VITAMINS E & C

Description
This section dealing with vitamin E is definitely the longest discussion of possible treatments for Peyronie’s disease (PD). Yet, much more could be written on this important topic. This large space was given to vitamin E because it is considered the most important of all possible PD therapies. Even so, this is still only a quick look at a large and complex subject, with speculation how it affects the scar tissue of PD. Like other sections that follow, it has been kept direct and practical to the problem of PD. If you would like to learn more about the technical aspects of vitamin E please see the excellent book, "The Vitamin E Factor", by Andreas Papas, PhD.

Just as there is no universal agreement about PD, there is controversy about vitamin E. Make no mistake about it: There are those who say vitamin E does not help PD – of course they also say that nothing helps PD, except surgery. But, others take a positive stand on vitamin E and many of these come with good research to back it up.

We may have put a man on the moon, but we still are debating even the most fundamental aspects of vitamin E. When you read vitamin E only does this, or it definitely can’t be used to treat that, remember that the American Journal of Clinical Nutrition ran an article that stated, “In conclusion, the scientists agreed that the functions of vitamin E were underestimated if one considered only its anti-oxidative properties. Future research on this essential vitamin should focus on what makes it essential for humans, why the body apparently utilizes -tocopherol preferentially, and what functions other forms of vitamin E have.”(1)

Vitamin E was discovered in 1922 as a nutrient that prevented miscarriages; all of the early work done on vitamin E had to do with its ability to influence reproduction. Yet in this same article mentioned above, published in 2002, the author observed, “In addition, (vitamin E’s) role in human reproduction has not been investigated in any detail.”(1) It is shocking to learn that after more than 80 years, vitamin E has “…not been investigated in any detail”. Think about that when you read that someone flatly states an opinion about vitamin E. We really don’t know much about vitamin E, and we are still learning what vitamin E can do for PD. Don’t believe everything that the experts are saying, because you now know the experts admit they haven’t even begun to study vitamin E seriously. Read on with an open mind.

Recent Scare Stories about Vitamin E
The recent false conclusions in the news about vitamin E just goes to show how little science knows about the subject.  It also shows the problem with using cheap synthetic vitamin products for your health. 

Here two reasons these conclusions are incorrect:
     1.  The research that was done used only the synthetic form of vitamin E, alpha-tocopherol acetate, not the naturally occurring form that is recommended by PDI.  Many times medical research uses the synthetic form of a vitamin as though there is no difference between the natural and synthetic form. There is a lot of evidence to dispute this idea.  For more, read A Honey of an Idea.
    2.   The research that was done used only the alpha form of vitamin E, and ignored the other seven members of the complete vitamin E family.  The Journal of the American Medical Association recently pointed out that the use of the alpha form of vitamin E -- alpha-tocopherol -- as a dietary supplement causes depletion of the gamma, beta and delta forms in the body, resulting in health risks.

To put a few things about vitamin E in perspective, it is good to recall that just 20 years ago the omega 3 fatty acids were widely ridiculed and their safety questioned. Today they are recommended by the FDA, the American Heart Association and others.  A few years ago vitamin C was also thought to cause cancer.  And not that long ago, the AMA laughed at the idea that there was a connection between a high fat diet and heart disease.  It all goes to show that there is still a lot that science does not know about nutrition.  

Why Vitamin E is Unproven
As explained in A Honey of an Idea, there usually is no interest in the drug industry to work on a therapy unless it has great financial potential. Vitamin E is a good example of this lack of enthusiasm; while vitamin E might be called an expensive vitamin, on one hand, it is very inexpensive compared to a drug, on the other hand. Not only that, but if a drug company discovered that vitamin E actually helped PD, it would have to somehow make vitamin E exclusive to that particular company in order to benefit from its own expensive research. Otherwise, every small vitamin company in the world could profit from their effort and expense. Therefore, the position of the scientific community is the use of vitamin E in many areas of health and disease – like treatment of PD – remains conveniently “unproven”.

