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Ascorbic Acid-Induced Uricosuria: A Consequence of Megavitamin Therapy

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Grant support: grants from the Medical Research Council of Canada (MRC-MT 4758) and the Canadian Arthritis and Rheumatism Society.

▸Requests for reprints should be addressed to Dr. Irving H. Fox, The Wellesley Hospital, 160 Wellesley Street East, Toronto, Ontario, M4Y 1J3, Canada.

Toronto, Ontario, Canada

Ann Intern Med. 1976;84(4):385-388. doi:10.7326/0003-4819-84-4-385
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The effect of ascorbic acid on the serum and urinary uric acid was studied in 14 subjects. Two to 6 h after the ingestion of 4.0 g of ascorbic acid, the fractional clearance of uric acid increased to 202% ± 41% of the control value. This uricosuria was inhibited by pyrazinamide and by low-dose acetylsalicylic acid, but was not accompanied by an increase of the creatinine clearance. Ascorbic acid did not diminish protein-bound uric acid. In 3 subjects who ingested 8.0 g of ascorbic acid for 3 to 7 days the serum uric acid decreased by 1.2 to 3.1 mg/dl as a result of a sustained uricosuria. These results suggest that ascorbic acid could invalidate studies involving the measurement of uric acid and obscure the diagnosis of gout in some cases. Theoretically it could precipitate attacks of gouty arthritis or renal calculi in predisposed persons. These observations show a pharmacologic effect of megadoses of a simple vitamin.





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