Vitamin C

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Vitamin C

Common Names

  • Ascorbate
  • Sodium ascorbate
  • Ascorbic Acid

For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.


What is it?

Vitamin C is a vitamin that keeps you healthy. Your body can’t make vitamin C on its own so you need to get it from food. Foods that are rich in vitamin C include citrus fruits like oranges, fresh vegetables, berries, and melons.

If you don’t get enough vitamin C from food, your healthcare provider may recommend you take vitamin C supplements or take a multivitamin that has vitamin C.

What is it used for?

Vitamin C is used to:

  • Prevent and treat the common cold
  • Treat upper respiratory infections (infections that affect your breathing)
  • Improve heart health
  • Heal wounds
  • Prevent and treat cancer

Vitamin C also has other uses that haven’t been studied by doctors to see if they work.

It’s generally safe to eat foods that are rich in vitamin C. However, talk with your healthcare provider before taking supplements or higher amounts of vitamin C.

Herbal supplements can interact with some medications and affect how they work. For more information, read the “What else do I need to know?” section below.

What are the side effects?

Vitamin C is generally safe. But supplements can sometimes cause side effects such as:

  • Nausea (feeling like you’re going to throw up)
  • Diarrhea (loose or watery bowel movements)
  • Stomach cramps
  • Low blood sugar
  • Low blood pressure
What else do I need to know?

Foods that are rich in vitamin C are safe. The statements below refer to vitamin C supplements.

  • Talk to your healthcare provider if you have kidney stones or kidney disease. Vitamin C can make these conditions worse.
  • Talk to your healthcare provider if you’re on dialysis for kidney disease. Vitamin C can worsen your condition.
  • Avoid vitamin C if you’re on bortezomib (Velcade®) as part of your cancer treatment. Vitamin C can affect the way this medication acts in your body.
  • Avoid vitamin C if you’re on radiation therapy or chemotherapy. Vitamin C can interfere with these treatments and decrease their effects.
  • Talk to your healthcare provider if you’re taking acetaminophen (paracetamol®). Vitamin C can increase the side effects of this medication.
  • Talk to your healthcare provider if you have hemochromatosis (a condition where too much iron builds up in your body). Vitamin C can increase how much iron your body absorbs.
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For Healthcare Professionals

Scientific Name
Ascorbic Acid, C6H8O6
Clinical Summary

Vitamin C, also known as ascorbic acid, exists as either ascorbic acid or ascorbate. It is a water-soluble vitamin found in many fresh fruits and vegetables, and is essential for a variety of physiologic functions including formation of collagen and catecholamines, and carnitine and peptide synthesis (1). It is not synthesized in the human body, and deficiency can cause scurvy.

Oral vitamin C is consumed as an antioxidant supplement for immune protection against colds and flu, wound healing, cardiovascular health, and cancer prevention. Although supplemental intake may reduce duration and severity of the common cold, the effect is minimal except in those exposed to acute physical stress (2). High-dose vitamin C supplementation alone or in combination with high-dose zinc did not decrease symptom duration in ambulatory patients infected with SARS-CoV-2 (90).

In large-scale randomized trials, supplemental vitamin C did not reduce risk of coronary heart disease (4) (5). Further, supplementation with vitamins C and E increased risk of mortality and nonfatal myocardial infarction in patients with coronary artery disease (6). Data on effects for reducing blood pressure are mixed (7) (8), and studies do not support prophylactic vitamin C to lower postoperative atrial fibrillation incidence among cardiac surgery patients (69) (70), but other data suggest reductions in length of hospital stay, duration of mechanical ventilation, and atrial fibrillation incidence (80).

The role of vitamin C in cancer prevention is not definitive. High plasma levels of vitamin C were associated with lower gastrointestinal cancer incidence probably due to protective effects against dietary carcinogenic nitroso compounds (19). Intake of vitamins A, C, or E reduced cervical cancer risk (20), but did not prevent gastrointestinal (21), prostate (22), lung (23) cancers or affect mortality (24) (73). Supplemental but not dietary vitamin C was associated with an increased risk of liver cancer (25).

