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[. The safety and efficacy of the use of vitamin C and other antioxidants during cancer treatment is controversial [55,93,94]. When taken after the onset of cold symptoms, vitamin C did not affect cold duration or symptom severity. [, Yoshida M, Takashima Y, Inoue M, Iwasaki M, Otani T, Sasaki S; JPHC Study Group. Antioxidant status and risk of cancer in the SU.VI.MAX study: is the effect of supplementation dependent on baseline levels? Ultraviolet radiation causes premature aging of the skin, resulting in wrinkles, hyperpigmentation, and skin sagging. This practice can cause vitamin C deficiency because cow's milk naturally has very little vitamin C and heat can destroy vitamin C [6,12]. [, Bruno EJ Jr, Ziegenfuss TN, Landis J. Vitamin C: research update. Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects. Vitamin C deficiency is uncommon in developed countries but can still occur in people with limited food variety. The researchers concluded that people with a high vitamin C … [, Taylor PR, Li B, Dawsey SM, Li JY, Yang CS, Guo W, et al. [, Evans J. A pooled analysis of nine prospective studies that included 293,172 subjects free of coronary heart disease at baseline found that people who took ≥700 mg/day of supplemental vitamin C had a 25% lower risk of coronary heart disease incidence than those who took no supplemental vitamin C [64]. [, Cheung MC, Zhao XQ, Chait A, Albers JJ, Brown BG. This is a fact sheet intended for health professionals. While researchers are unsure exactly how vitamin C reduces the risk of stroke, they believe it may be due to the vitamin's ability to lower blood pressure and reduce inflammation. Am J Cardiol 2008;101:75D-86D. Fruits and vegetables are some of the best sources of vitamin C. Citrus fruits, tomatoes, and potatoes can be a large source of vitamin C. Vitamin … Vitamin C is an antioxidant. Individuals undergoing chemotherapy or radiation should consult with their oncologist prior to taking vitamin C or other antioxidant supplements, especially in high doses [56]. Listing a study does not mean it … Free radicals: the pros and cons of antioxidants. Rockville, MD: Agency for Healthcare Research and Quality, 2003. 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.". Am J Clin Nutr. Pharmacologic ascorbic acid concentrations selectively kill cancer cells: action as a pro-drug to deliver hydrogen peroxide to tissues. Although the 2001–2002 NHANES analysis did not include data for breastfed infants and toddlers, breastmilk is considered an adequate source of vitamin C [8,16]. A new recommended dietary allowance of vitamin C for healthy young women. [, Carr AC, Frei B. A leading-edge research firm focused on digital transformation. New developments and novel therapeutic perspectives for vitamin C. J Nutr 2007;137:2171-84. [, Moyad MA, Combs MA, Vrablic AS, Velasquez J, Turner B, Bernal S. Vitamin C metabolites, independent of smoking status, significantly enhance leukocyte, but not plasma ascorbate concentrations. Sonne's Natural Source Vitamin C No 17. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. Proc Natl Acad Sci U S A 1989;86:6377-81. The chemical nature of vitamin C. Science 1932;75:357-358. JAMA Ophthalmol 2013. 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. In postmenopausal women with diabetes who participated in the Iowa Women's Health Study, supplemental (but not dietary) vitamin C intake (at least 300 mg/day) was significantly associated with an increased risk of cardiovascular disease mortality [61]. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. Nature 1998;392:559. Proc Natl Acad Sci U S A 2007;104:8749-54. [, Gaziano JM, Glynn RJ, Christen WG, Kurth T, Belanger C, MacFadyen J, et al. A randomized double-blind comparison. Evidence from many epidemiological studies suggests that high intakes of fruits and vegetables are associated with a reduced risk of cardiovascular disease [1,57,58]. In this trial, daily vitamin C supplements (120 mg) plus molybdenum (30 mcg) for 5–6 years significantly reduced the risk of cerebrovascular deaths by 8% during 10 years of follow-up after the end of the active intervention. Clinical trial of high-dose ascorbic acid supplements in advanced human cancer. [, Waters DD, Alderman EL, Hsia J, Howard BV, Cobb FR, Rogers WJ, et al. [, Padayatty SJ, Levine M. Vitamins C and E and the prevention of preeclampsia. Evidence Report/Technology Assessment Number 75. 