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Vitamin C offers some incredible health benefits. While it is generally associated with improved immunity and healthy skin, vitamin C also plays a significant role in the growth and repair of your connective tissues such as teeth, ligaments, cartilage, blood vessels and bones. And this is one of the reasons this popular vitamin is good for your heart and bone health. Can vitamin C help in joint pain too? Can vitamin C deficiency cause joint pain?
In this article, let’s explore if there is a link between vitamin C and joint health and also if this powerful anti-oxidant can help in joint pain.
Vitamin C in joint health
Vitamin C is good for joint health. While the trio of “calcium, vitamin D and magnesium” and exercise takes the spotlight when it comes to your bone health, vitamin C is equally important for healthy bones and joints.
You need vitamin C to make healthy collagen, which is a main structural protein present in your connective tissues of your bones and cartilages. Collagen gives strength and support to your tissues.
Vitamin C dependent collagen also provides a framework on which your bone mineral is laid out. In addition, vitamin C is required for the production of other proteins in the bone tissue.
And as an antioxidant, vitamin C also prevents and minimizes oxidative damage and inflammation in bone and other tissues.
Vitamin C is an important antioxidant that protects cells from the damage caused by free radicals. Environmental and lifestyle triggers such as air pollution, cigarette smoke, sun exposure, unhealthy diet, medications, infections, trauma and exposure to chemicals speed up the formation of free radicals in the body. These electron-snatching molecules cause oxidative damage to the cells, resulting in inflammation and premature ageing at the cellular level.
Food that we eat provides our body all the tools (in the form of vitamins, minerals and other antioxidants) that we need to limit this oxidative damage and chaos that damages tissues and organs and increases the risk of chronic disease.
All these properties highlight the importance of vitamin C in your bone health. In fact, its role in building and repairing collagen is what makes vitamin C indispensable to tissue repair, wound healing, skin health, and also heart health.
In addition, studies show that vitamin C deficiency may increase the risk of osteoporosis. Research suggest that vitamin C supplements can help maintain bone mineral density and lower the risk of fractures, especially in postmenopausal women.   
“Vitamin C is crucial for joint health. Your body needs vitamin C to make collagen, which is an important ingredient of the connective tissues of your bones, joints, and cartilages. Vitamin C also helps to maintain your bone density, reducing the risk of fractures in the elderly.”
Is vitamin C good for joint pain?
Preliminary studies suggest that it can be effective in reducing painful symptoms associated with rheumatoid arthritis (RA) and osteoarthritis (OA).
It offers benefits to people with early stages of OA and reduces oxidative stress and inflammation, linked with both OA and RA.
OA is a chronic condition caused by the break-down of cartilage, resulting in joint pain and stiffness. Many risk factors such as age, injuries, infections and obesity are involved in the degeneration and loss of cartilage. A cycle of tissue damage and inflammation that inevitably leads to further damage and pain.
As an antioxidant, vitamin C helps in lowering the risk of cartilage loss resulting from oxidative damage and inflammation.  
Antioxidant supplements such as zinc, magnesium, vitamin C and selenium can also help in addressing oxidative damage and inflammation in rheumatoid arthritis.  RA is an auto-immune disorder that causes inflammation, pain, stiffness and deformity in joints.
Many other studies have explored the link between vitamin C and pain. It appears that vitamin C can reduce pain and improve quality of life in conditions such as cancer, chronic regional pain syndrome and neuralgia. It can also help in limiting pain after surgery.
Vitamin C supplements can also help in preventing complex regional pain syndrome (CRPS), a painful condition that is typically experienced when a fracture heals. 
“Vitamin C supplements may help in reducing pain in rheumatoid arthritis (RA) and osteoarthritis (OA). It may work best for people in early stages of OA. Vitamin C benefits in joint pain may stem from its role in reducing oxidative stress and inflammation in tissues.”
How does vitamin C help in relieving pain?
A 2018 study discussed that vitamin C pain-relieving effects may be due to its antioxidant properties. It may protect nerves from oxidative damage. 
