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Vitamin C and the Novel Coronavirus

Vitamin C and the Novel Coronavirus

Main points

  • Vitamin C and the Common Cold
    • It can shorten the course of a cold and we have some data that it prevents the common cold
    • Exists but the scientific community has not reached a consensus about prevention
  • Vitamin C and other Infections
    • We have evidence that high dose Vitamin C can save lives in bad infections
  • Vitamin C and the Coronavirus
    • IV Vitamin C is already being used to treat COVID-19. You can do it at Health  and Wellness of Carmel

Vitamin C and the Common Cold

Almost singlehandedly Nobel Prize Winning Scientist Linus Pauling popularized the idea that Vitamin C could help viral respiratory infections. He took his work to the public in his classic 1970 book “Vitamin C and the Common Cold.” (1)  His research has been hotly debated since then with the general scientific census being that some studies support its use for this purpose while others did not..  Oregon State University has an entire center devoted to Linus Pauling’s research. The Linus Pauling Institute which gave an excellent summary of Pauling research affirms that the lack of consensus may be from a general lack of understanding of how Vitamin C really operates in the body (its pharmacokinetics)  (2).

One of the more respected reviews of the literature, The Cochrane database in 2004, noted regardless of its status for preventing the cold, it appears to have benefit in shortening the course. (3)

Regarding the new coronavirus, there could be real temptation to say, “We’ve been talking about Vitamin C since 1970. I have been there done that, bought the t-shirt, let’s move on.”  However, some researchers say, “not so fast.”

Vitamin C and other Infections

Beyond the common cold, The Journal of Orthomolecular Medicine reports successful use of IV Vitamin C for Influenza (4) Mononucleosis (5) and Zika Fever. (6)

More pursuant to Coronavirus, Fowler reports a case study in which Vitamin C lead to a dramatic turnaround of Viral induced Acute Respiratory Distress Syndrome (ARDS) (7). In this report, a 20 year old women so sick with a viral induced ARDS that she had to be placed on the absolute last ditch therapy doctors can do full heart, lung bypass (aka extracorporeal membrane oxygenation, ECMO).  She was then was given high dose IV Vitamin C and subsequently made a full recovery.    ARDS is the main mechanism by which people with the new coronavirus die.

ARDS is often part of a pervasive medical crisis called sepsis in which an infection leads to such an inflammatory storm that the organs of the body shut down.  Vitamin C has been used to treat that also.

Recognizing the potential for Vitamin C to calm the inflammatory storm of sepsis, researchers in 2017 did a randomized trial of 94 patients (8).  Half got IV Vitamin C along with Vitamin B1 and hydrocortisone (a natural hormone to the body depleted in massive stress).  Of The placebo group 40.4% died while only 8.5% of the treatment group died. (p=0.002)*.

Are kidding me?

How is this not better known? That’s a nearly 80% reduction in death!  Could it be that these things being natural to the body were unpatentable from which no significant money could ever be made?  Shockingly, another Vitamin C trial from 1994 of also lead to an 80% reduction in death but that was such a small study it didn’t quite make “statically significance” (9).

Truth be told, it would appear that not every study of IV Vitamin C shows such dramatic results.  One came out just last October whose authors suggested that they were not as impressed with the biomarkers as they hoped, but if you dive into the article, there are hidden pearls.   They present in this graph:

*”P=…” represents the probability that there really was no difference and we got that result just by chance. Here it means there is only a 2 in 1000 probably this could have occurred by chance. The agreed upon cut off is < 0.05)

Vitamin C and the Novel Coronavirus

This means that the Vitamin C group had such a dramatically lower risk of death that the chance that it was a fluke was only 1% (p=0.01).  ICU free days in the first 28 were 11 in the Vitamin C Group and 0 in the placebo group (p=.03), but in the summary (which is often the only thing busy doctors read) they only report about biomarkers.

Why these results didn’t make it into the abstract is beyond me.

Isn’t life and death a bit more important than blood tests?

Coronavirus and Vitamin C

Of course, the new coronavirus is something we have not seen before, but so far, Vitamin C is looking promising.  China is now in the midst of doing studies on Vitamin C for coronavirus (10).

