Vitamin C

Other Name(s):

Acide Ascorbique, Acide Cévitamique, Acide Iso-Ascorbique, Acide L-Ascorbique, Acido Ascorbico, Antiscorbutic Vitamin, Ascorbate, Ascorbate de Calcium, Ascorbate de Sodium, Ascorbic Acid, Ascorbic acid, Ascorbyl Palmitate, Calcium Ascorbate, Cevitamic Acid, Iso-Ascorbic Acid, L-Ascorbic Acid, Magnesium Ascorbate, Palmitate d'Ascorbyl, Selenium Ascorbate, Sodium Ascorbate, Vitamina C, Vitamine Antiscorbutique, Vitamine C.

Overview

Vitamin C is a vitamin. Some animals can make their own vitamin C, but people must get this vitamin from food and other sources. Good sources of vitamin C are fresh fruits and vegetables, especially citrus fruits. Vitamin C can also be made in a laboratory.

Most experts recommend getting vitamin C from a diet high in fruits and vegetables rather than taking supplements. Fresh-squeezed orange juice or fresh-frozen concentrate is a better pick than ready-to-drink orange juice. The fresh juice contains more active vitamin C. Drink fresh-frozen orange juice within one week after reconstituting it for the most benefit. It you prefer ready-to-drink orange juice, buy it 3 to 4 weeks before the expiration date, and drink it within one week of opening.

Historically, vitamin C was used for preventing and treating scurvy. These days, vitamin C is used most often for preventing and treating the common cold. Some people use it for other infections including gum disease, acne and other skin conditions, bronchitis, human immunodeficiency virus (HIV) disease, stomach ulcers caused by bacteria called Helicobacter pylori, tuberculosis, dysentery (an infection of the lower intestine), and skin infections that produce boils (furunculosis). It is also used for infections or inflammation of the bladder and prostate, nerve pain, pregnancy-related complications.

Some people use vitamin C for depression, thinking problems, dementia, Alzheimer's disease, physical and mental stress, fatigue including chronic fatigue syndrome (CFS), autism, attention deficit-hyperactivity disorder (ADHD), schizophrenia, Lou Gehrig's disease, and Parkinson's disease. It is also used to treat or prevent toxicity caused by certain drugs or metals and to treat peptic ulcers, swine flu, sudden hearing loss, gout, and tetanus.

Other uses include increasing the absorption of iron from foods. Vitamin C is also used in combination with a drug called deferoxamine to increase removal of iron from the blood. Some people use iron to correct a protein imbalance in certain newborns (tyrosinemia). It is also used to prevent the transfer of HIV from mothers to babies during breastfeeding. Vitamin C is also used to help reduce the side effects of bowel preparation.

There is some thought that vitamin C might help the heart and blood vessels. It is used for heart disease, hardening of the arteries, preventing clots in veins and arteries, heart attack, stroke, high blood pressure, high cholesterol, irregular heartbeat after surgery, nitrite tolerance, or inadequate blood flow that causes blood to pool in the legs. It is also thought that vitamin C may increase the healing of burns, ulcers, fractures, and other wounds. Vitamin C is also used to prevent long-term pain after surgery or injury.

Vitamin C is also used for glaucoma, preventing cataracts, preventing gallbladder disease, dental cavities and plaque, constipation, Lyme disease, age-related vision loss, boosting the immune system, heat stroke, hay fever and other allergy-related conditions, asthma and exercise-induced asthma, bronchitis, cystic fibrosis, sickle cell disease, infertility, diabetes, collagen disorders, arthritis and other types of joint inflammation, back pain and disc swelling, cancer, and osteoporosis and other bone conditions.

Additional uses include improving physical endurance and slowing aging, as well as counteracting the side effects of cortisone and related drugs, aiding drug withdrawal in addiction, and reducing side effects of radiation therapy.

Sometimes, people put vitamin C on their skin to protect it against the sun, pollutants, and other environmental hazards. Vitamin C is also applied to the skin to help with damage from radiation therapy.

Vitamin C is inhaled through the nose to treat hayfever.

How does work?

Vitamin C is required for the proper development and function of many parts of the body. It also plays an important role in maintaining proper immune function.

QUESTION

Next to red peppers, you can get the most vitamin C from ________________. See Answer

Uses

Effective for...