There are also conflicting theories against the use of vitamin C supplements during chemotherapy. Preclinical studies found that cancer cells preferentially uptake vitamin C (37) and render some chemotherapy drugs less effective (38). Also, a major concern surrounding the use of antioxidants such as vitamin C is that they can interfere with the actions of chemotherapy and radiation therapy that rely on the production of reactive oxygen species for their cytotoxic activities (39). However, a clinical study showed that ascorbic acid does not reduce the therapeutic effects of paclitaxel and carboplatin (40). Another study found an increase in chemotherapy-associated adverse effects with inadequate intake of vitamin C in children with acute lymphoblastic leukemia (41). In other preliminary studies, short-term vitamin C plus E supplementation during radiotherapy had a protective effect against xerostomia in patients with head and neck cancer (75); a combination of vitamins C, E, and selenium lowered radioiodine-induced oxidative stress in thyroid cancer patients (76); and supplementation may enhance effects of DNA methyl transferase inhibitors in patients with myeloid cancers (89). Still, older trials in advanced cancer patients using 10 g per day of oral vitamin C did not demonstrate significant benefits (29) (30). This lack of effect is explained by the finding of a pharmacokinetic study that ascorbic acid can only reach a limited plasma concentration through oral administration (31).

Intravenous high-dose vitamin C has been long been used as an alternative cancer treatment (26) based on the hypothesis that formation of new collagen resists malignant infiltration (27). In preclinical studies, higher pharmacologic concentrations could be achieved via intravenous injection and had selective cytotoxic effects on cancer cell lines (32) (33), and early reports using parenteral plus oral ascorbic acid showed promising results (28). Ascorbic acid is postulated to act as a carrier of hydrogen peroxide to the extracelluar fluid (32) where it generates free radicals against tumor cells (33). High-dose IV ascorbic acid up to 1.5 g/kg/day (34), or used with chemotherapy (74) appears to be well-tolerated. It may improve the quality of life of terminal cancer patients (35), and reduce chemotherapy-associated toxicity (67). This led to a renewed interest in studying high-dose IV vitamin C as an anticancer treatment (34) (36). However, it should be regarded as an investigational drug and used only in a clinical trial setting, as studies of IV vitamin C therapies in patients with sepsis have not found benefit (84) (85) (91) (92) and adverse events (93) (94) (95) and interference with glucometer readings (96) (97) have been reported.

Adverse effects from vitamin C supplements are generally rare, but there are reports of gastrointestinal upset, kidney stone formation (42), and hemolytic anemia in patients with G6PDH deficiency (43) (44). Patients with a history of oxalate kidney stones, renal insufficiency, hematochromatosis, or those undergoing chemotherapy should consult their physicians before taking vitamin C supplements.

Food Sources

Citrus fruits, fresh vegetables, berries, melons

Purported Uses
  • Bronchitis
  • Cancer
  • Cardiovascular disease
  • Common cold
  • Immunostimulation
  • Infections
  • Wound healing
Mechanism of Action

Vitamin C is essential for the formation and polymerization of collagen; therefore deficiency results in scurvy and poor wound healing (1). Vitamin C also inhibits hyaluronidase leading to the hypothesis that it can prevent cancer metastasis by strengthening the buildup and preventing the breakdown of collagen (45).

Ascorbic acid acts as an antioxidant to protect against oxidative damage from free radicals (46). It inactivates nitric oxide and improves endothelium-dependent vasodilation (47), and acts via different mechanisms depending on its plasma concentration. Plasma concentrations <0.1mM are achieved through oral intake of dietary or supplemental forms. At pharmacologic plasma concentrations of 0.3 - 20mM via intravenous injection, ascorbic acid is oxidized to an ascorbate radical which acts as a prodrug for hydrogen peroxide formation within interstitial fluids (33). This induces DNA damage and adenosine triphosphate (ATP) depletion, and triggers ataxia telangiectasia mutated (ATM)/adenosine monophosphate–activated protein kinase (AMPK) and inhibition of mammalian target of rapamycin (mTOR) in cancer cells (67).

Other preclinical studies suggest that ascorbate can regulate hematopoietic stem cell function and leukemogenesis (77). In leukemic cells, vitamin C compensated for Tet2 mutations to restore normal function (78). In non-small-cell lung cancer and glioblastoma cells, pharmacological ascorbate selectively sensitized these cells (79). Ascorbate decreases colon cancer cell proliferation by downregulating specificity proteins (48). It also depletes ATP and induces autophagy and cell death in prostate cancer cells (49). Preferential oxidative cytotoxic effects on cancer cells may be due to the presence of intracellular iron (50), copper (51), an increase in p53 activity (52), and overexpression of sodium-dependent vitamin C transporter 2 (53). Further, high-dose vitamin C was reported to inhibit metastasis of breast cancer cells by inhibiting epithelial-mesenchymal transition (82).