For the time being, the evidence for vitamin E benefitting PD must be deducted by reading between the lines about research done for similar health problems and in other areas. In the following list of worldwide research, whenever you read that vitamin E was found beneficial for heart disease, hardening of the arteries, atherosclerosis, fibrocystic breast disease, or keloids, this information is important to the PD sufferer because of the similarity or tie-in of fibrous tissue scar development in that disease to the scar of PD. Here is a brief sample of just some of the favorable findings of vitamin E research directly for PD, as well as in areas similar to PD:

• In a German study various methods of treating PD were discussed. One of the findings from this study was, “an analysis of the world literature shows a 75% improvement with vitamin E therapy.”(2)
• It is common to find references to vitamin E’s ability to change scar tissue; actually, it is quite common. For example, this recent European study stated, “Vitamin E…has anti-fibrotic, (anti-scar), anti-mitotic and anti-inflammatory effects in modifying the early stages of Peyronie's disease…”(3)
• Vitamin E has long been reported in medical journals and newspapers to relieve most cases of fibrocystic disease (breast lumps).(4) While fibrocystic breast disease is not the same problem as PD, there is a similar scar tissue buildup in both conditions. This similarity suggests vitamin E is an interesting treatment option in PD. In the absence of further direct research with vitamin E and PD, this type of correlation of similar circumstances is an accepted and common manner in which medical clinicians search for potential treatment options when none are supported by direct research.
• In a discussion of PD, the effectiveness of conservative therapy is described. The authors state that 400 units of vitamin E are used to promote healing and prevent scarring.(5)
• A California research report states that vitamin E can inhibit scar formation in eye tissue. It is mentioned as an inhibitor of scar formation and as an aid to healing.(6)
• Japanese research on several types of skin conditions was reported, including excessive scar, treated with vitamin E ointment on the surface of the problem area. Clinically, all of the lesions responded to topical vitamin E therapy.(7)
• Investigation was made into trauma of various origins, producing a connective tissue disorder that leads to keloid formation, a condition similar to excessive scar formation as in PD. Vitamin E is an important inclusion of a standard treatment method in scar treatment, especially in the prevention of excessive scars or keloids.(8)
• In this lengthy and detailed discussion from Croatia, the role of vitamin E is mentioned as an important part of wound treatment to reduce scar formation.(9)
• Failure of glaucoma surgery is reported to be mostly due to scar formation. Vitamin E was shown to reduce scar formation after eye surgery.(10)
• Research was done on pigs in which they were given a high dose of x-ray radiation. This resulted in a scar that extended from the surface of the skin down into deep tissue layers. The density, length, width, and depth of the scar tissue were monitored. Significant softening and shrinking of the scar was noted in the pigs dosed with vitamin E. Within 26 weeks there was a 50% decrease in the dimensions of the scar tissue.(11)
• Facial plastic surgeons discuss the problem encountered when managing facial scars. They report numerous treatment modalities are available for scar management, including topical applications of vitamin E.(12)
• A clinical study on humans indicates a mixture of tocopherols and tocotrienols not only slowed down the narrowing of scarred and damaged carotid arteries, but in 40% of these patients there was reversal of the narrowing – suggesting a reversal of the hardening or scar buildup that occurs in a damaged arterial wall.(13)
• A small study of men who had previously undergone a coronary artery bypass graft surgery found a reduction of hardening and disease of the coronary artery in those men who took at least 100 IU of alpha-tocopherol daily.(14)
• Patients with chronic kidney disease are at much greater risk of dying from cardiovascular disease than the general population. This is speculated to be due to increased stress of greater free radical damage than their ability to neutralize it. It was found that supplementation of renal dialysis patients with 800 IU of alpha-tocopherol for an average of 1.4 years resulted in a significantly reduced risk of heart attack and hardening of the arteries compared to a placebo control group.(15)
• Finnish researchers reported that combined supplements of natural vitamin E and time-release vitamin C, taken over a three-year period, slowed progression of atherosclerosis, (scarring and hardening of the artery wall), in men.(16) Using ultrasound to document blood-vessel changes, the researchers showed that the antioxidant vitamins reduced the thickening of the interior of the carotid artery, which could reduce and obstruct blood flow. In a follow-up study to this initial research, they assessed the effects of daily supplements containing natural vitamin E (136 IU) and time-release vitamin C (250 mg) over a six-year period. Overall, the combined supplements reduced thickening of the carotid artery in men by 37 percent compared to a placebo group. This study showed that a very modest daily supplement containing natural vitamin E and time-release vitamin C slowed the progression of atherosclerosis (artery wall thickening by scar tissue), particularly in men.(16)

