Vitamin C and Immune Function
Open accessAbstract
Vitamin C is an essential micronutrient for humans, with pleiotropic functions related to its ability to donate electrons. It is a potent antioxidant and a cofactor for a family of biosynthetic and gene regulatory enzymes. Vitamin C contributes to immune defense by supporting various cellular functions of both the innate and adaptive immune system. Vitamin C supports epithelial barrier function against pathogens and promotes the oxidant scavenging activity of the skin, thereby potentially protecting against environmental oxidative stress. Vitamin C accumulates in phagocytic cells, such as neutrophils, and can enhance chemotaxis, phagocytosis, generation of reactive oxygen species, and ultimately microbial killing. It is also needed for apoptosis and clearance of the spent neutrophils from sites of infection by macrophages, thereby decreasing necrosis/NETosis and potential tissue damage. The role of vitamin C in lymphocytes is less clear, but it has been shown to enhance differentiation and proliferation of B- and T-cells, likely due to its gene regulating effects. Vitamin C deficiency results in impaired immunity and higher susceptibility to infections. In turn, infections significantly impact on vitamin C levels due to enhanced inflammation and metabolic requirements. Furthermore, supplementation with vitamin C appears to be able to both prevent and treat respiratory and systemic infections. Prophylactic prevention of infection requires dietary vitamin C intakes that provide at least adequate, if not saturating plasma levels (i.e., 100–200 mg/day), which optimize cell and tissue levels. In contrast, treatment of established infections requires significantly higher (gram) doses of the vitamin to compensate for the increased inflammatory response and metabolic demand.
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Biochemically, vitamin C plasma levels below 11 μM are considered to coincide with clinical symptoms of scurvy.
“Biochemically, vitamin C plasma levels below 11 µM are considered to coincide with clinical symptoms of scurvy.”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [157]
The Introduction defines plasma vitamin C below 11 µmol/L as deficiency and says severe deficiency causes scurvy. It does not say that crossing the 11 µmol/L threshold coincides with clinical symptoms of scurvy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredTypical symptoms of scurvy include muscle weakness, swollen and bleeding gums, loss of teeth, petechial hemorrhaging, spontaneous ecchymoses, anemia, impaired wound healing, hyperkeratosis, weakness, myalgia, arthralgia, and weight loss.
“Typical symptoms of scurvy are muscle weakness, swollen and bleeding gums, loss of teeth, petechial hemorrhaging, spontaneous ecchymoses, anemia, impaired would healing, hyperkeratosis, weakness, myalgia, arthralgia, and weight loss”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [157]
Section 2, “Barrier Integrity and Wound Healing” (page unavailable), describes scurvy as characterized by bleeding gums, bruising, and impaired wound healing. It does not support the full symptom list, including tooth loss, anemia, hyperkeratosis, joint pain, and weight loss. (LLM, conf=0.87)
Experimental — accuracy not yet measuredAs vitamin C decreases the expression of proinflammatory mediators, it has important anti-inflammatory properties, especially during infection and wound healing.
“As vitamin C decreases the expression of proinflammatory mediators, it has important anti-inflammatory properties, especially during infection and wound healing138.”
From Key points for the development of antioxidant cocktails to prevent cellular stress and damage caused by reactive oxygen species (ROS) during manned space missions (2021) · cites this paper as [138]
Section 2 (Barrier Integrity and Wound Healing) says vitamin C decreases expression of pro-inflammatory mediators during wound healing. Section 3.6 (Inflammatory Mediators) reports reduced pro-inflammatory cytokines in some infection-related settings, but also says vitamin C’s effects depend on cell type and inflammatory stimulus. The claim overstates those context-dependent findings as a general decrease. (LLM, conf=0.84)
Experimental — accuracy not yet measuredVitamin C is important for the differentiation and function of immune cells and epithelial barrier cells.
“It can be shortly summarized that vitamin C is important for the differentiation and function of immune cells and epithelial barrier cells.”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [157]
Vitamin C is crucial for immune system function.
“Vitamin C is crucial for immune system function [1,2,3,4] and protects against damage from reactive oxygen species [5,6].”
From Enhanced Vitamin C Delivery: A Systematic Literature Review Assessing the Efficacy and Safety of Alternative Supplement Forms in Healthy Adults (2025) · cites this paper as [2]
Vitamin C prevents leucocyte adhesion to endothelial cells caused by both oxidized LDL and cigarette smoke.
