Account active A randomized factorial trial of vitamins C and E and beta carotene in the secondary prevention of cardiovascular events in women: results from the Women's Antioxidant Cardiovascular Study. [, Zhang S, Hunter DJ, Forman MR, Rosner BA, Speizer FE, Colditz GA, et al. It promotes healing and helps the body absorb iron. Although the IOM was unable to establish a specific vitamin C requirement for nonsmokers who are regularly exposed to secondhand smoke, these individuals should ensure that they meet the RDA for vitamin C [4,8]. 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]. Losing and finding a way at C: new promise for pharmacologic ascorbate in cancer treatment. Vitamin C plays an important role in many processes within the human body, from improving skin health to lowering your risk of stroke. Taking over 2,000 mg of vitamin C supplements can result in harmful side effects. Vitamin C: Most men 51 and older should aim for 75 mg each day. That means that any excess is simply flushed out of the body in urine. Citrus fruits are the best sources of vitamin C. Here are some non-citrus sources of vitamin C. [, Seifried HE, Anderson DE, Sorkin BC, Costello RB. After a median follow-up time of 7.5 years, antioxidant supplementation lowered total cancer incidence in men, but not in women. BMJ 2007;335:729. Fortunately, many of the best food sources of vitamin C, such as fruits and vegetables, are usually consumed raw. Join the ODS Email List. Antioxidants and cancer therapy: a systematic review. [, Carr A, Frei B. These values, which vary by age and gender [8], include: Table 1 lists the current RDAs for vitamin C [8]. Pharmacologic ascorbic acid concentrations selectively kill cancer cells: action as a pro-drug to deliver hydrogen peroxide to tissues. Subscriber Executive summary report. Until the end of the 18th century, many sailors who ventured on long ocean voyages, with little or no vitamin C intake, contracted or died from scurvy. [, The Age-Related Eye Disease Study 2 (AREDS2) Research Group. The Effect of Melatonin and Vitamin C on COVID-19 The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. A prospective study of the intake of vitamins C and B6, and the risk of kidney stones in men. High-dose vitamin C versus placebo in the treatment of patients with advanced cancer who have had no prior chemotherapy. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. Effect of the supplemental use of antioxidants vitamin C, vitamin E, and coenzyme Q10 for the prevention and treatment of cancer. 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]. The amount of vitamin C you need varies depending on your age, according to the National Institutes of Health. J Natl Cancer Inst 2009;101:507-18. J Natl Cancer Inst 2008;100:773-83. In the Moertel study, patients with advanced colorectal cancer who received 10 g/day vitamin C fared no better than those receiving a placebo. 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]. Rockville, MD: Agency for Healthcare Research and Quality, 2003. Prospective study showing that dietary vitamin C reduced the risk of age-related cataracts in a middle-aged Japanese population. Proc Natl Acad Sci U S A 1996;93:3704-9. Includes a variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), nuts, seeds, and soy products. Cochrane Database Syst Rev 2006;(2):CD000254. N Engl J Med 1985;312:137-41. J Emerg Med 2001;21:235-7. Am J Clin Nutr 2008;87:64-9. 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. 8. Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo. Arch Intern Med 2007;167:1610-8. Today's Best Sales: Adidas, Dyson, Aerie & More Beat the winter blues with some retail therapy. 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. [, Chen Q, Espey MG, Sun AY, Lee JH, Krishna MC, Shacter E, et al. It does have a … [, Carr AC, Frei B. What We Eat in America, NHANES 2001-2002: Usual Nutrient Intakes from Food Compared to Dietary Reference Intakes. The Dietary Guidelines for Americans describes a healthy eating pattern as one that: This fact sheet by the Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. Antioxidant status and risk of cancer in the SU.VI.MAX study: is the effect of supplementation dependent on baseline levels? 83 AHRQ Publication No. 