Ascorbic acid, also known as vitamin C, is an essential water-soluble vitamin. The symptoms of scurvy, which include bleeding and easy bruising, can be prevented with as little as 10 mg of vitamin C due to its association with collagen, but it can also be used to prevent a host of other disease processes (Sauberlich 1997).
Numerous people supplement their diet with vitamin C in order to prevent infection from viruses responsible for the common cold, yet research reviews over the last 20 years conclude that there is no significant impact on the incidence of infection (Hemila 1997). However, there are a few studies that show that certain groups of people who are susceptible to low dietary intake of vitamin C, such as marathon runners, may be less susceptible when supplementation is used. Furthermore, vitamin C may decrease the duration or severity of colds via an antihistamine effect when taken in large doses (Johnston et al. 1992).
There is some evidence that patients taking vitamin C supplements may have a reduced anticoagulant effect from warfarin or heparin. Increased doses of these anticoagulants might be advised to achieve therapeutic levels (Rosenthal 1971, Harris 1995). It is recommended that patients on anticoagulation therapy should limit vitamin C intake to 1 g/day. As always, the precise dosage regimen must be monitored by the appropriate lab studies. Since high doses may also interfere with certain laboratory tests such as serum bilirubin, creatinine, and stool guaiac assay, it is crucial to inquire about any over-the-counter supplementation with the vitamin (Hendler and Rorvik 2001). There is evidence that vitamin C may increase the inotropic effect of dobutamine in patients with abnormal left ventricular function. Infusion of vitamin C into individuals with normal heart function was shown to increase contractility of the left ventricle (Mak and Newton 2001). High doses of vitamin C may increase acetaminophen levels, while aspirin and oral contraceptives may lower serum levels of vitamin C (Houston and Levy 1976, Molloy and Wilson 1980, Rivers and Devine 1972).
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