Do People with Interstitial Cystitis Need to Avoid Vitamin C?
I have noticed that there is a lot of confusion among interstitial cystitis sufferers about vitamin C and whether or not it should be avoided. In this month’s blog post, I hope to briefly clear up some of that confusion!
Those of you who have been with Tiny Pioneer from the beginning might remember that my first ever post on Tiny’s Blog was about liposomal vitamin C. At the time, liposomal supplements were still quite new and I had been curious to investigate whether liposomal ascorbic acid was any more bladder friendly than the ordinary stuff. One very painful bout of cystitis later, I was able to conclude that no, it is not! Although that first post did touch a little on different types of vitamin C, it did not explicitly answer the question that I am asked on a fairly regular basis: “Do I need to avoid vitamin C if I have interstitial cystitis?”
The succinct answer to that question is, “No.” The more detailed answer is below!
Vitamin C comes in different forms. In the supplement industry the most commonly used and cheapest form is called ascorbic acid. Ascorbic acid is also often used as the official chemical name for vitamin C in general. For those able to tolerate it, there is nothing wrong with using ascorbic acid, although you should be aware that much of it is synthetically produced from GMO corn. Unfortunately, most people with interstitial cystitis or bladder sensitivity are not able to tolerate supplemental ascorbic acid as it exacerbates their symptoms and can cause painful flares.
Ascorbic acid is not only used in food supplements; it is also commonly used as a flavouring or preservative within the food industry. IC sufferers should therefore make a habit of checking food and beverage labels for ascorbic acid – I can usually get away with tiny amounts used in foods, but I cannot tolerate the amount used in the popular hot lemon drinks sold as cold and flu remedies.
While most people with interstitial cystitis experience are not able to tolerate vitamin C in its ascorbic acid form, they are usually able to tolerate it in buffered or non-acidic forms. These forms can be recognised by their names, which will contain the word ‘buffered’ and/or will end in the word ‘ascorbate’. Buffered vitamin C is created when ascorbic acid is reacted with a mineral to create a non-acidic version of vitamin C. If a supplement describes itself as buffered, its packaging should still contain the word ‘ascorbate’, because as a consumer you need to know what mineral has been used to neutralise the ascorbic acid. You may, however, see the word ‘ascorbate’ with no reference to buffering – the fact that you are buying vitamin C in an ascorbate form automatically means that the product is buffered.
Ascorbic acid is commonly buffered with calcium, magnesium or sodium. It is occasionally buffered with potassium or zinc too. Any of these forms should be perfectly fine for the majority of interstitial sufferers to use. You don’t need to pay extra for a product described as bladder friendly or specifically aimed at the interstitial cystitis market. Just get yourself any powder or capsule that contains an ascorbate form of vitamin C! Remember to check the ingredients list carefully, because vitamin C is sometimes mixed with other ingredients which might not be bladder friendly. For example, if you bought a calcium ascorbate powder with added citrus flavonoids, the citrus flavonoids might cause a flare! As long as you check that the product contains only mineral ascorbates, or that any extra ingredients are suitable for those with IC, then you should be fine.
When you use vitamin C in ascorbate form, you not only get the vitamin C itself, but also the mineral that has been used as the buffer. If you feel you need more calcium in your diet, you could therefore choose a calcium ascorbate supplement. If instead you think you’d benefit from extra magnesium, you could use magnesium ascorbate. Not many people need extra sodium (and sodium ascorbate should not be used regularly or in excessive amounts by people who need to monitor their sodium intake), but sodium ascorbate is well absorbed and tends to be cheaper than other forms. Some vitamin C products come as mixed ascorbates which, as the name suggests, contain more than one mineral ascorbate!
For daily use I like to use magnesium ascorbate, because I am quite highly strung and I feel like being able to get extra magnesium with my vitamin C is an added bonus. If I feel a cold coming on and want to increase my vitamin C intake (to around 3 grams every four hours), I also incorporate calcium ascorbate and sodium ascorbate, as it is difficult to megadose to bowel tolerance with just one type of mineral ascorbate. Too much sodium and you become very thirsty. Too much magnesium and you end up with loose stools before you’ve reached bowel tolerance from the vitamin C itself.