Findings of the Vitamin E Pioneers
Evan Shute, MD, and Wilfrid E. Shute, MD, were brothers who practiced cardiology. They are considered the foremost pioneer researchers of vitamin E in the early 1960s. Together they collected statistical and clinical research information from over 55,000 patients they treated. Their work and clinical data are still considered some of the most important and innovative uses of vitamin E. Because they attempted to treat serious cardiac problems with a vitamin, they were medical outcasts and were treated as though they were quacks. They were ridiculed and persecuted for the discoveries they made while “thinking outside the box”. They persisted because of the remarkable progress their patients made while being treated with vitamin E. Since they explored totally new areas of medical therapy, they had no prior information or research on which to base their work. The Shute brothers summarized their clinical research with vitamin E in this way:

1. Vitamin E has anti-thrombin ability, meaning that it prevents blood clots from occurring inside blood vessels. Yet it does not interfere with the normal clotting of blood in a wound and with the normal healing process. It actually accelerates the healing of burns and wounds.
2. Vitamin E conserves oxygen in the body because it is a natural antioxidant. It decreases the oxygen requirement of muscle by as much as 43%, and makes the reduced blood flow in a damaged coronary artery adequate to prevent the onset of heart pain after a heart attack.
3. Vitamin E is a dilator of blood vessels. It opens up new pathways in the damaged circulation, and bypasses blocks produced by clots and hardened arteries.
4. Vitamin E prevents excessive scar tissue production and is able to reduce existing scar tissue. It has been shown to reduce scar formation in many areas, from the hand to the urinary tract. Vitamin E cream or ointment will actually fill in acne or chicken pox scars on the face, often to the point where they are barely discernible. They also reported extensive experience with vitamin E dissolving scar tissue from a variety of previous surgery or even damage as a result of heart attack.

Warning: Drug interactions
Individuals on anticoagulant therapy (blood thinners) or who are vitamin K deficient should not take vitamin E supplements without close medical supervision because of increased risk of hemorrhage.(17) Certain medications may decrease the absorption of vitamin E: cholestyramine, colestipol, isoniazid, mineral oil, orlistat, sucralfate, and the fat substitute, olestra. Anticonvulsant drugs such as phenobarbitol, phenytoin, or carbamazepine may decrease plasma levels of vitamin E.(17, 18)

Theory for Variable Results of Vitamin E Usage
While it is commonly reported that treatment of PD with vitamin E provides variable and inconsistent results, two critically important issues are often overlooked that might explain why this is so. Most of the research on the effects of vitamin E on PD was done with just the single vitamin E family member, d-alpha-tocopherol, often in the synthetic or esterified form. The effectiveness of this form of vitamin E is only half of the natural form.(19-21) In the medical community it is common to assume that a synthetic or laboratory version of a natural product is the same or better than the original. Such is not the case with vitamin E; natural has been proven superior to manufactured.(22)

Not All “E” Created Equal
Not all vitamin E is the same, just as not all cars are the same – a Volkswagen is not a Rolls-Royce. One brand of vitamin E can be much different from another. When certain claims and results of vitamin E research are reported that are not substantiated or reproduced in other research, it is likely because a lesser quality or quantity of vitamin E was used in testing that directly diminished or altered the outcome. Often synthetic or minimal dose vitamin E is used in research that fails to produce positive results. If a man with PD uses a different quality or quantity of vitamin E than is recommended by PDI, results may be compromised.