  • Vitamin C deficiency. Taking vitamin C by mouth or injecting as a shot prevents and treats vitamin C deficiency, including scurvy. Also, taking vitamin C can reverse problems associated with scurvy.

Likely Effective for...

  • Iron absorption. Giving vitamin C along with iron can increase how much iron the body absorbs in adults and children.
  • A genetic disorder in newborns called tyrosinemia. Taking vitamin C by mouth or as a shot improves a genetic disorder in newborns in which blood levels of the amino acid tyrosine are too high.

Possibly Effective for...

  • Age-related vision loss (age-related macular degeneration; AMD). Taking vitamin C, vitamin E, beta-carotene, and zinc helps prevent AMD from becoming worse in people at high risk for developing advanced AMD. It's too soon to know if the combination helps people at lower risk for developing advanced AMD. Also, it's too soon to known if vitamin C helps prevents AMD.
  • Decreasing protein in the urine (albuminuria). Taking vitamin C plus vitamin E can reduce protein in the urine in people with diabetes.
  • Irregular heartbeat (atrial fibrillation). Taking vitamin C before and for a few days after heart surgery helps prevent irregular heartbeat after heart surgery.
  • For emptying the colon before a colonoscopy. Before a person undergoes a colonoscopy, the person must make sure that their colon is empty. This emptying is called bowel preparation. Some bowel preparation involves drinking 4 liters of medicated fluid. If vitamin C is included in the medicated fluid, the person only needs to drink 2 liters. This makes people more likely to follow through with the emptying procedure. Also fewer side effects occur. A specific medicated fluid containing vitamin C (MoviPrep, Salix Parmaceuticals, Inc.) has been approved by the U.S. Food and Drug Administration (FDA) for bowel preparation.
  • Common cold. There is some controversy about the effectiveness of vitamin C for treating the common cold. However, most research shows that taking 1-3 grams of vitamin C might shorten the course of the cold by 1 to 1.5 days. Taking vitamin C does not appear to prevent colds.
  • Redness (erythema) after cosmetic skin procedures. Using a skin cream containing vitamin C might decrease skin redness following laser resurfacing for scar and wrinkle removal.
  • Upper airway infections caused by heavy exercise. Using vitamin C before heavy physical exercise, such as a marathon, might prevent upper airway infections that can occur after heavy exercise.
  • Gout. Higher intake of vitamin C from the diet is linked to a lower risk of gout in men. But vitamin C doesn't help treat gout.
  • Worsening of stomach inflammation caused by medicine used to treat H. pylori infection. Some medicine used to treat H. pylori infection can worsen stomach inflammation. Taking vitamin C along with one of these medicines called omeprazole might decrease this side effect.
  • Abnormal breakdown of red blood cells (hemolytic anemia). Taking vitamin C supplements might help manage anemia in people undergoing dialysis.
  • High blood pressure. Taking vitamin C along with medicine to lower blood pressure helps lower systolic blood pressure (the top number in a blood pressure reading) by a small amount. But it does not seem to lower diastolic pressure (the bottom number). Taking vitamin C does not seem to lower blood pressure when taken without medicine to lower blood pressure.
  • Lead poisoning. Consuming vitamin C in the diet seems to lower blood levels of lead.
  • Helping medicines used for chest pain work longer. In some people who take medicines for chest pain, the body develops tolerance and the medicines stop working as well. Taking vitamin C seems to help these medicines, such as nitroglycerine, work for longer.
  • Osteoarthritis. Taking vitamin C from dietary sources or from calcium ascorbate supplements seems to prevent cartilage loss and worsening of symptoms in people with osteoarthritis.
  • Physical performance. Eating more vitamin C as part of the diet might improve physical performance and muscle strength in older people. Also, taking vitamin C supplements might improve oxygen intake during exercise in teenage boys.
  • Sunburn. Taking vitamin C by mouth or applying it to the skin along with vitamin E might prevent sunburn. But taking vitamin C alone does not prevent sunburn.
  • Wrinkled skin. Skin creams containing vitamin C seem to improve the appearance of wrinkled skin.

Possibly Ineffective for...

