Vitamin C Relieves Pain and Boosts Immunity

Many people have been using vitamin C supplements for decades to boost immunity during cold and flu season or to treat viral infections. High doses of vitamin C have been used intravenously by many holistic healthcare practitioners to treat chronic and life-threatening diseases. Did you know it is also helpful for treating pain?

Vitamin C and Pain

An excellent review of the research on vitamin C and the treatment of pain was published in the Journal of Translational Medicine. Interestingly, the authors report that various stressors on the body, including having a viral illness, trauma, surgery or cancer, can deplete the body’s vitamin C levels and result in the development of, or increases in, pain. They report that lower serum concentrations of vitamin C are found in those with many pain conditions compared with healthy controls. These include those with neck and back pain, arthritis, CRPS, postherpetic neuralgia (pain after a shingles infection), postsurgical pain and cancer pain.

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The same literature review reports that administering large doses of vitamin C to quickly normalize stores of vitamin C has a significant positive impact on pain levels in all of these conditions. Vitamin C has also been shown to reduce the dose of opioids needed post surgically or to control bone cancer pain.

Research also indicates that the body is limited in its ability to absorb large doses of vitamin C through oral administration, so that intravenous administration of vitamin C is often needed for optimum results once a person is ill. In addition, vitamin C has a short half-life, meaning that it is quickly eliminated from the body. Therefore, frequent dosing is necessary for optimum results.

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The mechanisms for how vitamin C helps pain are not well understood. It is a potent antioxidant and anti-inflammatory but its therapeutic benefits may extend beyond that. Vitamin C is also involved in the synthesis of many neurotransmitters that play a role in pain control.

How much Vitamin C is needed for pain relief?

For optimized pain relief, vitamin C supplementation can be beneficial, but the optimal dosage varies depending on the context and type of pain. Here are the key findings from the research:

Postoperative Pain: A 2 g preoperative dose of vitamin C has been shown to reduce postoperative morphine consumption, while a daily dose of 1 g for 50 days is effective in preventing complex regional pain syndrome (CRPS) after extremity surgery.
Foot and Ankle Trauma: Supplementation with 500 mg of vitamin C twice daily improved pain scores and reduced analgesic requirements in patients undergoing surgery for foot and ankle trauma.
Neuropathic Pain: In animal studies, vitamin C at 500 mg/kg enhanced the analgesic effect of gabapentin, suggesting a potential role in reducing neuropathic pain.
Tooth Extraction: A daily dose of 600 mg of vitamin C, taken in three doses, reduced pain scores and improved wound healing after tooth extraction4.
CRPS Prevention: A daily intake of at least 500 mg of vitamin C for 50 days post-surgery or injury significantly reduces the risk of developing CRPS, particularly in wrist fractures.
Acute Musculoskeletal Pain: A protocol involving 1000 mg of vitamin C twice daily for 14 days is being tested for its potential to reduce opioid consumption after emergency department visits for acute musculoskeletal pain.
Osteoarthritis (OA): Some studies suggest that vitamin C may help reduce symptoms of osteoarthritis, such as pain and inflammation, by protecting cartilage and reducing oxidative stress. It plays a role in collagen formation, which is crucial for maintaining joint health and may contribute to its protective effects in joint diseases.
Rheumatoid Arthritis (RA): Vitamin C, when used alongside standard treatments, has shown to improve pain scores and reduce inflammation in patients with rheumatoid arthritis.

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Vitamin C and Immunity

A 2019 review article published in the European Journal of Microbiology and Immunology reports that the “potent antioxidant, immunomodulatory, and anti-infectious effects of vitamin C are known since the 1930s” and that vitamin C has antimicrobial, antibacterial, antiviral, antiparasitic and antifungal properties. Studies have also shown that high doses of vitamin C, even in healthy subjects, increases the proliferation and activation of immune cells, including natural killer cells, microphages, neutropils, T lymphocytes and B lymphocytes.

For moderate infections such as colds or flu, oral doses of 1-2 grams/day have been shown to modestly reduce the duration and severity of symptoms. Higher doses of up to 10 grams/day in divided doses have been used in some cases, but high oral doses can cause diarrhea so IV administration is best. In serous infections, such as sepsis, pneumonia and COVID-19, intravenous administration of between 6 and 24 grams/day have been used.

The Chinese government approved multiple studies of intravenous vitamin C for the treatment of COVID-19, administering doses of 6000 mg/day and 12,000 mg/day for moderate and severe cases. The Shanghai government in early March, 2020 announced its official recommendation that COVID-19 should be treated with high doses of vitamin C, from 4000 to 16,000 mg per day administered by IV. According to Dr. Richard Cheng, a US board-certified specialist in anti-aging medicine reporting from China, ““Early and sufficiently large doses of intravenous vitamin C are critical. Vitamin C is not only a prototypical antioxidant, but also involved in virus killing and prevention of viral replication.”

Based on promising early results reported out of China, one large hospital system in the New York City area, Northwell Health, treated COVID-19 patients with high doses of intravenous vitamin C. The vitamin C was administered alongside other antiviral treatments. Dr Andrew Weber, a Long Island based pulmonologist and critical-care specialist with Northwell Health, says that patients with coronavirus who suffer sepsis - an inflammatory response that occurs when the body overreacts to the infection - suffer significant drops in vitamin C levels. 'It makes all the sense in the world to try and maintain this level of vitamin C,' he added.

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Contraindications:

Consult a physician if you have any of these conditions before supplementing with vitamin C:

A high amount of oxalic acid in urine
Iron metabolism disorder causing increasing iron storage
sickle cell anemia
Anemia from pyruvate kinase and G6PD deficiencies
Kidney disease

Difficulty Getting Recommended Doses of Vitamin C from Diet

It is difficult to get the recommended dosages of vitamin C from diet alone. For instance, an orange, a rich source of vitamin C, contains only 60-83 mg of vitamin C.

Conclusion

Vitamin C supplementation can aid in pain relief across various conditions, with dosages ranging from 500 mg to 2 g depending on the specific type of pain and severity. For postoperative and CRPS-related pain, higher doses and longer durations are recommended, while moderate doses are effective for trauma-related pain. Further research is needed to refine these recommendations and confirm the optimal dosages for different pain conditions. High doses of vitamin C can also be effective in preventing or treating many types of infections.

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