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Vitamin C and Ferritin


Does High Dose Vitamin C Administration Elevate Serum Ferritin Levels?
or
Does Hypovitaminosis C Cause Increased Ferritin Levels?

Ascorbic acid, Ascorbate, or otherwise commonly known as vitamin C, plays a crucial role in various physiological processes, including iron metabolism.

Vitamin C, as an antioxidant, plays a role in enhancing the absorption of nonheme iron (the form of iron found in plant-based foods and supplements) and in converting ferric iron (Fe³⁺) to ferrous iron (Fe²⁺), which is more easily absorbed by the body. By facilitating iron absorption, vitamin C helps maintain optimal iron levels and prevents iron deficiency.

Ferritin is a protein that stores iron within cells and is released into the bloodstream when iron stores are excessive. Elevated ferritin levels are often indicative of increased iron stores or iron overload in the body. Serum ferritin concentration is an indicator of total body iron stores.

Ascorbate deficiency, also known as Hypovitaminosis C, can affect serum ferritin concentration by hampering iron mobilization from storage sites, resulting in increased ferritin levels.

When ascorbate levels are low, deficient, or depleted, the ability to convert ferric iron to ferrous iron is compromised. As a result, iron absorption decreases, leading to reduced iron availability for erythropoiesis (the production of red blood cells) and increased iron deposition in tissues, including the liver, heart, and endocrine glands. The accumulation of iron in these organs can lead to organ dysfunction and damage.

Ascorbate deficiency can have significant effects on serum ferritin concentration in patients with S-thalassemia major and iron overload.

In cases of iron overload, or high ferritin levels, vitamin C does not directly contribute to further elevations in ferritin. Rather, in the context of iron overload, low ascorbate levels can contribute to elevated serum ferritin concentrations.

Furthermore, recent studies have shown that injection of vitamin C could reduce serum ferritin levels in hemodialysis patients. Therefore, intravenous vitamin C can be used as an adjunct in the treatment of anemia in these patients, as safe, effective, and affordable therapy, with few known complications in hemodialysis patients.

https://pubmed.ncbi.nlm.nih.gov/35271495/

It is important to note that vitamin C should be used with caution in individuals with iron overload disorders such as hereditary hemochromatosis. Excessive vitamin C intake in these individuals can potentially enhance iron absorption and worsen iron overload.

In addition, studies have demonstrated that ascorbate deficiency alone is not the primary cause of iron overload in S-thalassemia major patients. The major contributors are chronic blood transfusions and ineffective erythropoiesis. Moreover, ascorbate deficiency exacerbates the iron overload condition by impairing iron absorption and promoting iron retention in tissues, leading to increased serum ferritin levels.

https://pubmed.ncbi.nlm.nih.gov/7085892/

https://pubmed.ncbi.nlm.nih.gov/33772531/

To manage iron overload in S-thalassemia major patients, a comprehensive approach is required. This typically involves regular monitoring of iron parameters, such as serum ferritin, and the use of iron-chelating agents to remove excess iron from the body. Additionally, maintaining adequate ascorbate levels through dietary sources and daily supplementation can support iron absorption and mitigate further complications associated with iron overload.

To summarize, vitamin C does not contribute to elevated ferritin levels. Instead, it supports iron absorption and can help maintain optimal iron levels in the body.

https://pubmed.ncbi.nlm.nih.gov/35807904/

Therefore, if you have concerns about iron levels or iron overload, it is recommended to consult with a healthcare professional for personalized advice regarding vitamin C intake as an antioxidant or pro-oxidant therapy.


Authors: Lior Sher, JD, and Richard Fleming, PhD, MD, JD