Many people take vitamin C for general health or to boost their immune system. It’s also taken to treat vitamin C deficiency. Characteristic symptoms of vitamin C deficiency include: swollen and bleeding gums, fatigue, poor wound healing, joint pain, loose teeth, colored spots on the skin

In some cases, signs of scurvy can occur within a month of consuming less than 10 milligrams (mg) per day of vitamin C.

Vitamin C injections are approved by the U.S. Food and Drug Administration (FDA) for treating vitamin C deficiency. They’re also approved for helping to treat serious wounds from trauma or burns. However, vitamin C injections are typically only used when vitamin C levels need to be increased quickly or when oral supplements can’t be taken due to poor absorption or other reasons.

Off-label use

Vitamin C injections are sometimes used off-label for other conditions, including: cancer, general health, immune function, weight loss.

Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that has not been approved. However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So your doctor can prescribe a drug however they think is best for your care. Learn more about off-label prescription drug use.

Cancer

As early as the 1970s, some researchers were suggesting that using high doses of intravenous vitamin C along with cancer drugs could improve treatment of cancer. Intravenous vitamin C can produce very high levels of vitamin C in the body. Researchers believe that these high vitamin C levels can be toxic to cancer cells without harming the healthy cells of the body. Some researchers also believe that vitamin C might be able to reduce the side effects of cancer drugs. However, the potential benefits of intravenous vitamin C in cancer treatment remains controversial. In a systematic review Trusted Source, researchers found inadequate evidence to determine if intravenous vitamin C was beneficial for cancer treatment.

Weight loss

Vitamin C injection is sometimes used for weight loss. Some research Trusted Source suggests that people who don’t have adequate vitamin C intake aren’t able to burn fat very well. This means that it’s important to ensure adequate intake of vitamin C. However, there is no scientific research showing that taking vitamin C supplements orally or vitamin C injections causes weight loss.

General dosing

For treating vitamin C deficiency, the typical vitamin C injection dose is 200 mg once daily for up to a week.

For wound healing, the typical vitamin C injection dose is 1 gram once daily for 5 to 21 days.

For off-label uses, a wide variety of vitamin C injection doses have been used. These typically range from 10 to 100 grams. Doses may be given daily or periodically at different intervals.

Side effects of treatment

Vitamin C injections are safe when used for FDA-approved reasons at typical doses. The most common side effects are pain and swelling at the injection site. Very high doses of vitamin C injections also seem to have few side effects. Some of these include nausea and pain at injection site. Learn more about vitamin C side effects.

Risks of vitamin C injections

If you’re thinking about getting high doses of vitamin C through injection, talk with your doctor about the potential risks.

Vitamin C increases iron absorption from the food you eat. If you take very high doses of vitamin C, your body might absorb too much iron. This could be a potential problem if you already have high levels of iron in your body, If you have kidney disease, very high doses of vitamin C might result in kidney damage. High-dose vitamin C injections might increase your chance of developing a kidney stone. People who’ve had kidney stones in the past may have a greater risk. When any injection is given, there is also risk for infection.

Drug interactions

Vitamin C can interact with some other medications. Vitamin C can make your urine more acidic. In some cases, this can change how your body gets rid of certain medication. This in turn can change levels of some medications in your body and result in decreased effectiveness or increased side effects. Some of these medications include: fluphenazine (Prolixin) magnesium salicylate (Novasal) mexiletine (Mexitil) salsalate. There is some concern that high-dose vitamin C might make radiation therapy and some chemotherapy drugs less effective. However, this is controversial, and more evidence is needed. If you’re taking other medications or being treated for cancer, talk with your doctor before taking high-dose vitamin C injections.

Talk with your doctor before using vitamin C injections.

The following risk factors can increase the chance of developing vitamin B-12 deficiency:

alcohol abuse

smoking

certain prescription medications, including antacids and some type 2 diabetes drugs

having an endocrine-related autoimmune disorder, such as diabetes or a thyroid disorder

eating a vegetarian or vegan diet

certain gastrointestinal disorders, such as Crohn’s disease

gastric bypass or the removal of parts of the stomach

aging

People with gastrointestinal issues

A gastrointestinal tract that does not function normally may inhibit vitamin B-12 release or absorption. For this reason, people with disorders such as celiac disease and Crohn’s disease may be at higher risk of vitamin B-12 deficiency.

Individuals who have undergone gastrointestinal surgery, including weight loss surgery, may have less of the cells necessary to secrete stomach acid and intrinsic factor. As a result, they may struggle to absorb B-12.

