Vitamin C is available in both quick- and slow-release tablets, powders, as well as esterified form (Vitamin C chemically bonded with one or more minerals in a compound containing aldonolactones; see U.S. Patent #4,822,816) and effervescent forms.

Vitamin C may be in the reduced (ascorbic acid) or oxidized (ascorbate) forms. It may be found as ascorbic acid or complexed to calcium, sodium or other minerals as ascorbates. The mineral and esterified forms of ascorbate are advantageous because they are absorbed by the body more quickly, and are buffered so as to be less acidic and thus more easily tolerated by the stomach and kidneys than ascorbic acid (and also result in less urinary excretion of oxalates). However, PWHIV often have low stomach acid, so taking acidic supplements, like ascorbic acid, and NAC, with your food, may help offset this problem and allow for better digestion.

However, note that the Vitamin C Foundation flat out states that ascorbic acid is the only worthwhile Vitamin C and everything else is just marketing nonsense. They claim there is no convincing evidence to support superior bioavailability of these other forms that validates their expense.

White blood cells are dependent upon Vitamin C for normal functioning and it is known to speed wound healing. It also appears to have a protective effect against many forms of cancer and, of particular interest to women living with HIV, against cervical dysplasia. Because the cells lining the anal area are similar to those lining the vagina, it is also thought that low levels of C could increase the risk of developing anal dysplasia. Both men and women with HIV infection appear to be at increased risk of developing anal cancer.

Vitamin C is also a very powerful antioxidant, providing significant protection against oxidative stress in the bloodstream. It is also responsible for the reactivation of other key antioxidants, particularly vitamin E, beta-carotene, and glutathione, after they have been oxidized by donating electrons to neutralize a free radical (known as the redox process). Vitamin C and certain sulfur amino acids are the only water-soluble nutrients which can be taken in sufficiently large, yet safe, quantities to effectively conduct this redox process.

Low levels of C have also been shown to cause gum disease, a condition that is very prevalent in people with HIV. Supplementation with Vitamin C has been shown to decrease the permeability of the gums, blocking bacteria and toxic substances from entering the inner tissues and preventing gum deterioration. Vitamin C is also protective against toxic chemicals, having the ability to neutralize many of these in the body and prevent the damage they might otherwise cause.

For all these reasons, long-term supplementation with Vitamin C may be one of the most important things people with HIV can do to protect their bodies against oxidative stress and support body-wide health.

Never suddenly stop high doses of Vitamin C (above 5 grams per day) but instead reduce gradually over an extended period.

Use caution when taking any powdered form of ascorbic acid to avoid damaging tooth enamel.