Background: Vitamin C, traditionally associated with scurvy, is an important nutrient for
maintaining bone health. It is essential in the production of collagen in bone matrix. It also scavenges
free radicals detrimental to bone health.
Objective: This review aims to assess the current evidence of the bone-sparing effects of vitamin C derived
from cell, animal and human studies.
Results: Cell studies showed that vitamin C was able to induce osteoblast and osteoclast formation.
However, high-dose vitamin C might increase oxidative stress and subsequently lead to cell death. Vitamin
C-deficient animals showed impaired bone health due to increased osteoclast formation and decreased
bone formation. Vitamin C supplementation was able to prevent bone loss in several animal
models of bone loss. Human studies generally showed a positive relationship between vitamin C and
bone health, indicated by bone mineral density, fracture probability and bone turnover markers. Some
studies suggested that the relationship between vitamin C and bone health could be U-shaped, more
prominent in certain subgroups and different between dietary and supplemental form. However, most
of the studies were observational, thus could not confirm causality. One clinical trial was performed,
but it was not a randomized controlled trial, thus confounding factors could not be excluded.
Conclusion: vitamin C may exert beneficial effects on bone, but more rigorous studies and clinical
trials should be performed to validate this claim.