I am sometimes asked if we make a standalone vitamin C product. We don’t at the moment, although our No 6, Please! B complex without B6 Capsules do provide 800mg of vitamin C per daily serving in magnesium ascorbate form. That is more than you will find in some standalone vitamin C capsules! There are several bladder friendly vitamin C supplements already available in the UK – you just haven’t been Googling the right things! Remember, any ascorbate will do – it doesn’t have to be specifically labelled as safe for IC. Just check that there are no bladder irritants like citrus bioflavonoids added. Here are some products that you might like to look at:
Nature’s Best Vitamin C Powder as calcium ascorbate. Perfect if you want a clean, affordable, simple powder with a calcium base.
Bio-Health Vitamin C Buffered. A clean and convenient calcium ascorbate capsule. Excellent value for money too!
Biocare Vitamin C Powder. This is the product I use as my every day basic vitamin C. It is a clean magnesium ascorbate powder and is perfect for flexible dosing. I love it! (You can usually buy it more cheaply at Dolphin Fitness than from Biocare, unless Biocare has a sale on.)
Health Plus Sodium Ascorbate Powder is a product I have used in addition to my normal vitamin C at times when I’ve wanted to megadose. It’s clean, cheap and simple!
You can also get sodium ascorbate capsules from Epigenetics.
Nowadays when megadosing I use Biocare Liposomal Vitamin C, which is sodium ascorbate in liposomal form. Unlike the liposomal ascorbic acid which caused me to have cystitis, I am fine with Biocare’s liposomal sodium ascorbate, even at high doses. It is too expensive for daily use, but is noticeably superior to other vitamin C that I have tried, so if I’ve been around someone who has a cold, I always take some of this! I get mine from Dolphin Fitness unless Biocare has a sale on.
These are just a selection of the products you could choose. You will find that powders are cheaper than capsules and they have the benefit of offering more flexible dosing. They are also cleaner, because they require no flow agents, fillers, or capsule shells. This is why I choose a powder as my daily source of vitamin C, only adding in capsules or liposomal liquids if I need to bring in extra products to fend off some kind of infection.
Before I finish, I will just quickly answer a few extra questions you might have.
Q: What about Ester-C – is that bladder friendly?
A: Yes! Ester-C is just a branded type of calcium ascorbate. Ester-C is bladder-friendly, but do be aware that many UK products containing Ester-C also contain citrus bioflavonoids which might irritate your bladder. Remember to check the ingredients list before buying! If the product only contains Ester-C and nothing else, it should be fine for you.
Q: Is L-ascorbic acid the same as ascorbic acid?
Q: Is calcium L-ascorbate the same as calcium ascorbate?
Q: What about vitamin C in foods? Do people with IC need to avoid foods that are high in vitamin C?
A: No, not unless the food itself is a known trigger. For example, red peppers are high in vitamin C, but are well tolerated by most people with interstitial cystitis. Oranges are high in vitamin C (though not as high as you might think!), but are usually not well tolerated by people with interstitial cystitis. It depends on the specific food, not its vitamin C content. There is no need to avoid all foods that contain vitamin C.
Q: What about food state vitamin C supplements such as acerola cherry powder?
A: It depends what food has been used to make the food state supplement! If the food used is a known bladder irritant then the supplement itself is likely to trigger a flare. If the food is IC friendly then the supplement should be IC friendly as well.
Q: What do you mean by supplements being clean?
A: I mean made without fillers, binders or flow agents. Some people find this very important; others are not bothered. It is up to you.
Q: How much vitamin C should I take?
A: That’s a decision for you and your health professional! Nutritionists generally recommend between 1 and 2 grams a day as the optimal every day amount. I personally take at least a couple of grams a day. If I have been around someone who is ill or I feel run down, I take extra. During times of infection, I try to take 3 grams every four hours, although this does produce a laxative effect so it is somewhat dependent on my schedule for the following day!
I hope this has helped to clear up some confusion so that you can choose a vitamin C product with confidence!
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