There are vitamin E products of questionable quality and quantity. With any vitamin, especially E, do not make the mistake of hunting for bargains at a discount store. You get what you pay for. This is an expensive vitamin to make that costs more than many other vitamin products. When you find a “bargain” vitamin E it could be there is an issue with the quality or quantity of that product. After studying the various products we have a strong favorite we think is the best of the best; more about that later.

Conclusion About All the Research
Mildly favorable and strongly favorable references to vitamin E treatment are scattered throughout the PD literature. It is often mentioned as the primary method of initial care or use with a drug in the early phase of treatment. No effort is made to explain its effectiveness, except that it is an antioxidant. Considering the controversy with it and how little it has been studied, vitamin E is still the most common of the conservative methods used in medical practice.

In a publication from the National Institute of Health,(23) we learn that some researchers have given vitamin E orally to men with Peyronie's disease in small-scale studies and have reported improvements. But this same report also states there are no controlled studies that have established the effectiveness of vitamin E therapy. This last statement gets back to an idea brought up earlier, concerning the lack of “proof” of treatment for vitamin E. On the one hand, the government publication states that small-scale vitamin E studies have been shown favorable improvement. On the other hand, there is no follow through with the kind of large-scale research that is needed to prove vitamin E’s effectiveness. So, as a result of this neglect of interest in a simple and inexpensive treatment, the drug industry can correctly continue to say that vitamin E therapy is not proven as a treatment method for PD. Another brochure, this one from the world famous Mayo Clinic, states the very same thing: “Researchers have reported improvements in Peyronie's disease when vitamin E is taken orally, yet the effectiveness of vitamin E therapy has yet to be proved in controlled studies.”

For these reasons, PDI maintains that vitamin E is a safe and reasonable early treatment for PD. Do not be swayed by its lack of proven effectiveness – it is unproven because that is the way that the drug industry wants it to be classified; as long as they ignore vitamin E, it will always remain “unproven”. It is only a matter of time before the drug industry or the government gets around to doing the necessary testing to make its effectiveness official. In the meantime, we encourage its use as the first line of treatment for PD.

Science
Vitamin E is not one thing; it is actually a family of eight different but related fat-soluble compounds that exist in diverse forms, all widely found in the plant kingdom.

There are two basic groups of E, tocopherol and tocotrienol; each of these two forms has four subdivisions called alpha, beta, delta and gamma, for a total of eight variations or forms of vitamin E. Different forms of vitamin E are found in different parts of a plant; the green parts of a plant contain mostly alpha tocopherol and the seed germ and bran contain mostly tocotrienols. Please note: the most common form of vitamin E in the American diet is by far the gamma tocopherol form, which has been shown to have strong anti-inflammatory properties and other functions. Unfortunately most vitamin E supplements contain only alpha-tocopherol. This information should make it all the more obvious why a PD victim needs to carefully choose supplements that contain the complete vitamin E family of tocopherols plus tocotrienols and are especially rich in gamma-tocopherol. Like all families, each member has certain strengths and abilities, requiring a variety of workers to support the necessary tissue changes needed to improve the health and resistance of tissue damaged in PD. Here is a list of the eight forms of vitamin E:

Tocopherol group
 Alpha-tocopherol
 Beta-tocopherol
 Gamma-tocopherol
 Delta-tocopherol
Tocotrienol group
 Alpha-tocotrienol
 Beta-tocotrienol
 Gamma-tocotrienol
 Delta-tocotrienol

Each of the two forms has its own area of use or activity in the body.

