- Is Sodium Ascorbate Vitamin C effective in promoting collagen synthesis, reducing inflammation, reversing oxidative stress, and improving bone/ligament/tendon healing after musculoskeletal injuries?
- What about Dental Surgeries?
- Can Vitamin C be effective in pain management?
- Ascorbate plays a pivotal role in collagen synthesis and thus wound healing.
- Invasive circumstances (surgery, infection, sepsis) could induce an ascorbate deficiency.
- Vitamin C supplementation with therapeutic applications, such as the combination of oral intake, IV and local administration to the site of injury, improves wound healing drastically.
- Supplementation could greatly reduce discomfort, pain, reduce bacterial burden and secondary risk of infections, accelerate healing.
Adequate vitamin C intake, also known as ascorbate or ascorbic acid, can enhance the healing process and improve the quality of tissue repair following musculoskeletal injuries. Optimal ascorbate levels in the body are directly linked to improved recovery and regeneration after physical stress or injury, which can be particularly relevant in the context of orthopedic injuries and surgeries.
After a musculoskeletal injury, the activation of inflammatory cells has been observed to overproduce ROS, causing deleterious oxidative stress. Oxidative stress has been described as an imbalance between ROS and antioxidants, resulting in a hostile healing environment that negatively affects the viability and proliferation of recruited collagen-producing cells and ultimately promotes apoptosis.
Furthermore, the quality and strength of musculoskeletal tissues are directly related to the proper production and organization of collagen. If these tissues have poorly developed collagen matrices, they may not be as robust or resilient as they should be. This can lead to unsatisfactory outcomes following injuries, surgeries, or other physical stresses, and it can increase the risk of further injuries or reinjuries. In essence, the body’s ability to repair and rebuild these tissues is dependent on the successful synthesis and cross-linking of collagen.
Therapeutic applications of Vitamin C (combination of IV, Oral, Intra-Operative routes of administration) have been shown to improve healing after bone, tendon, and ligament injuries in vivo and in vitro, and have shown to be effective antioxidant protecting against fibrosis and promoting collagen synthesis.
Blood vitamin C concentration falls after surgeries and during trauma, and further decreases in surgical intensive care unit patients. The decline may be owing to increased demand caused by increased oxidative stress. To normalize plasma vitamin C concentration, much higher doses than the recommended daily allowance or doses recommended in parenteral nutrition guidelines are required in these patients.
Recent research and preclinical studies on the biochemical pathways after musculoskeletal injuries have demonstrated that vitamin C therapy has the potential to accelerate bone healing after a fracture, enhancing collagen I synthesis, improve soft tissue healing, and reduce oxidative stress parameters.
Role of Vitamin C in Healing
- Vitamin C is a potent antioxidant and an electron donor, capable of neutralizing ROS through redox reactions, relieving and reversing oxidative stress due to inflammation.Vitamin C also plays an essential role in collagen synthesis and in connective tissue healing. In addition to its role in collagen synthesis, vitamin C acts as a powerful antioxidant and an electron donor and is capable of neutralizing deleterious reactive oxygen species (ROS) through redox reaction, relieving and reversing oxidative stress caused by inflammation.While ROS have essential roles in the immune response, their overproduction during inflammation can contribute to cell apoptosis due to oxidative stress, activation of apoptotic pathways, and mitochondrial damage. Controlling ROS levels and maintaining a balanced immune response is crucial in minimizing potential harm to host cells during inflammation.Basic science investigations on the biochemical pathways after a musculoskeletal injury have suggested that vitamin C may enhance collagen synthesis and soft tissue healing, and reverse oxidative damage. Therefore, maintaining the health and proper functioning of collagen-producing cells, along with supporting factors like vitamin C (which is essential for collagen synthesis), can be crucial in promoting the recovery and strength of musculoskeletal tissues.Vitamin C requirement is increased drastically in surgical patients, and optimal supplementation protocol increases the plasma and tissue levels of vitamin C and thereby reduces oxidative stress.Vitamin C supplementation after trauma, prior, during, and after surgeries provide significant benefits in the rate of healing, due to the increase in type I collagen synthesis, and the reduction of oxidative stress parameters.
- So, what is the optimal protocol?
- How much Vitamin C is needed?
- Which form of Vitamin C is most bioavailable?
- Which route of administration is most effective?
- What is the right frequency and duration of treatment?
- How can Vitamin C be applied intra-operatively in dental surgeries?
Can it enhance any regenerative treatments such as PRF, PRP, or Stem Cell procedures?
What about non-invasive anti-aging treatments?
What about chronic oral infections?