Vitamin B-12 shots, rather than oral supplements, may be particularly helpful for people who have gastrointestinal issues because injections tend to bypass these areas.

Older adults

Research suggests that vitamin B-12 deficiency affects a greater number of older adults than those under the age of 65.

Older adults can be affected by conditions that are linked to a decrease in stomach acid production, including inflammation in the stomach (atrophic gastritis).

Furthermore, lower levels of stomach acid can encourage the growth of certain bacteria in the gut that use B-12, reducing the amount of the vitamin available to the body.

The Institute of Medicine recommend that adults over 50 meet their vitamin B-12 needs with fortified foods, B-12 shots, or other supplements, as these man-made forms appear to be more readily absorbed than naturally occurring B-12.

Vegetarians and vegans

As vitamin B-12 is found mainly in fish, meat, eggs, and dairy, people who do not consume these foods are at risk of B-12 deficiency and may benefit from regular B-12 shots or other supplements.

Research published in the European Journal of Clinical Nutrition indicates that vegans and some strict vegetarians have low levels of vitamin B-12.

Of 232 vegans studied, over half were classed as being deficient in vitamin B-12. The deficiency was observed in just 7 percent of the vegetarians studied, and in only one of the omnivores.

Vegetarian or vegan women who are pregnant will need to be especially careful about supplementing or consuming fortified foods, as vitamin B-12 transfers to the baby via the placenta and breast milk.

Infants who have vitamin B-12 deficiency can experience permanent and severe neurological issues.

Benefits

There are several reasons to consider getting a B-12 shot, including:

Reduced risk of vitamin B-12 deficiency and associated complications

The most obvious benefit of receiving vitamin B-12 shots is treating a vitamin B-12 deficiency and avoiding its associated symptoms.

In addition, B-12 shots reduce the risk of some serious complications associated with vitamin B-12 deficiency including:

heart disease

neurocognitive disorders

coordination problems (ataxia)

peripheral neuropathy

vision loss

infertility (although this usually resolves with B-12 treatment)

neural tube defects in the babies of women with B-12 deficiency

High levels of assimilation by the body

B-12 shots bypass the stomach and are absorbed directly into the bloodstream.

Therefore, they are a better option than oral supplements for those who have gastrointestinal issues, including older adults who have low levels of stomach acid or intrinsic factor.

Risks

Swollen ankles or feet are a potential side effect of vitamin B-12 shots, and require immediate medical attention.

There is no upper limit for the intake of vitamin B-12 because the risk of toxicity or overdose is extremely low.

However, B-12 shots may have other side effects.

Mild side effects and potential risks, which should be referred to a doctor if they persist or worsen, include:

pain, redness, or itching at the site of the injection

mild diarrhea

swelling sensation in the body

More serious side effects, which require immediate medical attention, include:

muscle cramps

irregular heartbeat

unusual weakness or tiredness

swelling of the ankles or feet

Severe reactions are very rare but require emergency intervention. These include:

itching and swelling of the face, throat, or tongue

breathing difficulties

severe dizziness

sudden vision changes

slurred speech

Drug interactions

Vitamin B-12 may interact with certain medications. People must always inform their doctor about all prescription and over-the-counter drugs they are taking before receiving a B-12 shot.

Some commonly prescribed medications that may interact with B-12 include:

Aspirin

antibiotics

H2 receptor antagonists

metformin

oral contraceptives

proton pump inhibitors

Allergy and medical conditions

Those who have allergies or medical conditions should always inform their doctor before receiving a B-12 shot.

Examples of allergies or conditions that may interact with B-12 shots include:

allergy to cyanocobalamin or cobalt

hypokalemia (low potassium levels)

kidney disease

polycythemia vera (a rare blood disorder)

Leber’s disease (an eye disease)

deficiencies in other nutrients, particularly folic acid and iron.

Thiamin (vitamin B1)

Thiamin, also known as vitamin B1, helps:

break down and release energy from food

keep the nervous system healthy

Good sources of thiamin

Thiamin is found in many types of food.

Good sources include:

peas

fresh and dried fruit

eggs

wholegrain breads

some fortified breakfast cereals

liver

How much thiamin do I need?

The amount of thiamin adults (aged 19 to 64) need is:

1mg a day for men

0.8mg a day for women

You should be able to get all the thiamin you need from your daily diet.

Thiamin cannot be stored in the body, so you need it in your diet every day.

What happens if I take too much thiamin?