The tocopherol forms function as strong antioxidants, with the alpha form being the most active of the four subdivisions. Vitamin E, like all antioxidants, protect at the cellular level against the effects of potentially damaging by-products of metabolism, called free radicals. A free radical is a molecule that has been involved in a chemical process in the body, and in so doing becomes unstable when it loses an electron. Free radicals can cause cell damage by attracting electrons from stable molecules in other areas in the body, thus making additional cells also unstable. Unless they are connected to an antioxidant, highly unstable free radicals attack the polyunsaturated fatty acids of cell membranes in a chain reaction. This process of losing and gaining electrons might contribute to the development of heart disease, cancer; Alzheimer's disease, arthritis, premature aging and cataracts and even excess scar formation.

PD Connection
The tocotrienol form of vitamin E has shown superior action in maintaining arterial health because of its ability to reduce plaque and fibrous tissue infiltration in damaged arterial walls. This same ability is suspected to result in reduction of scar and fibrous tissue buildup in other parts of the body.

Vitamin E has 75% worldwide approval as a first-line treatment of PD, yet its effectiveness has not been proven to scientific standards. It is the most popular of the alternative treatments used. Vitamin E is perhaps the most researched and tested of the alternative methods for treatment of PD, and yet it has not been researched or tested very much. It has been heavily researched and tested for other health conditions that have the same or similar scar and fibrous tissue formation, and it has proven its effectiveness. Use of vitamin E is based not only on the positive results it gets with PD, but also the positive results scored against other health conditions similar to it.

Maybe your family doctor or local urologist doesn’t recommend using vitamin E for PD, but you can now see there is a lot of science backing up this idea, and there are thousands of doctors from around the world who use it successfully. You are now aware of some of the reasons it is used as a first-line of treatment against PD.

If you were going to use only one therapy to improve the health of your tissue and increase your chance of repairing some of the damage of PD, vitamin E should be considered as that one thing. Using vitamin E – and therefore vitamin C – is the perhaps the most commonly recommended conservative method to assist the healing of the PD scar in traditional medical practice, as well as alternative medical practice.

Vitamin E Product Recommendation
We have spent considerable time and effort studying all the vitamin E products available, as a result we strongly recommend the interested person use only vitamin E products from Yasoo Health Inc. Here is why we recommend each of these individual Yasoo supplements to improve  systemic and local tissue health in PD:

Integral E 400/400 supplies all eight members of the vitamin E family – tocopherols plus tocotrienols – in their natural unesterified form as found in our food. It is particularly rich in gamma tocopherol and tocotrienols, which have anti-inflammatory properties and support vascular function and skin health. Each softgel supplies:

• 400 IU vitamin E activity from natural d-alpha-tocopherol, plus
• 400 milligrams of the other natural tocopherols plus tocotrienols.

Gamma E 500 provides 100% natural mixed tocopherols, not the less effective esterified or methylated forms. Gamma-Tocopherol is the effective form that fights nitrogen free radicals. Recent research suggests that gamma-tocopherol reduces inflammation. A metabolite of gamma-tocopherol (2,7,8-trimethyl-2-(beta-carboxyethyl)-6-hydroxychroman, known as gamma-CEHC) is also effective in reducing inflammation.(24-25) Gamma-tocopherol is more effective than alpha-tocopherol in increasing the activity of the antioxidant enzyme superoxide dismutase (SOD) in plasma and arterial tissues.(26) Gamma-tocopherol increases nitrogen oxide generation which helps support healthy arterial function. Each softgel contains:

• 800 milligrams of tocopherol concentrate high in gamma-tocopherol (500 mg)

Omega Q™ combines the benefits of all natural omega-3 fatty acids, natural tocopherols plus tocotrienols and CoQ10 in their most bioavailable form. Omega-3 fatty acids have been shown in clinical trials(27) to reduce heart disease, reduce triglyceride levels and reduce inflammation. Each serving of two softgels provides you with:

