Vitamin C or ascorbate is a water-soluble vitamin found in citrus and other fruits, berries and vegetables. It is found as a form of ascorbic acid. It is an essential nutrient involved in the repair of tissue, the formation of collagen, and the enzymatic production of certain neurotransmitters. It is required for the functioning of several enzymes and is important for immune system function. It is also an antioxidant. Most animals are able to synthesize their own vitamin C. However, higher primates (including humans), most bats, guinea pigs, some fish species, and some bird species must acquire it from dietary sources because a gene for a synthesis enzyme has mutations that render it dysfunctional; humans obtain this vitamin from those fruits and vegetables.
It is also a generic prescription medication and in some countries is sold as a non-prescription dietary supplement. As a therapy, it is used to prevent and treat scurvy, a disease caused by vitamin C deficiency. Vitamin C may be taken by mouth or by intramuscular, subcutaneous or intravenous injection. Various health claims exist on the supposition that moderate vitamin C deficiency increases disease risk, such as for the common cold, cancer or COVID-19. There are also claims of benefits from vitamin C supplementation in excess of the recommended dietary intake for people who are not considered vitamin C deficient. Vitamin C is generally well tolerated. Large doses may cause gastrointestinal discomfort, headache, trouble sleeping, and flushing of the skin. The United States National Academy of Medicine recommends against consuming large amounts.
Vitamin C was discovered in 1912, isolated in 1928, and in 1933, was the first vitamin to be chemically produced. Partly for its discovery, Albert Szent-Györgyi was awarded the 1937 Nobel Prize in Physiology or Medicine.
Chemistry
The name "vitamin C" always refers to the -enantiomers of ascorbic acid and its oxidized form, dehydroascorbate (DHA). Therefore, unless written otherwise, "ascorbate" and "ascorbic acid" refer in the nutritional literature to -ascorbate and -ascorbic acid respectively. Ascorbic acid is a weak sugar acid structurally related to glucose. In biological systems, ascorbic acid can be found only at low pH, but in solutions above pH 5 it is predominantly found in the ionized form, ascorbate.
Many analytical methods have been developed for ascorbic acid detection. For example, vitamin C content of a food sample such as fruit juice can be calculated by measuring the volume of the sample required to decolorize a solution of dichlorophenolindophenol (DCPIP) and then calibrating the results by comparison with a known concentration of vitamin C.
Deficiency Plasma vitamin C is the most widely applied test for vitamin C status. Adequate levels are defined as near 50 μmol/L. Hypovitaminosis of vitamin C is defined as less than 23 μmol/L, and deficiency as less than 11.4 μmol/L. For people 20 years of age or above, data from the US 2017–18 National Health and Nutrition Examination Survey showed mean serum concentrations of 53.4 μmol/L. Deficiency was reported in 5.9% of people. Globally, vitamin C deficiency is common in low and middle-income countries, and not uncommon in high income countries. In the latter, prevalence is higher in males than in females.
Plasma levels are considered saturated at about 65 μmol/L, achieved by intakes of 100 to 200 mg/day, which are well above the recommended intakes. Even higher oral intake does not further raise plasma nor tissue concentrations because absorption efficiency decreases and any excess that is absorbed is excreted in urine.
Diagnostic testing Vitamin C content in plasma is used to determine vitamin status. For research purposes, concentrations can be assessed in leukocytes and tissues, which are normally maintained at an order of magnitude higher than in plasma via an energy-dependent transport system, depleted slower than plasma concentrations during dietary deficiency and restored faster during dietary repletion, but these analyses are difficult to measure, and hence not part of standard diagnostic testing.
Diet Recommended consumption Recommendations for vitamin C intake by adults have been set by various national agencies: 40 mg/day: India National Institute of Nutrition, Hyderabad 45 mg/day or 300 mg/week: the World Health Organization 80 mg/day: the European Commission Council on nutrition labeling 90 mg/day (males) and 75 mg/day (females): Health Canada 2007 90 mg/day (males) and 75 mg/day (females): United States National Academy of Sciences 100 mg/day: Japan National Institute of Health and Nutrition 110 mg/day (males) and 95 mg/day (females): European Food Safety Authority
US vitamin C recommendations (mg per day)RDA (children ages 1–3 years)15RDA (children ages 4–8 years)25RDA (children ages 9–13 years)45RDA (girls ages 14–18 years)65RDA (boys ages 14–18 years)75RDA (adult female)75RDA (adult male)90RDA (pregnancy)85RDA (lactation)120UL (adult female)2,000UL (adult male)2,000
In 2000, the chapter on Vitamin C in the North American Dietary Reference Intake was updated to give the Recommended Dietary Allowance (RDA) as 90 milligrams per day for adult men, 75 mg/day for adult women, and setting a tolerable upper intake level (UL) for adults of 2,000 mg/day. The table here shows RDAs for the United States and Canada for children, and for pregnant and lactating women, as well as the ULs for adults.
For the European Union, the EFSA set higher recommendations for adults, and also for children: 20 mg/day for ages 1–3, 30 mg/day for ages 4–6, 45 mg/day for ages 7–10, 70 mg/day for ages 11–14, 100 mg/day for males ages 15–17, 90 mg/day for females ages 15–17. For pregnancy 100 mg/day; for lactation 155 mg/day.
