Vitamin c as an anti inflammatory
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The Anti-Inflammatory Effects of Vitamin C: A Comprehensive Review
Introduction to Vitamin C and Inflammation
Vitamin C, also known as ascorbic acid, is a potent antioxidant with numerous health benefits, including its role in reducing inflammation. Inflammation is a biological response to harmful stimuli, and chronic inflammation is linked to various diseases such as diabetes, hypertension, and cardiovascular diseases. This article synthesizes recent research on the anti-inflammatory effects of vitamin C.
Vitamin C and Inflammatory Markers in Metabolic Diseases
Hypertension and Diabetes
A study involving hypertensive and/or diabetic obese adults demonstrated that vitamin C supplementation significantly reduced levels of high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6), both of which are key inflammatory markers. The participants who received 500 mg of vitamin C twice daily showed marked improvements in these markers compared to the control group, indicating the potential of vitamin C in managing inflammation associated with metabolic diseases1.
Postoperative Inflammation
In patients undergoing total knee arthroplasty, high doses of vitamin C (15 g) administered postoperatively resulted in decreased levels of CRP and erythrocyte sedimentation rate (ESR), which are indicators of inflammation. This reduction in inflammatory markers was associated with faster recovery and reduced need for opioid analgesics, highlighting vitamin C's role in postoperative care3.
Vitamin C and Exercise-Induced Inflammation
Ultramarathon Running
Vitamin C supplementation has been shown to attenuate the inflammatory response induced by prolonged exercise. In ultramarathon runners, a daily intake of 1500 mg of vitamin C significantly lowered post-race levels of cortisol, adrenaline, IL-10, and IL-1Ra compared to lower doses or placebo. This suggests that higher doses of vitamin C can mitigate the stress and inflammation associated with intense physical activity4.
Acute Exercise
Meta-analyses of randomized clinical trials have confirmed that vitamin C reduces oxidative stress and IL-6 levels following acute exercise. However, no significant effects were observed on other markers such as creatine kinase (CK) and muscle soreness, indicating that while vitamin C can reduce some aspects of exercise-induced inflammation, its effects may be limited to specific markers5.
High-Dose Vitamin C and Lipoprotein Function
Daily consumption of high-dose vitamin C (1250 mg) for eight weeks improved the antioxidant and anti-inflammatory properties of serum lipoproteins. This was evidenced by reduced levels of advanced glycated end products and reactive oxygen species (ROS) in lipoproteins, as well as decreased triglyceride content. These changes suggest that vitamin C can enhance the anti-inflammatory and anti-atherosclerotic properties of lipoproteins, particularly in smokers6.
Localized Anti-Inflammatory Effects
Gingivitis Treatment
Vitamin C has also been explored for its localized anti-inflammatory effects. In a study on persistent gingivitis, local injection of vitamin C using mesotherapy significantly reduced plaque and sulcus bleeding indices compared to a placebo. This indicates that vitamin C can effectively reduce localized inflammation and promote tissue repair in gingival tissues7.
Vitamin C in Critical Illness
In critically ill patients, vitamin C deficiency is common and can exacerbate inflammation and oxidative stress. High-dose intravenous vitamin C has been shown to reduce vasopressor support and organ dysfunction in conditions such as sepsis and trauma, suggesting its potential as an adjunctive therapy in critical care settings8.
Conclusion
The body of research indicates that vitamin C has significant anti-inflammatory effects across various conditions, from metabolic diseases and postoperative recovery to exercise-induced inflammation and critical illness. While the optimal dosage and administration method may vary depending on the condition, vitamin C's role as an anti-inflammatory agent is well-supported by current evidence. Further large-scale studies are needed to fully elucidate its therapeutic potential and establish standardized guidelines for its use.
Sources and full results
Most relevant research papers on this topic
Effect of vitamin C on inflammation and metabolic markers in hypertensive and/or diabetic obese adults: a randomized controlled trial
Vitamin C (500 mg twice daily) may help reduce inflammation and improve metabolic markers in hypertensive and/or diabetic obese patients without significant changes in total cholesterol.
RCT
Rigorous Journal
Highly CitedVitamin C and Immune Function
Vitamin C contributes to immune defense by supporting various cellular functions of both the innate and adaptive immune systems, enhancing microbial killing, and preventing and treating respiratory and systemic infections.
Very Rigorous JournalHighly CitedAnti-Inflammatory Effect of Vitamin C during the Postoperative Period in Patients Subjected to Total Knee Arthroplasty: A Randomized Controlled Trial
Vitamin C administration during the postoperative period reduces inflammation, leading to faster recovery and better healing outcomes for patients undergoing total knee replacement surgery.
RCTVitamin C supplementation attenuates the increases in circulating cortisol, adrenaline and anti-inflammatory polypeptides following ultramarathon running.
Vitamin C supplementation with 1500 mg per day reduces the adrenal stress hormone and anti-inflammatory polypeptide response to prolonged exercise in ultramarathon runners.
RCTHighly CitedEffects of vitamin C on oxidative stress, inflammation, muscle soreness, and strength following acute exercise: meta-analyses of randomized clinical trials
Vitamin C supplementation reduces oxidative stress and inflammation after a single bout of exercise, without affecting muscle soreness or strength.
Meta-AnalysisRigorous JournalConsumption of high-dose vitamin C (1250 mg per day) enhances functional and structural properties of serum lipoprotein to improve anti-oxidant, anti-atherosclerotic, and anti-aging effects via regulation of anti-inflammatory microRNA.
Daily consumption of a high dose of vitamin C (1250 mg) for 8 weeks improves anti-aging and anti-atherosclerotic effects by enhancing lipoprotein parameters and microRNA expression through anti-oxidation and anti-glycation.
Non-RCTEvaluation of anti-inflammatory effect of vitamin c using mesotherapy approach in the treatment of persistent gingivitis
Locally injected vitamin C using mesotherapy effectively reduces plaque and sulcus bleeding in persistent gingivitis patients compared to placebo at 1 week follow-up.
RCTVitamin C: should we supplement?
Intravenous vitamin C in pharmacological doses may reduce oxidative stress and inflammation in severe sepsis, trauma, and reperfusion after ischemia, potentially decreasing mortality.
Literature ReviewHighly CitedLong-term combined supplementations with alpha-tocopherol and vitamin C have no detectable anti-inflammatory effects in healthy men.
Long-term combined supplementation with alpha-tocopherol and vitamin C in reasonable doses shows no detectable anti-inflammatory effects in healthy men with slight hypercholesterolemia and no overt signs of inflammation.
RCTHighly CitedImpact of Vitamin C on Gene Expression Profile of Inflammatory and Anti-Inflammatory Cytokines in the Male Partners of Couples with Recurrent Pregnancy Loss
Vitamin C treatment improves sperm parameters and modulates inflammatory and anti-inflammatory gene expression in male partners of couples with recurrent pregnancy loss.
RCTRigorous Journal