Vitamin C, Collagen and the Pauling Therapy for Heart Disease

Although I possess no medical degree, I became aware that the medical profession ignores an extraordinary medical claim that Linus Pauling made almost 10 years ago. This knowledge has been available in research papers and Linus Pauling made a video on the subject. Nature abhors a vacuum and since then, via the internet, almost by default, I have provided people limited advice on the Pauling discoveries and therapy that he and his associate, Matthias Ruth, MD invented.

Medicine has known since the 1970s that atherosclerotic plaque forms in response to blood vessel injury. Lipoprotein(a) binds to lysine and proline residues in the collagen matrix that are exposed from injury. Believe it or not, if your patient's arteries are strong and healthy, then regardless of their cholesterol levels, there are few lysine binding sites and plaques won't form. The confusion in the media is cause and effect. The fallacy is that cholesterol is the cause of heart disease, but plaque build-ups are the effect of heart disease.

According to the Pauling and Ruth unified theory, the root cause of heart disease is a vitamin C deficiency that limits the production of collagen. The Pauling therapy for this condition is to ingest orally, large doses of two substances: vitamin C and lysine. The recent USC study that created such a firestorm actually provides important supporting evidence for the Pauling/ Ruth unified theory. The USC finding is convincing, almost beyond a reasonable doubt, that the elderly cannot get the vitamin C they need without supplementing their diet.

The Pauling therapy is so safe, and the medical condition so grave, that there is no logical reason why any physician should resist it, especially in otherwise hopeless cases. I can say without hesitation that heart patients do benefit from large daily doses of vitamin C and lysine. Hundreds, if not thousands of people have already been helped. And there is new evidence that adding the amino acid proline to the therapy can increase the benefit. Some of these cases are documented, yet little has been scientifically proven, for reasons that escape me. I am not a doctor. And of course, as is always true in science, Linus Pauling may have been wrong. (Pauling wasn't often wrong, and he himself used the words "cure" in his last published interview and "miraculous" on the video.)

The Linus Pauling Therapy

This is a story of a remedy that has so far been ignored by the medical profession. Dubbed the Pauling therapy, the two substances that comprise the therapy; vitamin C and lysine, are not drugs. They are essential foods, extremely safe, and they happen to inhibit the binding of lipoprotein(a), (or Lp(a) for short) to the walls of damaged blood vessels. These perfectly non-toxic substances become the Pauling therapy when taken daily in large amounts.

Lp(a) is a sticky cholesterol-like substance similar to LDL that is only found in humans and other beings that do not make their own vitamin C. Pauling and Ruth have identified Lp(a) as one of the most important blood factors in heart disease, second to vitamin C.

In theory, human cardiovascular disease (variously called CVD, atherosclerosis, plaque, narrowing, arteriosclerosis, etc.) is a natural healing process. This process by itself rarely kills people, but plaque does make it more likely that people will suffer heart attack from a blood clot or blockage.

Vitamin C keeps vessels strong. Accordingly, strong blood vessels less prone to injury from mechanical stresses do not suffer plaque deposits. When the dietary intake of vitamin C is low, collagen production is limited, and arteries become thinner and weaker from wear and tear. Low vitamin C leads to increased levels of Lp(a) in the blood and plaques form that compensate by patching and strengthening the blood vessels. Dr. Rath's analogy for arterial plaque as nature's "plaster cast" is apt.

Pauling believed, and his belief is supported by a United States patent, that large megadoses of vitamin C and lysine taken orally can prevent and even dissolve existing atherosclerotic plaque build-ups. We have monitored the progress of the many people who have contacted our web site. We tell anybody seeking advice to view the Linus Pauling video on heart disease. Many of these people have then reported their personal experiences with the Pauling therapy. These reports are universally positive and match the first three case studies on the heart disease video. We have received no complaints, and so far, no deaths have been reported.

Based upon these anecdotal "miraculous" reports, on our understanding of the Pauling/Ruth unified theory, and on the Lp(a) medical literature that we have reviewed via MEDLINE, we are now convinced that vitamin C and lysine work. Naturally, no self-respecting medical doctor would take my word for it. But why haven't the necessary studies been run years ago?

