Vitamin C; Types, Deficiency Symptoms, Food Source

Vitamin C; Types, Deficiency Symptoms
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Vitamin C known as ascorbic acid and L-ascorbic acid is a vitamin found in food and used as a dietary supplement. The disease scurvy is prevented and treated with vitamin C-containing foods or dietary supplements.Evidence does not support use in the general population for the prevention of the common cold.There is, however, some evidence that regular use may shorten the length of colds. It is unclear if supplementation affects the risk of cancer cardiovascular disease, or dementia. It may be taken by mouth or by injection.

Vitamin C is required for the biosynthesis of collagen, L-carnitine, and certain neurotransmitters; vitamin C is also involved in protein metabolism . Collagen is an essential component of connective tissue, which plays a vital role in wound healing. Vitamin C is also an important physiological antioxidant  and has been shown to regenerate other antioxidants within the body, including alpha-tocopherol (vitamin E) .

The body is not able to make vitamin C on its own, and it does not store vitamin C. It is therefore important to include plenty of vitamin C-containing foods in your daily diet.

Types of Vitamin C

The form of vitamin C most frequently used in supplements is ascorbic acid, which has a bioavailability that is equivalent to the vitamin C that naturally occurs in foods like orange juice and broccoli.1

Other types of vitamin C include:

  • sodium ascorbate (a mineral ascorbate)
  • calcium ascorbate (a mineral ascorbate)
  • other mineral ascorbates (it’s a long list!)
  • ascorbic acid with bioflavonoids
  • combination vitamin C products that blend different forms
  • Ascorbyl Palmitate
  • Ascorbyl Silanol
  • Sodium Ascorbate
  • Ascorbyl Glucoside
  • Ascorbyl Glucosamine
  • Ascorbyl Methylsilanol Pectinate

Some studies have shown minor differences in absorption rates between the various types of vitamin C, but the body of research surrounding vitamin C supplementation reflects high absorption no matter which form you choose.

Different forms of vitamin C

 • Ascorbic acid – is basically the proper name for vitamin C.  This is vitamin C in its simplest and often most reasonably priced form, however some people find that it upsets their stomach, and may need to choose a different form that is gentler on the gut, or a time-release version which releases the vitamin C over a couple of hours, reducing the risk of an upset stomach.

 • Vitamin C with bioflavonoids – Bioflavanoids are polyphenolic compounds found in vitamin C-rich foods.  They increase the absorption of vitamin C when they are taken together.

 • Mineral ascorbates – also known as ‘buffered’ vitamin C, mineral salts (mineral ascorbates) are less acidic and are often recommended to people who experience gastrointestinal upset with plain ascorbic acid.  Most common mineral ascorbates include sodium ascorbate, calcium ascorbate, potassium ascorbate and magnesium ascorbate.  Mineral ascorbates are usually more expensive than ascorbic acid and much gentler on the gastrointestinal system.

 • Ester-C– This version of vitamin C contains mainly calcium ascorbate (buffered vitamin C) and vitamin C metabolites, which increase the bioavailability of vitamin C.  Ester C is usually more expensive than mineral ascorbates.

Deficiency Symptoms of Vitamin C

The first symptoms of vitamin C deficiency tend to be

Recommended Intakes of Vitamin C

Intake recommendations for vitamin C and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine (IOM) of the National Academies (formerly National Academy of Sciences) . DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. These values, which vary by age and gender , include

  • 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.
  • Adequate Intake (AI) – Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA.
  • Estimated Average Requirement (EAR) – Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals.
  • Tolerable Upper Intake Level (UL) – Maximum daily intake unlikely to cause adverse health effects.

Tolerable Upper Intake Levels (ULs) for Vitamin C 
Age Male Female Pregnancy Lactation
0–12 months Not possible to establish* Not possible to establish*
1–3 years 400 mg 400 mg
4–8 years 650 mg 650 mg
9–13 years 1,200 mg 1,200 mg
14–18 years 1,800 mg 1,800 mg 1,800 mg 1,800 mg
19+ years 2,000 mg 2,000 mg 2,000 mg 2,000 mg

*Formula and food should be the only sources of vitamin C for infants.

Recommended Dietary Allowances (RDAs) for Vitamin C 
Age Male Female Pregnancy Lactation
0–6 months 40 mg* 40 mg*
7–12 months 50 mg* 50 mg*
1–3 years 15 mg 15 mg
4–8 years 25 mg 25 mg
9–13 years 45 mg 45 mg
14–18 years 75 mg 65 mg 80 mg 115 mg
19+ years 90 mg 75 mg 85 mg 120 mg
Smokers Individuals who smoke require 35 mg/day
more vitamin C than nonsmokers.