Dr. Richard Cheng, a leader in use of Vitamin C for the coronavirus, says, “Early and sufficiently large doses of intravenous Vitamin C are critical. Vitamin C is not only a prototypical antioxidant, but is also involved in virus killing and prevention of viral replication. The significance of large dose intravenous Vitamin C is not just at antiviral level. It is acute respiratory distress syndrome (ARDS) that kills most people from coronaviral pandemics (SARS, MERS and now NCP). “ARDS is a common final pathway leading to death”. (11)

Another researcher, Dr. Mao, stated that his group treated ~ 50 cases of moderate to severe cases of COVD-19 infection with high doses of IV Vitamin C. The IV Vitamin C dosing was in the range of 10,000 mg to 20,000 mg a day for 7-10 days with the 10,000 mg for moderate cases and the 20,000 for more severe cases, determined by pulmonary status (mostly the oxygenation index) and coagulation status. All patients who receive IV Vitamin C improved and there was no mortality. Compared to the average of a 30-day hospital stay for all COVID-19 patients, those patients who received high dose IV Vitamin C had a hospital stay about 3-5 days shorter than the overall patients (12).

Dr. Mao, in fact, was a leader amongst the 38 experts in Shanghai who wrote a consensus paper from a main hospital doing this to other hospitals urging them to adopt high dose IV Vitamin C (13).  In it they state that part of the treatment is:

Prevention of “cytokine storm”:
It is recommended to use high-dose vitamin C and unfractionated heparin for anticoagulation. High-dose vitamin C is intravenously injected from 100 to 200 mg / kg per day.

It seems that what we have here is a treatment for which there is mounting evidence for working that comes generally without side effects. High dose IV Vitamin C has been clinically used for several decades and a recent NIH expert panel document states clearly that high dose IV Vitamin C (1.5 g/kg body weight) is safe and without major side effects (14).

Should we be using high dose Vitamin C in hospitals here?

YES.

In fact, desperate doctors already are in New York City (15-20).

Should you take it now?

We recommend 2 g three times a day orally as an extra layer of protection and yes for extra support or to treat symptom we can do high dose IV Vitamin C in our office.  If you want that, call ahead. We have lot of people doing it.

1  Pauling, Linus, Vitamin C and the Common Cold , Freeman, San Francisco  1970

https://lpi.oregonstate.edu/mic/vitamins/vitamin-C

https://www.ncbi.nlm.nih.gov/pubmed/10796569

4 https://isom.ca/article/high-dose-vitamin-c-influenza-case-report/

5 https://isom.ca/article/intravenous-vitamin-c-infectious-mononucleosis-case-report/

6 https://www.isom.ca/wp-content/uploads/High-Dose-Intravenous-Vitamin-C-Treatment-for-Zika-Fever-31.1.pdf

7 https://www.ncbi.nlm.nih.gov/pubmed/28224112

8 https://www.sciencedirect.com/science/article/abs/pii/S0012369216625643

9 https://www.ncbi.nlm.nih.gov/pubmed/7814237

10 https://clinicaltrials.gov/ct2/show/NCT04264533

11 https://www.globalresearch.ca/three-intravenous-vitamin-c-research-studies-approved-treating-covid-19/5705405

12     https://orthomolecular.activehosted.com/index.php?action=social&chash=0a09c8844ba8f0936c20bd791130d6b6.148&s=bad97c655476f96a390a72c05a742011

13  https://mp.weixin.qq.com/s/bF2YhJKiOfe1yimBc4XwOA
http://orthomolecular.org/resources/omns/v16n11-chi.shtml

14   High-Dose Vitamin C (PDQ(r))-Health Professional Version – National Cancer Institute
[Internet]. [cited 2020 Feb 9]. Available from: https://www.cancer.gov/about
cancer/treatment/cam/hp/vitamin-c-pdq

15    https://www.dailymail.co.uk/news/article-8149191/New-York-hospitals-treating-corona-patients-6000-milligrams-VITAMIN-C.html

16 https://www.newsweek.com/new-york-hospitals-vitamin-c-coronavirus-patients-1494407

17 https://www.washingtonexaminer.com/news/new-york-hospitals-giving-patients-16-times-the-daily-recommended-dose-of-vitamin-c-to-fight-coronavirus

18 https://www.dailymail.co.uk/news/article-8149191/New-York-hospitals-treating-corona-patients-6000-milligrams-VITAMIN-C.html

19 https://newyork.cbslocal.com/2020/03/25/max-minute-whats-the-deal-with-high-dose-vitamin-c-helping-ward-off-coronavirus/

20 https://www.techtimes.com/articles/248318/20200324/overdose-of-vitamin-c-actually-effective-against-covid-19-doctors-think-so.htm

Bruce Thomas, MD