Report after report provides more evidence that the Pauling therapy works in most people in as little as 14 to 30 days (depending on the daily dosage) especially when augmented by proline and antioxidant vitamins. Some have reported that the vitamin C/lysine therapy didn't change their condition, or else required much longer, sometimes over 10 months. But most people (>90%) report relief in weeks rather than months. Not every person who visits the web site and who presumably tries the Pauling therapy communicates with us. To this date more than 100,000 unique visitors have visited the web site since it was first posted in 1995.

Lp(a) levels in the blood provide additional objective evidence. People have shared a few lab reports with us that document drops in serum Lp(a) between 70% to 90% down to the accepted safe range (<14). Such drops have been reported in as little as 30 days on the Tower Laboratories Heart Technology product. We have been concerned by the lack of interest in conducting clinical studies, but there is now at least one independent lab thoroughly investigating the effect of the Pauling therapy (e.g., Heart Technology) on serum Lp(a).

USC Report Confirms Pauling's Theory

Recently, a widely publicized media report associated vitamin C pills and clogged arteries. Surprised by the media coverage, I contacted James Dwyer of the USC Medical School, one of the principal researchers mentioned in the 03/03/ 2000 news reports. As suspected, this research seems to be good news for elderly vitamin C takers whose carotid arteries have 'thinned' with age. Dr. Dwyer informed me that his team only looked at carotid arterial thickness. There is no evidence of occlusion or clogging. The findings show vitamin C supplements induced significant physiological changes, especially for smokers.

The arterial growth was unexpected and alarmed the researchers, whose paper is in peer-review and has not yet been accepted for publication. Thickening without plaque is exactly what you want to avoid heart disease. The USC finding is so pronounced that it can only mean one thing: All elderly people should be taking vitamin C pills.

Robert Cathcart III, MD of Palos Altos, California learned about the value of vitamin C from Linus Pauling. His medical practice uses high doses and says: "My experience with 25, 000 patients since 1969 indicates that this media report is ridiculous, I know that follow-up is not perfect in private practice but I have had no patient who had a good heart when I first saw them and who took massive doses of vitamin C who ever developed heart problems. I have to add that I advise all my patients to avoid sugar, chemicals, and highly processed foods, and put them on a number of other nutrients.

"If it turns out that there is thickening of the carotid, I think it is reversing the thinning that occurs with aging. It is interesting that the effect is so dramatic in the reversing of the effect on smokers. I have to congratulate you at the Vitamin C Foundation on unveiling the other two findings that could have been measured which were not reported. Probably the finding that C helped would not be publishable."

Experimental Science

Since we are invoking the name of one of this country's greatest scientists, it is fair to ask what experimental evidence there is to support the unified theory. Animals, other than guinea pigs (and a few others) manufacture their own vitamin C in the amount adjusted for body weight of several thousand milligrams every day. Humans, like guinea pigs and other high-order primates, cannot manufacture a single molecule of vitamin C in their bodies. If vitamin C deficiency causes heart disease, then experiments with guinea pigs would prove it.

There have been careful experiments with guinea pigs, first attempted by the Canadian medical doctor Willis in the mid-1950s. The result is always the same. When guinea pigs are deprived of vitamin C they die a terrible scurvy death in a matter of weeks. When their vitamin C is limited to the US RDA they live, but develop atherosclerosis. When they are fed roughly the human equivalent of 3 to 5 gm of vitamin C, they thrive with no signs of atherosclerosis. Disease in guinea pigs occurs in weeks, the human form of the disease usually takes decades to develop. While differences are to be expected in animal experiments, the lesions produced by these experiments in guinea pigs are remarkable for their similarity to the human lesion. Pauling waited until his own guinea pig experiments were run at his institute and the results repeated the Willis work, and also showed that Lp(a) rises when vitamin C is limited, before he made his announcement that heart disease can be "completely controlled" even "cured." The Pauling/Rath vitamin C theory makes sense, at least to me, I have not been through medical school.

Unified Theory

A Nobel prize was awarded for the discovery that damage to the walls of blood vessels are a necessary precondition for the formation of atherosclerotic plaques in human beings. The three most popular competing theories as to why these lesions occur include:

1. Oxidized cholesterol in the blood,
2. Elevated levels and oxidized homocysteine in the blood, and
3. Vitamin deficiencies.

Note: Elevated LDL (Bad) cholesterol is conspicuous by its absence.

In our view, any competing theory must account for:

1. Why occlusive cardiovascular disease does not generally occur in animals that make their own vitamin C, and
2. Why infarctions in humans are not distributed randomly. They usually occur where plaque forms in the arteries at locations where the mechanical stress (blood pressure, arterial bending and stretching, etc.) is a factor.