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]. This is a fact sheet intended for health professionals. Vitamin supplement use in a low-risk population of US male physicians and subsequent cardiovascular mortality. Cutis 2005;76:261-6. II. A few studies in humans have examined whether bioavailability differs among the various forms of vitamin C. In one study, Ester-C® and ascorbic acid produced the same vitamin C plasma concentrations, but Ester-C® produced significantly higher vitamin C concentrations in leukocytes 24 hours after ingestion [20]. [, Galan P, Briançon S, Favier A, Bertrais S, Preziosi P, Faure H, et al. Ask ODS Slow, steady release over an 8-hour period for improved utilization of vitamin C. Thanks to vitamin C's role as an antioxidant, it may also play a role in heart health. Svirbely J, Szent-Györgyi A. Hexuronic acid as the antiscorbutic factor. Research in mice suggests that pharmacologic doses of IV vitamin C might show promise in treating otherwise difficult-to-treat tumors [51]. [, Coulter I, Hardy M, Shekelle P, Udani J, Spar M, Oda K, et al. No such association has been observed in any other epidemiological study, so the significance of this finding is uncertain. Effects of hormone replacement therapy and antioxidant vitamin supplements on coronary atherosclerosis in postmenopausal women: a randomized controlled trial. It offers you other health benefits as well. Cochrane Database Syst Rev 2008;(3):CD004183. [, Jacob RA, Sotoudeh G. Vitamin C function and status in chronic disease. Other clinical trials have generally examined the effects on cardiovascular disease of supplements combining vitamin C with other antioxidants, such as vitamin E and beta-carotene, making it more difficult to isolate the potential contribution of vitamin C. The SU.VI.MAX study examined the effects of a combination of vitamin C (120 mg/day), vitamin E (30 mg/day), beta-carotene (6 mg/day), selenium (100 mcg/day), and zinc (20 mg/day) in 13,017 French adults from the general population [35]. In one study, Chinese adults who took daily supplements of 120 mg vitamin C plus 30 mcg molybdenum for 5 years did not have a significantly lower cataract risk [78]. The total body content of vitamin C ranges from 300 mg (at near scurvy) to about 2 g [4]. Am J Clin Nutr 2004;80:1194-200. 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. 03-E043. Fruits and vegetables are the best sources of vitamin C (see Table 2) [12]. In addition to its antioxidant properties, vitamin C has been shown to reduce monocyte adherence to the endothelium, improve endothelium-dependent nitric oxide production and vasodilation, and reduce vascular smooth-muscle-cell apoptosis, which prevents plaque instability in atherosclerosis [2,59]. [, Age-Related Eye Disease Study Research Group. JAMA Ophthalmol 2013. 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]. In the Women's Angiographic Vitamin and Estrogen (WAVE) study, involving 423 postmenopausal women with at least one coronary stenosis of 15%–75%, supplements of 500 mg vitamin C plus 400 IU vitamin E twice per day not only provided no cardiovascular benefit, but significantly increased all-cause mortality compared with placebo [67]. Vitamin C status is typically assessed by measuring plasma vitamin C levels [4,16]. [, Sperduto RD, Hu TS, Milton RC, Zhao JL, Everett DF, Cheng QF, et al. It acts as a reductor agent required for synthesis of collagen fibers through hydroxylation of proline and lysine. Approaches to cancer prevention based on an understanding of N-nitrosamine carcinogenesis. In some cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less-than-recommended amounts.". Institute of Medicine. Foods providing 20% or more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet. [, van Leeuwen R, Boekhoorn S, Vingerling JR, Witteman JC, Klaver CC, Hofman A, et al. 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. Vitamin C-induced decomposition of lipid hydroperoxides to endogenous genotoxins. [, Gaziano JM, Glynn RJ, Christen WG, Kurth T, Belanger C, MacFadyen J, et al. [, Wang AH, Still C. Old world meets modern: a case report of scurvy. The U.S. Food and Drug Administration (FDA) developed DVs to help consumers compare the nutrient contents of foods and dietary supplements within the context of a total diet. King, CG, Waugh, WA. However, at least some of these conclusions were a consequence of assay artifact, and additional studies have not confirmed these observations [8]. 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]. JAMA 2013;309:2005-15. 