Vitamin C

Is a glass of OJ or vitamin C tablets your go-to when the sniffles come? Loading up on this
vitamin was a practice spurred by Linus Pauling in the 1970s, a double Nobel laureate and self-
proclaimed champion of vitamin C who promoted daily megadoses (the amount in 12 to 24
oranges) as a way to prevent colds and some chronic diseases.

Vitamin C, or ascorbic acid, is a water-soluble vitamin. This means that it dissolves in water and
is delivered to the body’s tissues but is not well stored, so it must be taken daily through food or
supplements. Even before its discovery in 1932, nutrition experts recognized that something in
citrus fruits could prevent scurvy, a disease that killed as many as two million sailors between
1500 and 1800. [1]

Vitamin C plays a role in controlling infections and healing wounds, and is a powerful
antioxidant that can neutralize harmful free radicals. It is needed to make collagen, a fibrous
protein in connective tissue that is weaved throughout various systems in the body: nervous,
immune, bone, cartilage, blood, and others. The vitamin helps make several hormones and
chemical messengers used in the brain and nerves. [2]

While megadosing on this vitamin is not uncommon, how much is an optimum amount needed to
keep you healthy, and could taking too much be counterproductive? 

Recommended Amounts

 RDA:  The Recommended Dietary Allowance for adults 19 years and older is 90 mg

daily for men and 75 mg for women. For pregnancy and lactation, the amount
increases to 85 mg and 120 mg daily, respectively. Smoking can deplete vitamin C
levels in the body, so an additional 35 mg beyond the RDA is suggested for smokers.

 UL:   The Tolerable Upper Intake Level is the maximum daily intake unlikely to cause
harmful effects on health. The UL for vitamin C is 2000 mg daily; taking beyond this
amount may promote gastrointestinal distress and diarrhea. Only in specific scenarios,
 such as under medical supervision or in controlled clinical trials, amounts higher than
the UL are sometimes used. [2]

Vitamin C absorption and megadosing

The intestines have a limited ability to absorb vitamin C. Studies have shown that
absorption of vitamin C decreases to less than 50% when taking amounts greater than
1000 mg. In generally healthy adults, megadoses of vitamin C are not toxic because
once the body’s tissues become saturated with vitamin C, absorption decreases and
any excess amount will be excreted in urine. However, adverse effects are possible with
intakes greater than 3000 mg daily, including reports of diarrhea, increased formation of
kidney stones in those with existing kidney disease or history of stones, increased levels
of uric acid (a risk factor for gout), and increased iron absorption and overload in
individuals with hemochromatosis, a hereditary condition causing excessive iron in the
blood. [2]

Absorption does not differ if obtaining the vitamin from food or supplements. Vitamin C
is sometimes given as an injection into a vein (intravenous) so higher amounts can
directly enter the bloodstream. This is usually only seen in medically monitored settings,
such as to improve the quality of life in those with advanced stage cancers or in
controlled clinical studies. Though clinical trials have not shown high-dose intravenous
vitamin C to produce negative side effects, it should be administered only with close
monitoring and avoided in those with kidney disease and hereditary conditions like
hemochromatosis and glucose 6-phosphate dehydrogenase deficiency.

Vitamin C is involved with numerous metabolic reactions in the body, and obtaining the
RDA or slightly higher may be protective against certain disease states. However, a
health benefit of taking larger amounts has not been found in people who are generally
healthy and well-nourished. Cell studies have shown that at very high concentrations,
vitamin C can switch roles and act as a tissue-damaging pro-oxidant instead of an
antioxidant. [2,3] Its effects in humans at very high doses well beyond the RDA are
unclear, and can lead to increased risk of kidney stones and digestive upset.

Vitamin C and Health

There is interest in the antioxidant role of vitamin C, as research has found the vitamin to
neutralize free radical molecules, which in excess can damage cells. Vitamin C is also involved
in the body’s immune system by stimulating the activity of white blood cells. Does this translate
to protection from certain diseases?

Chronic diseases
Age-related vision diseases
The common cold

Food Sources

Fruits and vegetables are the best sources of this vitamin.

 Citrus (oranges, kiwi, lemon, grapefruit)

 Bell peppers

 Strawberries

 Tomatoes

 Cruciferous vegetables (broccoli, Brussels sprouts, cabbage, cauliflower)

 White potatoes

Signs of Deficiency

Vitamin C deficiency is rare in developed countries but may occur with a limited diet that
provides less than 10 mg daily for one month or longer. In developed countries, situations at
greatest risk for deficiency include eating a diet restricted in fruits and vegetables, smoking or
long-term exposure to secondhand smoke, and drug and alcohol abuse. The following are the
most common signs of a deficiency.

 Scurvy, the hallmark disease of severe vitamin C deficiency, displays symptoms

resulting from loss of collagen that weakens connective tissues:

o Skin spots caused by bleeding and bruising from broken blood vessels

o Swelling or bleeding of gums, and eventual loss of teeth

o Hair loss

o Delayed healing of skin wounds

 Fatigue, malaise

 Iron-deficiency anemia due to decreased absorption of non-heme iron