Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA. Rockville, MD: Agency for Healthcare Research and Quality, 2003. [, Wang AH, Still C. Old world meets modern: a case report of scurvy. The authors of a 2006 meta-analysis of randomized controlled trials concluded that antioxidant supplements (vitamins C and E and beta-carotene or selenium) do not affect the progression of atherosclerosis [68]. A prospective study of the intake of vitamins C and B6, and the risk of kidney stones in men. [, Carr AC, Frei B. [, Brown BG, Zhao XQ, Chait A, Fisher LD, Cheung MC, Morse JS, et al. A 2008 review of vitamin C and other antioxidant supplements for the prevention of gastrointestinal cancers found no convincing evidence that vitamin C (or beta-carotene, vitamin A, or vitamin E) prevents gastrointestinal cancers [41]. Based on these findings and a few case reports of patients with advanced cancers who had remarkably long survival times following administration of high-dose IV vitamin C, some researchers support reassessment of the use of high-dose IV vitamin C as a drug to treat cancer [3,49,51,54]. If subjects' vitamin C levels were already close to saturation at study entry, supplementation would be expected to have made little or no difference on measured outcomes [24,25,43,44]. JAMA 2005;294:3101-7. [, Bjelakovic G, Nikolova D, Simonetti RG, Gluud C. Antioxidant supplements for preventing gastrointestinal cancers. Am J Clin Nutr 2008;87:64-9. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? The use of vitamin C supplements might shorten the duration of the common cold and ameliorate symptom severity in the general population [82,85], possibly due to the anti-histamine effect of high-dose vitamin C [86]. Consuming enough vitamin C is also important because it might lower your risk of stroke. Curr Sports Med Rep 2006;5:177-81. Lutein/zeaxanthin for the treatment of age-related cataract: AREDS2 randomized trial report no. Intake of vitamins A, C, and E and postmenopausal breast cancer. Most women 51 and older should aim for 90 mg each day. King, CG, Waugh, WA. Due to the enhancement of nonheme iron absorption by vitamin C, a theoretical concern is that high vitamin C intakes might cause excess iron absorption. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice. Initial symptoms can include fatigue (probably the result of impaired carnitine biosynthesis), malaise, and inflammation of the gums [4,11]. Am J Epidemiol 2004;160:339-49. In the 1970s Linus Pauling suggested that vitamin C could successfully treat and/or prevent the common cold [81]. [, Taylor EN, Stampfer MJ, Curhan GC. [, Curhan GC, Willett WC, Rimm EB, Stampfer MJ. 04-E003. The most common complaints are diarrhea, nausea, abdominal cramps, and other gastrointestinal disturbances due to the osmotic effect of unabsorbed vitamin C in the gastrointestinal tract [4,8]. Dietary carotenoids and vitamins A, C, and E and risk of breast cancer. As vitamin C deficiency progresses, collagen synthesis becomes impaired and connective tissues become weakened, causing petechiae, ecchymoses, purpura, joint pain, poor wound healing, hyperkeratosis, and corkscrew hairs [1,2,4,6-8]. "[Vitamin C] is an antioxidant, which limits the damaging effects of free radicals," explains Amanda Izquierdo, MPH, RD, a Chicago-based registered dietitian. J Natl Cancer Inst 2009;101:14-23. J Emerg Med 2001;21:235-7. Proc Natl Acad Sci U S A 2008;105:11105-9. [, Douglas RM, Hemilä H, Chalker E, Treacy B. Vitamin C for preventing and treating the common cold. However, some subsequent studies—including a randomized, double-blind, placebo-controlled clinical trial by Moertel and colleagues at the Mayo Clinic [47]—did not support these findings. Approaches to cancer prevention based on an understanding of N-nitrosamine carcinogenesis. [, Johnston CS, Luo B. Online May 5. [, Johnston CS. AHRQ Publication No. PLoS Med 2005;2:e168. ... Foods in nutrient-dense forms contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects. Other forms of vitamin C supplements include sodium ascorbate; calcium ascorbate; other mineral ascorbates; ascorbic acid with bioflavonoids; and combination products, such as Ester-C®, which contains calcium ascorbate, dehydroascorbate, calcium threonate, xylonate and lyxonate [19]. The authors of a 2007 systematic review and meta-analysis of prospective cohort studies and randomized clinical trials concluded that the current evidence does not support a role for vitamin C and other antioxidants, including antioxidant supplements, in the primary prevention of early AMD [72]. Arch Ophthalmol 2001;119:1417-36. High vitamin C intakes also have the potential to increase urinary oxalate and uric acid excretion, which could contribute to the formation of kidney stones, especially in individuals with renal disorders [8]. Get it now on Libro.fm using the button below. Healthcare providers should monitor lipid levels in individuals taking both statins and antioxidant supplements [56]. [, Willcox BJ, Curb JD, Rodriguez BL. Thus, researchers have hypothesized that vitamin C and other antioxidants play a role in the