NutriStack
Esomeprazole and Vitamin C, a caution.
Esomeprazole lowers the concentration of bioavailable vitamin C in the stomach. In healthy volunteers, four weeks of a PPI reduced plasma vitamin C by about 12% even on a stable diet. The reduction is mostly subclinical but may matter for people with marginal vitamin C intake or active H. pylori infection.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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What the row says.
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At a glance
- Substances
- Esomeprazole and Vitamin C
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. Esomeprazole lowers the concentration of bioavailable vitamin C in the stomach. In healthy volunteers, four weeks of a PPI reduced plasma vitamin C by about 12% even on a stable diet. The reduction is mostly subclinical but may matter for people with marginal vitamin C intake or active H. pylori infection.
Mechanism. Vitamin C is secreted into gastric juice in its active reduced (ascorbate) form, which is unstable at the higher pH produced by PPIs. The result is faster oxidation to less-bioavailable dehydroascorbate and lower systemic vitamin C levels.
Recommendation. Eat vitamin C-rich foods daily while on esomeprazole. If supplementing, a standard 250-500 mg dose taken with a meal is reasonable; there is no need to separate dosing from the PPI.
Sources (2)
- Henry EB, Carswell A, Wirz A, Fyffe V, McColl KE. Proton pump inhibitors reduce the bioavailability of dietary vitamin C. Aliment Pharmacol Ther. 2005;22(6):539-45. PMID 16167970
- Freedberg DE, Kim LS, Yang YX. The Risks and Benefits of Long-term Use of Proton Pump Inhibitors: Expert Review and Best Practice Advice From the American Gastroenterological Association. Gastroenterology. 2017;152(4):706-15. PMID 28257716
Stack Score
How this pair moves the number.
Effect on the composite score
If both Esomeprazole and Vitamin C are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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