High-Dose Vitamin C IV (IVC)

Full ingredient list

Exact amounts delivered in each size. Formulas are compounded per patient and can be adjusted by your provider.

Supporting studies

• 1

  Giving vitamin C by vein produces blood levels the digestive tract simply cannot achieve — up to roughly 60 times higher than the maximum tolerated oral dose.

  NIH investigators studied 17 healthy hospitalized volunteers, measuring plasma and urine vitamin C after matched oral and intravenous doses, then modeled doses from 1 to 100 grams. A 1.25 g dose produced mean peak plasma levels of 134.8 micromol/L taken orally versus 885 micromol/L given intravenously. Modeling predicted a ceiling of about 220 micromol/L for maximal oral dosing (3 g every 4 hours) compared with 13,400 micromol/L for a single 50 g IV dose. The authors concluded that oral vitamin C is tightly controlled by the body, and only intravenous administration produces these high plasma and urine concentrations.

  Clinical pharmacokinetic study in healthy volunteers with pharmacokinetic modeling Padayatty SJ, Sun H, Wang Y, Riordan HD, Hewitt SM, Katz A, Wesley RA, Levine M Vitamin C pharmacokinetics: implications for oral and intravenous use. Annals of Internal Medicine. 2004. PMID 15068981 ↗

• 2

  At the pharmacologic levels only IV dosing reaches, vitamin C switches roles and acts as a delivery system for hydrogen peroxide into tissue fluid — while blood itself stays unaffected.

  In this in vivo follow-up to the NIH group's landmark cell work, animals received ascorbate at doses equivalent to those used in humans. Intravenous injection raised concentrations from a 50-100 micromol/L baseline to peaks above 8 mM, while the identical dose given by mouth never exceeded 150 micromol/L. Ascorbate radical concentrations in extracellular fluid ran 4- to 12-fold higher than in blood, and hydrogen peroxide was detected in extracellular fluid only after parenteral dosing. The authors concluded that pharmacologic ascorbate acts as a prodrug that preferentially forms hydrogen peroxide in the extracellular space but not in the blood. (Route: intravenous/intraperitoneal versus oral.)

  Mechanistic/preclinical in vivo study Chen Q, Espey MG, Sun AY, Lee JH, Krishna MC, Shacter E, Choyke PL, Pooput C, Kirk KL, Buettner GR, Levine M Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo. Proceedings of the National Academy of Sciences of the USA. 2007. PMID 17502596 ↗

• 3

  In a nationwide NIH survey of more than 9,000 treated patients, high-dose intravenous vitamin C was found to be remarkably safe and well tolerated.

  Researchers at the National Institute of Diabetes and Digestive and Kidney Diseases surveyed practitioners who administered IV vitamin C, reviewed manufacturer sales data, and analyzed the FDA Adverse Events Database. Among 172 practitioners treating 11,233 patients in 2006 and 8,876 in 2008, the average dose was 28 grams. Of 9,328 patients with available data, only 101 reported any side effect, and these were mostly minor. The authors' stated conclusion was that, apart from known precautions in people with kidney impairment or G6PD deficiency, high-dose intravenous vitamin C 'appears to be remarkably safe.' (Route: intravenous.)

  Practitioner survey and adverse event database analysis Padayatty SJ, Sun AY, Chen Q, Espey MG, Drisko J, Levine M Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PLoS One. 2010. PMID 20628650 ↗

• 4

  Vitamin C concentrates inside white blood cells and directly boosts how well they hunt down, engulf, and kill microbes.

  This comprehensive review synthesizes the evidence on vitamin C across innate and adaptive immunity. It documents that vitamin C accumulates in phagocytic cells such as neutrophils and there enhances chemotaxis (the cells' ability to migrate toward infection), phagocytosis, generation of reactive oxygen species, and ultimately microbial killing. It also supports epithelial barrier function against pathogens and promotes oxidant-scavenging activity in the skin. The authors note that treating an established infection requires substantially higher doses than prevention, because inflammation and metabolic demand dramatically increase the body's vitamin C requirement.

  Comprehensive narrative review of human and mechanistic evidence Carr AC, Maggini S Vitamin C and Immune Function. Nutrients. 2017. PMID 29099763 ↗

• 5

  In a systematic review of randomized trials, intravenous vitamin C improved neutrophil chemotaxis — the ability of front-line immune cells to migrate toward an infection.

