Skeptic Hat: Sorry To Burst Your Fizzy Vitamin C Bubbles, But You're Getting Ripped Off

You can't imagine how scary vitamins are to write about. This is an industry at war. With the American Medical Association, science, pharmaceutical companies, the press, doctors. . . holy jeeze. And it's huge. A few years ago, the vitamin industry in America was estimated at about $6 billion; it's only grown during the recession. (Click the link to see the logic behind that.)

Also, this chapter from Ben Goldacre's book Bad Science about vitamin peddler and titan of industry (ahem, scumbag, ahem) Matthias Rath, who endangered the lives of thousands by claiming his supplements could cure AIDS and then sued a Guardian journalist (unsuccessfully) for writing about it, is 100 percent necessary reading if you're still under the impression the vitamin business is a benevolent alternative to a sinister pharmaceutical industry (whose dirt I think we're all a bit more aware of).

So you have a massive push and pull between two fronts of the health industry, alternative medicine and evidenced-based medicine, and the actual public health. Not to mention that there is a ton of research about vitamins and what they might and might not do — vitamin C and the common cold being a prime example. A search on PubMed for articles to use with this post basically sent me into information overload. Which makes vitamin C a kind of neat exception in the world of alternative medicine, which tends to use a lack of research on its remedies to its advantage.

Anyhow, vitamin C bombing — taking huge doses — has been a pretty big thing for a good while now. Emergen-C, those little fizzy packets, was created in 1994 but it seems like it took a while longer to hit mainstream saturation. (At least I don't remember seeing it at every drug store checkout until sometime last decade.) Meanwhile, Airborne, the candy-ish vitamin C tablets, made it to Trader Joe's in 1997 and beyond in 1999. It's since gotten into trouble a few times, in 2006 for basically making up a testing facility, and then in a class-action lawsuit in 2008 for making the bogus claim that it can cure stuff. Quoth the FTC:

Like Emergen-C, Airborne's hitting you with 1000 mg of vitamin C. (I think some editions of both product go higher.) Notably that's the same vitamin C you might get in any vitamin pill, albeit with a slick marketing campaign, some extra sugar. and a wicked markup. A box of Emergen-C, 36 packets of 1000 mg each, goes for around $15, while a generic bottle of 1000 500 mg tablets can be had for $40. That's .008 cents/mg versus 1 cent/mg.

In either case, most of those mg's are literally going down the toilet. 1000 mg might as well be arbitrary as a dosage: go above 500 mg and you pee it out. All your tissues are as vitamin C saturated as they can get. While at only 200 mg, your bloodstream is nearing 80-percent maximum concentration, according to a 1999 National Institutes of Health study.

It looks like you could probably bomb the hell out of your body with vitamin C and be OK, especially compared to a lot of things. But it's not without risks: there's been some correlation shown with vitamin C bombing and kidney stones; taken as ascorbic acid, vitamin C can lead to indigestion and diarrhea; a study in the 1930s stuffed a bunch of people with 6 grams of vitamin C a day for almost five years, finding some toxic effects. It'd take a couple of pounds of straight-up vitamin C to straight up kill a 150 pound person. (Though, that's based on research in rats, so please don't test it out.)

But why are you doing this in the first place? Some of it's marketing, some of it traces back to Linus Pauling, a researcher that released a book in 1970 advocating so-called megadoses of vitamin C. As things tend to go in alt-medicine it, well, caught on. Anecdote spurs flawed research study spurs anecdote spurs more marketing. And here we are.

Research since Pauling's book has been fairly conclusive that going above 200 mg a day with vitamin C is worthless for normal people. For marathon runners and people that live in very cold climates, going up to 250 mg to 1000 mg a day can cut cold incidence down by up to 50-percent. I suspect that is not you; it sure isn't me. (Though I did live in the statistical coldest town in the lower 48 for a number of years, for what it's worth.)

A meta-analysis done in 2005, covering studies done from 1940 through 2004, found no discernible difference in 23 community subgroups bombing regularly with up to 2 grams of vitamin C a day. Likewise, no effects were shown for subjects that started taking vitamin C at the outset of symptoms, which is how I usually see Emergen-C being used (and, well. . . the name). One finding in the meta-analysis, published in PLoS Medicine, was that subjects taking high doses of vitamin C on a regular basis to prevent colds wound up shortening their sickness time by about 8-percent.

The conclusion:

Please note that 250 mg of vitamin C is what you should be getting anyhow. That's the recommended five servings or fruits and vegetables a day, nothing revolutionary. An orange, for example, delivers about 70 mg of vitamin C per fruit.

There's a whole other discussion here, of course, about the placebo effect and why things might seem to work that actually don't. And how that information spreads, but let's save it for now.

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Reach this writer at michaelb@motherboard.tv.

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