Dehydroascorbic acid, the oxidized form of vitamin C, may have cytoprotective effects by preserving mitochondrial membrane potential (38).

Contraindications
  • Recurrent kidney stone formation
  • Renal impairment or on chronic hemodialysis
  • Hematochromatosis
  • Known G6PDH deficiency
Adverse Reactions

Common: Nausea, diarrhea and stomach cramps.

Case reports: Oral
Increased oxalate kidney stone formation, nephrolithiasis, acute renal failure, or renal insufficiency: In patients with history of kidney stones (42) (58) (59).
Hemolytic anemia: May occur at high doses in patients with G6PDH deficiency (43) (44).
Severe cyanide poisoning: With concurrent use of amygdalin 3 grams + vitamin C 4800 mg per day (60).
Eroded tooth enamel or dental caries: With excessive use of chewable tablets (61).

Case reports: Intravenous
During infusion  (74)
Common: Thirst and increased urinary flow.
Isolated incidences: nausea/vomiting, rumbling or unpleasant fluttering in abdomen, chills, and/or headache.
Post-infusion  (74)
Isolated incidences: Mental haze, increased leg edema lasting for a few days.
Oxalate nephropathy: In critically ill patients who received intravenous vitamin C as supportive sepsis therapy (93) (94) (95).
Factitious hyperglycemia: In a peritoneal dialysis patient receiving high-dose vitamin-C that persisted for 6 days after therapy discontinuation (96).
Intratubular oxalate deposits: Attributed to high-dose vitamin C used as an immune booster in a kidney transplant patient who also had COVID-19 (98).
Methemoglobinemia and hemolytic anemia: In a 75-year-old woman with previously unrecognized G6PD deficiency, who had jaundice, dark urine, and shortness of breath after receiving 30 g of vitamin C infusion as an unconventional therapy for hemifacial spasm (99).

Herb-Drug Interactions

Iron: Ascorbic acid increases iron absorption and modulates transport and storage in the body. Significant in patients with hematochromatosis (61).
Chemotherapy drugs: Vitamin C may reduce the effectiveness of some antineoplastic agents including vincristine, doxorubicin, methotrexate, cisplatin, and imatinib (38).
Bortezomib: Ascorbic acid intake reduces the activity of bortezomib (62). In a clinical trial using these agents together, the interaction is minimized by administrating bortezomib in the morning and ascorbic acid in the evening (63).
Glutathione: Glutathione as an antioxidant reduces the pro-oxidant cytotoxic effects of ascorbic acid (64).
Beta-blockers: Ascorbic acid can enhance the cardioprotective effects of beta-blockers in post-bypass patients (65).
Paracetamol: When taken simultaneously, vitamin C increased the extent of absorption of paracetamol in healthy volunteers, and may increase the risk of side effects (83).

Herb Lab Interactions

Ascorbic acid supplementation may cause a false negative guaiac (occult blood) test (66).

Erroneous interpretation of point-of-care blood glucometer readings were attributed to interference from high-dose IV vitamin C, resulting in a patient death and highlighting the potential for incorrect diagnosis of pseudohyperglycemia or pseudohypoglycemia (97). In a peritoneal dialysis patient receiving high-dose IV vitamin C, factitious hyperglycemia persisted for 6 days after therapy discontinuation (96).

