 13 (11) ◽

pp. 3910

Author(s):

Jennifer Crook ◽

Ann Horgas ◽

Saun-Joo Yoon ◽

Oliver Grundmann ◽

Versie Johnson-Mallard

Keyword(s):

United States ◽

At Risk ◽

Vitamin C ◽

Mexican Americans ◽

Secondary Analysis ◽

Health Impact ◽

The United States ◽

Plasma Vitamin ◽

Cross Sectional ◽

Key Factor

Vitamin C, well-established in immune function and a key factor in epigenetic inflammatory modifications, is only obtained through consistent dietary intake. Identifying individuals at risk for Vitamin C insufficiency may guide prevention and treatment, however, national surveillance has not been evaluated in the United States since 2006. A descriptive, cross-sectional secondary analysis was performed utilizing data from the 2003–2006 National Health and Nutrition Examination Surveys (NHANES) assessing non-institutionalized adults. Five categories of plasma Vitamin C were delineated: deficiency (<11 μmol/L), hypovitaminosis (11–23 μmol/L), inadequate (23–49 μmol/L), adequate (50–69 μmol/L), and saturating (≥70 μmol/L). Results indicated 41.8% of the population possessed insufficient levels (deficiency, hypovitaminosis, and inadequate) of Vitamin C. Males, adults aged 20–59, Black and Mexican Americans, smokers, individuals with increased BMI, middle and high poverty to income ratio and food insecurity were significantly associated with insufficient Vitamin C plasma levels. Plasma Vitamin C levels reveal a large proportion of the population still at risk for inflammatory driven disease with little to no symptoms of Vitamin C hypovitaminosis. Recognition and regulation of the health impact of Vitamin C support the goal of Nutrition and Healthy Eating as part of the Healthy People 2030.

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