There's not enough evidence to know what the effects might be of taking high doses of thiamin supplements each day.

Riboflavin (vitamin B2)

Riboflavin, also known as vitamin B2, helps:

keep skin, eyes and the nervous system healthy

the body release energy from food

Good sources of riboflavin

Good sources of riboflavin include:

milk

eggs

fortified breakfast cereals

rice

UV light can destroy riboflavin, so ideally these foods should be kept out of direct sunlight.

How much riboflavin do I need?

The amount of riboflavin adults (aged 19 to 64) need is about:

1.3mg a day for men

1.1mg a day for women

You should be able to get all the riboflavin you need from your daily diet.

Riboflavin cannot be stored in the body, so you need it in your diet every day.

What happens if I take too much riboflavin?

There's not enough evidence to know what the effects might be of taking high doses of riboflavin supplements each day.

Niacin (vitamin B3)

Niacin, also known as vitamin B3, helps:

release energy from the foods we eat

keep the nervous system and skin healthy

Good sources of niacin

There are 2 forms of niacin: nicotinic acid and nicotinamide. Both are found in food.

Good sources of niacin include:

meat

fish

wheat flour

eggs

milk

How much niacin do I need?

The amount of niacin you need is about:

16.5mg a day for men

13.2mg a day for women

You should be able to get all the niacin you need from your daily diet.

Niacin cannot be stored in the body, so you need it in your diet every day.

What happens if I take too much niacin?

Taking high doses of nicotinic acid supplements can cause skin flushes. Taking high doses for a long time could lead to liver damage.

There's not enough evidence to know what the effects might be of taking high daily doses of nicotinamide supplements.

Pantothenic acid

Pantothenic acid has several functions, such as helping to release energy from food.

Good sources of pantothenic acid

Pantothenic acid is found in almost all meats and vegetables, including:

chicken

beef

potatoes

porridge

tomatoes

kidney

eggs

broccoli

wholegrains, such as brown rice and wholemeal bread

Breakfast cereals are also a good source if they have been fortified with pantothenic acid.

How much pantothenic acid do I need?

You should be able to get all the pantothenic acid you need from your daily diet, as it's found in many foods.

Pantothenic acid cannot be stored in the body, so you need it in your diet every day.

What happens if I take too much pantothenic acid?

There's not enough evidence to know what the effects might be of taking high daily doses of pantothenic acid supplements.

What does the Department of Health and Social Care advise?

You should be able to get all the pantothenic acid you need by eating a varied and balanced diet.

If you take supplements, do not take too much as this might be harmful.

Taking 200mg or less a day of pantothenic acid in supplements is unlikely to cause any harm.

Vitamin B6

Vitamin B6, also known as pyridoxine, helps:

allow the body to use and store energy from protein and carbohydrates in food

form haemoglobin, the substance in red blood cells that carries oxygen around the body

Good sources of vitamin B6 

Vitamin B6 is found in a wide variety of foods, including:

pork

poultry, such as chicken or turkey

fish

bread

wholegrain cereals, such as oatmeal, wheatgerm and brown rice

eggs

vegetables

soya beans

peanuts

milk

potatoes

some fortified breakfast cereals

How much vitamin B6 do I need?

The amount of vitamin B6 adults (aged 19 to 64) need is about:

1.4mg a day for men

1.2mg a day for women

You should be able to get all the vitamin B6 you need from your daily diet.

What happens if I take too much vitamin B6?

Taking more than 200mg a day of vitamin B6 for a long time can lead to a loss of feeling in the arms and legs known as peripheral neuropathy.

This will usually improve once you stop taking the supplements.

But in a few cases when people have taken large amounts of vitamin B6, particularly for more than a few months, the effect can be permanent.

Taking doses of 10 to 200mg a day for short periods may not cause any harm.

But there's not enough evidence to say how long these doses could be taken for safely.

What does the Department of Health and Social Care advise?

You should be able to get the vitamin B6 you need by eating a varied and balanced diet.

If you take vitamin B6 supplements, do not take too much as this could be harmful.

Do not take more than 10mg of vitamin B6 a day in supplements unless advised to by a doctor.

Biotin (vitamin B7)

Biotin is needed in very small amounts to help the body break down fat.

The bacteria that live naturally in your bowel are able to make biotin, so it's not clear if you need any additional biotin from the diet.

Biotin is also found in a wide range of foods, but only at very low levels.

What happens if I take too much biotin?

There's not enough evidence to know what the effects might be of taking high daily doses of biotin supplements.

