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Prednisone will SUCK the vitamin C out of your body faster then you can say boo (that was our experience). However, Vit. C will give you strong cell integrity to help prevent bleeding. It is not recommended to take high doses of C though without having a G6PD test run first. If one has this gene deficiency, large doses (I mean like 5K +) can damage the body. The gene deficiency is mostly seen in those of asian descent. However, we did this test anyway as a precaution (we were using HIGH doses of C).
As a side note - when Luke's count were zero for so long (3 months), we were using HIGH doses of powdered vit. C to keep his cell integrity strong. It doesn't prevent bleeding, but it did make the cells less likely to burst. So long as he was on it we managed to keep him from any bleeding episodes (minus the prednisone incident). If we dropped the vit. C at all he would start to get bloody noses and petechiae. We did find that using capsules did NOT work as it took too long for them to open in the gut and simply caused the runs. But powder put into applesauce goes straight into the blood stream and works well for cell integrity. When Luke started bleeding we started researching and found that prednisone actually leaches vit. C from the body. Which is something else to consider in all this.
The trick with Vit. C is to NOT use capsules but use powder put into applesauce or some other tolerable substance. Bowel tolerance is MUCH higher with powder because it absorbs immediately whereas the capsules have to dissolve first. That might seem trivial but if he has ITP, he has gut damage (that's a given), which means dissolving that capsule will take longer which means the vit. C is further into the intestinal system before it actually can hits his blood stream. This causes way more bowel disturbance. We did 2500mg. of powdered vit. C 6 times a day in 3 tbls or so of applesauce and that worked well for our boy. Your son's tolerance level will be different, but the goal is to get cell integrity at whatever dose he can handle. I would recommend using powder (or opening the capsules) as he'll be able to handle more and have better cell integrity. Also, spreading throughout the day is crucial. Minimum 5-6 times is what we aimed for.
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