These two observations are the cornerstones of the unified vitamin C theory. The theory explains the lesions as the effect of weakness in the arterial wall, not from a "poison" circulating in the blood that should affect all blood vessels equally. Thanks to Linus Pauling's recognition that Lp(a) is acting as a surrogate for low levels of ascorbate, we human beings no longer have to fear heart disease or suffer the chest pain of Angina Pectoris or fear premature death or heart attack caused by progressive cardiovascular disease (CVD). The genius of Pauling was to recognize that blood vessels are made stronger by vitamin C, but when vitamin C is deficient, that they can also be made stronger by Lp(a) plaques. And Pauling, the master chemist, has given ordinary people a much safer way to control heart disease than to risk heart by-pass surgery or angioplasty. We don't even have to run to a doctor for a prescription.

The Pauling invention is to increase both vitamin C and the amino acid lysine well beyond what we normally consume in our diets. Both substances are safe and known to improve health in higher amounts. These substances attack the root cause of the problem, the lack of proper collagen formation, and also work to inhibit the binding of Lp(a) to the arterial wall.

Tissue Saturation

A common criticism of Pauling and his recommended vitamin C intake of 3000 mg is based on the faulty assumption that optimal intake is reached when body tissues "saturate" or when the blood serum reaches the maximum ascorbate concentration. This focus on saturation misses one of Linus Pauling's most powerful points: Ascorbic acid is transformed or destroyed as the body uses it for a wide variety of metabolic functions. For example, vitamin C is destroyed during the production of collagen. Ascorbate tissue saturation is just the starting point for many pathways that are not otherwise activated. It would seem that Cathcart's bowel tolerance is a better measure of each individual's optimal vitamin C intake.

It is hard to maintain the fiction that humans require no more than 60 milligrams of vitamin C in the face of what is known about collagen. Collagen is the most abundant protein in animals. Cellulose in plants, collagen in animals, provide the organism with structural integrity. Today's authoritative pre-med biochemistry textbooks ignore the role of vitamin C in the human body. Completely. Medical students are not taught, and they don't know the important role of ascorbate in producing collagen. It is little wonder orthodox doctors are ignorant and cannot believe a vitamin C deficiency is the cause of heart disease. (The USC scientists are not happy about this lack of information in their textbooks, I can tell you.)

What I don't understand is why alternative medical practitioners, who presumably read Pauling, make the same mistake. The following literature presents the concepts that cement the foundation of the unified vitamin C theory. It has been taken verbatim from the books by the nutrition masters Linus Pauling and Dr. Roger J. Williams.

Vitamin C and Collagen: A Tutorial

"We have come upon reasons why we require for good health so much larger amounts of vitamin C than are present in the plants we use as food.... It has recently been shown that one molecule of vitamin C is destroyed for each H atom replaced by OH... In the critical reactions that assemble collagen in the tissues, Vitamin C does not serve merely as a catalyst but is destroyed."

Linus Pauling

Linus Pauling

The synthesis of collagen, for which vitamin C is essential, proceeds in the body as one of its major manufacturing enterprises. A person who is dying of scurvy stops making this substance, and his body falls apart - his joints fail, because he can no longer keep the cartilage and tendons strong, his blood vessels break open, his gums ulcerate and his teeth fall out, his immune system deteriorates, and he dies.

Collagen is a protein, one of the thousands of different kinds of proteins in the human body. Most proteins occur in only small amounts: the various enzymes, for example, are so powerful in their ability to cause specific chemical reactions to take place rapidly that only a gram or two or even a few milligrams may be needed in the body. There are a few exceptions. There is a great amount of hemoglobin in red blood cells. There is even more collagen in the skin, bones, teeth, blood vessels, eye, heart, and, in fact, essentially all parts of the body. Collagen as strong white fibers, stronger than steel wire of the same weight, and as yellow elastic networks (called elastin), usually together with macropolysaccharides, constitutes the connective tissue that holds our bodies together.