Cigarette smokers and people exposed to secondhand smoke have lower serum vitamin C levels than nonsmokers. The reasoning is that inhalation of smoke causes oxidative damage, depleting this antioxidant vitamin. The US Institute of Medicine estimated that smokers need 35 mg more vitamin C per day than nonsmokers, but did not formally establish a higher RDA for smokers.
The US National Center for Health Statistics conducts biannual National Health and Nutrition Examination Survey (NHANES) to assess the health and nutritional status of adults and children in the United States. Some results are reported as What We Eat In America. The 2013–2014 survey reported that for adults ages 20 years and older, men consumed on average 83.3 mg/d and women 75.1 mg/d. This means that half the women and more than half the men are not consuming the RDA for vitamin C. The same survey stated that about 30% of adults reported they consumed a vitamin C dietary supplement or a multi-vitamin/mineral supplement that included vitamin C, and that for these people total consumption was between 300 and 400 mg/d.
Tolerable upper intake level In 2000, the Institute of Medicine of the US National Academy of Sciences set a tolerable upper intake level (UL) for adults of 2,000 mg/day. The amount was chosen because human trials had reported diarrhea and other gastrointestinal disturbances at intakes of greater than 3,000 mg/day. This was the Lowest-Observed-Adverse-Effect Level (LOAEL), meaning that other adverse effects were observed at even higher intakes. ULs are progressively lower for younger and younger children. In 2006, the European Food Safety Authority (EFSA) also pointed out the disturbances at that dose level, but reached the conclusion that there was not sufficient evidence to set a UL for vitamin C, as did the Japan National Institute of Health and Nutrition in 2010.
Food labeling For US food and dietary supplement labeling purposes, the amount in a serving is expressed as a percent of Daily Value (%DV). For vitamin C labeling purposes, 100% of the Daily Value was 60 mg, but as of May 27, 2016, it was revised to 90 mg to bring it into agreement with the RDA. A table of the old and new adult daily values is provided at Reference Daily Intake.
European Union regulations require that labels declare energy, protein, fat, saturated fat, carbohydrates, sugars, and salt. Voluntary nutrients may be shown if present in significant amounts. Instead of Daily Values, amounts are shown as percent of Reference Intakes (RIs). For vitamin C, 100% RI was set at 80 mg in 2011.REGULATION (EU) No 1169/2011 OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL Official Journal of the European Union. page 304/61. (2009).
Sources Although also present in other plant-derived foods, the richest natural sources of vitamin C are fruits and vegetables. Vitamin C is the most widely taken dietary supplement.
Plant sources
The following table is approximate and shows the relative abundance in different raw plant sources. The amount is given in milligrams per 100 grams of the edible portion of the fruit or vegetable:
Raw plant sourceAmount (mg / 100g)Kakadu plum 1000–5300Camu camu 2800Acerola 1677Indian gooseberry 445Rose hip 426Common sea-buckthorn 400Guava 228Blackcurrant 200Yellow bell pepper/capsicum 183Red bell pepper/capsicum 128Kale 120Broccoli 90Kiwifruit 90 Raw plant sourceAmount (mg / 100g)Green bell pepper/capsicum 80Brussels sprouts 80Loganberry, redcurrant 80Cloudberry, elderberry 60Strawberry 60Papaya 60Orange, lemon 53Cauliflower 48Pineapple 48Cantaloupe 40Passion fruit, raspberry 30Grapefruit, lime 30Cabbage, spinach 30 Raw plant sourceAmount (mg / 100g)Mango 28Blackberry, cassava 21Potato 20Honeydew melon 20Tomato 14Cranberry 13Blueberry, grape 10Apricot, plum, watermelon 10Avocado 8.8Onion 7.4Cherry, peach 7Apple 6Carrot, asparagus 6
Animal sources Animal-sourced foods do not generally provide much vitamin C, and what there is, is largely destroyed by heat during cooking. For example, raw chicken liver contains 17.9 mg/100 g, but fried, the content is reduced to 2.7 mg/100 g. Vitamin C is present in human breast milk at 5.0 mg/100 g. Cow's milk contains 1.0 mg/100 g, but the heat of pasteurization destroys it.
Food preparation Vitamin C chemically decomposes under certain conditions, many of which may occur during the cooking of food. Vitamin C concentrations in various food substances decrease with time in proportion to the temperature at which they are stored. Cooking can reduce the vitamin C content of vegetables by around 60%, possibly due to increased enzymatic destruction. Longer cooking times may add to this effect. Another cause of vitaminC loss from food is leaching, which transfers vitaminC to the cooking water, which is decanted and not consumed.
Supplements
Vitamin C dietary supplements are available as tablets, capsules, drink mix packets, in multi-vitamin/mineral formulations, in antioxidant formulations, and as crystalline powder. Vitamin C is also added to some fruit juices and juice drinks. Tablet and capsule content ranges from 25 mg to 1500 mg per serving. The most commonly used supplement compounds are ascorbic acid, sodium ascorbate and calcium ascorbate. Vitamin C molecules can also be bound to the fatty acid palmitate, creating ascorbyl palmitate, or else incorporated into liposomes.
Food fortification