Taking 0.9mg or less a day of biotin in supplements is unlikely to cause any harm.

Folate and folic acid

Folate is a B vitamin found in many foods. The man-made form of folate is called folic acid.

Folate is also known as folacin and vitamin B9.

Folate helps:

the body form healthy red blood cells

reduce the risk of central neural tube defects, such as spina bifida, in unborn babies

A lack of folate could lead to folate deficiency anaemia.

Folate is found in small amounts in many foods.

Good sources include:

broccoli

brussels sprouts

liver (but avoid this during pregnancy)

leafy green vegetables, such as cabbage and spinach

peas

chickpeas

breakfast cereals fortified with folic acid

How much folate do I need?

Adults need 200 micrograms of folate a day. A microgram is 1,000 times smaller than a milligram (mg). The word microgram is sometimes written with the Greek symbol μ followed by the letter g (μg).

There are no long-term stores in the body, so you need to eat folate-containing foods frequently.

Most people should be able to get the amount they need by eating a varied and balanced diet.

If you're pregnant or could get pregnant

If you're pregnant, trying for a baby or could get pregnant, it's recommended that you take a 400 microgram folic acid supplement daily until you're 12 weeks pregnant.

Folic acid supplements need to be taken before you get pregnant, so start taking them before you stop using contraception or if there's a chance you might get pregnant.

This is to help prevent birth defects, such as spina bifida, in your baby.

Some women have an increased risk of having a pregnancy affected by a neural tube defect and are advised to take a higher dose of 5mg of folic acid each day until they're 12 weeks pregnant.

This is important and unlikely to cause harm, as it's taken on a short-term basis, but speak to your doctor first.

What happens if I take too much folic acid?

Taking doses of folic acid higher than 1mg can mask the symptoms of vitamin B12 deficiency, which can eventually damage the nervous system if it's not spotted and treated.

This is particularly a concern for older people because it becomes more difficult to absorb vitamin B12 as you get older.

What does the Department of Health and Social Care advise?

The Department of Health and Social Care recommends that folic acid supplements are taken by all women who are pregnant or could get pregnant.

Women who cannot get pregnant and men should be able to get all the folate they need by eating a varied and balanced diet.

If you're taking folic acid supplements, it's important not to take too much as this could be harmful.

Taking 1mg or less a day of folic acid supplements is unlikely to cause any harm.

Vitamin B12

Vitamin B12 is involved in:

making red blood cells and keeping the nervous system healthy

releasing energy from food

using folic acid

A lack of vitamin B12 could lead to vitamin B12 deficiency anaemia.

Good sources include:

meat

salmon

cod

milk

cheese

eggs

some fortified breakfast cereals

How much vitamin B12 do I need?

Adults (aged 19 to 64) need about 1.5 microgram a day of vitamin B12.

If you eat meat, fish or dairy foods, you should be able to get enough vitamin B12 from your diet.

But as vitamin B12 is not found naturally in foods such as fruit, vegetables and grains, vegans may not get enough of it. 

Read about the vegan diet for nutrition information and advice.

What happens if I take too much vitamin B12?

There's not enough evidence to show what the effects may be of taking high doses of vitamin B12 supplements each day.

What does the Department of Health and Social Care advise?

You should be able to get all the vitamin B12 you need by eating a varied and balanced diet.

If you take vitamin B12 supplements, do not take too much as this could be harmful.

Taking 2mg or less a day of vitamin B12 in supplements is unlikely to cause any harm.

Common side effects may include:

skin changes (acne, dryness, redness, bruising, discoloration);

increased hair growth, or thinning hair;

nausea, bloating, appetite changes;

stomach or side pain;

cough, runny or stuffy nose;

headache, sleep problems (insomnia);

a wound that is slow to heal;

sweating more than usual; or.

Does kenalog injection work immediately?

Cortisone starts to work immediately following the injection, and inflammation usually begins to subside within a few days. Depending on how quickly the inflammation subsides, the timing of pain relief can vary from a few days to a few weeks

Is kenalog a cortisone injection?

Cortisone is a type of medication called a corticosteroid. Doctors use these drugs to treat inflammation (swelling) caused by injury and illness. ... Commonly used cortisone variants include Kenalog® (tramcinolone) Depo-Medrol® (methylprednisolone), and Celestone® (Betamethasone)

1. What Kenalog IA/IM Injection is and what it is used for

The name of this medicine is Kenalog IA/IM Injection. Each injection contains triamcinolone acetonide 40 mg/ml as the active ingredient. Triamcinolone acetonide belongs to a group of medicine called corticosteroids (steroids).