  • Bronchitis. Taking vitamin C by mouth does not seem to have any effect on bronchitis.
  • Asthma. Some people with asthma have low vitamin C levels in their blood. But taking vitamin C does not seem to reduce the chance of getting asthma or improve asthma symptoms in people who already have asthma.
  • Hardening of the arteries (atherosclerosis). Higher intake of vitamin C as part of the diet is not linked with a reduced risk of atherosclerosis. Also, taking vitamin C supplements does not seem to prevent atherosclerosis from becoming worse in most people with this condition.
  • Bladder cancer. Taking vitamin C supplements does not seem to prevent bladder cancer or reduce bladder cancer-related deaths in men.
  • Inherited disorders that damage nerves in the arms and legs (Charcot-Marie-Tooth disease; CMT). Taking vitamin C does not seem to prevent nerve damage from becoming worse in people with Charcot-Marie-Tooth disease.
  • Colon cancer. Higher intake of vitamin C from food or supplements is not linked with a lower risk of cancer in the colon or rectum.
  • Fracture. Taking vitamin C does not seem to improve function, symptoms, or healing rates in people with a wrist fracture.
  • Helicobacter pylori (H. pylori) infection. Taking vitamin C along with medicines used to treat H. pylori infection doesn't seem to get rid of H. pylori better than taking the medicines alone.
  • Eye damage associated with a medicine called interferon. Taking vitamin C by mouth does not seem to prevent eye damage in people receiving interferon therapy for liver disease.
  • Leukemia. Taking vitamin C does not seem to prevent leukemia or death due to leukemia in men.
  • Lung cancer. Taking vitamin C, alone or with vitamin E, does not seem to prevent lung cancer or death due to lung cancer.
  • Melanoma. Taking vitamin C, alone or with vitamin E, does not prevent melanoma or death due to melanoma.
  • Death from any cause. High blood levels of vitamin C have been linked with a reduced risk of death from any cause. But taking vitamin C supplements along with other antioxidants does not seem to prevent death.
  • Pancreatic cancer. Taking vitamin C together with beta-carotene plus vitamin E does not prevent pancreatic cancer.
  • High blood pressure during pregnancy (pre-eclampsia). Most research shows that taking vitamin C with vitamin E does not prevent high blood pressure during pregnancy.
  • Complications during pregnancy. Taking vitamin C, alone or with vitamin E, does not prevent many pregnancy complications, including preterm birth, miscarriage, stillbirth, and others.
  • Prostate cancer. Taking vitamin C supplements does not seem to prevent prostate cancer.
  • Skin problems related to radiation cancer treatments. Applying a vitamin C solution to the skin does not prevent skin problems caused by radiation treatments.

Insufficient Evidence to Rate Effectiveness for...

