LIFESTREAM Natural Vitamin C (Acerola Berries)

Choosing acerola over a synthetic tablet comes down to what you're after. These are the questions our naturopaths ask in store.

A good fit if

• You want vitamin C that comes from real fruit, not a lab
• A smaller dose per scoop suits you fine
• You'd rather buy something labelled and sold as a food

Check with us first if

• You've had kidney stones or been told you make too much oxalate. Your body gets rid of more oxalate when you take more vitamin C.
• You're having chemotherapy or radiotherapy. The US NIH advises talking to your oncologist before taking vitamin C or other antioxidant supplements.
• You take niacin with a statin. Vitamin C with other antioxidants may reduce the rise in HDL (good) cholesterol you'd get from that combination.
• It's for a child. Children need 35 to 40 mg a day, so check the label against that, not against an adult dose.

• Wholefood vitamin C (acerola). Best known for: Vitamin C inside the whole fruit, at a naturally low dose per scoop, and often sold as a food. Absorption: We haven't found a trial comparing it with ascorbic acid. Typical use: Powders and capsules made from dried, ground fruit.
• Plain ascorbic acid (the comparison). Best known for: The form used in almost every vitamin C trial, with nothing else added. Absorption: The benchmark: fully absorbed in single doses up to 200 mg, with absorption dropping from 500 mg. Typical use: Tablets or powder, spread across the day.
• Calcium ascorbate. Best known for: A buffered, non-acidic vitamin C that comes with calcium. Absorption: No difference from ascorbic acid at 250 mg. At 500 mg, some white blood cell and immune measures differed, in one early single-dose trial. Typical use: Powder stirred into water or juice, or tablets.
• Ester-C. Best known for: Calcium ascorbate plus vitamin C breakdown products, and the one buffered form with a published stomach trial. Absorption: In a small trial, it gave higher vitamin C in white blood cells at 24 hours than ascorbic acid, with no difference in the blood. Typical use: Buffered tablets, often 1,000 mg once a day.
• Liposomal vitamin C. Best known for: Vitamin C wrapped in tiny fat (phospholipid) bubbles. Absorption: About 27% higher peak blood level than standard vitamin C in one blinded 500 mg trial. Typical use: Liquids, softgels and capsules.

Reference values. Acerola doesn't change how much vitamin C you need. The NHMRC Recommended Dietary Intake for adult men and women is 45 mg a day, rising to 60 mg in pregnancy and 85 mg while breastfeeding for ages 19 to 50. Children need 35 to 40 mg.

Typical supplemental range. Acerola powders have much less vitamin C per serve than synthetic tablets, because the fresh fruit is only 1 to 4.5% vitamin C by weight. A serve can have anywhere from under 100 mg to a few hundred milligrams. Check your product's label for the actual vitamin C amount rather than assuming it matches a 500 mg or 1,000 mg tablet.

Upper level. Australia hasn't set an Upper Level for vitamin C. In the NHMRC's words: 'It is not possible to establish a UL for vitamin C, but 1,000 mg/day is a prudent limit.' A typical acerola serve sits well under that.

Worth knowing. Your body fully absorbs a single 200 mg dose of vitamin C, and absorbs less and less from 500 mg upward. What you need depends on your age, diet and health, so talk to one of our naturopaths.

Food first, where the diet allows it.

• Acerola cherry, fresh, per 100 g: 1,000 to 4,500 mg, the richest source in this family
• Red capsicum, raw, half a cup: 95 mg, for comparison
• Orange, 1 medium: 70 mg, which already clears the adult RDI of 45 mg

If any of these sound like you, talk to one of our naturopaths or your doctor before you start.

• Pregnant or breastfeeding. The acerola fruit extract itself has a recorded 'avoid use' position; there isn't enough information on safety in pregnancy and breastfeeding.
• Hereditary haemochromatosis or iron overload. NIH lists iron overload among the concerns with too much vitamin C.
• Kidney stones or high oxalate in the urine (hyperoxaluria). Oxalate and urate in the urine rise at higher vitamin C intakes.
• Chemotherapy or radiotherapy. NIH advises talking to your oncologist before taking antioxidant supplements.
• Niacin with simvastatin. Vitamin C with other antioxidants may reduce the rise in HDL cholesterol.
• Children. The RDI is 35 to 40 mg a day, well under most adult acerola serves.
• If you take prescription medicines, check with your doctor, pharmacist or our naturopaths before you start.