Vitamin C and the Common Cold -papers

by Harri Hemilä


Department of Public Health
University of Helsinki, Finland
harri.hemila@helsinki.fi
https://www.mv.helsinki.fi/home/hemila
Feb 13, 2025

The impact of Linus Pauling in the initiation of the series of
controlled trials in the 1970s: see a brief summary with links at:
 https://www.mv.helsinki.fi/home/hemila/pauling

For the
problems in flawed meta-analyses and reviews
on vitamin C and the common cold, see summaries at:
https://www.mv.helsinki.fi/home/hemila/flawed_vitC_colds.htm 


The papers on the common cold are divided in categories and if the same paper falls into several categories, it is listed in each of them

    1. Cochrane Review on vitamin C and the common cold

    2. Other reviews on vitamin C and the common cold

    3. Vitamin C and the incidence of colds

    4. Vitamin C and common cold duration and severity

    5. Vitamin C and complications of the common cold: exacerbation of asthma

    6. Linus Pauling and the common cold

    7. Flaws in papers on vitamin C and the common cold



Cochrane Review on vitamin C and the common cold


On Jan
2025, this review had the Altmetric score 4427
https://cochrane.altmetric.com/details/1229303

On Oct 2022, this review had the Altmetric score 3382, which was position 1439 out of all the 22,246,158 outputs, and 5th of the Cochrane reviews:
https://www.mv.helsinki.fi/home/hemila/AltmetricVitC_Colds_2022Oct.htm#score


Hemilä H, Chalker E.
Vitamin C for preventing and treating the common cold.
Cochrane Database Syst Rev 2013; CD000980
https://pmc.ncbi.nlm.nih.gov/articles/PMC8078152
https://hdl.handle.net/10138/225864
https://www.researchgate.net/publication/273209193
https://doi.org/10.1002/14651858.cd000980.pub4
https://www.mv.helsinki.fi/home/hemila/CC/2013_Coch_Colds_CD000980.pdf
https://www.ncbi.nlm.nih.gov/pubmed/23440782

References to the review:
https://www.mv.helsinki.fi/home/hemila/CC

Commentaries on ‘Vitamin C for Preventing and Treating the Common Cold’ with a response from the review author
     [Reply to Bax, Spee and Madderom].
     [Reply to Shamseer and Vohra].
     Evidence-Based Child Health: A Cochrane Review Journal 2008;3:724-728
https://hdl.handle.net/10138/228088
https://www.researchgate.net/publication/244785237
https://doi.org/10.1002/ebch.261
https://www.mv.helsinki.fi/home/hemila/H/2008_L_EBCH.pdf





Other reviews on vitamin C and the common cold

Hemilä H, Chalker E.
Vitamin C for the common cold and pneumonia.
Pol Arch Intern Med. 2025
https://pubmed.ncbi.nlm.nih.gov/39803741

Hemilä H, Chalker E.
Vitamin C reduces the severity of common colds: a meta-analysis.
BMC Public Health. 2023
https://pubmed.ncbi.nlm.nih.gov/38082300


Summary of vitamin C, vitamin E, zinc lozenge  studies on the common cold:
Hemilä H.
Vitamins and minerals [book chapter].
In: "Common cold " (Eccles R, Weber O, eds.) Birkhauser Verlag, 2009:275-307
Abstract and references:
https://www.mv.helsinki.fi/home/hemila/birkhauser
Available at:
https://doi.org/10.1007/978-3-7643-9912-2_13
https://doi.org/10.1007/978-3-7643-9912-2
A manuscript version:
https://hdl.handle.net/10138/228060




Douglas RM, Hemilä H.
Vitamin C for preventing and treating the common cold.
PLoS Med 2005;2:e168
https://doi.org/10.1371/journal.pmed.0020168
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc1160577/

Hemilä H.
Vitamin C, respiratory infections, and the immune system.
Trends Immunol 2003;24:579-580
https://doi.org/10.1016/j.it.2003.09.004
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7129436/

Hemilä H, Douglas RM.
Vitamin C and acute respiratory infections.
Int J TB Lung Disease 1999;3:756-761
https://www.ingentaconnect.com/content/iuatld/ijtld/1999/00000003/00000009/art00004
https://www.mv.helsinki.fi/home/hemila/H/HH_1999_IJTLD.pdf



Vitamin C and the incidence of colds

Although there is strong evidence that vitamin C does not decrease the averge incidence of colds in the general community, there is strong evidence that some sub-populations benefit of vitamin C, so that colds are prevented in them:
Hemilä H.
Prophylactic benefit of vitamin C in large trials (Table 20).
In: Do vitamins C and E affect respiratory infections? Thesis 2006 pp.
44
https://hdl.handle.net/10138/20335
https://doi.org/10.5281/zenodo.6395595
https://www.researchgate.net/publication/35656439