  • Hay fever (Allergic rhinitis). Using nasal spray containing vitamin C seems to improve nasal symptoms in people with allergies that last all year. Taking vitamin C by mouth might block histamine in people with seasonal allergies. But results are conflicting.
  • Alzheimer's disease. Higher intake of vitamin C from food is linked with a reduced risk of Alzheimer's disease.
  • Amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease). Higher intake of vitamin C from food or supplements is not linked with a reduced risk of ALS.
  • Stomach damage caused by aspirin. Taking vitamin C might prevent stomach damage caused by aspirin.
  • Atopic disease. Higher intake of vitamin C is not linked with a lower risk of eczema, wheezing, food allergies, or allergic sensitization.
  • Attention deficit-hyperactivity disorder (ADHD). Taking high doses of vitamins, including vitamin C, does not seem to reduce ADHD symptoms. But taking lower doses of vitamin C along with flaxseed oil might improve some symptoms, such as restlessness and self-control.
  • Autism. Early research shows that taking vitamin C might reduce the severity of autism symptoms in children.
  • Breast cancer. It's too soon to know if higher intake of vitamin C from food helps prevent breast cancer from developing. But a higher intake of vitamin C from food seems to be linked with a reduced risk of death in people diagnosed with breast cancer. Also, taking vitamin C supplements after being diagnosed with breast cancer seems to help reduce the risk of dying from breast cancer.
  • Burns. Early research suggests that receiving a vitamin C infusion within the first 24 hours of severe burns reduces wound swelling.
  • Cancer. Higher intake of vitamin C from food is linked with a lower risk of developing cancer. But taking vitamin C supplements doesn't seem to prevent cancer. In people diagnosed with advanced cancer, taking large doses (10 grams) of vitamin C by mouth doesn't seem to improve survival or prevent cancer from getting worse. But high doses of vitamin C might increase survival when given by IV.
  • Hardening of the arteries after heart transplant. Early research shows that taking vitamin C and vitamin E for a year after a heart transplant helps prevent hardening of the arteries.
  • Heart disease. Research on the use of vitamin C for heart disease is controversial. More research on the use of vitamin C supplements for preventing heart disease is needed. But increasing intake of vitamin C from food might provide some benefit.
  • Cataracts. Early research shows that people who take any supplements containing vitamin C for 10 years have a lower risk of developing cataracts. But taking supplements containing vitamin C for less time doesn't seem to help.
  • Cervical cancer. Some early research suggests that taking vitamin C reduces the risk of cervical cancer.
  • Side effects of chemotherapy. Early research suggests that higher intake of vitamin C from food is linked with fewer chemotherapy side effects in children being treated for leukemia.
  • Damage to the colon due to radiation exposure (chronic radiation proctitis). Early research suggests that taking vitamin C plus vitamin E might improve some symptoms of chronic radiation proctitis.
  • Long-term pain after surgery or injury. Some research shows that taking vitamin C supplements might help prevent long-term pain after surgery or injury. But other research shows that vitamin C doesn't help and might actually worsen long-term pain following a wrist fracture.
  • Kidney damage occurring within 72 hours of treatment with a contrast agent. Some research shows that taking vitamin C before and after receiving a contrast agent helps reduce the risk of developing kidney damage. But other research shows that it doesn't work.
  • Dental plaque. Chewing gum containing vitamin C appears to reduce dental plaque.
  • Depression. Early research shows that taking vitamin C along with the antidepressant drug fluoxetine reduces depression symptoms in children better than fluoxetine alone.
  • Diabetes. Taking vitamin C supplements might improve blood sugar control in people with diabetes. But results are conflicting. Higher intake of vitamin C from food isn't linked with a lower risk of developing diabetes.
  • Damage to heart caused by the drug doxorubicin. Early research shows that taking vitamin C, vitamin E, and N-acetyl cysteine may reduce heart damage caused by the drug doxorubicin.
  • Cancer that begins in the uterus (endometrial cancer). Higher intake of vitamin C from food might be linked with a lower risk of endometrial cancer. But conflicting results exist.
  • Esophageal cancer. Taking vitamin C along with beta-carotene plus vitamin E does not reduce the risk of developing esophageal cancer. But higher intake of vitamin C from food is linked with a lower risk of esophageal cancer.
  • Asthma caused by exercise. Taking vitamin C might prevent asthma caused by exercise.
  • Gallbladder disease. Taking vitamin C might help to prevent gallbladder disease in women but not men.
  • Stomach cancer. Higher intake of vitamin C from food is not linked with a lower risk of stomach cancer in most research. Also, taking vitamin C along with other antioxidants doesn't seem to prevent stomach cancer. But taking vitamin C supplements might prevent precancerous sores in the stomach from progressing to cancer in people at high risk. This includes people previously treated for H. pylori infection.
  • HIV/AIDS. Taking high or low doses of vitamin C along with other antioxidants doesn't reduce the amount of HIV in the blood of people with HIV/AIDS.
  • HIV transmission. Taking vitamin C along with vitamin B and vitamin E during pregnancy and breast-feeding seems to reduce the risk of transmitting HIV to the infant.
  • High cholesterol. Taking vitamin C does not seem to lower cholesterol in people with normal cholesterol levels. But taking vitamin C might reduce low-density lipoprotein (LDL or "bad") cholesterol in people with high cholesterol.
  • High phosphate levels. People with kidney disease who are undergoing dialysis often have high blood phosphate levels. Giving vitamin C by IV seems to reduce phosphate levels in these people.
  • Sudden hearing loss. Early research shows that vitamin C may improve hearing in people with sudden hearing loss when used with steroid therapy.
  • Infertility. There is early evidence that women with certain fertility problems might benefit from taking vitamin C daily.
  • Mental stress. Early research suggests that vitamin C might reduce blood pressure and symptoms during times of mental stress.
  • Liver disease (nonalcoholic steatohepatitis; NASH). Taking vitamin C along with vitamin E might reduce liver scarring in people with a type of liver disease called nonalcoholic steatohepatitis. But it doesn't seem to decrease liver swelling.
  • Cancer that affects white blood cells (Non-Hodgkin lymphoma). Higher intake of vitamin C from foods or supplements is linked with a lower risk of developing non-Hodgkin lymphoma in postmenopausal women.
  • Osteoporosis. Some research shows that vitamin C might improve bone strength. But higher vitamin C blood levels in postmenopausal women have been linked to lower bone mineral densities. More information is needed on the effects of vitamin C on bone mineral density.
  • Mouth cancer. Higher intake of vitamin C from food is linked with a lower risk of mouth cancer.
  • Ovarian cancer. Higher intake of vitamin C from food is not linked with a lower risk of ovarian cancer.
  • Parkinson's disease. Higher intake of vitamin C from food is not linked with a lower risk of Parkinson's disease.
  • Poor circulation that reduces blood flow to the limbs. Higher intake of vitamin C from food is linked with a lower risk of developing poor circulation in women but not men.
  • Pain after surgery. Taking vitamin C one hour after anesthesia reduces the need for morphine after surgery. This suggests that it might reduce pain. But vitamin C doesn't seem to improve satisfaction or the need to use the pain-relieving drug paracetamol.
  • Pneumonia. Some research suggests that vitamin C might reduce the risk of pneumonia, as well as the duration of pneumonia once it develops. This effect seems greatest in those with low vitamin C levels before treatment. It's not clear if vitamin C is beneficial in people with normal vitamin C levels.
  • Breaking of the amniotic sac before labor begins (premature rupture of membranes; PROM). Taking vitamin C plus vitamin E starting during the second or third trimester and continuing until delivery seems to help prevent the amniotic sac from breaking too early.
  • Bed sores (pressure ulcers). Some research suggests that taking vitamin C does not improve wound healing in people with pressure ulcers. But other research shows that taking vitamin C reduces the size of pressure ulcers.
  • Restless legs syndrome. Taking vitamin C alone or in combination with vitamin E seems to reduce the severity of restless legs syndrome in people undergoing hemodialysis. But it's not known if vitamin C is beneficial in people with restless legs syndrome that is not related to hemodialysis.
  • Sickle cell disease. Taking vitamin C with aged garlic extract and vitamin E might benefit people with sickle cell disease.
  • Stroke. Higher intake of vitamin C from food seems to be linked with a reduced risk of stroke. But conflicting results exist. Taking vitamin C supplements doesn't seem to be linked with a reduced risk of stroke.
  • Bacterial infection in the nervous system (tetanus). Taking vitamin C along with conventional treatment appears to reduce the risk of death in children with tetanus.
  • Urinary tract infections (UTI). Research suggests that taking vitamin C does not prevent UTIs in older people.
  • Mental decline caused by reduced blood flow to the brain (vascular dementia). Higher intake of vitamin C and vitamin E from supplements does not seem to be linked with a reduced risk of vascular dementia in Japanese-American men.
  • Acne.
  • Chronic fatigue syndrome (CFS).
  • Constipation.
  • Cystic fibrosis.
  • Dental cavities.
  • Kidney disease.
  • Lyme disease.
  • Tuberculosis.
  • Wounds.
  • Other conditions.
More evidence is needed to rate vitamin C for these uses.