  This systematic review gathered randomized controlled trials measuring vitamin C's effect on specific neutrophil functions including migration, phagocytosis, oxidative burst, and apoptosis. Of three trials assessing neutrophil chemotaxis in hospitalized patients or outpatients, two showed improved neutrophil function following intravenous vitamin C administration. The authors specifically note that intravenous vitamin C delivers significantly higher plasma concentrations than oral dosing, making it the more effective route for achieving these cellular effects. (Route: intravenous.)

  Systematic review of randomized controlled trials Liugan M, Carr AC Vitamin C and Neutrophil Function: Findings from Randomized Controlled Trials. Nutrients. 2019. PMID 31487891 ↗

• 6

  Collagen literally cannot be built correctly without vitamin C — it is the required cofactor for the enzyme step that locks the collagen triple helix into shape.

  This National Cancer Institute review lays out the biochemistry linking vitamin C to connective tissue and wound healing. Ascorbate is required for the hydroxylation of proline residues in procollagen, and the resulting hydroxyproline is what stabilizes collagen's triple-helical structure. Because of this, ascorbate stimulates the secretion of procollagen from the cell. The paper connects this directly to the defective connective tissue and impaired wound healing seen when vitamin C is deficient.

  Mechanistic review with preclinical data Peterkofsky B Ascorbate requirement for hydroxylation and secretion of procollagen: relationship to inhibition of collagen synthesis in scurvy. The American Journal of Clinical Nutrition. 1991. PMID 1720597 ↗

• 7

  A double-blind randomized trial in 141 healthy adults found a single 10-gram IV vitamin C infusion measurably reduced fatigue within two hours — and the effect lasted a full day.

  Healthy office workers aged 20 to 49 were randomized double-blind to receive either 10 grams of vitamin C in saline intravenously or saline alone. Fatigue scores dropped significantly in the vitamin C group at two hours and remained lower at one day (p = 0.004). The infusion also raised plasma vitamin C levels and lowered markers of oxidative stress compared with placebo (both p < 0.001). Benefits were most pronounced in participants who started with lower baseline vitamin C. The authors concluded that high-dose intravenous vitamin C was safe and effectively reduced fatigue in this population. (Route: intravenous.)

  Double-blind randomized controlled trial Suh SY, Bae WK, Ahn HY, Choi SE, Jung GC, Yeom CH Intravenous vitamin C administration reduces fatigue in office workers: a double-blind randomized controlled trial. Nutrition Journal. 2012. PMID 22264303 ↗

• 8

  A meta-analysis of 18 controlled trials found vitamin C shortened ICU stays by nearly 8% and cut time on a ventilator by 18%.

  This meta-analysis pooled 18 controlled trials covering 2,004 patients to evaluate vitamin C's effect on intensive care outcomes. Across 12 trials with 1,766 patients, vitamin C reduced length of ICU stay by an average of 7.8% (95% CI 4.2% to 11.2%; p = 0.00003). In three trials of patients requiring mechanical ventilation beyond 24 hours, vitamin C shortened ventilation duration by 18.2% (95% CI 7.7% to 27%; p = 0.001). Six trials using oral vitamin C at 1-3 g/day showed an 8.6% reduction in ICU stay. (Routes: both oral and intravenous trials included.)

  Meta-analysis of controlled trials Hemilä H, Chalker E Vitamin C Can Shorten the Length of Stay in the ICU: A Meta-Analysis. Nutrients. 2019. PMID 30934660 ↗

• 9

  In a randomized trial of septic shock patients, high-dose IV ascorbic acid nearly halved the dose of blood-pressure-support medication needed and shortened how long it was required.

  Critically ill surgical patients in septic shock who required vasopressor support were randomized to 25 mg/kg intravenous ascorbic acid every 6 hours or matching placebo for 72 hours. Mean norepinephrine dose was significantly lower with ascorbic acid (7.44 vs 13.79 mcg/min, p = 0.004), as was the duration of norepinephrine administration (49.6 vs 71.6 hours, p = 0.007). Twenty-eight-day mortality was also significantly lower in the ascorbic acid group (14.3% vs 64.3%, p = 0.009). The authors concluded high-dose ascorbic acid may be an effective and safe adjuvant therapy in this setting. (Route: intravenous.)

  Randomized placebo-controlled trial Zabet MH, Mohammadi M, Ramezani M, Khalili H Effect of high-dose Ascorbic acid on vasopressor's requirement in septic shock. Journal of Research in Pharmacy Practice. 2016. PMID 27162802 ↗

• 10

  In severely burned patients, high-dose IV ascorbic acid cut resuscitation fluid requirements nearly in half and reduced tissue swelling.

