Let v(a) denote the numerical radius of an element a in a C *algebra A. An element a ∈ A is called the numerical radius Birkhoff-James orthogonal to another elementif and only if for each θ ∈ [0, 2π), there exists a positive state ϕ on A such that |ϕ(a)| = v(a) and Re e iθ ϕ(a)ϕ(b) ≥ 0. Moreover, we compute the numerical radius derivatives in A. In addition, we characterize when the numerical radius norm of the sum of two (or three) elements in A equals the sum of their numerical radius norms.2010 Mathematics Subject Classification. Primary 46L05, 47A12; Secondary 46B20, 46C50.