Side Effects

Vitamin C is LIKELY SAFE for most people when taken by mouth in recommended doses, when applied to the skin, when injected into the muscle, and when injected intravenously (by IV) and appropriately. In some people, vitamin C might cause nausea, vomiting, heartburn, stomach cramps, headache, and other side effects. The chance of getting these side effects increases the more vitamin C you take. Amounts higher than 2000 mg daily are POSSIBLY UNSAFE and may cause a lot of side effects, including kidney stones and severe diarrhea. In people who have had a kidney stone, amounts greater than 1000 mg daily greatly increase the risk of kidney stone recurrence.

Precautions

Pregnancy and breast-feeding: Vitamin C is LIKELY SAFE for pregnant or breast-feeding women when taken by mouth in amounts no greater than 2000 mg daily for women over 19 years-old, and 1800 mg daily for women 14 to 18 years-old, or when given intravenously (by IV) or intramuscularly and appropriately. Taking too much vitamin C during pregnancy can cause problems for the newborn baby. Vitamin C is POSSIBLY UNSAFE when taken by mouth in excessive amounts.

Infants and children: Vitamin C is LIKELY SAFE when taken by mouth appropriately. Vitamin C is POSSIBLY UNSAFE when taken by mouth in amounts higher than 400 mg daily for children 1 to 3 years, 650 mg daily for children 4 to 8 years, 1200 mg daily for children 9 to 13 years, and 1800 mg daily for adolescents 14 to 18 years.