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]. Most case-control studies have found an inverse association between dietary vitamin C intake and cancers of the lung, breast, colon or rectum, stomach, oral cavity, larynx or pharynx, and esophagus [2,4]. That means that any excess is simply flushed out of the body in urine. Immune-enhancing role of vitamin C and zinc and effect on clinical conditions. Iron deficiency anemia can also occur due to increased bleeding and decreased nonheme iron absorption secondary to low vitamin C intake [6,11]. Vitamin C has low toxicity and is not believed to cause serious adverse effects at high intakes [8]. Free Radic Biol Med 2009;47:27-9. JAMA 2008;300:2123-33. Food Labeling: Revision of the Nutrition and Supplement Facts Labels. 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. We encourage you to talk to your healthcare providers (doctor, registered dietitian, pharmacist, etc.) Under certain conditions, vitamin C can act as a pro-oxidant, potentially contributing to oxidative damage [8]. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. Yes To Inc. has issued a voluntary recall of all lots of its Grapefruit Vitamin C Glow-Boosting Unicorn Paper Mask in response to complaints of skin irritation and redness. Food Labeling: Revision of the Nutrition and Supplement Facts Labels and Serving Sizes of Foods That Can Reasonably Be Consumed at One Eating Occasion; Dual-Column Labeling; Updating, Modifying, and Establishing Certain Reference Amounts Customarily Consumed; Serving Size for Breath Mints; and Technical Amendments; Proposed Extension of Compliance Dates. J Emerg Med 2001;21:235-7. 2010 Feb;91(2):487-93. Results from pharmacokinetic studies indicate that oral doses of 1.25 g/day ascorbic acid produce mean peak plasma vitamin C concentrations of 135 micromol/L, which are about two times higher than those produced by consuming 200–300 mg/day ascorbic acid from vitamin C-rich foods [10]. Arch Intern Med 2007;167:1610-8. 8. [, Prasad KN. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. [, Willcox BJ, Curb JD, Rodriguez BL. ... 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. Although research has not shown that antioxidants play a role in AMD development, some evidence suggests that they might help slow AMD progression [73]. [, Evans JR. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. It is not known whether this interaction occurs with other lipid-altering regimens [56]. Use of vitamin C-containing supplements is also relatively common, adding to the total vitamin C intake from food and beverages. N Engl J Med 2001;345:1583-92. Another study found no differences in plasma vitamin C levels or urinary excretion of vitamin C among three different vitamin C sources: ascorbic acid, Ester-C®, and ascorbic acid with bioflavonoids [19]. Individuals taking these medications on a regular basis should discuss their vitamin C intakes with their healthcare providers. Good sources include citrus, red and green peppers, tomatoes, broccoli, and greens. The physiologic importance of dehydroascorbic acid uptake and its contribution to overall vitamin C economy is unknown. Overall, the evidence to date suggests that regular intakes of vitamin C at doses of at least 200 mg/day do not reduce the incidence of the common cold in the general population, but such intakes might be helpful in people exposed to extreme physical exercise or cold environments and those with marginal vitamin C status, such as the elderly and chronic smokers [83-85]. Today, vitamin C deficiency and scurvy are rare in developed countries [8]. ascorbic acid in advanced malignancy. Vitamin C antagonizes the cytotoxic effects of antineoplastic drugs. Rockville, MD: Agency for Healthcare Research and Quality, 2003. Curr Sports Med Rep 2006;5:177-81. Vitamin C also removes oxidants caused by exposure to ultraviolet radiation, which helps to prevent sun damage. Dietary supplement use by US adults: data from the National Health and Nutrition Examination Survey, 1999-2000. As discussed below, it is uncertain whether supplemental vitamin C and other antioxidants might interact with chemotherapy and/or radiation [55]. [, Chen Q, Espey MG, Krishna MC, Mitchell JB, Corpe CP, Buettner GR, et al. 