Dosage (OneMSK Only)
References
  1. Sauberlich HE. Pharmacology of vitamin C. Annual review of nutrition. 1994;14:371-391.
  2. Hemila H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013;1:CD000980.
  3. Ye Z, Song H. Antioxidant vitamins intake and the risk of coronary heart disease: meta-analysis of cohort studies. Eur J Cardiovasc Prev Rehabil. Feb 2008;15(1):26-34.
  4. Sesso HD, Buring JE, Christen WG, et al. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians’ Health Study II randomized controlled trial. JAMA. Nov 12 2008;300(18):2123-2133.
  5. Cook NR, Albert CM, Gaziano JM, et al. 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. Arch Intern Med. Aug 13-27 2007;167(15):1610-1618.
  6. Waters DD, Alderman EL, Hsia J, et al. Effects of hormone replacement therapy and antioxidant vitamin supplements on coronary atherosclerosis in postmenopausal women: a randomized controlled trial. JAMA. Nov 20 2002;288(19):2432-2440.
  7. Kim MK, Sasaki S, Sasazuki S, et al. Lack of long-term effect of vitamin C supplementation on blood pressure. Hypertension. Dec 2002;40(6):797-803.
  8. Mullan BA, Young IS, Fee H, et al. Ascorbic acid reduces blood pressure and arterial stiffness in type 2 diabetes. Hypertension. Dec 2002;40(6):804-809.
  9. Afkhami-Ardekani M, Shojaoddiny-Ardekani A. Effect of vitamin C on blood glucose, serum lipids & serum insulin in type 2 diabetes patients. Indian J Med Res. Nov 2007;126(5):471-474.
  10. Ochoa-Brust GJ, Fernandez AR, Villanueva-Ruiz GJ, et al. Daily intake of 100 mg ascorbic acid as urinary tract infection prophylactic agent during pregnancy. Acta Obstet Gynecol Scand. 2007;86(7):783-787.
  11. Nathens AB, Neff MJ, Jurkovich GJ, et al. Randomized, prospective trial of antioxidant supplementation in critically ill surgical patients. Ann Surg. Dec 2002;236(6):814-822.
  12. Foley DJ, White LR. Dietary intake of antioxidants and risk of Alzheimer disease: food for thought. JAMA. Jun 26 2002;287(24):3261-3263.
  13. Engelhart MJ, Geerlings MI, Ruitenberg A, et al. Dietary intake of antioxidants and risk of Alzheimer disease. JAMA. Jun 26 2002;287(24):3223-3229.
  14. Zojaji H, Talaie R, Mirsattari D, et al. The efficacy of Helicobacter pylori eradication regimen with and without vitamin C supplementation. Dig Liver Dis. Sep 2009;41(9):644-647.
  15. Mathew MC, Ervin AM, Tao J, et al. Antioxidant vitamin supplementation for preventing and slowing the progression of age-related cataract. Cochrane Database Syst Rev. 2012;6:CD004567.
  16. Chong EW, Wong TY, Kreis AJ, et al. Dietary antioxidants and primary prevention of age related macular degeneration: systematic review and meta-analysis. BMJ. Oct 13 2007;335(7623):755.
  17. Gomez-Cabrera MC, Domenech E, Romagnoli M, et al. Oral administration of vitamin C decreases muscle mitochondrial biogenesis and hampers training-induced adaptations in endurance performance. Am J Clin Nutr. Jan 2008;87(1):142-149.
  18. Muralikrishnan G, Amanullah S, Basha MI, et al. Effect of vitamin C on lipidperoxidation and antioxidant status in tamoxifen-treated breast cancer patients. Chemotherapy. 2010;56(4):298-302.
  19. Loh YH, Jakszyn P, Luben RN, et al. N-Nitroso compounds and cancer incidence: the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk Study. Am J Clin Nutr. May 2011;93(5):1053-1061.
  20. Kim J, Kim MK, Lee JK, et al. Intakes of vitamin A, C, and E, and beta-carotene are associated with risk of cervical cancer: a case-control study in Korea. Nutr Cancer. 2010;62(2):181-189.
  21. Bjelakovic G, Nikolova D, Simonetti RG, et al. Antioxidant supplements for prevention of gastrointestinal cancers: a systematic review and meta-analysis. Lancet. Oct 2-8 2004;364(9441):1219-1228.