Alcoholism: Alcohol intake can cause the body to excrete vitamin C in the urine. People who regularly use alcohol, especially those who have other illnesses, often have vitamin C deficiency. These people might need to be treated for a longer time than normal to restore vitamin C levels to normal.

Alzheimer's disease: Taking vitamin C along with vitamin E and alpha-lipoic acid might worsen mental function in people with Alzheimer's disease.

Angioplasty, a heart procedure: Avoid taking supplements containing vitamin C or other antioxidant vitamins (beta-carotene, vitamin E) immediately before and following angioplasty without the supervision of a health care professional. These vitamins seem to interfere with proper healing.

Cancer: Cancerous cells collect high concentrations of vitamin C. Until more is known, only use high doses of vitamin C under the direction of your oncologist.

Diabetes: Vitamin C might raise blood sugar. In older women with diabetes, vitamin C in amounts greater than 300 mg per day increases the risk of death from heart disease. Do not take vitamin C in doses greater than those found in basic multivitamins.

A metabolic deficiency called "glucose-6-phosphate dehydrogenase" (G6PD) deficiency: Large amounts of vitamin C can cause red blood cells to break in people with this condition. Avoid excessive amounts of vitamin C.

Blood-iron disorders, including conditions called "thalassemia" and "hemochromatosis": Vitamin C can increase iron absorption, which might make these conditions worse. Avoid large amounts of vitamin C.

Kidney stones, or a history of kidney stones: Large amounts of vitamin C can increase the chance of getting kidney stones. Do not take vitamin C in amounts greater than those found in basic multivitamins.

Heart attack: Vitamin C levels are reduced during a heart attack. However, low vitamin C has not been linked to an increased risk for heart attack.

Kidney transplant rejection: Long-term use of vitamin C in high doses before a kidney transplant may increase the risk of transplant rejection or delay how long it takes until the transplanted kidney works.

Schizophrenia: Taking vitamin C along with vitamin E might worsen psychosis in some people with schizophrenia when taken with antipsychotic drugs.

Sickle cell disease: Vitamin C might make this condition worse. Avoid using large amounts of vitamin C.

Smoking and chewing tobacco: Smoking and chewing tobacco lowers vitamin C levels. Vitamin C intake in the diet should be increased in people who smoke or chew tobacco.

SLIDESHOW

Vitamin D Deficiency: How Much Vitamin D Is Enough? See Slideshow

Interactions

AluminumInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Aluminum is found in most antacids. Vitamin C can increase how much aluminum the body absorbs. However, it is not clear if this interaction is a big concern. Take vitamin C two hours before or four hours after antacids.

EstrogensInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

The body breaks down estrogens to get rid of them. Vitamin C might decrease how quickly the body gets rid of estrogens. Taking vitamin C along with estrogens might increase the effects and side effects of estrogens.

Fluphenazine (Prolixin)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Large amounts of vitamin C might decrease how much fluphenazine (Prolixin) is in the body. Taking vitamin C along with fluphenazine (Prolixin) might decrease the effectiveness of fluphenazine (Prolixin).

Indinavir (Crixivan)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Indinavir (Crixivan) is a medication used for HIV/AIDS. Taking large amounts of vitamin C along with indinavir (Crixivan) might decrease how much of indinavir (Crixivan) stays in the body. It's not clear if this interaction is a big concern.

Medications for cancer (Chemotherapy)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Vitamin C is an antioxidant. There is some concern that antioxidants might decrease the effectiveness of some medications used for cancers. But it is too soon to know if this interaction occurs.

Medications used for lowering cholesterol (Statins)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking vitamin C, beta-carotene, selenium, and vitamin E together might decrease the effectiveness of some medications used for lowering cholesterol. It is not known if vitamin C alone decreases the effectiveness of some medications used for lowering cholesterol.

Some medications used for lowering cholesterol include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), and pravastatin (Pravachol).

NiacinInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking vitamin C along with vitamin E, beta-carotene, and selenium might decrease some of the helpful effects of niacin. Niacin can increase the good cholesterol. Taking vitamin C along with these other vitamins might decrease the effectiveness of niacin for increasing good cholesterol.

PentobarbitalInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking vitamin C with pentobarbital might increase the sedative effects of pentobarbital.