Strong evidence that in some conditions males and females differ:
Hemilä H.
Vitamin C and sex differences in respiratory tract infections.
Respir Med 2008;102:625-626
https://hdl.handle.net/10138/228090
https://www.researchgate.net/publication/5628489
https://doi.org/10.1016/j.rmed.2007.12.011
https://www.mv.helsinki.fi/home/hemila/H/2008_L_RespMed.pdf 

Effects of vitamin C on military personnel may be explained by heavy physical stress and crowding of people:
Hemilä H.
Vitamin C supplementation and respiratory infections: a systematic review. Mil Med 2004;169:920-925
https://hdl.handle.net/10138/225867
https://www.researchgate.net/publication/8123995
https://doi.org/10.7205/milmed.169.11.920
https://www.mv.helsinki.fi/home/hemila/H/HH_2004.pdf

Dietary vitamin C had no correlation with common cold incidence in middle-aged male smokers
Hemilä H, Kaprio J, Albanes D, Heinonen OP, Virtamo J.
Vitamin C, vitamin E and beta-carotene in relation to common cold incidence in male smokers.
Epidemiology 2002;13:32-37
https://hdl.handle.net/10138/18059
https://doi.org/10.1097/00001648-200201000-00006
https://www.jstor.org/pss/3703244

Studies with males in the UK found decrease in common cold incidence; the explanation may be low dietary vitamin C intake when the trials were carried out:
Hemilä H.
Vitamin C intake and susceptibility to the common cold.
Br J Nutr 1997;77:59-72 [Discussion in: 1997;78:857-866, see below]
https://hdl.handle.net/10138/223362
https://www.researchgate.net/publication/14153016
https://doi.org/10.1017/s0007114500002889
https://www.mv.helsinki.fi/home/hemila/H/HH_1997_BJN.pdf
   
Discussion:
    Hemilä H.
Vitamin C intake and susceptibility to the common cold – Reply.
    Br J Nutr 1997;78:861-866
https://hdl.handle.net/10138/223364
https://doi.org/10.5281/zenodo.14610440
https://www.researchgate.net/publication/28369859
https://doi.org/10.1079/BJN19970201
https://www.mv.helsinki.fi/home/hemila/H/HH_1997_BJN2.pdf

Another presentation of the UK study findings:
Hemilä H.
Prophylactic effect of vitamin C on recurrent colds in the UK trials (Table 22).
In: Do vitamins C and E affect respiratory infections? Thesis 2006 pp.
46-47
https://hdl.handle.net/10138/20335
https://doi.org/10.5281/zenodo.6395595
https://www.researchgate.net/publication/35656439


The first meta-analysis on the effect of vitamin C on people under heavy short-term physical stress which was based on 3 RCTs
Hemilä H.
Vitamin C and common cold incidence: a review of studies with subjects under heavy physical stress.
Int J Sports Med 1996;17:379-383
https://hdl.handle.net/10138/225881
https://www.researchgate.net/publication/14347859
https://doi.org/10.1055/s-2007-972864
https://www.mv.helsinki.fi/home/hemila/H/HH_1996_IJSM.pdf

1 g/day of vitamin C does not prevent colds:
Hemilä H.
Does vitamin C alleviate the symptoms of the common cold? A review of current evidence.
Scand J Infect Dis 1994;26:1-6
https://www.researchgate.net/publication/15008493
https://hdl.handle.net/10250/8077
https://doi.org/10.3109/00365549409008582
https://www.mv.helsinki.fi/home/hemila/H/HH_1994.pdf

1 g/day of vitamin C does not prevent colds:
Hemilä H.
Vitamin C and the common cold.
Br J Nutr 1992;67:3-16
https://hdl.handle.net/10138/223363
https://www.researchgate.net/publication/259425819
https://doi.org/10.1079/BJN19920004
https://www.mv.helsinki.fi/home/hemila/H/HH_1992.pdf

Vitamin C and common cold duration and severity

Vitamin C has greater effect on common cold severity than on common cold duration
Hemilä H, Chalker E.
Vitamin C reduces the severity of common colds: a meta-analysis.
BMC Public Health. 2023
https://pubmed.ncbi.nlm.nih.gov/38082300

Vitamin C halved the duration of colds in male adolescent swimmers but not in female adolescent swimmers:
Constantini NW, Dubnov-Raz G, Eyal BB, Berry EM, Cohen AH, Hemilä H.
The effect of vitamin C on upper respiratory infections in adolescent swimmers: a randomized trial.
Eur J Pediatrics 2011;170:59-63
https://hdl.handle.net/10138/228085
https://www.academia.edu/17790460
https://doi.org/10.1007/s00431-010-1270-z
https://www.mv.helsinki.fi/home/hemila/H/HH_2011_EurJPediatr.pdf 

