SUPPLEMENT - VITAMIN

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What is vitamin C and what does it do?


Vitamin C, also known as ascorbic acid, is a water-soluble nutrient found in some foods. In the body, it acts as an antioxidant, helping to protect cells from the damage caused by free radicals. Free radicals are compounds formed when our bodies convert the food we eat into energy. People are also exposed to free radicals in the environment from cigarette smoke, air pollution, and ultraviolet light from the sun.

The body also needs vitamin C to make collagen, a protein required to help wounds heal. In addition, vitamin C improves the absorption of iron from plant-based foods and helps the immune system work properly to protect the body from disease.

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. Humans, unlike most animals, are unable to synthesize vitamin C endogenously, so it is an essential dietary component [1].

Vitamin C is required for the biosynthesis of collagen, L-carnitine, and certain neurotransmitters; vitamin C is also involved in protein metabolism [1,2]. Collagen is an essential component of connective tissue, which plays a vital role in wound healing. 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]. Ongoing research is examining whether vitamin C, by limiting the damaging effects of free radicals through its antioxidant activity, might help prevent or delay the development of certain cancers, cardiovascular disease, and other diseases in which oxidative stress plays a causal role. 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. Insufficient vitamin C intake causes scurvy, which is characterized by fatigue or lassitude, widespread connective tissue weakness, and capillary fragility [1,2,4,6-9].


How much vitamin C do I need?


The amount of vitamin C you need each day depends on your age. Average daily recommended amounts for different ages are listed below in milligrams (mg).

  LifeStage

  RecommendedAmount

  Birth to 6 months

40 mg  

  Infants 7–12 months

50 mg  

  Children 1–3 years

15 mg  

  Children 4–8 years

25 mg  

  Children 9–13 years

45 mg  

  Teens 14–18 years (boys)

75 mg  

  Teens 14–18 years (girls)

65 mg  

  Adults (men)

90 mg  

  Adults (women)

75 mg  

  Pregnant teens

80 mg  

  Pregnant women

85 mg  

  Breastfeeding teens

115 mg  

  Breastfeeding women

120 mg  


If you smoke, add 35 mg to the above values to calculate your total daily recommended amount.

The total body content of vitamin C ranges from 300 mg (at near scurvy) to about 2 g [4]. High levels of vitamin C (millimolar concentrations) are maintained in cells and tissues, and are highest in leukocytes (white blood cells), eyes, adrenal glands, pituitary gland, and brain. Relatively low levels of vitamin C (micromolar concentrations) are found in extracellular fluids, such as plasma, red blood cells, and saliva [4].


What happens if I don’t get enough vitamin C?


Vitamin C deficiency is rare in the United States and Canada. People who get little or no vitamin C (below about 10 mg per day) for many weeks can get scurvy. Scurvy causes fatigue, inflammation of the gums, small red or purple spots on the skin, joint pain, poor wound healing, and corkscrew hairs. Additional signs of scurvy include depression as well as swollen, bleeding gums and loosening or loss of teeth. People with scurvy can also develop anemia. Scurvy is fatal if it is not treated.


What are some effects of vitamin C on health?


Scientists are studying vitamin C to understand how it affects health. Here are several examples of what this research has shown.

Cancer prevention and treatment

People with high intakes of vitamin C from fruits and vegetables might have a lower risk of getting many types of cancer, such as lung, breast, and colon cancer. However, taking vitamin C supplements, with or without other antioxidants, doesn’t seem to protect people from getting cancer.

It is not clear whether taking high doses of vitamin C is helpful as a treatment for cancer. Vitamin C’s effects appear to depend on how it is administered to the patient. Oral doses of vitamin C can’t raise blood levels of vitamin C nearly as high as intravenous doses given through injections. A few studies in animals and test tubes indicate that very high blood levels of vitamin C might shrink tumors. But more research is needed to determine whether high-dose intravenous vitamin C helps treat cancer in people.

Vitamin C dietary supplements and other antioxidants might interact with chemotherapy and radiation therapy for cancer. People being treated for cancer should talk with their oncologist before taking vitamin C or other antioxidant supplements, especially in high doses.