It appears that vitamin C reduces markers of inflammation and oxidative stress. This is no surprise as it is a powerful antioxidant. Additionally, vitamin C is involved in the production of neurotransmitters such as serotonin and norepinephrine.
These brain hormones are integrally involved in how your body controls pain. These hormones have a positive association with your mood, sleep, stress-response and emotional well-being, and possibly one of the reasons why vitamin C helps in reducing stress. Yes, you heard it right.
Vitamin C can be a powerful ally if you are looking to beat your stress through nutrition and supplements. Did you know your adrenal glands store the highest concentration of vitamin C in the body?
Vitamin C helps in smooth functioning of your adrenal glands, clears excess cortisol from your system, and helps in the production of certain brain chemicals that are linked with mood, anxiety and stress.
A 2017 study explored another mechanism through which vitamin C may help in reducing pain.  Researchers thought that vitamin C acts like opioids in reducing pain. Vitamin C improves the production of endomorphins, and these chemicals function as natural pain killers. Endorphins also reduce inflammation.
The study also found that vitamin C may also help in the production of calcitonin, that has been used to treat osteoporosis for years. Calcitonin lowers bone pain and pain associated with Paget’s disease, and complex regional pain syndrome. Calcitonin may enhance the release of endorphins, and these natural chemicals help in pain relief, making you feel good overall.
This study suggested that high-doses of vitamin C may be useful in postherpetic neuralgia where it reduced pain, possibly due to its role in the production of collagen and neurotransmitters. 
“Vitamin C may be used as an adjunct to reduce pain in certain conditions. It appears that its anti-inflammatory properties, and its role in the synthesis of certain hormones and in improving the production of endomorphins may be the reason why vitamin C could be helpful in reducing pain and inflammation.”
Can vitamin C deficiency cause joint pain?
Chronic vitamin C deficiency can spell disaster for the health of your tissues.
A severe shortage of vitamin C, over a period of three months or more, can cause scurvy. Lack of vitamin C means your body can’t make new collagen, which adversely affect the growth, repair, regeneration and healing of tissues.
Depletion of collagen weakens connective tissues and as the condition progresses, tissues begin to break down.
Vitamin C deficiency is responsible for:
- Disturbance in collagen production
- Defective formation of new bone (osteoid, which is made of collagen and other proteins)
- Increased destruction of bone tissues (a process known as bone resorption and that leads to bone loss)
- Weakening and breaking down of connective tissues
In fact, musculoskeletal symptoms are important indicators of scurvy. These signs include joint pain, muscle pain, and bleeding into a joint cavity and muscles.
Chronic alcoholics may develop latent scurvy presenting with extreme weakness and pain in legs. Vitamin C supplements can help improve these symptoms and improve the quality of life in such cases.
This paper explained that vitamin C is required for metabolism of carnitine, an amino acid that plays an important role in transporting fats to the mitochondria, and therefore in energy production. Low vitamin C levels impair the metabolism of carnitine and low levels of this amino acid can cause muscle pain and weakness. 
Children with scurvy are known to experience severe pain in lower limbs, that can lead to limpness and inability to walk. In fact, a 2020 paper highlighted scurvy to be cause of skeletal pain in young children of about 3 years of age. Children in this case report also presented signs that mimicked infections or malignant diseases. 
A study found that vitamin C deficiency appears to be more common in people with back pain. Low levels are linked with higher prevalence of neck pain, lower back pain and lower back pain with pain below the knee.
The authors concluded that “the association between vitamin C deficiency and spinal pain warrants further investigation to determine the possible importance of vitamin C in the treatment of back pain patients.” 
“Persistent vitamin C deficiency causes many symptoms including joint pain and muscle pain. Lack of vitamin C in the body interferes with the process of collagen synthesis, that leads to tissue break down and subsequent bleeding into joints and muscles.”
Some interesting facts about Vitamin C
- Protects against radiation exposure
- Helps in fat metabolism and energy production
- Maintains and boosts cardiovascular health
- May help manage high blood pressure
- Reduces risk of gout attacks
- Improves production of neurotransmitters that affect mood, anxiety, stress, pain response and sleep
- All mammals, except fruit bats, humans and guinea pigs, can make their own vitamin C.