development and/or treatment of these diseases. Vitamin C is required for the biosynthesis of collagen, L-carnitine, and certain neurotransmitters; vitamin C is also involved in protein metabolism [1,2]. Evidence Report/Technology Assessment Number 75. It's also important for wound healing. Am J Clin Nutr 2006;84:880-7. Thanks to vitamin C's role as an antioxidant, it may also play a role in heart health. Nutr Clin Pract 2007;22:445-8. For a reader-friendly overview of Vitamin C, see our consumer fact sheet on Vitamin C. For information on Vitamin C and COVID-19, see the NIH COVID-19 Treatment Guidelines on Vitamin C. Vitamin C, also known as L-ascorbic acid, is a water-soluble vitamin that is naturally present in some foods, added to others, and available as a dietary supplement. J Natl Cancer Inst 2008;100:773-83. Science 2001;292:2083-6. Research in mice suggests that pharmacologic doses of IV vitamin C might show promise in treating otherwise difficult-to-treat tumors [51]. AMD and cataracts are two of the leading causes of vision loss in older individuals. Taking over 2,000 mg of vitamin C supplements can result in harmful side effects. However, in individuals with hereditary hemochromatosis, chronic consumption of high doses of vitamin C could exacerbate iron overload and result in tissue damage [4,8]. This study was the first randomized clinical trial that … [, Wintergerst ES, Maggini S, Hornig DH. Effects of hormone replacement therapy and antioxidant vitamin supplements on coronary atherosclerosis in postmenopausal women: a randomized controlled trial. Vitamin C also removes oxidants caused by exposure to ultraviolet radiation, which helps to prevent sun damage. The total body content of vitamin C ranges from 300 mg (at near scurvy) to about 2 g [4]. Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo. We looked for studies in humans and found three trials with a total of 2335 participants that looked at whether vitamin C … Proc Natl Acad Sci U S A 1971;68:2678-81. Food and Nutrition Board. Total and cancer mortality after supplementation with vitamins and minerals: follow-up of the Linxian General Population Nutrition Intervention Trial. Vitamin C deficiency is uncommon in developed countries but can still occur in people with limited food variety. Oral administration of vitamin C, even of very large doses, can raise plasma vitamin C concentrations to a maximum of only 220 micromol/L, whereas IV administration can produce plasma concentrations as high as 26,000 micromol/L [49,50]. In addition to its biosynthetic and antioxidant functions, vitamin C plays an important role in immune function [4] and improves the absorption of nonheme iron [5], the form of iron present in plant-based foods. Updated: February 27, 2020 History of changes to this fact sheet, U.S. Department of Health & Human Services, Strengthening Knowledge and Understanding of Dietary Supplements, My Dietary Supplement and Medicine Record, How To Evaluate Health Information on the Internet, NIH Consortium for Advancing Research on Botanical and Other Natural Products (CARBON) Program, Analytical Methods and Reference Materials (AMRM), Dietary Supplement Ingredient Database (DSID), Computer Access to Research on Dietary Supplements (CARDS) Database, NIH COVID-19 Treatment Guidelines on Vitamin C, Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids, Guidance for Industry: A Food Labeling Guide. Similarly, a systematic review of vitamin C's effects on the prevention and treatment of cardiovascular disease found that vitamin C did not have favorable effects on cardiovascular disease prevention [69]. ascorbic acid in advanced malignancy. Although research has not shown that antioxidants play a role in AMD development, some evidence suggests that they might help slow AMD progression [73]. The amount of vitamin C you need varies depending on your age, according to the National Institutes of Health. The vitamin C content of food may be reduced by prolonged storage and by cooking because ascorbic acid is water soluble and is destroyed by heat [6,8]. Arch Ophthalmol 1993;111:1246-53. DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. Applies to ascorbic acid: oral capsule, oral capsule extended release, oral liquid, oral powder, oral powder for solution, oral powder for suspension, oral solution, oral tablet, oral tablet chewable, oral tablet extended release, oral waferOther dosage forms: 1. intravenous solutionAlong with its needed effects, ascorbic acid (the active ingredient contained in Vitamin C) may cause some unwanted effects. Cochrane Database Syst Rev 2008;(3):CD004183. [, Yoshida M, Takashima Y, Inoue M, Iwasaki M, Otani T, Sasaki S; JPHC Study Group. A 2007 Cochrane review examined placebo-controlled trials involving the use of at least 200 mg/day vitamin C taken either continuously as a prophylactic treatment or after the onset of cold symptoms [83]. Prevention of esophageal cancer: the nutrition intervention trials in Linxian, China. [, Mangels AR, Block G, Frey CM, Patterson BH, Taylor PR, Norkus EP, et al. FASEB J 1999 Jun;13:1007-24. [, Sesso HD, Buring JE, Christen WG, Kurth T, Belanger C, MacFadyen J, et al. [, Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Hoffman FA. NHANES data from 1999–2000 indicate that approximately 35% of adults take multivitamin supplements (which typically contain vitamin C) and 12% take a separate vitamin C supplement [22]. Subscriber Join the ODS Email List. Eur J Cardiovasc Prev Rehabil 2008;15:26-34. An extra-high dose of vitamin C is somewhere around 200 mg.  "The evidence is pretty weak, but the benefits of taking some extra vitamin C when you are sick probably outweigh any risks, for almost everyone.". JAMA 2013;309:2005-15. We encourage you to talk to your healthcare providers (doctor, registered dietitian, pharmacist, etc.) [, The Age-Related Eye Disease Study 2 (AREDS2) Research Group. Ann Oncol 2008;19:1969-74. The Yes To Grapefruit Vitamin C Nourishing Moisturizer has a creamy texture and it is very easy to apply. Citrus fruits are the best sources of vitamin C. Here are some non-citrus sources of vitamin C. Svirbely J, Szent-Györgyi A. Hexuronic acid as the antiscorbutic factor. Ask ODS Stephen R, Utecht T. Scurvy identified in the emergency department: a case report. J Nutr 1993;123:1054-61. Proc Natl Acad Sci U S A 2001;98:9842-6. The intestinal absorption of vitamin C is regulated by at least one specific dose-dependent, active transporter [4]. [, Ladas EJ, Jacobson JS, Kennedy DD, Teel K, Fleischauer A, Kelly KM. Dietary intake of antioxidants and risk of age-related macular degeneration. Rheumatoid arthritis, a type of autoimmune arthritis that causes joint swelling and pain, Neurodegenerative diseases like Alzheimer's disease, Parkinson's disease, and multiple sclerosis. Due to its function as an antioxidant and its role in immune function, vitamin C has been promoted as a means to help prevent and/or treat numerous health conditions. People who have limited food variety—including some elderly, indigent individuals who prepare their own food; people who abuse alcohol or drugs; food faddists; people with mental illness; and, occasionally, children—might not obtain sufficient vitamin C [4,6-9,11]. Vitamin C-induced decomposition of lipid hydroperoxides to endogenous genotoxins. Institute of Medicine. However, at doses above 1 g/day, absorption falls to less than 50% and absorbed, unmetabolized ascorbic acid is excreted in the urine [4]. Vitamin C.... is Spanish for Vitamin Yes! 3. No matter how sustained it is, any business needs innovation. During the 1970s, studies by Cameron, Campbell, and Pauling suggested that high-dose vitamin C has beneficial effects on quality of life and survival time in patients with terminal cancer [45,46]. The AREDS2 study, which also tested formulations containing 500 mg vitamin C, confirmed these findings [80]. Ascorbic acid bioavailability in foods and supplements. Intake of vitamins B6 and C and the risk of kidney stones in women. However, most prospective studies do not support these findings [71]. Nature 1932;129: 690. The mechanism for this effect, if real, is not clear and this finding is from a subgroup of patients in an epidemiological study. Vitamin C, in combination with other antioxidants, may attenuate the increase in high-density lipoprotein levels resulting from combination niacin–simvastatin (Zocor®) therapy [98,99]. It is important for your skin, bones, and connective tissue. The authors of a 2008 meta-analysis of prospective cohort studies, including 14 studies reporting on vitamin C for a median follow-up of 10 years, concluded that dietary, but not supplemental, intake of vitamin C is inversely associated with coronary heart disease risk [57]. Arch Ophthalmol 2001;119:1439-52. Our Natural Source Vitamin C tablets contain natural vitamin C derived from dehydrated juice of the acerola berry and wild Spanish … The authors of a 2003 review assessing the effects of vitamin C in patients with advanced cancer concluded that vitamin C confers no significant mortality benefit [42]. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. JAMA 2009;301:52-62. But aside from vitamin C, there are far more brightening ingredients to discover in the skin-care world and we created a guide to make navigating the options easy. Arch Intern Med 2002;162:1472-6. BMJ 2007;335:755. The Age-Related Eye Disease Study (AREDS), a large, randomized, placebo-controlled clinical trial, evaluated the effect of high doses of selected antioxidants (500 mg vitamin C, 400 IU vitamin E, 15 mg beta-carotene, 80 mg zinc, and 2 mg copper) on the development of advanced AMD in 3,597 older individuals with varying degrees of AMD [74]. These values, which vary by age and gender [8], include: Table 1 lists the current RDAs for vitamin C [8]. [, Lawenda BD, Kelly KM, Ladas EJ, Sagar SM, Vickers A, Blumberg JB. Purpose: To present a critical evaluation of the current evidence concerning the therapeutic value of vitamin C for the prophylaxis and treatment of the common cold. J Am Soc Nephrol 2004;15:3225-32. [, Cameron E, Campbell A. Prophylactic use of vitamin C did not significantly reduce the risk of developing a cold in the general population.