Warfarin (Coumadin)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Warfarin (Coumadin) is used to slow blood clotting. Large amounts of vitamin C might decrease the effectiveness of warfarin (Coumadin). Decreasing the effectiveness of warfarin (Coumadin) might increase the risk of clotting. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Acetaminophen (Tylenol, others)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

The body breaks down acetaminophen (Tylenol, others) to get rid of it. Large amounts of vitamin C can decrease how quickly the body breaks down acetaminophen. It is not clear exactly when or if this interaction is a big concern.

AspirinInteraction Rating: Minor Be cautious with this combination.Talk with your health provider.

Aspirin is removed by the body through the kidneys and in the urine. Some scientists have raised concern that vitamin C might decrease how the body removes aspirin and could potentially increase the amount of aspirin in the body. There is concern that this could increase the chance of aspirin-related side effects. However, some research suggests that this is not an important concern and that vitamin C does not interact in a meaningful way with aspirin. Some research actually suggests that taking vitamin C with buffered aspirin might decrease the stomach irritation caused by aspirin. More evidence is needed about this possible benefit.

Choline Magnesium Trisalicylate (Trilisate)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

Vitamin C might decrease how quickly the body gets rid of choline magnesium trisalicylate (Trilisate). It is not clear if this interaction is a big concern.

Medications used for HIV/AIDS (Protease Inhibitors)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

Taking large doses of vitamin C might reduce how much of some medications used for HIV/AIDS stays in the body. This could decrease the effectiveness of some medications used for HIV/AIDS.

Some of these medications used for HIV/AIDS include amprenavir (Agenerase), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Fortovase, Invirase).

Nicardipine (Cardene)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

Vitamin C is taken up by cells. Taking nicardipine (Cardene) along with vitamin C might decrease how much vitamin C is taken in by cells. The significance of this interaction is not clear.

NifedipineInteraction Rating: Minor Be cautious with this combination.Talk with your health provider.

Vitamin C is taken up by cells. Taking nifedipine (Adalat, Procardia) along with vitamin C might decrease how much vitamin C is taken in by cells. The significance of this interaction is not clear.

Salsalate (Disalcid)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

Vitamin C might decrease how quickly the body gets rid of salsalate (Disalcid). Taking vitamin C along with salsalate (Disalcid) might cause too much salsalate (Disalcid) in the body, and increase the effects and side effects of salsalate.

Dosing

The following doses have been studied in scientific research:

BY MOUTH:

  • General: The daily recommended dietary allowances (RDAs) are: 90 mg for men and 75 mg for women; Pregnancy and Lactation: age 18 or younger, 115 mg; ages 19 to 50 years 120 mg. People who use tobacco should take an additional 35 mg per day. Do not take more than the following amounts of vitamin C: 1800 mg per day for adolescents and pregnant and breast-feeding women 14 to 18 years, and 2000 mg per day for adults and pregnant and lactating women.
  • For vitamin C deficiency: 100-250 mg once or twice daily for several days for scurvy.
  • For empting the colon before a colonoscopy: 2 liters of solution containing polyethylene glycol and vitamin C is used the evening prior to colonoscopy or as a split-dose taken on the evening prior to and the morning of colonoscopy. The most commonly studied product for this indication is MoviPrep (Norgine BV).
  • For improving iron absorption: 200 mg of vitamin C per 30 mg of iron.
  • For an age-related eye disease that causes blindness (age-related macular degeneration; AMD: 500 mg of vitamin C, 400 IU of vitamin E, and 15 mg of beta-carotene, with or without 80 mg of zinc, per day for up to 10 years.
  • For treating the common cold: 1-3 grams daily.
  • For slowing progression of hardening of the arteries: 250 mg of slow-release vitamin C in combination with 91 mg (136 IU) of vitamin E twice daily for up to 6 years. Also 500 mg of vitamin C plus 400 IU of vitamin E twice daily for one year has been used.
  • For reducing protein in the urine of patients with type 2 diabetes: 1250 mg of vitamin C with 680 IU of vitamin E per day for 4 weeks has been used.
  • For preventing irregular heart beat after heart surgery: 1-2 grams of vitamin C per day for 1-3 days before heart surgery followed by 1-2 grams in two divided doses daily for 4-5 days after heart surgery has been used.
  • For respiratory infections due to exercise: 600 mg to 1 gram of vitamin C per day for 3-8 weeks before heavy exercise has been used.
  • Worsening of stomach inflammation caused by medicine used to treat H. pylori infection.: 1200 mg of vitamin C daily along with omeprazole has been used.
  • For hemolytic anemia: 200-300 mg of vitamin C three times per week for 3-6 months has been used.
  • For high blood pressure: 500 mg of vitamin C per day along with blood pressure-lowering medication has been used.
  • For preventing nitrate tolerance: 3-6 grams of vitamin C daily has been used.
  • For osteoarthritis: 1 gram of vitamin C in the form of calcium ascorbate daily for 2 weeks has been used.
  • For preventing sunburn: 2 grams of vitamin C along with 1000 IU vitamin E taken before sun exposure has been used.
APPLIED TO THE SKIN:
  • For skin redness/rash: A formulation containing 10% vitamin C, 2% zinc sulfate, and 0.5% tyrosine applied daily for 8 weeks has been used.
  • For wrinkled skin: Most topical preparations used for aged or wrinkled skin are applied daily. Studies have used creams containing 3% to 10% vitamin C. In one study a specific vitamin C formulation (Cellex-C High Potency Serum) used 3 drops applied daily to areas of facial skin. Don't apply vitamin C preparations to the eye or eyelids. Also avoid contact with hair or clothes. It can cause discoloration.
CHILDREN