  Thirty-seven patients with burns covering more than 30% of body surface area were randomized within two hours of injury to receive high-dose intravenous ascorbic acid (66 mg/kg per hour) plus standard Ringer lactate resuscitation, or standard resuscitation alone. The vitamin C group required substantially less fluid (3.0 ± 1.7 vs 5.5 ± 3.1 mL/kg per percent burn area), gained less weight from edema (9.2% vs 17.8%), and needed mechanical ventilation for far fewer days (12.1 ± 8.8 vs 21.3 ± 15.6). Markers of lipid peroxidation were also reduced. (Route: intravenous.)

  Randomized prospective clinical trial Tanaka H, Matsuda T, Miyagantani Y, Yukioka T, Matsuda H, Shimazaki S Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study. Archives of Surgery. 2000. PMID 10722036 ↗

• 11

  Vitamin C supplementation raised glutathione — the body's master antioxidant — inside red blood cells by nearly 50%.

  In this double-blind study, adults consumed vitamin C-restricted diets and took placebo for a baseline week, then 500 mg of L-ascorbate daily for two weeks, then 2,000 mg daily for two weeks, then placebo again. Mean red blood cell glutathione rose nearly 50% after the 500 mg period compared with baseline (p < 0.05), with individual increases ranging from +8% to +84%. The authors concluded that vitamin C supplementation maintains reduced glutathione concentrations in blood and improves the overall antioxidant protective capacity of blood. (Route: oral.)

  Double-blind human supplementation study Johnston CS, Meyer CG, Srilakshmi JC Vitamin C elevates red blood cell glutathione in healthy adults. The American Journal of Clinical Nutrition. 1993. PMID 8317379 ↗

• 12

  Vitamin C recharges spent vitamin E inside human cells, letting a single vitamin E molecule keep protecting cell membranes over and over.

  Working with intact human red blood cells, researchers showed that intracellular ascorbate both protects and recycles alpha-tocopherol (vitamin E). When cells were depleted of ascorbate, oxidants destroyed alpha-tocopherol to a much greater extent; when cells were loaded with ascorbate, alpha-tocopherol loss dropped significantly. Critically, ascorbate was consumed first and almost completely before alpha-tocopherol began to decline, demonstrating that vitamin C is spent to spare and regenerate vitamin E in the cell membrane.

  Mechanistic study in human cells May JM, Qu ZC, Mendiratta S Protection and recycling of alpha-tocopherol in human erythrocytes by intracellular ascorbic acid. Archives of Biochemistry and Biophysics. 1998. PMID 9448716 ↗

• 13

  Vitamin C markedly increases how much plant-source (non-heme) iron the body can actually absorb from a meal.

  This landmark human study measured non-heme iron absorption in 299 subjects using meals labeled with two different radio-iron isotopes, served with and without ascorbic acid to the same person. Ascorbic acid produced marked enhancement of iron absorption, with the most pronounced effects in meals high in phytates and tannins — the dietary compounds that normally block iron uptake. Crystalline ascorbic acid and naturally occurring ascorbic acid in foods worked equally well. The authors concluded ascorbic acid has a key physiologic role in facilitating non-heme iron absorption, with about 50 mg per main meal desirable for optimal effect. (Route: oral, with meals.)

  Human isotope-labeled absorption study Hallberg L, Brune M, Rossander L Effect of ascorbic acid on iron absorption from different types of meals. Studies with ascorbic-acid-rich foods and synthetic ascorbic acid given in different amounts with different meals. Human Nutrition. Applied Nutrition. 1986. PMID 3700141 ↗

• 14

  Vitamin C is a required cofactor for building carnitine, the molecule that shuttles fat into cells to be burned for energy.

  This review documents that ascorbate serves as a cofactor for two alpha-ketoglutarate-dependent dioxygenase reactions in the carnitine biosynthesis pathway: epsilon-N-trimethyllysine hydroxylase and gamma-butyrobetaine hydroxylase. Because carnitine is required for cells to generate metabolic energy from fat, the author notes this link has been proposed to explain the fatigue and weakness that characterize vitamin C deficiency. Evidence from enzyme preparations, perfused liver, and in vivo animal models is described as compelling support for ascorbic acid's participation in carnitine synthesis.

