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Ascorbic Acid

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From Pharmacopedia
Ascorbic acid (vitamin C)
Generic; huge OTC presence

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Summary
Common uses
Scurvy (vitamin C deficiency)0, Enhancement of nonheme iron absorption0, Urinary acidification (selected, e.g. methemoglobinemia treatment adjunct)0, General supplementation (limited evidence for prevention of common cold or other indications)0
Pharmacy
Starting dose
General supplementation 75-90 mg/d (RDA); scurvy treatment 100-1000 mg/d for several weeks; megadose claims unsupported
Preparations
100, 250, 500, 1000 mg tablets, chewables, gummies, effervescent; IV (specialty)
US FDA Max
UL 2000 mg/d in adults
Pharmacology
Routes
Oral, IV
Onset
Days for symptom improvement in scurvy
Duration
Hours
Half-life
~10-20 days (steady-state body pool); single dose plasma ~2 hours
Bioavailability
~70-90% at typical doses; saturable at high doses (>500 mg)
Pregnancy
Safe at routine doses; routinely supplemented in pregnancy.[citation needed]
Legal status
OTC in US
Purported mechanism
Ascorbate is an essential cofactor for hydroxylase enzymes including prolyl and lysyl hydroxylases (collagen synthesis), dopamine β-hydroxylase, and the demethylating Fe(II)/α-ketoglutarate-dependent dioxygenases (including TET enzymes in DNA demethylation); it also serves as a major water-soluble antioxidant, recycling other antioxidants like tocopherol and glutathione.0 Deficiency (scurvy) presents with hemorrhagic gums, perifollicular hemorrhage, hair coiling, fatigue, and poor wound healing — direct consequences of impaired collagen cross-linking. Megadose claims for cold prevention and other indications are not supported by high-quality evidence beyond minor effects on cold duration in some studies. High-dose supplementation may raise risk of oxalate kidney stones in predisposed individuals.

References

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