Many people prepare practically for an operation. They arrange transport, take time off work and ensure they are fasting on the day of the procedure. But what is often forgotten is that an operation also represents a significant physical strain.
Under normal circumstances, a daily intake of about 100–200 mg of vitamin C seems sufficient for optimal blood and tissue levels. However, during periods of physical strain — such as operations, infections, intensive sports exertion or smoking — the consumption of vitamin C increases significantly. Research shows that vitamin C levels often drop during illness and recovery, which can temporarily raise the need.
During an operation, controlled tissue damage also occurs. The body then has to recover from inflammation, wound healing and sometimes temporary loss of muscle strength or fitness. That recovery process does not begin after the operation, but already before it.
The nutritional status with which someone enters an operation plays an important role.
The body needs building blocks
After an operation, the body switches to recovery. Sufficient building blocks are needed for that recovery: proteins, vitamins, minerals and energy. Yet, deficiencies appear to occur surprisingly often. Think of low vitamin C and vitamin D levels or insufficient protein intake — all essential factors for good recovery.
A recent Australian study showed that nearly one in four admitted patients had a vitamin C deficiency. Deficiencies were more common in men and in patients with malnutrition or an increased risk of it. Particularly in severely ill patients and ICU patients, low vitamin C levels were regularly observed.
In addition, we see an increased risk of deficiencies in people with:
• chronic stress
• overweight or diabetes
• older age
• little vegetable and fruit intake
• dryness
• prolonged fatigue
• intensive sports strain
You may feel healthy or look healthy, while the body is not optimally prepared for recovery.
Vitamin C: more than just good for wound healing
Vitamin C is an essential nutrient that the body cannot produce on its own. We are therefore completely dependent on food to obtain sufficient vitamin C.
Although vegetables and fruits are still important sources of vitamins and minerals, various studies suggest that the nutrient density of some foods has decreased over the past few decades. Additionally, vitamin C is sensitive to storage, transport, heating, and long-term preservation. As a result, actual intake may be lower than many people think.
Vitamin C plays an important role in recovery processes in the body, particularly in wound healing, connective tissue repair, and combating oxidative stress. A good vitamin C status before surgery therefore seems important for optimal recovery.
The most well-known function of vitamin C is its role in collagen formation. Collagen is an important building block for skin, connective tissue, blood vessels, tendons, and bones. During wound healing, collagen is essential for the recovery and strength of newly formed tissue. Without sufficient vitamin C, this production is less efficient and the quality of the recovery may decrease.
A vitamin C deficiency has long been known for symptoms such as fragile skin, bleeding gums, and poor wound healing.
Oxidative stress and recovery
Vitamin C also acts as a powerful antioxidant. During surgery, there is temporarily more physical stress and inflammatory activity. This releases so-called free radicals: substances that are normal in small amounts but can cause damage to cells and tissues in larger quantities.
Antioxidants such as vitamin C help to 'capture' these harmful substances and thus support the recovery process. This seems particularly important in skin and connective tissue, where vitamin C is present in relatively high concentrations.
Because vitamin C is involved in wound healing, inflammatory regulation, and limiting oxidative stress, the body's need increases during recovery after surgery. Research shows that vitamin C levels regularly drop after surgeries, especially in people at increased risk of deficiencies, such as smokers, people with diabetes, or patients with a reduced nutritional status.
Vitamin C and recovery under physical stress
Vitamin C also seems to do more than just support collagen formation.
There is evidence that it is also involved in:
There is evidence that it is also involved in:
• activation and growth of fibroblasts: the cells that create new connective tissue and wound healing
• formation of new blood vessels
• protection of nerve tissue
• regulation of inflammatory processes
• reduction of damage to cells and tissues from stress and inflammatory reactions
• support of bone formation and connective tissue repair
Interestingly, research on vitamin C around surgeries not only shows effects on wound healing.
In studies on heart surgeries, vitamin C was associated with:
• fewer arrhythmias
• less oxidative stress
• shorter ICU stays
• less ventilation time
Also within orthopaedics and pain treatment, interesting results have been found. Various studies show that vitamin C around surgeries may be associated with:
• less postoperative pain
• less opioid use
• faster functional recovery
• possibly a lower risk of CRPS (Complex Regional Pain Syndrome) after orthopaedic procedures
The precise mechanism of action is likely multifactorial. Vitamin C appears to influence oxidative stress, inflammatory responses, nerve function, collagen formation, and possibly also body substances involved in pain regulation.
Vitamin C and the immune system
Vitamin C also plays an important role in the immune system. It supports various immune cells involved in inflammatory responses, wound healing, and protection against infections. Vitamin C also helps keep the skin and mucous membranes — important natural barriers of the body — healthy.
During physical stress, such as surgery or infection, the consumption of vitamin C increases. As a result, vitamin C levels can drop at times when the body actually has an increased need for recovery and defence.
Research shows that a vitamin C deficiency is associated with reduced immunity and a greater susceptibility to infections. At the same time, a good vitamin C status seems important for the optimal functioning of recovery and immune cells.
Recovery is about the big picture
During my training, I learned from my trainer to have patients start taking vitamin C at least four weeks before surgery, alongside Arnica. At that time, this was often viewed critically, as the scientific basis was limited.
In practice, however, I noticed that many patients appreciate being able to actively contribute to a good recovery. More and more research is now emerging on the role of nutritional status, vitamin C, oxidative stress, and recovery around surgeries.
Supplements alone do not ensure a successful recovery, of course. The body recovers best when multiple factors are in order:
• sufficient protein intake
• good sleep
• movement where possible
• quitting smoking
• stable blood sugars
• sufficient vitamins and minerals
• in good condition before the operation
An operation is not only a technical procedure, but also a form of controlled physical stress. The nutritional status with which someone enters an operation affects how the body recovers.
Not everyone needs high doses of supplements. But a body with deficiencies usually recovers less efficiently.
The literature mentioned in this article is just a small selection of the studies that are now available on this topic.
Literature
• Carr AC, Maggini S. Vitamin C and Immune Function. Nutrients. 2017;9(11):1211.
• Sarathy M et al. Effect of vitamin C on postoperative pain in patients undergoing lower limb surgery. JEMTAC. 2025.
• Pullar JM, Carr AC, Vissers MCM. The Roles of Vitamin C in Skin Health. Nutrients. 2017;9(8):866.
• Bechara N et al. A Systematic Review on the Role of Vitamin C in Tissue Healing. Antioxidants (Basel). 2022 Aug 19;11(8):1605.
• Moores J. Vitamin C: A Wound Healing Perspective. Wound Care. 2013.
• Thaler R et al. Vitamin C Epigenetically Controls Osteogenesis and Bone Mineralization. Nature Communications. 2022.
• Athanasiou A et al. Preoperative and Postoperative Administration of Vitamin C in Cardiac Surgery Patients. Annals of Medicine and Surgery. 2024.
• Han G et al. Effect of Perioperative Single Dose Intravenous Vitamin C on Pain After Total Hip Arthroplasty. Journal of Orthopaedic Surgery and Research. 2024.
• Mędrzycka-Dabrowska W et al. Vitamin C as an Adjuvant Analgesic Therapy in Postoperative Pain Management. Journal of Clinical Medicine. 2025.
• Lal Bhardwaj R et al. Foods. 2024.
• Golder J et al. The Prevalence, Risk Factors, and Clinical Outcomes of Vitamin C Deficiency in Adult Hospitalised Patients. Nutrients. 2025.