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]. Dietary carotenoids and vitamins A, C, and E and risk of breast cancer. Cochrane Database Syst Rev 2008;(3):CD004183. J Urol 1996;155:1847-51. Kidney Blood Press Res 2003;26:100-6. [, The Age-Related Eye Disease Study 2 (AREDS2) Research Group. [, Age-Related Eye Disease Study Research Group. Estimated Average Requirement (EAR): Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals. 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. Executive summary report. Humans, unlike most animals, are unable to synthesize vitamin C endogenously, so it is an essential dietary component [1]. • You can get our delic... ious, nutritious 30 packed, 125mg, Vitamin C gummy sticks from @chandaranafoodplus @onn_the_way @zucchini_ke @goodlifepharmacyafrica a… Results of subsequent controlled studies have been inconsistent, resulting in confusion and controversy, although public interest in the subject remains high [82,83]. [, Douglas RM, Hemilä H. Vitamin C for preventing and treating the common cold. Slow, steady release over an 8-hour period for improved utilization of vitamin C. "Vitamin C increases iron absorption in the gut.". 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]. Initial symptoms can include fatigue (probably the result of impaired carnitine biosynthesis), malaise, and inflammation of the gums [4,11]. Intake of vitamins B6 and C and the risk of kidney stones in women. A 2013 paper published in the Journal of the American Heart Association reviewed 16 studies to determine relationships between vitamin C intake and the likelihood of having a stroke.. The intestinal absorption of vitamin C is regulated by at least one specific dose-dependent, active transporter [4]. Join the ODS Email List. [, The Age-Related Eye Disease Study 2 (AREDS2) Research Group. "But many other fruits and vegetables are also good sources.". Vitamin C can help stimulate collagen production in the skin. [, Francescone MA, Levitt J. Scurvy masquerading as leukocytoclastic vasculitis: a case report and review of the literature. Additionally, vitamin C deficiency can increase your risk of becoming susceptible to some bacteria and viruses. The researchers concluded that people with a high vitamin C intake — ranging from an average of 45 mg to 1,167 mg a day — were less likely to have had strokes. Results from most clinical trials suggest that modest vitamin C supplementation alone or with other nutrients offers no benefit in the prevention of cancer. It does have a … It offers you other health benefits as well. [, Lee DH, Folsom AR, Harnack L, Halliwell B, Jacobs DR Jr. Some medical conditions can reduce the absorption of vitamin C and/or increase the amount needed by the body. In a cohort of 82,234 women aged 33–60 years from the Nurses' Health Study, consumption of an average of 205 mg/day of vitamin C from food (highest quintile of intake) compared with an average of 70 mg/day (lowest quintile of intake) was associated with a 63% lower risk of breast cancer among premenopausal women with a family history of breast cancer [32]. [, Myint PK, Luben RN, Welch AA, Bingham SA, Wareham NJ, Khaw KT. Vitamin C might lower your risk of stroke . Plasma concentrations of vitamin C are also lower in people with cancer than controls [2]. Proc Natl Acad Sci U S A 2008;105:11105-9. A substantial limitation in interpreting many of these studies is that investigators did not measure vitamin C concentrations before or after supplementation. Nutr Clin Care 2002;5:66-74. After an average follow-up period of 6.3 years, participants at high risk of developing advanced AMD (i.e., those with intermediate AMD or those with advanced AMD in one eye) who received the antioxidant supplements had a 28% lower risk of progression to advanced AMD than participants who received a placebo. Cancer Res 2008;68:8031-8. Subscriber Proc Natl Acad Sci U S A 1971;68:2678-81. A review by Carr and Frei concluded that in the majority of prospective cohort studies not reporting a significantly lower cancer risk, most participants had relatively high vitamin C intakes, with intakes higher than 86 mg/day in the lowest quintiles [2]. It's also important for wound healing. High-dose vitamin C versus placebo in the treatment of patients with advanced cancer who have had no prior chemotherapy. AHRQ Publication No. [. Vitamin C is also an important physiological antioxidant [3] and has been shown to regenerate other antioxidants within the body, including alpha-tocopherol (vitamin E) [4]. A high concentration of vitamin C may act as a pro-oxidant and generate hydrogen peroxide that has selective toxicity toward cancer cells [51-53]. 