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Quick Summary tl;dr
Atherosclerotic plaques develop when damage to artery walls cannot be repaired and an internal clot develops instead to prevent excess bleeding.
Vitamin C is needed to repair damaged artery walls by promoting the formation of collagen, the main structural component of blood vessels.
Lp(a) is presumed to be an evolutionary surrogate for Vitamin C. This hypothesis was first put forth by Linus Pauling. Pauling is the only person in history to ever be awarded two Nobel Prizes ( 2).
Human experiments to see if high-dose vitamin C supplementation can lower Lp(a) and heart risk in humans with high Lp(a) are currently ongoing ( 6).
A car is driving along the highway when… SMASH… car crash! It’s a 10-car pileup and the road is wrecked. Of course, the first priority is to cordon off the space to prevent further damage. This necessarily congests traffic.
But, because nobody was hurt, once the cars are removed and the highway is repaired with new asphalt, the blockade is removed, and traffic continues as normal; it is as if nothing had happened.
But what if there wasn’t enough new asphalt to repair the road? The blockade would have to stay up and traffic would remain congested. Furthermore, as more and more car accidents occurred overtime, the highway would become more damaged, the number and size of blockades would grow, and the highway would eventually need to be shutdown.
This, of course, is an analogy. In this analogy, the highway is your arteries, the blockade is a clot (a.k.a. an atherosclerotic plaque) and the new asphalt is collagen, the substance used to build artery walls.
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The Role of Vitamin C in Collagen Formation and the Accumulation of Lp(a) Deposits
I also want to introduce two more metabolic players: Vitamin C and Lp(a). Vitamin C you know as the antioxidant present in oranges, but it is also an essential player in collagen formation ( 1).
Procollagen, the precursor to collagen, requires “lysine and proline hydroxylation” to become the mature collagen that is needed to repair the artery highway. Therefore, if you don’t have enough vitamin C, you can’t make collagen (new asphalt) and the artery highway remains broken.
Vitamin C is needed to repair damaged artery walls by promoting the formation of collagen, the main structural component of blood vessels.
Lp(a) is a lipoprotein (it is similar to LDL cholesterol particles, but with a tail) that acts like the physical barriers blocking off traffic (or orange cones) in our analogy. In arteries, Lp(a) binds to the damaged area and promotes clotting. In the short term, this is good as it prevents excess bleeding. However, in the absence of vitamin C, Lp(a) blockades accumulate, leading to eventual complete highway closure ( 2, 3).
So, let’s review. The highway is your arteries, the blockade is a clot (atherosclerotic plaque), the new asphalt is collagen, which requires vitamin C to be produced, and Lp(a) is the physical barrier blocking off traffic. If you don’t have vitamin C, Lp(a) deposits — the atherosclerotic plaque — grows, and eventually you end up with serious heart disease.
When it comes to heart health, we need vitamin C to prevent Lp(a) deposits from accumulating. Atherosclerotic plaques develop when damage to artery walls cannot be repaired and an internal clot develops instead to prevent excess bleeding.
How Much Vitamin C Do Humans Need?
So, now that you know all about why vitamin C is important in heart health, I want to share two animal fun facts with you that might make you think twice about how much vitamin C you might want to get through your diet and supplements each day.
First, animals that can produce their own vitamin C from glucose ( 4), which includes most animals, don’t tend to get heart disease. By contrast, those who can’t produce vitamin C, specifically primates and guinea pigs ( 5), are prone to heart disease.
You can give a guinea pig heart disease by simply removing vitamin C from its diet, even if its diet lacks cholesterol. Second, goats make more vitamin C in their bodies than any other animal. The average 70 kg goat (which is the same weight as your typical fully grown woman) makes 13,300 mg of vitamin C per day.
By contrast, the human recommended daily allowance (RDA) of vitamin C is a measly 75 mg for women and 90 mg for men, the amount required to just barely avoid getting scurvy. What’s more, when goats are stressed or becoming sick, they bump their vitamin C production by 10-100-fold! That means a stressed goat is producing 15,000-times more vitamin C per day than is currently clinically recommended for the averaged stressed human (and most of us are stressed most of the time).
Broccoli, cauliflower, Brussels sprouts and red bell peppers are all great low-carb, keto-friendly sources of vitamin C.
If you’re a visual learner, Martina and I helped Thomas DeLauer produce a video on this topic that you can find here.
For more science-backed articles related to this topic, read the posts below:
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