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Vitamin C for Gallstone Prevention
Vitamin C can help prevent gallstone formation. Various studies have demonstrated that higher vitamin C intake levels are connected with a lower incidence of gallstone formation, even in patients with existing gallstones or sludge. While consuming extra vitamin C in food is valuable (such as in the form of fresh orange juice, potatoes, or other vitamin C rich foods), the therapeutic, medicinal effect of vitamin C on preventing gallstones requires the use of vitamin C supplements (specifically those containing L-ascorbic acid, the natural form of vitamin C) taken in higher doses.
Symptoms of Having Too Little Vitamin C
Vitamin C deficiency is known as scurvy. A lot of people are aware of some of the hallmark symptoms of a severe vitamin C deficiency, such as bleeding gums, but most people aren’t aware of some of the early signs of deficiency or those that indicate a low level deficiency. I’ve included these core symptoms of vitamin C deficiency in this article for reference. Readers should know that although these are the most characteristic symptoms of vitamin C deficiency that having too little vitamin C can also cause other health problems not listed here (including gallstone formation, which I’ll talk about in more depth below).
Below are some of the main symptoms of vitamin C deficiency:
- Keratosis pilaris (bumpy skin, particularly on the backs of the upper arms, thighs, and butt, caused by the buildup of keratin in the pores)
- Bright red hair follicles
- Fingernail abnormalities (specifically, spoon-shaped fingernails that are brittle with red spots or lines)
- Easy bruising
- Dry and/or damaged skin
- Wounds that heal slowly
- Joint pain or swelling
- Weak, brittle bones and teeth
- Bleeding gums
- Decreased immunity
- Iron deficiency anemia (this may result in fatigue, breathlessness, dry hair/skin, headaches, etc.)
- Unexplained weight gain/trouble with weight loss
- Chronic inflammation
Why does vitamin C prevent gallstone formation?
Vitamin C is a cofactor for the enzyme 7α-hydroxylase, which ultimately is responsible for regulating the conversion of cholesterol into bile salts. Specifically, this enzyme increases the rate that cholesterol is converted into bile salts (note that this conversion process is completed in the liver before bile is released into the gallbladder). Therefore, without sufficient amounts of vitamin C, gallstones are more likely to form since less of this enzyme will be produced. Without enough 7α-hydroxylase, cholesterol in the bile can build up in the gallbladder since it isn’t being converted into usable bile salts, and then cholesterol gallstones can eventually form.
Studies Done on Vitamin C and Gallstone Formation
In multiple studies, adequate to high intakes of vitamin C have been directly connected to lower incidence of gallstone formation. In one animal study on guinea pigs, two groups of guinea pigs were fed a high-cholesterol diet. In the one group given vitamin C, none of the guinea pigs developed gallstones, while in the other group that was fed a diet deficient in vitamin C, gallstones were much more likely to develop. While this principle applies to guinea pigs, studies have also demonstrated the same thing in humans.
One survey carried out between 1988-1994 in a group of 7042 women noted a strong association between low serum vitamin C levels and the rate of gallbladder disease. Interestingly, the men participating in this survey didn’t show the same association as the women in regard to vitamin C and gallbladder issues. In a different study on patients with existing gallstones, administration of 2g of vitamin C daily over the course of 2 weeks was shown to reduce the lithogenicity of the patients’ bile salts, thus decreasing the risk of further gallstone formation.
In yet another human study on a group of 2,169 people in Germany between the ages of 18-65, patients who were taking supplemental vitamin C regularly only showed a 4.7% prevalence of having gallstones, while those patients who were NOT taking supplemental vitamin C were nearly twice as likely to have gallstones (8.2%).
How much vitamin C should I take daily to prevent gallstones?
One study administered 2000mg (2g) of vitamin C daily as a preventative measure against gallstone formation. This dose in this particular study was shown to be effective in reducing the lithogenicity of the bile, and therefore in reducing the risk of gallstone development. Nevertheless, readers should note that the safe “upper intake level” of vitamin C is likely to be much higher than this for most people, especially in cases of mild deficiency. In other words, though 2g per day of vitamin C is likely to be effective, it’s possible to take more than this, and may even be necessary for some people.
Since vitamin C is a water-soluble vitamin, when a person takes too much, it will be excreted in the urine relatively quickly (the same is true with other water-soluble vitamins, like the B-vitamins, for example). Therefore, the risk of taking too much vitamin C is very low. Experts in orthomolecular medicine who prescribe vitamin C for the treatment or prevention of different health problems often recommend taking enough vitamin C to reach your own individual “saturation level” of the vitamin. When a person has reached their “saturation level” of vitamin C, they may start to have some stomach gurgles, but should not necessarily have diarrhea. For some people this dose may be very high, while for others it may be lower. Start with a lower dose of about 1000mg, and then take another 1000mg every hour until you start to feel your stomach move. This is your saturation dose that you should aim to take daily while following a therapeutic protocol with vitamin C.
Note that vitamin C has a half-life of about 10-12 hours. Thus, if you’ve taken a dose of vitamin C that is too much for you, most symptoms are likely to pass within this period of time. If you experience diarrhea or other similar symptoms, reduce your dose by at least half and work back up slowly until you find your saturation dose.
Choose a vitamin C product that contains only L-ascorbic acid. This is the natural form of vitamin C. The synthetic form, DL-ascorbic acid, should be avoided, since this form of vitamin C is more likely to do more harm than good, but is also less likely to be truly effective (as with any synthetic vitamin or substance). L-ascorbic acid can be purchased in a powder form, or in a capsulized form, depending on your preference. If you take the powder form in water, make sure to rinse your mouth with plain water after each dose.
 Julson, Erica (2018). 15 Signs and Symptoms of Vitamin C Deficiency. Retrieved June 14, 2022 from: https://www.healthline.com/nutrition/vitamin-c-deficiency-symptoms#TOC_TITLE_HDR_18
 Gaby, Alan R. (2009). Nutritional Approaches to the Prevention and Treatment of Gallstones. Retrieved June 14, 2022 from: http://www.peirsoncenter.com/uploads/6/0/5/5/6055321/258.pdf
 Walcher, Thomas, et. al. (2009). Vitamin C supplement use may protect against gallstones: an observational study on a randomly selected population. Retrieved June 14, 2022 from: https://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-9-74