Vitamin C: an essential "stress hormone" during sepsis.

Plain Language Summary

Most mammals can synthesise vitamin C, except humans, other primates and guinea pigs, who lost this ability through a mutation. It is estimated that goats produce 2-4g of vitamin C per day, but significantly more when stressed. Vitamin C is thought to play an important role in our stress response. This short review articles discusses the importance of vitamin C during stress, in particular the stress of sepsis. The adrenal glands, our “stress organs”, contain very high levels of vitamin C which is released when the hypothalamus-pituitary-adrenal (HPA) axis (which deals with our response to stressors) is stimulated. In animals, there is an inverse relationship between vitamin C internal manufacture and cortisol release under stress: the less vitamin C an animal can produce, the more cortisol they release. A number of vitamin C’s biological actions including antioxidant, anti-inflammatory, immune function, synthesis of the stress hormones adrenaline and noradrenaline and wound healing, may play an important role during a stress response. During sepsis vitamin C gets used up at alarming rate. Sepsis is a complex disease and vitamin C’s biological actions can affect many of the underlying pathophysiological processes. Preclinical and clinical studies have shown a beneficial effect of vitamin C in patients with sepsis and synergistic effects are seen with thiamine (vitamin B1), corticosteroids and antibiotics.