  22. Kirsh VA, Hayes RB, Mayne ST, et al. Supplemental and dietary vitamin E, beta-carotene, and vitamin C intakes and prostate cancer risk. J Natl Cancer Inst. Feb 15 2006;98(4):245-254.
  23. Cortes-Jofre M, Rueda JR, Corsini-Munoz G, et al. Drugs for preventing lung cancer in healthy people. Cochrane Database Syst Rev. 2012;10:CD002141.
  24. Lin J, Cook NR, Albert C, et al. Vitamins C and E and beta carotene supplementation and cancer risk: a randomized controlled trial. J Natl Cancer Inst. Jan 7 2009;101(1):14-23.
  25. Zhang W, Shu XO, Li H, et al. Vitamin intake and liver cancer risk: a report from two cohort studies in China. J Natl Cancer Inst. Aug 8 2012;104(15):1173-1181.
  26. Padayatty SJ, Sun AY, Chen Q, et al. Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PloS one. 2010;5(7):e11414.
  27. Cameron E, Pauling L, Leibovitz B. Ascorbic acid and cancer: a review. Cancer Res. Mar 1979;39(3):663-681.
  28. Cameron E, Campbell A. The orthomolecular treatment of cancer. II. Clinical trial of high-dose ascorbic acid supplements in advanced human cancer. Chem Biol Interact. Oct 1974;9(4):285-315.
  29. Creagan ET, Moertel CG, O’Fallon JR, et al. Failure of high-dose vitamin C (ascorbic acid) therapy to benefit patients with advanced cancer. A controlled trial. New Engl J Med. Sep 27 1979;301(13):687-690.
  30. Moertel CG, Fleming TR, Creagan ET, et al. High-dose vitamin C versus placebo in the treatment of patients with advanced cancer who have had no prior chemotherapy. A randomized double-blind comparison. New Engl J Med. Jan 17 1985;312(3):137-141.
  31. Padayatty SJ, Sun H, Wang Y, et al. Vitamin C pharmacokinetics: implications for oral and intravenous use. Ann Int Med. Apr 6 2004;140(7):533-537.
  32. Chen Q, Espey MG, Krishna MC, et al. Pharmacologic ascorbic acid concentrations selectively kill cancer cells: action as a pro-drug to deliver hydrogen peroxide to tissues. Proc Natl Acad Sci U S A. Sep 20 2005;102(38):13604-13609.
  33. Chen Q, Espey MG, Sun AY, et al. Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice. Proc Natl Acad Sci U S A. Aug 12 2008;105(32):11105-11109.
  34. Hoffer LJ, Levine M, Assouline S, et al. Phase I clinical trial of i.v. ascorbic acid in advanced malignancy. Ann Oncol. Nov 2008;19(11):1969-1974.
  35. Yeom CH, Jung GC, Song KJ. Changes of terminal cancer patients’ health-related quality of life after high dose vitamin C administration. J Korean Med Sci. Feb 2007;22(1):7-11.
  36. Padayatty SJ, Riordan HD, Hewitt SM, et al. Intravenously administered vitamin C as cancer therapy: three cases. CMAJ. Mar 28 2006;174(7):937-942.
  37. Agus DB, Vera JC, Golde DW. Stromal cell oxidation: a mechanism by which tumors obtain vitamin C. Cancer Res. Sep 15 1999;59(18):4555-4558.
  38. Heaney ML, Gardner JR, Karasavvas N, et al. Vitamin C antagonizes the cytotoxic effects of antineoplastic drugs. Cancer Res. Oct 1 2008;68(19):8031-8038.
  39. Lawenda BD, Kelly KM, Ladas EJ, et al. Should supplemental antioxidant administration be avoided during chemotherapy and radiation therapy? J Natl Cancer Inst. Jun 4 2008;100(11):773-783.
  40. Pathak AK, Bhutani M, Guleria R, et al. Chemotherapy alone vs. chemotherapy plus high dose multiple antioxidants in patients with advanced non small cell lung cancer. J Am Coll Nutr. Feb 2005;24(1):16-21.
  41. Kennedy DD, Tucker KL, Ladas ED, et al. Low antioxidant vitamin intakes are associated with increases in adverse effects of chemotherapy in children with acute lymphoblastic leukemia. Am J Clin Nutr. Jun 2004;79(6):1029-1036.