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]. Comparison of the absorption and excretion of three commercially available sources of vitamin C. J Am Diet Assoc 1994;94:779-81. Fruits and vegetables are the best sources of vitamin C (see Table 2) [12]. 3. The U.S. Department of Agriculture's (USDA's) FoodData Central lists the nutrient content of many foods and provides a comprehensive list of foods containing vitamin C arranged by nutrient content and by food name. Ascorbic acid bioavailability in foods and supplements. [, Padayatty SJ, Riordan HD, Hewitt SM, Katz A, Hoffer LJ, Levine M. Intravenously administered vitamin C as cancer therapy: three cases. The Linxian cataract studies. The SU.VI.MAX Study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Hemoglobin is a protein found in red blood cells that transports oxygen to cells and organs. It promotes healing and helps the body absorb iron. However, at doses above 1 g/day, absorption falls to less than 50% and absorbed, unmetabolized ascorbic acid is excreted in the urine [4]. Data sources: Cochrane, PubMed, … 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. Pediatrics 2001;108:E55. Here are the 10 best vitamin C supplements for 2021. [, Chen Q, Espey MG, Sun AY, Pooput C, Kirk KL, Krishna MC, et al. However, due to the physiologically tight control of vitamin C, it is unclear whether oral vitamin C supplements could alter vitamin C concentrations enough to produce the suggested effects. [, Zhang S, Hunter DJ, Forman MR, Rosner BA, Speizer FE, Colditz GA, et al. * Adequate Intake (AI) Sources of Vitamin C Food. Cutis 2005;76:261-6. Visit Insider's Health Reference library for more advice. [. Thus, through a varied diet, most people should be able to meet the vitamin C RDA or at least obtain enough to prevent scurvy. [, Osganian SK, Stampfer MJ, Rimm E, Spiegelman D, Hu FB, Manson JE, et al. 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]. Nature 1932;129: 690. Online May 5. Journal of the American Heart Association, 5 science-backed benefits of vitamin B12 and how to get enough of it in your diet, Vitamin E is a powerful antioxidant that can boost your immune system — here's how to get enough of it, The best vitamins to help your hair's growth, thickness, and overall health, 6 healthy foods rich in vitamin D and easy ways to incorporate them into your diet. Arch Pediatr Adolesc Med 2007;161:978-85. Intake of vitamins A, C, and E and postmenopausal breast cancer. Vitamin C supplements have the potential to interact with several types of medications. Results from prospective studies examining associations between vitamin C intake and cardiovascular disease risk are conflicting [58]. 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]. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. These values, which vary by age and gender [8], include: Table 1 lists the current RDAs for vitamin C [8]. Br J Nutr 2008:1-19. Though we can get Vitamin C from food (orange juice, of course) the recommended daily intake for Vitamin C is 75 mg for women and 90 mg for men so many people turn to supplements. In a 5-year prospective cohort study conducted in Japan, higher dietary vitamin C intake was associated with a reduced risk of developing cataracts in a cohort of more than 30,000 adults aged 45–64 years [76]. [, Deicher R, Hörl WH. A follow-up AREDS2 study confirmed the value of this and similar supplement formulations in reducing the progression of AMD over a median follow-up period of 5 years [75]. Since then, researchers have published follow-up data from the Linxian trial, a population nutrition intervention trial conducted in China [40]. [, Lee SH, Oe T, Blair IA. During the first months of the pandemic, up to 1,000 NHS staff received free wellness packs – including vitamin C, vitamin D and zinc – from a voluntary initiative called the Frontline … JAMA 2009;301:1336. Results from most clinical intervention trials have failed to show a beneficial effect of vitamin C supplementation on the primary or secondary prevention of cardiovascular disease. 