When the results of the Womens Antioxidant Vitamin Estrogen (WAVE) trial were reanalyzed based on Hp genotype, antioxidant therapy (1,000 mg/day of vitamin C + 800 IU/day of vitamin E) was associated with improvement of coronary atherosclerosis in diabetic women with Hp1-1 genotype but worsening of coronary atherosclerosis in those carrying the Hp2-2 genotype (148). A 2012 meta-analysis of 29 trials found no effect of oral vitamin C, given alone or in combination with other antioxidants, on all-cause mortality (127). Because vitamin C can inactivate urease (an enzyme that facilitates H. pylori survival and colonization of the gastric mucosa at low pH) in vitro, vitamin C may be most effective as a prophylactic agent in those without achlorhydria(77, 78). The recommended intake for smokers is 35 mg/day higher than for nonsmokers, because smokers are under increased oxidative stress from the toxins in cigarette smoke and generally have lower blood concentrations of vitamin C (36). Therefore, as in many studies of vitamin C intake and chronic disease risk, it is difficult to separate the effects of vitamin C from the effects of other components of fruit and vegetables. Ischemic stroke occurs when an obstruction within a blood vessel blocks blood flow to the brain. (PubMed), 87. Liability for individual actions or omissions based upon the contents of this site is expressly disclaimed. . (PubMed), 46 Knekt P, Ritz J, Pereira MA, et al. Phase I clinical trial to evaluate the safety, tolerability, and pharmacokinetics of high-dose intravenous ascorbic acid in patients with advanced cancer. Chen GC, Lu DB, Pang Z, Liu QF. N Engl J Med. 1998;147(12):1162-1174. 195. Chest. J Am Coll Nutr. Stephen R, Utecht T. Scurvy identified in the emergency department: a case report. Atherosclerosis. (PubMed), 169 Riordan HD, Casciari JJ, Gonzalez MJ, et al. Adjuvant effect of vitamin C on omeprazole-amoxicillin-clarithromycin triple therapy for Helicobacter pylori eradication. Annu Rev Nutr. Administration of a 1-gram (g) vitamin C infusion one hour prior to the angioplasty reduced the concentrations of oxidative stress markers and improved microcirculatory perfusion compared to placebo (130). 1983;29(5):305-310. Corvallis, Oregon 97331, phone: 541-737-5075 | fax: 541-737-5077 2012;66(5):561-568. Specifically, plasma vitamin C ranged from approximately 23 to 70 mol/L in men and 33 to 82 mol/L in women; across this range, every 20 mol/L increase in plasma vitamin C was associated with a 9% reduction in risk of heart failure. 2010;341:c4229. 307 Linus Pauling Science Center (PubMed). P R Health Sci J. 2018;148(3):419-426. Some (24, 191, 192), but not all (193-195), studies have reported that supplemental vitamin C increases urinary oxalate concentrations. In addition, a 2013 systematic review by the same investigators identified only two small randomized, double-blind, placebo-controlled trials that examined the effect of vitamin C on the incidence of respiratory infection-induced asthma(179). 2007;104(21):8749-8754. Vitamin C is known to function as a highly effective antioxidant in living organisms. Adv Nutr. A number of observational studies have found increased dietary vitamin C intake to be associated with decreased risk of gastric (stomach) cancer, and laboratory experiments indicate that vitamin C inhibits the formation of carcinogenic N-nitroso compounds in the stomach (70-72). (PubMed). Johnston CS, Luo B. 2013;173(5):386-388. Thus, the Linus Pauling Institute recommends a vitamin C intake of 400 mg daily for adults to ensure replete tissue concentrations (29)an amount substantially higher than the RDA yet with minimal risk of side effects. Int J Vitam Nutr Res. Urate crystals may form in joints, resulting in inflammation and pain, as well as in the kidneys and urinary tract, resulting in kidney stones. Natural Medicines. Both vitamin C and aspirin reduced fasting blood glucose and HbA1c concentrations and improved blood lipid profile in metformin-treated patients. Arlt S, Muller-Thomsen T, Beisiegel U, Kontush A. Higher doses (>500 mg) result in fractionally less vitamin C being absorbed as the dose increases. Association between plasma vitamin C concentrations and blood pressure in the European prospective investigation into cancer-Norfolk population-based study. Zhang ZW, Patchett SE, Perrett D, Katelaris PH, Domizio P, Farthing MJ. Crit Care. (PubMed), 167. Carr AC, Vissers MC. Taylor EN, Stampfer MJ, Curhan GC. Each of the cohort studies used self-administered food frequency questionnaires at baseline to assess vitamin C intake. 1994;94(7):779-781. Other trials also failed to show any evidence of an effect of vitamin C on the risk of stroke. (PubMed), 136. Dingchao H, Zhiduan Q, Liye H, Xiaodong F. The protective effects of high-dose ascorbic acid on myocardium against reperfusion injury during and after cardiopulmonary bypass. Modern Nutrition in Health and Disease, 11th ed. In another randomized, double-blind, controlled trial in 28 critically ill patients with septic shock, infusion of 25 mg of vitamin C per kg every six hours for 72 hours significantly limited the requirement to vasopressor norepinephrinedecreasing both the dose and duration of treatmentand dramatically improved the 28-day survival rate (155). (PubMed), 124. 2014;13(4):280-300. Although liposomal encapsulation could increase vitamin C bioavailability, plasma vitamin C concentrations were much lower than those achieved with intravenous vitamin C administration (190). Divergent effects of alpha-tocopherol and vitamin C on the generation of dysfunctional HDL associated with diabetes and the Hp 2-2 genotype. Vitamin C intake from diary recordings and risk of breast cancer in the UK Dietary Cohort Consortium. By pooling data from 13 prospective cohort studies comprising 676,141 participants, it was determined that dietary intake of vitamin C was not associated with colon cancer, while total intake of vitamin C (i.e., from food and supplements) was associated with a 19% reduced risk of colon cancer (79). Crit Rev Food Sci Nutr. Hepatogastroenterology. The effect of intravenous vitamin C infusion on periprocedural myocardial injury for patients undergoing elective percutaneous coronary intervention. Proc Natl Acad Sci U S A. (PubMed), 106. 2010;119(3):753-765. (PubMed), 44. The majority of large, population-based studies examining the relationship of vitamin C intake or supplementation with AD incidence have reported null results (100). (PubMed), 151. 2013;2(6):e000329. Symptoms of scurvy include subcutaneous bleeding, poor wound closure, and bruising easily, hair and tooth loss, and joint pain and swelling. 1996;93(8):3704-3709. Milner AD, Rao H, Greenough A. Jariwalla RJ, Harakeh S. Mechanisms underlying the action of vitamin C in viral and immunodeficiency disease.

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