  42. Thomas LD, Elinder CG, Tiselius HG, et al. Ascorbic acid supplements and kidney stone incidence among men: a prospective study. JAMA Int Med. Mar 11 2013;173(5):386-388.
  43. Mehta JB, Singhal SB, Mehta BC. Ascorbic-acid-induced haemolysis in G-6-PD deficiency. Lancet. Oct 13 1990;336(8720):944.
  44. Rees DC, Kelsey H, Richards JD. Acute haemolysis induced by high dose ascorbic acid in glucose-6-phosphate dehydrogenase deficiency. BMJ. Mar 27 1993;306(6881):841-842.
  45. Cameron E. Vitamin C and cancer: an overview. Int J Vitam Nutr Res Suppl. 1982;23:115-127.
  46. Chen K, Suh J, Carr AC, et al. Vitamin C suppresses oxidative lipid damage in vivo, even in the presence of iron overload. Am J Physiol Endocrinol Metab. Dec 2000;279(6):E1406-1412.
  47. Taddei S, Virdis A, Ghiadoni L, et al. Vitamin C improves endothelium-dependent vasodilation by restoring nitric oxide activity in essential hypertension. Circulation. Jun 9 1998;97(22):2222-2229.
  48. Pathi SS, Lei P, Sreevalsan S, et al. Pharmacologic doses of ascorbic acid repress specificity protein (Sp) transcription factors and Sp-regulated genes in colon cancer cells. Nutr Cancer. 2011;63(7):1133-1142.
  49. Chen P, Yu J, Chalmers B, et al. Pharmacological ascorbate induces cytotoxicity in prostate cancer cells through ATP depletion and induction of autophagy. Anti-Cancer Drugs. Apr 2012;23(4):437-444.
  50. Duarte TL, Almeida GM, Jones GD. Investigation of the role of extracellular H2O2 and transition metal ions in the genotoxic action of ascorbic acid in cell culture models. Toxicol Lett. Apr 5 2007;170(1):57-65.
  51. Ullah MF, Khan HY, Zubair H, et al. The antioxidant ascorbic acid mobilizes nuclear copper leading to a prooxidant breakage of cellular DNA: implications for chemotherapeutic action against cancer. Cancer Chemother Pharmacol. Jan 2011;67(1):103-110.
  52. Kim J, Lee SD, Chang B, et al. Enhanced antitumor activity of vitamin C via p53 in cancer cells. Free Radic Biol Med. Oct 15 2012;53(8):1607-1615.
  53. Hong SW, Lee SH, Moon JH, et al. SVCT-2 in breast cancer acts as an indicator for L-ascorbate treatment. Oncogene. Mar 21 2013;32(12):1508-1517.
  54. Corpe CP, Tu H, Eck P, et al. Vitamin C transporter Slc23a1 links renal reabsorption, vitamin C tissue accumulation, and perinatal survival in mice. J Clin Invest. Apr 2010;120(4):1069-1083.
  55. Krajcovicova-Kudlackova M, Babinska K, Valachovicova M, et al. Vitamin C protective plasma value. Bratisl Lek Listy. 2007;108(6):265-268.
  56. Robitaille L, Mamer OA, Miller WH, Jr., et al. Oxalic acid excretion after intravenous ascorbic acid administration. Metabolism. Feb 2009;58(2):263-269.
  57. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington (DC): National Academy Press; 2000.
  58. Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol. Dec 2004;15(12):3225-3232.
  59. McAllister CJ, Scowden EB, Dewberry FL, et al. Renal failure secondary to massive infusion of vitamin C. JAMA. Oct 5 1984;252(13):1684.
  60. Bromley J, Hughes BG, Leong DC, et al. Life-threatening interaction between complementary medicines: cyanide toxicity following ingestion of amygdalin and vitamin C. Ann Pharmacother. Sep 2005;39(9):1566-1569.
  61. Pronsky ZM. Food-Medication Interactions. 11th ed2000.
  62. Perrone G, Hideshima T, Ikeda H, et al. Ascorbic acid inhibits antitumor activity of bortezomib in vivo. Leukemia. Sep 2009;23(9):1679-1686.
  63. Berenson JR, Yellin O, Woytowitz D, et al. Bortezomib, ascorbic acid and melphalan (BAM) therapy for patients with newly diagnosed multiple myeloma: an effective and well-tolerated frontline regimen. Eur J Hematol. Jun 2009;82(6):433-439.