* Adequate Intake (AI)

Food Source of Vitamin C

Selected Food Sources of Vitamin C 
Food Milligrams (mg) per serving Percent (%) DV*
Red pepper, sweet, raw, ½ cup 95 158
Orange juice, ¾ cup 93 155
Orange, 1 medium 70 117
Grapefruit juice, ¾ cup 70 117
Kiwifruit, 1 medium 64 107
Green pepper, sweet, raw, ½ cup 60 100
Broccoli, cooked, ½ cup 51 85
Strawberries, fresh, sliced, ½ cup 49 82
Brussels sprouts, cooked, ½ cup 48 80
Grapefruit, ½ medium 39 65
Broccoli, raw, ½ cup 39 65
Tomato juice, ¾ cup 33 55
Cantaloupe, ½ cup 29 48
Cabbage, cooked, ½ cup 28 47
Cauliflower, raw, ½ cup 26 43
Potato, baked, 1 medium 17 28
Tomato, raw, 1 medium 17 28
Spinach, cooked, ½ cup 9 15
Green peas, frozen, cooked, ½ cup 8 13

*DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration (FDA) to help consumers compare the nutrient contents of products within the context of a total diet. The DV for vitamin C is 60 mg for adults and children aged 4 and older. The FDA requires all food labels to list the percent DV for vitamin C. Foods providing 20% or more of the DV are considered to be high sources of a nutrient.The U.S. Department of Agriculture’s (USDA’s) Nutrient Database Web site lists the nutrient content of many foods and provides a comprehensive list of foods containing vitamin C arranged by nutrient content and by food name.

Plant sources of Vitamin C

The amount is given in milligrams per 100 grams of the edible portion of the fruit or vegetable

Plant source Amount
(mg / 100g)
Kakadu plum 1000–5300
Camu camu 2800
Acerola 1677
Seabuckthorn 695
Indian gooseberry 445
Rose hip 426
Guava 228
Blackcurrant 200
Red bell pepper/capsicum 128
Kale 120
Kiwifruit, broccoli 90
Loganberry, redcurrant, Brussels sprouts 80
Cloudberry, elderberry 60
Papaya, strawberry 60
Orange, lemon 53
Pineapple, cauliflower 48
Cantaloupe 40
Grapefruit, raspberry 30
Passion fruit, spinach 30
Cabbage, lime 30
Mango 28
Blackberry 21
Plant source Amount
(mg / 100g)
Potato, honeydew melon 20
Tomato 14
Cranberry 13
Blueberry, grape 10
Apricot, plum, watermelon 10
Avocado 8.8
Onion 7.4
Cherry, peach 7
Carrot, apple, asparagus 6

The FNB has established ULs for vitamin C that apply to both food and supplement intakes (Table 3) . Long-term intakes of vitamin C above the UL may increase the risk of adverse health effects. The ULs do not apply to individuals receiving vitamin C for medical treatment, but such individuals should be under the care of a physician .

Uses  Indications of Vitamin C

Vitamin C is one of many antioxidants. Antioxidants are nutrients that block some of the damage caused by free radicals.The body is not able to make vitamin C on its own, and it does not store vitamin C. It is therefore important to include plenty of vitamin C-containing foods in your daily diet.

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 – Administering 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.
  • Increasing 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.
  • 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.
  • A chronic pain condition called complex regional pain syndrome – Taking vitamin C after surgery or injury to the arm or leg seems to prevent complex regional pain syndrome from developing.
  • 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.
  • Stomach inflammation (gastritis) – 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.
  • 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).
  • High cholesterol – Taking vitamin C might reduce low-density lipoprotein (LDL or “bad”) cholesterol in people with high cholesterol.
  • 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.
  • 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.
  • 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.
  • Ulcers caused by a bacterium called Helicobacter pylori (H. pylori) – 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.
  • Inherited nerve damage (hereditary motor and sensory neuropathy) – Charcot-Marie-Tooth disease is a group of inherited disorders that cause nerve damage. Taking vitamin C does not seem to prevent nerve damage from becoming worse in people with this condition.
  • 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.
  • Overall risk of death – 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.
  • 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 for

