I have been asked to talk about vitamin C in Cornelius from many of my patients over the past few weeks. I am looking to separate fact from fiction here. There is actually a lot of confusion about Vitamin C and how we can use it to help our health. Hopefully, this can shed some truth on the situation and separate fact from fiction.

So I have been posting about all sorts of studies being done around the world on COVID-19 and just an outpouring of great news articles talking about likely higher infection rates but lower overall mortality rates…also also about different ways to treat the virus once a person is infected.

As most of you know, New York City hospitals started using IV Vitamin C 1500mg 4x/day. These doses are significantly higher than the daily recommended allowance of Vitamin C, but we also know that Vitamin C supplementation has been used in Integrative Cancer Therapy and Autoimmune Therapy for years and there is a growing body of evidence that does help support healthy immune function.

This regimen being used at Northwell Health on Long Island (and hopefully elsewhere) is based in part on treatment that was being used in Wuhan and Shanghai, where they are using 24,000mg Vitamin C to treat COVID-19 patients.

It is actually a clinical trial which won't be completed till September, most likely long after this current pandemic is calming down or hopefully resolved…but early results do show great promise with the IV Vitamin C patients in China supposedly resolving all Coronavirus symptoms within 7 days. The primary goal is to show that Vitamin C reduces the inflammatory effects of the virus on the lungs, but I will be curious to see and frankly expect that additional benefits will be shown in these trials.

Regardless, I know there is confusion between Liposomal Vitamin C, Ascorbic Acid, Whole Food Vitamin C, and other forms and I wanted to share some information to help clarify what the science shows in these treatments.

Also, Intravenous dosing is significantly higher than oral dosing…so the questions are what CAN we use orally and what type of dose is effective? I will try to answer this.

OK…let's get to it.

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What is the difference between Vitamin C and Ascorbic Acid?

Vitamin C and Ascorbic Acid are the exact same thing. Some people have theorized that Vitamin C needs other nutrients like rose hips or bioflavonoids to absorb…this is not shown in the scientific literature and is simply not true.

With all the talk on Intravenous or IV Vitamin C, the question is can we get the same levels with other methods of delivery, including oral? The short answer is NO. There is currently no clinical support for these claims according to the Linus Pauling Institute at Oregon State University.

How about Natural versus Synthetic? I have often touted the more natural or whole food forms of the vitamin. There is currently no evidence that natural sources have greater bioavailability than synthetic vitamin C or even straight ascorbic acid. There are some studies in animals that show the difference, but the current studies in humans do not show any differences.

How about taking a Liposomal, Esterified, Time-Release or mineral form of Vitamin C or Ascorbic Acid versus plain ascorbic acid?

Many companies claim their product has greater bioavailability, but the scientific, peer-reviewed literature simply does not support this claim. The few studies that do show differences point towards NOT using slow-release preparations of vitamin C. There is support for the use of mineral ascorbates, often called "buffered vitamin C". The main support is that it does not upset the stomach or cause diarrhea as easily as plain ascorbic acid. But this does not seem to affect absorption rates at all. Some of the buffered forms have too much calcium or sodium as well so you have to be careful.

Ester-C is another form that we have seen in various products. The study they used was not published in a peer-reviewed journal, so you have to take the evidence with a grain of salt, but there may be increased bioavailability of vitamin C in these products.

Last but not least, there is at least one study that shows that Liposomal encapsulated vitamin C may be better absorbed than other forms, and the study was peer-reviewed and published in 2016. This may show the best hope for finding a better quality vitamin C product, although larger-scale studies are needed.

In summary, I do recommend Liposomal vitamin C if possible, but I know lots of people who use regular vitamin C, ascorbic acid or buffered vitamin C products and honestly I think you are going to be fine with any of these products.

The other issue is absorption based on dosing.

You can simply not dose to 24,000mg daily orally. Nor SHOULD you dose to 8,000-12,000mg daily. In fact I would not recommend a dosing above 1,000mg 4x/day if treating an active infection or 1,000mg 2x/day if preventive. In fact some research shows that lower doses may be better absorbed and you are only going to actually absorb a small portion of these higher doses in oral form.

Best recommendations for my patients I tend to recommend somewhere between 500mg-1000mg 2-4x/day, but do not take less than every 4 hours.

I hope this helps clear up what we do and don't know about Vitamin C.

Let me know if you have more questions or are interested in getting Vitamin C and we will do all we can to help you out.

Yours in health,

Dr. Akiba Green