• 840 milligrams of omega-3 fatty acids as natural triglycerides, including 420 milligrams of EPA and 280 milligrams of DHA from premium cold water marine oils
• 200 milligrams natural tocopherols
• 28 milligrams natural tocotrienols
• 20 milligrams Coenzyme Q10

Callisto™ Therapeutic High-Potency Vitamin E Oil. Rich in the full family of tocopherols and tocotrienols in their natural unesterified form. This powerful combination of antioxidants, in a natural grape seed and almond oil carrier, provides excellent protection against free radical damage and inflammation. Applied directly to the skin, it allows for the penetration of active components of the vitamin E family into deeper layers of the tissue to maximize benefit, thus helping wound healing and reducing scar tissue.(29-32) 

Another High Quality Vitamin E at a reduced price level
Vitamin E is the one nutrient a man with PD should not cheat on.  It is that important.  While vitamin E alone – nor any other Alternative Medicine therapy used by itself – cannot be counted on to turn a PD problem around, it is a critical contributor in the overall synergy of a well-rounded therapy plan.  That is why you need not only a good vitamin E, you need the best one you can find.    

For purely financial reasons many men choose to use a lower priced vitamin E product than the very best Yasoo Healthcare Products, known as Integral E 400/400 and Gamma E 500. Every man must do what he has to in order to take care of all aspects of this life, and that includes his finances.  However, since this is the direction that some men are forced to take, PDI also offers the best of the lower cost products. 

After considerable testing and investigation PDI has found another company that also produces a high quality vitamin E product. PDI now offers this other product as an excellent option to the Yasoo vitamin E products. This product is UNIQUE-E from the A.C. Grace Company, of Big Sandy, Texas, a well established American supplier who enjoys an excellent reputation for quality and integrity.  This is perhaps the oldest company in the current vitamin E marketplace, and for good reason.  Unique-E, their flagship vitamin E product, has proved itself in ongoing research studies and clinical trials over the years.

                                                          

William Bodri, in his excellent book, “How to Dissolve Your Peyronies Plaques Naturally…11 Ways to do it”, strongly advocates Unique-E as the vitamin E to use in treating PD.   If you are convinced about Unique-E after reading his book, or if you have had good experience with Unique-E, or have heard of its excellent reputation, as many have, and you therefore prefer to use Unique-E, then that is perhaps the product you should use.  Now you can get UNIQUE-E from PDI at the best prices around.  We are pleased to offer Unique-E to you at our always competitive price.  Either way – with the Yasoo or A. C. Grace vitamin E products – you are assured high quality vitamin E at the very bet price when your deal with PDI. 

Vitamin C, also
We recommend that in addition to the vitamin E you will be taking you should also include 2000-4000 mg (2 to 4 grams) of vitamin C daily. We could extend this discussion for a few more pages, explaining the complex biochemical benefit of combining the two vitamins, E and C. However, this is what it comes down to: Both E and C are antioxidants. When taken together, they work to make each other work better and last longer in your body. It is said that vitamin E makes the C work better and last longer in your system, and vitamin C does the same thing for vitamin E. If you have a strong interest in biochemistry, Dr. Papas’ book will explain all of the detail of this relationship to you

Recommended Use of Vitamin E (and Vitamin C)
Anyone taking blood thinning medication should consult with their prescribing doctor before starting a high dose vitamin E and omega fatty acid therapy. Because vitamin E and omega-3 act as very mild anticoagulants they may have an additive effect and cause further thinning of the blood beyond the desired level. In general, PDI strongly advises anyone taking any other medication for any reason, to first check with their treating physician before undergoing any suggested supplements or therapy offered for study and consideration.