  64. Chen P, Stone J, Sullivan G, et al. Anti-cancer effect of pharmacologic ascorbate and its interaction with supplementary parenteral glutathione in preclinical cancer models. Free Radic Biol Med. Aug 1 2011;51(3):681-687.
  65. Eslami M, Badkoubeh RS, Mousavi M, et al. Oral ascorbic acid in combination with beta-blockers is more effective than beta-blockers alone in the prevention of atrial fibrillation after coronary artery bypass grafting. Tex Heart Inst J. 2007;34(3):268-274.
  66. Jaffe RM, Kasten B, Young DS, et al. False-negative stool occult blood tests caused by ingestion of ascorbic acid (vitamin C). Ann Int Med. Dec 1975;83(6):824-826.
  67. Ma Y, Chapman J, Levine M. High-Dose Parenteral Ascorbate Enhanced Chemosensitivity of Ovarian Cancer and Reduced Toxicity of Chemotherapy. Sci Transl Med. 2014 Feb 5;6(222):222ra18.
  68. Elalfy MS, Saber MM, Adly AA, et al. Role of vitamin C as an adjuvant therapy to different iron chelators in young beta-thalassemia major patients: efficacy and safety in relation to tissue iron overload. Eur J Haematol. Mar 2016;96(3):318-326.
  69. Antonic M, Lipovec R, Gregorcic F, et al. Perioperative ascorbic acid supplementation does not reduce the incidence of postoperative atrial fibrillation in on-pump coronary artery bypass graft patients. J Cardiol. Jan 2017;69(1):98-102.
  70. Colby JA, Chen WT, Baker WL, et al. Effect of ascorbic acid on inflammatory markers after cardiothoracic surgery. Am J Health Syst Pharm. Sep 01 2011;68(17):1632-1639.
  71. Safaei N, Babaei H, Azarfarin R, et al. Comparative effect of grape seed extract (Vitis vinifera) and ascorbic acid in oxidative stress induced by on-pump coronary artery bypass surgery. Ann Card Anaesth. Jan-Mar 2017;20(1):45-51.
  72. Ayatollahi V, Dehghanpour Farashah S, Behdad S, et al. Effect of intravenous vitamin C on postoperative pain in uvulopalatopharyngoplasty with tonsillectomy. Clin Otolaryngol. Feb 2017;42(1):139-143.
  73. Wang L, Sesso HD, Glynn RJ, et al. Vitamin E and C supplementation and risk of cancer in men: posttrial follow-up in the Physicians’ Health Study II randomized trial. Am J Clin Nutr. Sep 2014;100(3):915-923.
  74. Hoffer LJ, Robitaille L, Zakarian R, et al. High-dose intravenous vitamin C combined with cytotoxic chemotherapy in patients with advanced cancer: a phase I-II clinical trial. PLoS One. 2015;10(4):e0120228.
  75. Chung MK, Kim do H, Ahn YC, et al. Randomized Trial of Vitamin C/E Complex for Prevention of Radiation-Induced Xerostomia in Patients with Head and Neck Cancer. Otolaryngol Head Neck Surg. Sep 2016;155(3):423-430.
  76. Rosario PW, Batista KC, Calsolari MR. Radioiodine-induced oxidative stress in patients with differentiated thyroid carcinoma and effect of supplementation with vitamins C and E and selenium (antioxidants). Arch Endocrinol Metab. Aug 2016;60(4):328-332.
  77. Agathocleous M, Meacham CE, Burgess RJ, et al. Ascorbate regulates haematopoietic stem cell function and leukaemogenesis. Nature. 2017 Sep 28;549(7673):476-481.
  78. Cimmino L, Dolgalev I, Wang Y, et al. Restoration of TET2 Function Blocks Aberrant Self-Renewal and Leukemia Progression. Cell. 2017 Sep 7;170(6):1079-1095.e20.
  79. Schoenfeld JD, Sibenaller ZA, Mapuskar KA, et al. O2- and H2O2-Mediated Disruption of Fe Metabolism Causes the Differential Susceptibility of NSCLC and GBM Cancer Cells to Pharmacological Ascorbate. Cancer Cell. Apr 10 2017;31(4):487-500.e488.
  80. Hill A, Clasen KC, Wendt S, et al. Effects of Vitamin C on Organ Function in Cardiac Surgery Patients: A Systematic Review and Meta-Analysis. Nutrients. 2019 Sep 4;11(9). pii: E2103.
  81. van Gorkom GNY, Lookermans EL, Van Elssen CHMJ, Bos GMJ. The Effect of Vitamin C (Ascorbic Acid) in the Treatment of Patients with Cancer: A Systematic Review. Nutrients. 2019 Apr 28;11(5). pii: E977.