Cardiovascular disease

People who eat lots of fruits and vegetables seem to have a lower risk of cardiovascular disease. Researchers believe that the antioxidant content of these foods might be partly responsible for this association because oxidative damage is a major cause of cardiovascular disease. However, scientists aren’t sure whether vitamin C itself, either from food or supplements, helps protect people from cardiovascular disease. It is also not clear whether vitamin C helps prevent cardiovascular disease from getting worse in people who already have it.

Age-related macular degeneration (AMD) and cataracts

AMD and cataracts are two of the leading causes of vision loss in older people. Researchers do not believe that vitamin C and other antioxidants affect the risk of getting AMD. However, research suggests that vitamin C combined with other nutrients might help slow AMD progression.

In a large study among older people with AMD who were at high risk of developing advanced AMD, those who took a daily dietary supplement with 500 mg vitamin C, 80 mg zinc, 400 IU vitamin E, 15 mg beta-carotene, and 2 mg copper for about 6 years had a lower chance of developing advanced AMD. They also had less vision loss than those who did not take the dietary supplement. People who have or are developing the disease might want to talk with their doctor about taking dietary supplements.

The relationship between vitamin C and cataract formation is unclear. Some studies show that people who get more vitamin C from foods have a lower risk of getting cataracts. But further research is needed to clarify this association and to determine whether vitamin C supplements affect the risk of getting cataracts.

The common cold

Although vitamin C has long been a popular remedy for the common cold, research shows that for most people, vitamin C supplements do not reduce the risk of getting the common cold. However, people who take vitamin C supplements regularly might have slightly shorter colds or somewhat milder symptoms when they do have a cold. Using vitamin C supplements after cold symptoms start does not appear to be helpful.


Can vitamin C be harmful?


Taking too much vitamin C can cause diarrhea, nausea, and stomach cramps. In people with a condition called hemochromatosis, which causes the body to store too much iron, high doses of vitamin C could worsen iron overload and damage body tissues.
The daily upper limits for vitamin C include intakes from all sources—food, beverages, and supplements—and are listed below:

  LifeStage

  UpperLimit

  Birth to 12 months

Not established  

  Children 1–3 years

400 mg  

  Children 4–8 years

650 mg  

  Children 9–13 years

1,200 mg  

  Teens 14–18 years

1,800 mg  

  Adults

2,000 mg  


Where can I find out more about vitamin C?


• For general information on vitamin C:
o Office of Dietary Supplements Health Professional Fact Sheet on Vitamin C
o Vitamin C, MedlinePlus®
• For more information on food sources of vitamin C:
o U.S. Department of Agriculture’s (USDA’s) FoodData Central 
o Nutrient List for vitamin C (listed by food or by vitamin C content), USDA
• For more advice on choosing dietary supplements:
• For information about building a healthy dietary pattern:


References


1. Li Y, Schellhorn HE. New developments and novel therapeutic perspectives for vitamin C. J Nutr 2007;137:2171-84. [PubMed abstract]

2. Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr 1999;69:1086-107. [PubMed abstract]

3. Frei B, England L, Ames BN. Ascorbate is an outstanding antioxidant in human blood plasma. Proc Natl Acad Sci U S A 1989;86:6377-81. [PubMed abstract]

4. Jacob RA, Sotoudeh G. Vitamin C function and status in chronic disease. Nutr Clin Care 2002;5:66-74. [PubMed abstract]

5. Gershoff SN. Vitamin C (ascorbic acid): new roles, new requirements? Nutr Rev 1993;51:313-26. [PubMed abstract]

6. Weinstein M, Babyn P, Zlotkin S. An orange a day keeps the doctor away: scurvy in the year 2000. Pediatrics 2001;108:E55. [PubMed abstract]

7. Wang AH, Still C. Old world meets modern: a case report of scurvy. Nutr Clin Pract 2007;22:445-8. [PubMed abstract]

8. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids . Washington, DC: National Academy Press, 2000.

9. Stephen R, Utecht T. Scurvy identified in the emergency department: a case report. J Emerg Med 2001;21:235-7. [PubMed abstract]

10. Health information data from U.S. National Institutes of Health

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