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Does vitamin C help prevent or treat the common cold? Maybe not, after all.

Linus Pauling's book Vitamin C and The Common Cold, published in 1970, was a bestseller and led many people to believe in the value of the vitamin for cold prevention and treatment. But an article in this month's PLoS Medicine reviewing all of the best clinical research on this topic, suggests that the public's enthusiasm for the vitamin may be unjustified.

Robert M Douglas of the Australian National University, Canberra, and Harri Hemilä of the University of Helsinki, Finland, reviewed the best quality studies on vitamin C and the common cold done over the last 65 years. All of these studies compared a daily dose of 200mg of vitamin C or more against a dummy pill (placebo).

Did vitamin C given for prevention reduce the risk of picking up a cold? The authors looked at 23 studies done in the general population, using doses of up to 2g daily, and found that vitamin C did not reduce the risk. They conclude that "the lack of effect of prophylactic vitamin C supplementation on the incidence of common cold in normal populations throws doubt on the utility of this wide practice."

In these prevention studies, those people who were given vitamin C and then caught a cold experienced a small reduction in the duration of the cold compared with those taking a placebo. The authors say that the clinical significance of this minor reduction "is questionable, although the consistency of these findings points to a genuine biological effect."

But the authors did find evidence that the vitamin could help prevent colds in people exposed to extreme physical exertion or cold weather. They found six studies in which the vitamin or a placebo was given to marathon runners, skiers and soldiers exposed to significant cold and/or physical stress. Those taking the vitamin experienced, on average, a 50% reduction in common cold incidence. The authors urge "great caution", though, in making generalizations from this finding in 6 studies that is mainly based on marath on runners.

What about vitamin C as a possible treatment for an established cold? The authors found seven trials (all in adults) evaluating whether vitamin C taken when their symptoms started would shorten the cold. When they looked at all seven studies together, they found no benefit from taking the vitamin. But in one of the seven trials, patients took a single very high dose of the vitamin (8 g) on the day their symptoms started and experienced a shorter illness compared with people who took a placebo pill. (3) The authors say that the results in this single trial are "tantalising and deserve further assessment."

Douglas and Hemilä's article summarizes their more detailed review of the evidence that is published by the Cochrane Library (see and that is freely available via the PLoS Medicine website.



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