Vitamin C for preventing and treating the common cold.

BACKGROUND: The role of oral ascorbic acid (vitamin C) in the prevention and treatment of colds remains controversial despite many controlled trials. There have also been a number of efforts to synthesize and/or overview the results of these trials, and controversy over what these overviews tell us. OBJECTIVES: The objective of this review was to answer the following two questions: (1) Does regular high dosage supplementation with vitamin C reduce the incidence of colds? (2) Does taking vitamin C in high doses at the onset of a cold have a therapeutic effect? SEARCH STRATEGY: This review currently deals only with published trials from two previously published reviews by Kleijnen 1989 and Hemila 1992. SELECTION CRITERIA: Randomised and non-randomised trials of vitamin C taken to prevent or treat the common cold. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed trial quality. MAIN RESULTS: Thirty trials were included. The quality of the included trials was variable. Vitamin C in doses as high as one gram daily for several winter months, had no consistent beneficial effect on incidence of the common cold. For both preventive and therapeutic trials, there was a consistently beneficial but generally modest therapeutic effect on duration of cold symptoms. This effect was variable, ranging from -0.07% to a 39% reduction in symptom days. The weighted difference across all of the studies revealed a reduction of a little less than half a symptom day per cold episode, representing an 8% to 9% reduction in symptom days. There was no clear indication of the relative benefits of different regimes or vitamin C doses. However in trials that tested vitamin C after cold symptoms occurred, there was some evidence that a large dose produced greater benefits than lower doses. REVIEWER'S CONCLUSIONS: Long term daily supplementation with vitamin C in large doses daily does not appear to prevent colds. There appears to be a modest benefit in reducing duration of cold symptoms from ingestion of relatively high doses of vitamin C. The relation of dose to therapeutic benefit needs further exploration.