Kenalog IA/IM Injection is for the treatment of joint pain, swelling and stiffness in inflammatory disorders such as rheumatoid arthritis.

It is also for the treatment of various allergic disorders including asthma, blood disorders, hormone problems, rheumatic fever, and problems associated with digestive system, kidneys, lungs or skin.

2. What you need to know before you are given Kenalog IA/IM Injection

Do not receive Kenalog IA/IM Injection if;

You have had an allergic reaction to a similar medicine or any of the ingredients in this medicine. 

Kenalog IA/IM Injection is not recommended for children under 6 years.

You must tell your doctor if:

You have had any recent infection [including tuberculosis (TB)]

You have had recent bowel surgery

You have, or have had a bowel disorder or stomach ulcer

You have an infection or inflammation of the veins in your legs

You have had any mental health disorders or epilepsy

You have had any kidney, liver or thyroid (gland in the neck) problems as the dose of Kenalog may need to be adjusted

You have recently suffered from any form of cancer

You have thin or brittle bones (osteoporosis)

You have myasthenia gravis (a disease which causes weak muscles)

You have high blood pressure or heart failure

You or someone in your family has glaucoma (increased pressure in your eyes).

You are diabetic as your insulin dose may need to be changed

Check with your doctor first:

If you are taking triamcinolone acetonide [Kenalog IA/IM Injection] and medicines to control HIV (anti-retrovirals) or fungal infections (anti-fungals) because you could experience more adverse effects and your doctor may wish to monitor you carefully. Refer to list of medicines mentioned in “Taking other medicines with Adcortyl IA/ID Injection.”

If you have ever had severe depression or manic-depression (bipolar disorder). This includes having had depression before while taking steroid medicines like Kenalog IA/IM Injection.

If any of your close family has had these illnesses.

If any of these applies to you, talk to a doctor before taking Kenalog IA/IM Injection.

Steroid medicines suppress your body's natural immune response. Therefore, if you come into contact with anyone who has an infectious disease such as chickenpox, shingles or measles, consult your doctor as soon as possible.

While you are being treated with this medicine (or if you have recently stopped a course of treatment) do not have any vaccination without consulting your doctor.

You must take care not to over-use a joint which feels better after you receive Kenalog IA/IM injection. The joint will still need to recover from the inflammation which caused your symptoms.

Taking other medicines with Kenalog IA/IM Injection

Please tell your doctor if you are taking, or have recently taken any other medicines, including medicines obtained without a prescription.

Some medicines may increase the effects of Adcortyl and your doctor may wish to monitor you carefully if you are taking these medicines (including some medicines for HIV: ritonavir, cobicistat).

This is especially important if you are taking;

Aspirin, ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) as corticosteroids can increase the chance of bleeding from the gut.

Anti-retroviral inhibitors and anti-fungals: ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, ketoconazole, and telithromycin because increased adverse effects may occur, resulting in systemic corticosteroid effects including Cushing’s syndrome and adrenal suppression

Warfarin or other medicines to thin the blood

Oral contraceptive pill or hormone replacement therapy (HRT)

Human growth hormone

A medicine called ciclosporin

A medicine called rifampicin

or medicines to treat;

High blood pressure or irregular heart beat (e.g. digoxin)

Myasthenia gravis (a disease which causes weak muscles)

Epilepsy or other sorts of fits (e.g. phenytoin)

Tuberculosis (TB)

Diabetes

Thyroid problems

If you are taking any of these medicines, or are not sure, please consult your doctor.

If you are due to have surgery

Before surgery and anaesthesia (even at the dentist) you should tell the doctor or dentist that you are being treated with Kenalog IA/IM injection.

Pregnancy and breastfeeding

If you are pregnant, planning to become pregnant, or if you are breast-feeding you should make sure you discuss this with your doctor as soon as possible before receiving Kenalog IA/IM injection.

Driving and using machines

This medicine does not usually affect your ability to drive or operate machinery but it can affect your eyesight. Tell your doctor immediately if you have any pain in the eyes or problems with your vision.

Vitamin C Injection - £60

Can be taken evewry 4 weeks

Vitamin B12 Injection - £40

Can be taken every 4 weeks

Vitamin B-Complex - £70 

Can be taken Every 4 weeks 

Kanalog Hay-Fever Injection - £180

ECan be taken once every six months