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. Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals. Data sources: Cochrane, PubMed, … Individuals taking these medications on a regular basis should discuss their vitamin C intakes with their healthcare providers. [, Waters DD, Alderman EL, Hsia J, Howard BV, Cobb FR, Rogers WJ, et al. [, Shekelle P, Morton S, Hardy M. Effect of supplemental antioxidants vitamin C, vitamin E, and coenzyme Q10 for the prevention and treatment of cardiovascular disease. Moreover, during 10 years of follow-up, this supplementation regimen failed to significantly affect total morbidity or mortality from esophageal, gastric, or other cancers [40]. The safety and efficacy of the use of vitamin C and other antioxidants during cancer treatment is controversial [55,93,94]. Other good food sources include red and green peppers, kiwifruit, broccoli, strawberries, Brussels sprouts, and cantaloupe (see Table 2) [8,12]. Yes, I said it. J Am Coll Cardiol 2003;42:246-52. JAMA 2002;288:2432-40. During the mid-1700s, Sir James Lind, a British Navy surgeon, conducted experiments and determined that eating citrus fruits or juices could cure scurvy, although scientists did not prove that ascorbic acid was the active component until 1932 [26-28]. [, Picciano MF, Dwyer JT, Radimer KL, Wilson DH, Fisher KD, Thomas PR, et al. Cells accumulate vitamin C via a second specific transport protein. Am J Clin Nutr. Other measures, such as leukocyte vitamin C concentration, could be more accurate indicators of tissue vitamin C levels, but they are more difficult to assess and the results are not always reliable [4,9,16]. Am J Epidemiol 1996;144:165-74. Vitamin C was identified in the early 1900s and suggestions that one of its biological roles may be to resist infections are supported by numerous animal studies. The FNB has established ULs for vitamin C that apply to both food and supplement intakes (Table 3) [8]. Rockville, MD: Agency for Healthcare Research and Quality, 2003. JAMA 2005;294:3101-7. Vitamin C is extremely important for your immune system. Am J Epidemiol 2004;160:339-49. A much smaller study indicated that postmenopausal women with diabetes who took at least 300 mg/day vitamin C supplements had increased cardiovascular disease mortality [61]. Proc Natl Acad Sci U S A 1971;68:2678-81. Other reported effects of high intakes of vitamin C include reduced vitamin B12 and copper levels, accelerated metabolism or excretion of ascorbic acid, erosion of dental enamel, and allergic responses [8]. Here are the 10 best vitamin C supplements for 2021. Prevention of esophageal cancer: the nutrition intervention trials in Linxian, China. N Engl J Med 2006;355:1065. [, Bjelakovic G, Nikolova D, Simonetti RG, Gluud C. Antioxidant supplements for preventing gastrointestinal cancers. Consuming five varied servings of fruits and vegetables a day can provide more than 200 mg of vitamin C. *DV = Daily Value. Collagen is an essential component of connective tissue, which plays a vital role in wound healing. However, evidence from prospective cohort studies is inconsistent, possibly due to varying intakes of vitamin C among studies. New developments and novel therapeutic perspectives for vitamin C. J Nutr 2007;137:2171-84. Routinely used supplements for babies Vitamin K • Prevent hemorrhagic ... • Vitamin C… 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]. Arch Pediatr Adolesc Med 2007;161:978-85. [, Hercberg S, Galan P, Preziosi P, Bertrais S, Mennen L, Malvy D, et al. Vitamin C, also known as ascorbic acid, is used for various processes in the body including building bone, collagen, and muscles. 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]. Proc Soc Exp Biol Med 1997;216:181-91. 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. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? Food Labeling: Revision of the Nutrition and Supplement Facts Labels. Intake of vitamins A, C, and E and postmenopausal breast cancer. [, The Age-Related Eye Disease Study 2 (AREDS2) Research Group. The Linxian cataract studies. Since then, researchers have published follow-up data from the Linxian trial, a population nutrition intervention trial conducted in China [40]. However, in trials involving marathon runners, skiers, and soldiers exposed to extreme physical exercise and/or cold environments, prophylactic use of vitamin C in doses ranging from 250 mg/day to 1 g/day reduced cold incidence by 50%. Ultraviolet radiation causes premature aging of the skin, resulting in wrinkles, hyperpigmentation, and skin sagging. [, Bruno EJ Jr, Ziegenfuss TN, Landis J. Vitamin C: research update. 