Special Diets

Caution: People with the following conditions should consult their doctor before supplementing with vitamin C: glucose-6-phosphate dehydrogenase deficiency, iron overload (hemosiderosis or hemochromatosis), history of kidney stones, or kidney failure.

Some people develop diarrhea after as little as a few grams of vitamin C per day, while others are not bothered by ten times this amount. Strong scientific evidence to define and defend an upper tolerable limit for vitamin C is not available. A review of the available research concluded that high intakes (2–4 grams per day) are well-tolerated by healthy people.¹¹

It is widely (and mistakenly) believed that mothers who consume large amounts of vitamin C during pregnancy are at risk of giving birth to an infant with a higher-than-normal requirement for the vitamin. The concern is that the infant could suffer “rebound scurvy,” a vitamin C deficiency caused by not having this increased need met. Even some medical textbooks have subscribed to this theory.¹² In fact, however, the concept of “rebound scurvy” in infants is supported by extremely weak evidence.¹³ Since the publication in 1965 of the report upon which this mistaken notion is based, millions of women have consumed high amounts of vitamin C during pregnancy and not a single new case of rebound scurvy has been reported.¹⁴

A preliminary study found that people who took 500 mg per day of vitamin C supplements for one year had a greater increase in wall thickness of the carotid arteries (vessels in the neck that supply blood to the brain) than those who did not take vitamin C.¹⁵ Thickness of carotid artery walls is an indicator of progression of atherosclerosis. Currently, no evidence supports a cause-and-effect relationship for the outcome reported in this study. The vast preponderance of research suggests either a protective or therapeutic effect of vitamin C for heart disease, or no effect at all.

It has been suggested that people who form calcium oxalate kidney stones should avoid vitamin C supplements, because vitamin C can be converted into oxalate and increase urinary oxalate.^{16, 17} Initially, these concerns were questioned because of potential errors in the laboratory measurement of oxalate.^{18, 19} However, using newer methodology that rules out this problem, recent evidence shows that as little as 1 gram of vitamin C per day can increase the urinary oxalate levels in some people, even those without a history of kidney stones.^{20, 21} In one case, 8 grams per day of vitamin C led to dramatic increases in urinary oxalate excretion and kidney stone crystal formation causing bloody urine.²² People with a history of kidney stones should consult a doctor before taking large amounts (1 gram or more per day) of supplemental vitamin C.

Despite possible therapeutic effects of vitamin C in people with diabetes at lower intakes, one case of increased blood sugar levels was reported after taking 4.5 grams per day.²³