  Mechanistic review with enzyme and preclinical data Rebouche CJ Ascorbic acid and carnitine biosynthesis. The American Journal of Clinical Nutrition. 1991. PMID 1962562 ↗

• 15

  Vitamin C drives the conversion of dopamine into norepinephrine, boosting production of this key alertness and stress-response neurotransmitter several-fold.

  Using cultured human neuronal cells, researchers showed that cells supplied with dopamine generated intracellular norepinephrine at rates stimulated several-fold by intracellular ascorbate, which serves as the electron donor for the enzyme dopamine beta-hydroxylase. The effect was half-maximal at intracellular ascorbate concentrations of 0.2-0.5 mM, matching the known kinetics of the enzyme, and these levels were reached from extracellular concentrations under 25 micromol/L because the cells actively concentrate vitamin C. Ascorbate loading also prevented the rise in cellular superoxide caused by dopamine, showing it both fuels the enzyme and protects the cell.

  Mechanistic/preclinical cell study May JM, Qu ZC, Nazarewicz R, Dikalov S Ascorbic acid efficiently enhances neuronal synthesis of norepinephrine from dopamine. Brain Research Bulletin. 2013. PMID 23022576 ↗

References

• 1Padayatty SJ, Sun H, Wang Y, Riordan HD, Hewitt SM, Katz A, Wesley RA, Levine M. Vitamin C pharmacokinetics: implications for oral and intravenous use. Annals of Internal Medicine. 2004. PMID 15068981 ↗
• 2Chen Q, Espey MG, Sun AY, Lee JH, Krishna MC, Shacter E, Choyke PL, Pooput C, Kirk KL, Buettner GR, Levine M. Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo. Proceedings of the National Academy of Sciences of the USA. 2007. PMID 17502596 ↗
• 3Padayatty SJ, Sun AY, Chen Q, Espey MG, Drisko J, Levine M. Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PLoS One. 2010. PMID 20628650 ↗
• 4Carr AC, Maggini S. Vitamin C and Immune Function. Nutrients. 2017. PMID 29099763 ↗
• 5Liugan M, Carr AC. Vitamin C and Neutrophil Function: Findings from Randomized Controlled Trials. Nutrients. 2019. PMID 31487891 ↗
• 6Peterkofsky B. Ascorbate requirement for hydroxylation and secretion of procollagen: relationship to inhibition of collagen synthesis in scurvy. The American Journal of Clinical Nutrition. 1991. PMID 1720597 ↗
• 7Suh SY, Bae WK, Ahn HY, Choi SE, Jung GC, Yeom CH. Intravenous vitamin C administration reduces fatigue in office workers: a double-blind randomized controlled trial. Nutrition Journal. 2012. PMID 22264303 ↗
• 8Hemilä H, Chalker E. Vitamin C Can Shorten the Length of Stay in the ICU: A Meta-Analysis. Nutrients. 2019. PMID 30934660 ↗
• 9Zabet MH, Mohammadi M, Ramezani M, Khalili H. Effect of high-dose Ascorbic acid on vasopressor's requirement in septic shock. Journal of Research in Pharmacy Practice. 2016. PMID 27162802 ↗
• 10Tanaka H, Matsuda T, Miyagantani Y, Yukioka T, Matsuda H, Shimazaki S. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study. Archives of Surgery. 2000. PMID 10722036 ↗
• 11Johnston CS, Meyer CG, Srilakshmi JC. Vitamin C elevates red blood cell glutathione in healthy adults. The American Journal of Clinical Nutrition. 1993. PMID 8317379 ↗
• 12May JM, Qu ZC, Mendiratta S. Protection and recycling of alpha-tocopherol in human erythrocytes by intracellular ascorbic acid. Archives of Biochemistry and Biophysics. 1998. PMID 9448716 ↗
• 13Hallberg L, Brune M, Rossander L. Effect of ascorbic acid on iron absorption from different types of meals. Studies with ascorbic-acid-rich foods and synthetic ascorbic acid given in different amounts with different meals. Human Nutrition. Applied Nutrition. 1986. PMID 3700141 ↗
• 14Rebouche CJ. Ascorbic acid and carnitine biosynthesis. The American Journal of Clinical Nutrition. 1991. PMID 1962562 ↗
• 15May JM, Qu ZC, Nazarewicz R, Dikalov S. Ascorbic acid efficiently enhances neuronal synthesis of norepinephrine from dopamine. Brain Research Bulletin. 2013. PMID 23022576 ↗