  • 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.
  • Higher intake of vitamin C from food is linked with a reduced risk of Alzheimer’s disease.
  • Higher intake of vitamin C from food or supplements is not linked with a reduced risk of ALS.
  • Taking vitamin C might prevent stomach damage caused by aspirin.
  • Higher intake of vitamin C is not linked with a lower risk of eczema, wheezing, food allergies, or allergic sensitization.
  • 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.
  • Early research shows that taking vitamin C might reduce the severity of autism symptoms in children.
  • 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.
  • Early research suggests that receiving a vitamin C infusion within the first 24 hours of severe burns reduces wound swelling.
  • 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.
  • Early research shows that taking vitamin C and vitamin E for a year after a heart transplant helps prevent hardening of the arteries.
  • 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.
  • Higher intake of vitamin C from food is linked with a lower risk of developing cataracts. Some early research shows that people who take supplements containing vitamin C for at least 10 years have a lower risk of developing cataracts. But taking supplements containing vitamin C for less time doesn’t seem to help.
  • Some early research suggests that taking vitamin C reduces the risk of cervical cancer.
  • Early research suggests that higher intake of vitamin C from food is linked with fewer chemotherapy side effects in children being treated for leukemia.
  • Early research suggests that taking vitamin C plus vitamin E might improve some symptoms of chronic radiation proctitis.
  • 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.
  • Chewing gum containing vitamin C appears to reduce dental plaque.
  • Early research shows that taking vitamin C along with the antidepressant drug fluoxetine reduces depression symptoms in children and teens better than fluoxetine alone. But taking vitamin C along with the antidepressant drug citalopram does not reduce depression symptoms in adults better than citalopram alone.
  • 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.
  • Early research shows that taking vitamin C, vitamin E, and N-acetyl cysteine may reduce heart damage caused by the drug doxorubicin.
  • Higher intake of vitamin C from food might be linked with a lower risk of endometrial cancer. But conflicting results exist.
  • 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.
  • Taking vitamin C might prevent asthma caused by exercise.
  • Taking vitamin C might help to prevent gallbladder disease in women but not men.
  • 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.
  • 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.
  • 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.
  • 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.
  • Early research shows that vitamin C may improve hearing in people with sudden hearing loss when used with steroid therapy.
  • There is early evidence that women with certain fertility problems might benefit from taking vitamin C daily.
  • Early research suggests that vitamin C might reduce blood pressure and symptoms during times of mental stress.
  • 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.
  • Higher intake of vitamin C from foods or supplements is linked with a lower risk of developing non-Hodgkin lymphoma in postmenopausal women.
  • Higher intake of vitamin C from food is linked with a lower risk of mouth cancer.
  • 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.
  • Higher intake of vitamin C from food is not linked with a lower risk of ovarian cancer.
  • Higher intake of vitamin C from food is not linked with a lower risk of Parkinson’s disease.
  • Higher intake of vitamin C from food is linked with a lower risk of developing poor circulation in women but not men.
  • 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.
  • 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 Taking vitamin C alone during pregnancy might help prevent the amniotic sac from breaking before labor begins. But taking vitamin C with other supplements doesn’t seem to help. Also, taking vitamin C, alone or with other supplements, does not prevent many other pregnancy complications including preterm birth, miscarriage, stillbirth, and others.
  • Taking vitamin C plus vitamin E starting during the second or third trimester and continuing until delivery seems to help delay delivery in pregnant women whose amniotic sacs broke early.
  • 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.
  • 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.
  • Taking vitamin C with aged garlic extract and vitamin E might benefit people with sickle cell disease.
  • 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.
  • Taking vitamin C along with conventional treatment appears to reduce the risk of death in children with tetanus.
  • Research suggests that taking vitamin C does not prevent UTIs in older people.
  • 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.
  • Form an important protein used to make skin, tendons, ligaments, and blood vessels
  • Heal wounds and form scar tissue
  • Repair and maintain cartilage, bones, and teeth
  • Aid in the absorption of iron
  • Free radicals are made when your body breaks down food or when you are exposed to tobacco smoke or radiation.
  • The buildup of free radicals over time is largely responsible for the aging process.
  • Free radicals may play a role in cancer, heart disease, and conditions like arthritis.

For many years, vitamin C has been a popular household remedy for the common cold.

  • Research shows that for most people, vitamin C supplements or vitamin C-rich foods 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.
  • Taking a vitamin C supplement after a cold starts does not appear to be helpful.
  • Acne.
  • Chronic fatigue syndrome (CFS).
  • Constipation.
  • Cystic fibrosis.
  • Dental cavities.
  • Kidney disease.
  • Lyme disease.
  • Tuberculosis.
  • Wounds.
  • Other conditions.

References

Vitamin C; Types, Deficiency Symptoms

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