BY MOUTH:

  • General: The daily recommended dietary allowances (RDAs) are: Infants 0 to 12 months, human milk content (older recommendations specified 30-35 mg); Children 1 to 3 years, 15 mg; Children 4 to 8 years, 25 mg; Children 9 to 13 years, 45 mg; Adolescents 14 to 18 years, 75 mg for boys and 65 mg for girls; Pregnancy and Lactation: age 18 or younger, 115 mg. Do not take more than the following amounts of vitamin C: 400 mg per day for children ages 1 to 3 years, 650 mg per day for children 4 to 8 years, 1200 mg per day for children 9 to 13 years, and 1800 mg per day for adolescents and pregnant and breast-feeding women 14 to 18 years.
  • For tyrosinemia in premature infants on high protein diets: 100 mg of vitamin C.
  • For improving iron absorption: 25-70 mg of vitamin C taken with iron-containing foods has been used.
  • For improving physical performance: 70 mg of vitamin C per day for 2 months has been used in adolescent boys.
BY IV:
  • For tyrosinemia in premature infants on high protein diets: 100 mg of vitamin C has been used.
AS A SHOT:
  • For tyrosinemia in premature infants on high protein diets: 100 mg of vitamin C has been used.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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Camargo, C. A., Jr., Rifas-Shiman, S. L., Litonjua, A. A., Rich-Edwards, J. W., Weiss, S. T., Gold, D. R., Kleinman, K., and Gillman, M. W. Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. Am.J Clin.Nutr 2007;85(3):788-795. View abstract.

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Negri, E., La, Vecchia C., Franceschi, S., D'Avanzo, B., Talamini, R., Parpinel, M., Ferraroni, M., Filiberti, R., Montella, M., Falcini, F., Conti, E., and Decarli, A. Intake of selected micronutrients and the risk of breast cancer. Int J Cancer 1-17-1996;65(2):140-144. View abstract.

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No author. Multicenter ophthalmic and nutritional age-related macular degeneration study--part 1: design, subjects and procedures. Age-related Macular Degeneration Study Group. J Am.Optom.Assoc. 1996;67(1):12-29. View abstract.

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Ochs-Balcom, H. M., Grant, B. J., Muti, P., Sempos, C. T., Freudenheim, J. L., Browne, R. W., McCann, S. E., Trevisan, M., Cassano, P. A., Iacoviello, L., and Schunemann, H. J. Antioxidants, oxidative stress, and pulmonary function in individuals diagnosed with asthma or COPD. Eur.J Clin.Nutr 2006;60(8):991-999. View abstract.

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Osrin, D., Vaidya, A., Shrestha, Y., Baniya, R. B., Manandhar, D. S., Adhikari, R. K., Filteau, S., Tomkins, A., and Costello, A. M. Effects of antenatal multiple micronutrient supplementation on birthweight and gestational duration in Nepal: double-blind, randomised controlled trial. Lancet 3-12-2005;365(9463):955-962. View abstract.

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