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Does vitamin C help sepsis?

No. In 18 hospital trials with 3,364 patients, vitamin C given by IV drip did not lower deaths from sepsis (grade A), and in the largest trial, 872 adults in intensive care had more death or lasting organ failure with it than with a placebo. No trial has tested vitamin C pills as a sepsis treatment. Sepsis is an emergency: call 911 and get hospital care fast.

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How we grade evidenceEditorial policy

What the studies found

  • Grade A. Pooling 18 trials (3,364 patients with sepsis or septic shock), vitamin C given by IV did not lower short-term deaths. It shortened the time on blood-pressure drugs a little and nudged organ-failure scores down, but side effects were more common. (Liang 2023)
  • Grade B. In the LOVIT trial, 872 adults in intensive care whose sepsis needed blood-pressure drugs got IV vitamin C or a placebo for up to 4 days. By day 28, 44.5% of the vitamin C group had died or still had organ failure, against 38.5% with placebo. (Lamontagne 2022)
  • Grade B. Two US trials found no benefit either. Adding IV vitamin C, thiamine and hydrocortisone did not give 501 adults more days off ventilators and blood-pressure drugs, and IV vitamin C alone did not improve organ failure in 167 people with sepsis and lung injury. (Sevransky 2021, Fowler 2019)
  • Grade B. Over 90 days to a year, the 10 trials that followed people that long (7,096 patients) found no fewer deaths with vitamin C, thiamine (vitamin B1), steroids, or any mix of them. (Fujii 2022)

Who should be careful

  • Call 911 for possible sepsis. The CDC lists clammy or sweaty skin, confusion, extreme pain, fever or shivering or feeling very cold, a high heart rate or weak pulse, and shortness of breath as signs.
  • After a hospital stay for sepsis, check any new supplement with the care team, especially if your kidneys were affected.
  • Vitamin C pills: the adult upper limit is 2,000 mg a day, and high intakes can cause diarrhea and cramps and may add to kidney stone risk in people with kidney problems (NIH ODS).
  • Pregnant or breastfeeding, or under 18: ask a clinician first.
  • Don't stop or change a prescribed medicine on your own.

Try first

  • Fast hospital treatment. In 49,331 people with sepsis in New York hospitals, every hour that antibiotics were delayed went with a higher chance of death. (Seymour 2017)
  • Know the warning signs and act on them the same day, for yourself or someone you care for.

Sources

  1. Liang B, et al. The outcome of IV vitamin C therapy in patients with sepsis or septic shock: a meta-analysis of randomized controlled trials. Crit Care. 2023. PubMed 36915173 · doi:10.1186/s13054-023-04392-y
  2. Lamontagne F, et al. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. N Engl J Med. 2022. PubMed 35704292 · doi:10.1056/NEJMoa2200644
  3. Sevransky JE, et al. Effect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis: The VICTAS Randomized Clinical Trial. JAMA. 2021. PubMed 33620405 · doi:10.1001/jama.2020.24505
  4. Fowler AA 3rd, et al. Effect of Vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe Acute Respiratory Failure: The CITRIS-ALI Randomized Clinical Trial. JAMA. 2019. PubMed 31573637 · doi:10.1001/jama.2019.11825
  5. Fujii T, et al. Effect of adjunctive vitamin C, glucocorticoids, and vitamin B1 on longer-term mortality in adults with sepsis or septic shock: a systematic review and a component network meta-analysis. Intensive Care Med. 2022. PubMed 34750650 · doi:10.1007/s00134-021-06558-0
  6. Seymour CW, et al. Time to Treatment and Mortality during Mandated Emergency Care for Sepsis. N Engl J Med. 2017. PubMed 28528569 · doi:10.1056/NEJMoa1703058