Effects of vitamin C on military personnel may be explained by heavy physical stress or/and crowding of people:
Hemilä H.
Vitamin C supplementation and respiratory infections: a systematic review.
Mil Med 2004;169:920-925
https://hdl.handle.net/10138/225867
https://www.researchgate.net/publication/8123995
https://doi.org/10.7205/milmed.169.11.920
https://www.mv.helsinki.fi/home/hemila/H/HH_2004.pdf

On average the benefit of vitamin C has been greater in adults than in children, and with a dose of >=2 g/day compared with 1 g/day.
Hemilä H.
Vitamin C supplementation and common cold symptoms: factors affecting the magnitude of the benefit.
Med Hypotheses 1999;52:171-178
https://hdl.handle.net/10138/223761
https://www.researchgate.net/publication/12959141
https://doi.org/10.1054/mehy.1997.0639
https://www.mv.helsinki.fi/home/hemila/H/HH_1999_MH.pdf

1 g/day of vitamin C shortens and alleviates colds:
Hemilä H.
Does vitamin C alleviate the symptoms of the common cold? A review of current evidence.
Scand J Infect Dis 1994;26:1-6
https://hdl.handle.net/10250/8077
https://www.researchgate.net/publication/15008493
https://doi.org/10.3109/00365549409008582
https://www.mv.helsinki.fi/home/hemila/H/HH_1994.pdf

1 g/day of vitamin C shortens and alleviates colds:
Hemilä H.
Vitamin C and the common cold. Br J Nutr 1992;67:3-16
https://hdl.handle.net/10138/223363
https://www.researchgate.net/publication/259425819
https://doi.org/10.1079/BJN19920004
https://www.mv.helsinki.fi/home/hemila/H/HH_1992.pdf



Vitamin C and complications of the common cold: exacerbation of asthma

Hemilä H. Vitamin C and common cold-induced asthma: a systematic review and statistical analysis.
Allergy, Asthma Clin Immunol 2013;9:46
https://doi.org/10.1186/1710-1492-9-46
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4018579 



Linus Pauling and the common cold

Hemilä H. Vitamin C and the common cold; Meta-analysis; Pauling's meta-analyses (1971a,b);
In: Do vitamins C and E affect respiratory infections? Thesis 2006 pp.
11-13, 28, 35-36
https://hdl.handle.net/10138/20335
https://doi.org/10.5281/zenodo.6395595
https://www.researchgate.net/publication/35656439



Hemilä H.
Vitamin C supplementation and the common cold - was Linus Pauling right or wrong?
Int J Vitam Nutr Res 1997;67:329-335
https://doi.org/10.5281/zenodo.6406111
https://hdl.handle.net/10250/7980

https://www.mv.helsinki.fi/home/hemila/H/HH_1997_IJVNR.pdf
https://www.ncbi.nlm.nih.gov/pubmed/9350474





Flaws in papers on vitamin C and the common cold

See other page for further links:

https://www.mv.helsinki.fi/home/hemila/flawed_vitC_colds.htm






Hemilä H. Shortcomings in the vitamin C and common cold meta-analysis by Ran et al. (2018) Pubpeer 2021
https://pubpeer.com/publications/077EAB95E9141BE6A455C30F0A688E#1
Comments on the following meta-analysis:
https://doi.org/10.1155/2018/1837634
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6057395/



Because of the severe flaws, the Ran et al. review was retracted in 2023:

Retracted: Extra dose of vitamin C based on a daily supplementation shortens the common cold:
a meta-analysis of 9 randomized controlled trials. Biomed Res Int. 2023; 2023: 9848057
https://doi.org/10.1155/2023/9848057
https://pmc.ncbi.nlm.nih.gov/articles/PMC10110384









Hemilä H, Chalker E. Meta-analysis on vitamin C and the common cold in children may be misleading.
Eur J Clin Pharmacol. 2019
http
s://hdl.handle.net/10138/318103
https://doi.org/10.1007/s00228-019-02733-x
https://www.mv.helsinki.fi/home/hemila/H/Vorilhon_2019_Problems.pdf
https://www.mv.helsinki.fi/home/hemila/H/Vorilhon_2019_Problems_Supplement.pdf
https://doi.org/10.5281/zenodo.6395643

This is comment on:
Vorilhon P, et al. Efficacy of vitamin C for the prevention and treatment of upper respiratory tract infection. A meta-analysis in children. Eur J Clin Pharmacol. 2019
https://doi.org/10.1007/s00228-018-2601-7

Further severe problems in the Vorilhon meta-analysis are describe in this document:
https://hdl.handle.fi/10138/333365

https://doi.org/10.5281/zenodo.6395731

Because of the severe flaws, the Vorilhon meta-analysis was retracted in 2021:

Vorilhon P et al. Retraction Note: Efficacy of vitamin C for the prevention and treatment of upper respiratory tract infection. A meta-analysis in children. Eur J Clin Pharmacol. 2021 Jun;77(6):941.
https://pubmed.ncbi.nlm.nih.gov/33988724/
https://doi.org/10.1007/s00228-021-03150-9