1. One softgel per day of Integral E 400/400, taken at the first meal of the day. The advantage of this form is that it supplies 400 IU vitamin E activity from natural d-alpha-tocopherol plus 400 milligrams of the other natural tocopherols plus tocotrienols that have additional benefits. NOTE: Two vitamin E 400/400 may be taken initially for a few weeks, at the beginning of treatment, then reduced to one daily.
2. One softgel per day of Gamma E 500 taken at the last meal of the day. The extra gamma tocopherol can help with inflammation and arterial function. Each softgel contains: 800 milligrams of tocopherol concentrate high in gamma-tocopherol.
3. Two softgels of Omega Q™ taken with any meal during the day. Combines the benefits of all natural omega-3 fatty acids, natural tocopherols plus tocotrienols and CoQ10 in their most bioavailable form. Omega-3 fatty acids have been shown in clinical trials(33-34) to reduce heart disease, reduce triglyceride levels and reduce inflammation.
4. Twice daily use the Callisto oil, which is very rich in gamma tocopherols and tocotrienols directly over the PD scar (along with PMD Topical DMSO Solution to increase penetration) to help reduce inflammation, promote healing and may reduce scarring. This is really recommended because it is another avenue of entry of vitamin E into the tissue. By taking vitamin E through an external source – in addition to the much needed internal source – you are assuring maximum saturation of vitamin E into the area. Apply a small amount of Callisto oil to the area of the shaft where the scar(s) is located and rub in until slight resistance is felt, indicating that most of the vitamin E oil has been worked into tissue. It may happen in some individuals that if you apply any oil too often, a rash may develop on the site of application; if so, just reduce number of applications so that skin is able to handle increased oil.
5. Douglas Laboratory vitamin C, 2,000-4,000 mg.(2-4 grams) daily, in divided doses with food, depending on your ability to handle this amount of vitamin C. Some people take 6-8,000 mg (6-8 grams) of C of this product because they have absolutely no problem with it, but only a very few have any gastric distress with 2,000 mg daily. Dosage should be in the 2,000-4,000 mg. range if at all possible. If you experience diarrhea or gastric distress after taking vitamin C, you can temporarily reduce the dose until you do not have these symptoms, wait a week and then slowly increase your intake again. Or, if you know you are highly sensitive to vitamin C, you should consider taking a buffered vitamin C that will make it easier to take doses in the 2,000 mg to 4,000 mg (2-4 gram) range. Douglas Laboratory makes a buffered Vitamin C product, Ascorbplex 1000, that will tend to protect the digestive tract from such irritation.

As an example, if you experience diarrhea at 2,000 to 4,000 mg (2 to 4 grams) a day and you are taking the vitamin C with your meals and in divided doses as you should, then go down to 1,000 mg (1 gram) for 10-14 days to accustom your body to the vitamin C. Break a 1,000 mg tablet in half (500 mg) so that you can then go to 1,500 mg daily for a week or so, then to 2,000 mg for another week or so, and so on. It is important that you get your intake as high as you can for maximum tissue response.

Vitamin C Product Recommendation
There could easily be several hundred companies that manufacture or label vitamin C. And just as with vitamin E, not all vitamin C products are created equal either. The vitamin C we really like is a 1 gram (1,000 mg) tablet of vitamin C, called Natural C, from Douglas Laboratory. Once again we use a product from this company simply because of value and reputation. Douglas Laboratory knows the nutrition business and has been a leader for a long time. We are pleased to make this high quality product available for your PD program of care.

Once your tissue repair mechanism has been supported so that your PD is under control, and your scar has been absorbed by the body, IT IS MOST HIGHLY RECOMMENDED that you stay on a dose of one softgel each of Integral E 400/400, Gamma E 500, Omega-Q, and vitamin C for the rest of your life. Besides the countless health benefits of these products for general health, they are an important first line of defense to prevent recurrence (oh yes, PD can come back!) of future episodes of PD. More about reappearance of PD, in another section.

For ideas and suggestions to put this information together in a treatment plan of your own design, click Create a PD Treatment Plan.