  82. Zeng LH, Wang QM, Feng LY, et al. High-dose vitamin C suppresses the invasion and metastasis of breast cancer cells via inhibiting epithelial-mesenchymal transition. Onco Targets Ther. 2019 Sep 10;12:7405-7413.
  83. Jaccob AA, Ahmed ZH, Aljasani BM. Vitamin C, omega-3 and paracetamol pharmacokinetic interactions using saliva specimens as determiners. J Basic Clin Physiol Pharmacol. 2019 Aug 6;30(5).
  84. Fowler AA 3rd, Truwit JD, Hite RD, et al. Effect of Vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe Acute Respiratory Failure: The CITRIS-ALI Randomized Clinical Trial. JAMA. 2019 Oct 1;322(13):1261-1270.
  85. Moskowitz A, Huang DT, Hou PC, et al. Effect of Ascorbic Acid, Corticosteroids, and Thiamine on Organ Injury in Septic Shock: The ACTS Randomized Clinical Trial. JAMA. 2020 Aug 18;324(7):642-650.
  86. Wang D, Wang M, Zhang H, et al. Effect of Intravenous Injection of Vitamin C on Postoperative Pulmonary Complications in Patients Undergoing Cardiac Surgery: A Double-Blind, Randomized Trial. Drug Des Devel Ther. 2020 Aug 11;14:3263-3270.
  87. Emadi N, Nemati MH, Ghorbani M, Allahyari E. The Effect of High-Dose Vitamin C on Biochemical Markers of Myocardial Injury in Coronary Artery Bypass Surgery. Braz J Cardiovasc Surg. 2019 Dec 1;34(5):517-524.
  88. Batista GMS, Rocha HNM, Storch AS, et al. Ascorbic acid inhibits vascular remodeling induced by mental stress in overweight/obese men. Life Sci. 2020 Jun 1;250:117554.
  89. Gillberg L, Ørskov AD, Nasif A, et al. Oral vitamin C supplementation to patients with myeloid cancer on azacitidine treatment: Normalization of plasma vitamin C induces epigenetic changes. Clin Epigenetics. 2019 Oct 17;11(1):143.
  90. Thomas S, Patel D, Bittel B, et al. Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial. JAMA Netw Open. Feb 1 2021;4(2):e210369.
  91. Hwang SY, Ryoo SM, Park JE, et al. Combination therapy of vitamin C and thiamine for septic shock: a multi-centre, double-blinded randomized, controlled study. Intensive Care Med. Nov 2020;46(11):2015-2025.
  92. Sevransky JE, Rothman RE, Hager DN, et al. Effect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis: The VICTAS Randomized Clinical Trial. JAMA. Feb 23 2021;325(8):742-750.
  93. Mahling M, Köppen M, Mühlbacher T, et al. Acute Kidney Allograft Injury Following Vitamin C Administration for Septic Shock. Kidney Int Rep. Nov 2020;5(11):2114-2118.
  94. Fontana F, Cazzato S, Giovanella S, et al. Oxalate Nephropathy Caused by Excessive Vitamin C Administration in 2 Patients With COVID-19. Kidney Int Rep. Oct 2020;5(10):1815-1822.
  95. Wissanji T, Dupuis ME, Royal V, et al. Vitamin C-Induced Oxalate Nephropathy in a Septic Patient. Crit Care Explor. Apr 2021;3(4):e0389.
  96. Lachance O, Goyer F, Adhikari NKJ, et al. High-dose vitamin-C induced prolonged factitious hyperglycemia in a peritoneal dialysis patient: a case report. J Med Case Rep. May 21 2021;15(1):297.
  97. Orija IB, Zahid SH. Pseudohyperglycemia Secondary to High-Dose Intravenous Vitamin C Managed as Diabetic Ketoacidosis: An Endocrinological Catastrophe. AACE Clin Case Rep. Jul-Aug 2021;7(4):239-242.
  98. Anandh U, Gowrishankar S, Sharma A, et al. Kidney transplant dysfunction in a patient with COVID - 19 infection: role of concurrent Sars-Cov 2 nephropathy, chronic rejection and vitamin C-mediated hyperoxalosis: case report. BMC Nephrol. Mar 15 2021;22(1):91.
  99. Lo YH, Mok KL. High dose vitamin C induced methemoglobinemia and hemolytic anemia in glucose-6-phosphate dehydrogenase deficiency. Am J Emerg Med. Nov 2020;38(11):2488.e3-2488.e5.
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