“it prevents leucocytes adhesion to endothelial cells caused by both oxidized LDL and cigarette smoke [157]”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [157]
Section 4 reports that vitamin C may protect against oxidative damage associated with tobacco smoke, and Section 3 discusses leukocyte function. Neither passage addresses prevention of leukocyte adhesion to endothelial cells caused by cigarette smoke or oxidized LDL. Searches for endothelial adhesion and oxidized LDL found no passage stating the claimed effect. (LLM, conf=0.75)
Experimental — accuracy not yet measuredAscorbic acid recovers α-tocopherol from the α-tocopherol radical.
“Here, the ascorbic acid seems to play a crucial role since it recovers α-tocopherol [157].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [157]
The Introduction describes vitamin C as an electron-donating antioxidant, but does not say it regenerates α-tocopherol from its radical. Searches for tocopherol-radical regeneration and vitamin E recycling returned only related references, not a passage stating that mechanism in this paper. (LLM, conf=0.75)
Experimental — accuracy not yet measuredSymptoms of scurvy are not seen unless the total vitamin C content in the body falls below 300-400 mg.
“Similarly, symptoms are not seen unless the total vitamin C content in the body falls below 300–400 mg [2,3,6,157,170].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [157]
The Introduction says severe vitamin C deficiency causes scurvy and gives an approximate daily intake needed to prevent it, but it does not give a total-body vitamin C threshold for symptoms. Searches for 300–400 mg and for body-store thresholds found no passage stating the claimed cutoff; pages were not available in our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measuredHigh-dose vitamin C improves how innate and adaptive immune cells work.
“A compelling hypothesis is offered by the utilization and combination of high-dose vitamin C, which is known to enhance the function of both innate and adaptive immune cells109,110.”
From Targeting cancer vulnerabilities with high-dose vitamin C (2019) · cites this paper as [109]
Higher levels of vitamin C are required during infection to compensate for the increased inflammatory response and metabolic demand induced by the pathogen, and thus help to reduce the duration and severity of symptoms.
“while higher levels are required during infection to compensate for the increased inflammatory response and metabolic demand induced by the pathogen, and thus help to reduce the duration and severity of symptoms [12].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [12]
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Flagged first, then by citations
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“As for vitamin C, even though its role as an antioxidant agent [77,78] and necessary micronutrient for leukocyte function is well recognized [79], a few positive findings were reported in some trials but results were largely inconsistent in relation to most outcomes.”
ResultEl Attar, Y., Doghaim, N., El Far, N., El hedody, S., & Hawwam, S. A. (2022) · Journal of Cosmetic Dermatology · doi:10.1111/jocd.14538 · Cited by 26 · see citing works
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“157 However, studies indicate that daily supplementation exceeding the tolerable upper intake level (2000 mg) in adults may cause adverse reactions such as diarrhea, headaches, gastrointestinal discomfort, and an increased risk of other diseases, impacting patients’ quality of life and potentially…”
Rajat, S., Thanawala, S., & Abiraamasundari, R. (2022) · Journal of Pharmacology and Pharmacotherapeutics · doi:10.1177/0976500x221111669 · Cited by 4 · see citing works
- Authors
- Carr, A., & Maggini, S.
- Affiliations
- University of Otago (NZ)
- Bayer (Switzerland) (CH)
- Corresponding author
- Carr, Anitra
- ORCID
- Carr, Anitra
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2017-11-03
- Volume
- 9
- Issue
- 11
- Pages
- 1211
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC5707683
- OpenAlex
- W2766820812
- Cited by
- 2,035
- References
- 256
- Citations by year
- 2026: 190 · 2025: 267 · 2024: 261 · 2023: 287 · 2022: 319 · 2021: 328 · 2020: 274 · 2019: 65 · 2018: 38 · 2017: 4 · 2016: 1
- FWCI
- 10.69
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Health Research Council of New Zealand (16/037)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Vitamin C and Antioxidants Research
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Keywords
- vitamin C, immune function, antioxidants, innate immunity, adaptive immunity, epithelial barrier function, neutrophils, phagocytosis, reactive oxygen species, NETosis, apoptosis, lymphocyte differentiation, scurvy, infection susceptibility, vitamin C supplementation, respiratory infections, systemic infection, inflammation, oxidative stress
- MeSH terms
- Animals, Antioxidants, Ascorbic Acid, Ascorbic Acid Deficiency, Communicable Diseases, Humans, Immune System, Immunity, Innate, Leukocytes, Wound Healing, Dietary Supplements, Adaptive Immunity
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