Like other proteins, collagen consists of polypeptide chains; the long chains of this fibrous molecule contain about one thousand amino-acid residues, about 16,000 atoms. It differs from almost all other proteins in being substantially composed of but two amino acids, glycine and hydroxyproline. Collagen is a kind of super-molecule, however, in its three-dimensional architecture. The polypeptide chains of the two amino acids, alternating with one another and punctuated by the presence of certain other amine acids, are coiled in a left-handed helix. Three of these helical strands are twisted around one another, like strands of a rope, in a right handed super-helix, to compose the complete molecule.

Understandably, the synthesis of this structure proceeds in steps. While it has been known for more than half a century that vitamin C is essential to the manufacture of collagen, the process is only now yielding to inquiry. It appears that vitamin C is involved at every step.

First, a three-dimensional stranded structure is assembled, with the amine acids glycine and proline as its principal components. This is not yet collagen but its precursor, procollagen. A recent study shows that vitamin C must have an important role in its synthesis. Prolonged exposure of cultures of human connective-tissue cells to ascorbate induced an eight-fold increase in the synthesis of collagen with no increase in the rate of synthesis of other proteins (Murad et al., 1981). Since the production of procollagen must precede the production of collagen, vitamin C must have a role in this step - the formation of the polypeptide chains of procollagen - along with its better understood role in the conversion of procollagen to collagen.

The conversion involves a reaction that substitutes a hydroxyl group, OH, for a hydrogen atom, H, in the proline residues at certain points in the polypeptide chains, converting those residues to hydroxyproline. This hydroxylation reaction secures the chains in the triple helix of collagen. The hydroxylation, next, of the residues of the amino acid lysine, transforming them to hydroxylysine, is then needed to permit the cross-linking of the triple helices into the fibers and networks of the tissues.

These hydroxylation reactions are catalyzed by two different enzymes: prolyl-4-hydroxylase and lysyl-hydroxylase. Vitamin C also serves with them in inducing these reactions. It has recently been shown by Myllyla and his colleagues that, in this service, one molecule of vitamin C is destroyed for each H replaced by OH. [Myllyla et al., "Ascorbate is Consumed Stoichiometrically in the Uncoupled Reactions Catalyzed by Prolyl-4-Hydroxylase and Lysyl Hydroxylase. Journal of Biological Chemistry 259:5403-5405. 1984]

We have come upon the two big reasons why we require for good health so much larger amounts of vitamin C than are present in the plants we use as food. First, there is the body's continuing need for the synthesis of large amounts of collagen for growth and for replacement of the collagen degraded by daily wear and tear. Second, vitamin C, in the critical reactions that assemble collagen in the tissues, does not serve merely as a catalyst but is destroyed.

Linus Pauling, How to Live Longer and Feel Better (1986) Pages 89-91

Roger J. Williams

Vitamin C is essential for the building of collagen, the most abundant protein built in our bodies and the major component of connective tissue. [Wolbach, S.B., and Howe, P.R. Intercellular substance in experimental scorbutus" Arch. Path., 1:1, 1926] This connective tissue has structural and supportive functions which are indispensable to heart tissues, to blood vessels, - in fact, to all tissues. Collagen is not only the most abundant protein in our bodies, it also occurs in larger amounts than all other proteins put together. It cannot be built without vitamin C. No heart or blood vessel or other organ could possibly perform its functions without collagen. No heart or blood vessel can be maintained in healthy condition without vitamin C.

Victims of prison camps who have suffered from vitamin C deficiency have been found to have widespread fatty deposits (atherosclerosis) in their arteries. It is quite possible that vitamin C deficiency is directly implicated; it is unlikely that such deposits could have been due to too much fat or cholesterol in diet.

Strong evidence has recently been presented that individual needs for vitamin C vary widely, and that some individuals have much higher needs than has hitherto been supposed. While the functioning of vitamin C, except for its role in building collagen, is obscure, it is quite possible that many hearts and blood vessels would be better protected if an abundant environmental supply of this vitamin were available in the circulating fluids that bathe the tissue cells.

Roger J. Williams, Nutrition Against Disease (1971 ) Pages 85-86


Owen R. Fonorow Vitamin C Foundation P.O. Box 73172 Houston, Texas 77273 USA Fax: 630-416-1309 Email:

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12. Klezovitch O; Scanu AM; Edelstein C (1996). Evidence that the fibrinogen binding domain of Apo(a) is outside the lysine binding site of kringle IV-10: a study involving naturally occurring lysine binding defective lipoprotein(a) phenotypes J Clin Invest 1996 Jul 1;98(1):185-91

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By Owen R. Fonorow

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