1985;55 (1 Suppl):295-300. Left untreated, scurvy is fatal [6,9]. The Yes To Grapefruit Vitamin C Nourishing Moisturizer has a creamy texture and it is very easy to apply. 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]. [, Honarbakhsh S, Schachter M. Vitamins and cardiovascular disease. For this reason, the IOM concluded that smokers need 35 mg more vitamin C per day than nonsmokers [8]. 04-E003. However, at least some of these conclusions were a consequence of assay artifact, and additional studies have not confirmed these observations [8]. since, “No Rules Rules: Netflix and the Culture of Reinvention”. [, Rautiainen S, Lindblad BE, Morgenstern R, Wolk A. Vitamin C supplements and the risk of age-related cataract: a population-based prospective cohort study in women. [, Gregory JF 3rd. Am J Epidemiol 2004;160:339-49. A prospective study of the intake of vitamins C and B6, and the risk of kidney stones in men. Proc Soc Exp Biol Med 1997;216:181-91. [, Wintergerst ES, Maggini S, Hornig DH. [, Frei B, England L, Ames BN. Ann Intern Med 2004;140:533-7. However, as discussed in the cancer prevention section, clinical trial data for vitamin C are limited by the fact that plasma and tissue concentrations of vitamin C are tightly controlled in humans. Cancer Res 1994;54(7 Suppl):2029s-31s. 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. In a large intervention trial conducted in Linxian, China, daily supplements of vitamin C (120 mg) plus molybdenum (30 mcg) for 5–6 years did not significantly affect the risk of developing esophageal or gastric cancer [39]. [, Cameron E, Pauling L. Supplemental ascorbate in the supportive treatment of cancer: prolongation of survival times in terminal human cancer. A 2017 study published in Nutrients found that normal skin contains high levels of vitamin C because it plays two important roles in skin health: assisting with collagen production and preventing sun damage. J Natl Cancer Inst 2009;101:14-23. [, Padayatty SJ, Levine M. Antioxidant supplements and cardiovascular disease in men. Epidemiologic evidence suggests that higher consumption of fruits and vegetables is associated with lower risk of most types of cancer, perhaps, in part, due to their high vitamin C content [1,2]. [, Taylor EN, Stampfer MJ, Curhan GC. Arch Intern Med 2004;164:2335-42. Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts. Vitamins C and E and beta carotene supplementation and cancer risk: a randomized controlled trial. Mean intakes for children and adolescents aged 1-18 years range from 75.6 mg/day to 100 mg/day, also meeting the RDA for these age groups [21]. Overall, the currently available evidence does not indicate that vitamin C, taken alone or with other antioxidants, affects the risk of developing AMD, although some evidence indicates that the AREDS formulations might slow AMD progression in people at high risk of developing advanced AMD. In the Moertel study, patients with advanced colorectal cancer who received 10 g/day vitamin C fared no better than those receiving a placebo. Br J Nutr 2005;94:125-32. [, Cameron E, Campbell A. Nutr Rev 1993;51:313-26. Although vitamin C is not naturally present in grains, it is added to some fortified breakfast cereals. Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians' Health Study II randomized controlled trial. [, Hercberg S, Galan P, Preziosi P, Bertrais S, Mennen L, Malvy D, et al. Dietary intake of antioxidants and risk of age-related macular degeneration. FDA does not require the new food food labels to list vitamin C content unless vitamin C has been added to the food. FDA required manufacturers to use these new labels starting in January 2020, but companies with annual sales of less than $10 million may continue to use the old labels that list a vitamin C DV of 60 mg until January 2021 [13,15]. [, Pauling L. The significance of the evidence about ascorbic acid and the common cold.

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