- Smokers must consider increasing their vitamin C intake.
Vitamin C deficiency
While vitamin C deficiency is rare, certain conditions and lifestyle can cause your levels to go south. Vitamin C is present in most fresh fruit and vegetables.
Citrus fruits such as lemons, oranges and grapefruit are not the only good source of vitamin C. It is also found in guava, red and green peppers, Brussel sprouts, broccoli, strawberries, cauliflower, papaya, leafy greens, and tomatoes.
As cooking destroys most of the vitamin C present in our food, it is important to include fresh, whole foods in your diet to get your C.
Factors that may cause vitamin C deficiency include:
- Stress, infections and chronic diseases
- Smoking and alcohol abuse
- Restrictive eating and not eating enough fresh foods
- Conditions that affect the body's ability to digest and absorb food, such as Crohn's disease and ulcerative colitis.
Vitamin C levels have been found to be low in people with cancer, after trauma, surgery and sepsis. These conditions deplete vitamin C.
Depending on its severity and duration, vitamin C deficiency can cause a range of symptoms like red or purple spots on skin, easy bruising, poor wound healing, teeth loss and spontaneous bleeding such as nosebleeds and sudden bleeding from gums. Tissue break-down and bleeding into the joints is what causes pain in legs and joints.
Lack of vitamin C also causes anaemia, as the vitamin helps in iron absorption. This shortage results in exhaustion and weakness. Vitamin C shortage can also cause dry skin and splitting hair.
Liposomal vitamin C supplements
Oral vitamin C supplements are not easily absorbed by the body. However, supplements made by break-through liposomal technology addresses this challenge.
The content of the traditional oral supplements is mostly destroyed during digestion. As a result, only a small amount of the nutrient reaches cells. Liposomal supplements improve the bioavailability and absorption of the nutrients because these supplements use liposomes to deliver the nutrients directly to the cells. Liposomes are nano-sized bubbles that can safely carry and transport the enclosed nutrients to its delivery address … your cells and tissues.
Studies show that our body can absorb only a very small percent of the vitamin C that you get through regular oral supplements, usually in powder or tablet formulation. And when you take high doses, it can cause gastrointestinal side-effects such as bloating, diarrhoea and even nausea and heartburn in some cases. This can further compromise absorption and bioavailability.
Eating vitamin C-rich foods and taking vitamin C supplements will keep your bones and joints in good shape, mostly by building healthy collagen and healthy bones; improving bone mineral density; and reducing inflammation and oxidative damage in bone tissue.
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- Kim et al. Favorable effect of dietary vitamin C on bone mineral density in postmenopausal women (KNHANES IV, 2009): discrepancies regarding skeletal sites, age, and vitamin D status. Osteoporos Int. 2015
- Sahni et al. Protective effect of total and supplemental vitamin C intake on the risk of hip fracture: a 17-year follow-up from the Framingham Osteoporosis Study. Osteoporos Int 2009.
- Ripani et al. Vitamin C May Help to Reduce the Knee’s Arthritic Symptoms. Outcomes Assessment of Nutriceutical Therapy. Med Arch. 2019
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- Arablou et al. Association between dietary intake of some antioxidant micronutrients with some inflammatory and antioxidant markers in active Rheumatoid Arthritis patients. International Journal for Vitamin and Nutrition Research. 2019.
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- Schencking et al. Intravenous vitamin C in the treatment of shingles: results of a multicenter prospective cohort study. Med Sci Monit. 2012
- Christine Lux-Battistelli and Daniel Battistelli. Latent scurvy with tiredness and leg pain in alcoholics. Medicine (Baltimore). 2017
- Chalouhi et al. Scurvy: A New Old Cause of Skeletal Pain in Young Children. Frontiers in Pediatrics. 2020.
- Dionee et al. Serum vitamin C and spinal pain: a nationwide study. Pain. 2016.