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. 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]. [, Padayatty SJ, Riordan HD, Hewitt SM, Katz A, Hoffer LJ, Levine M. Intravenously administered vitamin C as cancer therapy: three cases. In the Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) study, a randomized, double-blind, placebo-controlled clinical trial,13,017 healthy French adults received antioxidant supplementation with 120 mg ascorbic acid, 30 mg vitamin E, 6 mg beta-carotene, 100 mcg selenium, and 20 mg zinc, or placebo [35]. [, 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. Free radicals are compounds produced both by normal cell processes and by external sources like pollution or cigarette smoke. Vitamin C helps with the absorption of non-heme iron, which is a type of dietary iron found in plant-based foods like leafy vegetables, nuts, and grains. 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]. For more information about building a healthy diet, refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture's MyPlate. J Clin Oncol 2004;22:517-28. 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]. According to the 2001–2002 National Health and Nutrition Examination Survey (NHANES), mean intakes of vitamin C are 105.2 mg/day for adult males and 83.6 mg/day for adult females, meeting the currently established RDA for most nonsmoking adults [21]. Supplements of 500 mg/day vitamin C plus 400 IU vitamin E every other day for a mean follow-up period of 8 years failed to reduce the risk of prostate or total cancer compared with placebo in middle-aged and older men participating in the Physicians' Health Study II [37]. Emerging research suggests that the route of vitamin C administration (intravenous vs. oral) could explain the conflicting findings [1,48,49]. Li Y, Schellhorn HE. Too much iron stored in the body can cause cirrhosis, heart failure, other organ failure, and diabetes. [, Osganian SK, Stampfer MJ, Rimm E, Spiegelman D, Hu FB, Manson JE, et al. Vitamin C (ascorbic acid): new roles, new requirements? Free radicals: the pros and cons of antioxidants. 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. The best evidence that vitamin C contributes to kidney stone formation is in patients with pre-existing hyperoxaluria [25]. In children, bone disease can be present [6]. In the general population, use of prophylactic vitamin C modestly reduced cold duration by 8% in adults and 14% in children. Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice. Eur J Nutr 2007;46:118-24. Plant-based supplement with 500 mg of vitamin C for all-day immune support.† Made with acerola cherries, one of nature's most concentrated forms of vitamin C, grown on our own farms. Plasma and tissue concentrations of vitamin C are tightly controlled in humans. We looked for studies in humans and found three trials with a total of 2335 participants that looked at whether vitamin C … Oral vitamin C produces tissue and plasma concentrations that the body tightly controls. Results from two case-control studies indicate that vitamin C intakes greater than 300 mg/day reduce the risk of cataract formation by 70%–75% [2,4]. 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 … The federal government's 2015-2020 Dietary Guidelines for Americans notes that "Nutritional needs should be met primarily from foods. 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]. A new recommended dietary allowance of vitamin C for healthy young women. In the Nurses' Health Study, a 16-year prospective study involving 85,118 female nurses, total intake of vitamin C from both dietary and supplemental sources was inversely associated with coronary heart disease risk [60]. • You can get our delic... ious, nutritious 30 packed, 125mg, Vitamin C gummy sticks from @chandaranafoodplus @onn_the_way @zucchini_ke @goodlifepharmacyafrica a… Although the Linxian trial data suggest a possible benefit, overall, the findings from most intervention trials do not provide convincing evidence that vitamin C supplements provide protection against cardiovascular disease or reduce its morbidity or mortality.