Order Vitamins E and C

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1. Regina Brigelius-Flohé, Frank J Kelly, Jukka T Salonen, Jiri Neuzil, Jean-Marc Zingg and Angelo Azzi, Vol. 76, No. 4, 703-716, October 2002, American Society for Clinical Nutrition, The European perspective on vitamin E: current knowledge and future research.
2. Wagenknecht LV, Meyer WH, Wiskemann A. Value of various therapeutic procedures in penile induration (Peyronie’s disease). Urol Int. 1982;37(5):335-48. [Article in German]
3. Prieto Castro RM, Leva Vallejo ME, Regueiro Lopez JC, Anglada Curado FJ, Alvarez Kindelan J, Requena Tapia MJ. BJU Int. 2003 Apr;91(6):522-4. Andrology unit, Department of Surgery, Service of Urology, Regional University Hospital Reina Sofia, Medicine Faculty, Cordoba University, Spain.
4. Shute, Wilfrid, "Overcome and Prevent Illness with Natural Vitamin E," The Shute Foundation.
5. Tunuguntla HS. Management of Peyronie's disease--a review. North Florida Urology Research Institute, Gainesville, FL 32605. World J Urol. 2001 Aug;19(4):244-50.
6. Satterfield D, Taube D, Kenney MC. Effect of vitamin E on the production of collagen, DNA and fibronectin in keratocytes in vitro. Department of Ophthalmology, School of Medicine, University of California, Davis.
7. Mizutani H, Yoshida T, Nouchi N, Hamanaka H, Shimizu M. Topical tocoretinate improved hypertrophic scar, skin sclerosis in systemic sclerosis and morphea. Department of Dermatology, Mie University, Faculty of Medicine, Japan. J Dermatol. 1999 Jan;26(1):11-7.
8. Palmieri B, Gozzi G, Palmieri G. Vitamin E added silicone gel sheets for treatment of hypertrophic scars and keloids. Department of Surgical Semeiotics, University of Modena, Italy. Int J Dermatol. 1995 July; 34(7):506-9.
9. Komarcevic A. The modern approach to wound treatment. Med Pregl. 2000 Jul-Aug;53(7-8):363-8. [Article in Croatian] Institut za zdravstvenu zastitu dece i omladine Klinika za decju hirurgiju, Medicinski fakultet, Novi Sad.
10. Haas AL, Boscoboinik D, Mojon DS, Bohnke M, Azzi A. Vitamin E inhibits proliferation of human Tenon's capsule fibroblasts in vitro. Ophthalmic Res. 1996;28(3):171-5. University Eye Clinic, Inselspital, Bern, Switzerland.
11. Lefaix JL, Delanian S, Vozenin MC, Leplat JJ, Tricaud Y, Martin M. Striking regression of subcutaneous fibrosis induced by high doses of gamma rays using a combination of pentoxifylline and alpha-tocopherol: an experimental study. Int J Radiat Oncol Biol Phys. CEA - DSV - DRR- Laboratoire de Radiobiologie et d'Etude du Genome, CEA-Saclay, Gif sur Yvette, France. 1999 Mar 1;43(4):839-47.
12. Chang CW, Ries WR. Non-operative techniques for scar management and revision. Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, TN 37232-2559, USA. Facial Plast Surg. 2001 Nov;17(4):283-8.
13@@. Kooyenga, D.K., Watkins, T. R., Geller, M., et al. Benefits of tocotrienols in patients with carotid stenosis over three years. Atherosclerosis, 1999; (in press)
14. Azen SP, Qian D, Mack WJ, et al. Effect of supplementary antioxidant vitamin intake on carotid arterial wall intima-media thickness in a controlled clinical trial of cholesterol lowering. Circulation. 1996;94(10):2369-2372.
15. Boaz M., Smetana S., Weinstein T., et al. Secondary prevention with antioxidants of cardiovascular disease in end-stage renal disease (SPACE): randomized placebo-controlled trial. Lancet. 2000;356(9237):1213-1218.
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