The Black Hole of Vitamin C

When a plane crashes the black box is recovered, a device that records everything that’s gone wrong. The wreckage is combed through. Safety experts work out exactly what went wrong and changes get made across the industry.

Six months on from the first cases of COVID-19 countries are posting different death rates ranging from 5 to over 500 per million population. Intensive Care Units (ICUs) range from zero deaths in patients to two thirds on ventilators dying in the UK.

Professor Joseph Varon, Chief of Critical Care at the United Memorial Medical Centre in Houston, Texas says: “We’ve not had one single death. Not one.” Professor Paul Marik, at East Virginia Medical School Hospital says the same thing. “Actually, we had one resurrection. A patient came in, declared dead from a heart attack, but came back to life.” Between these two ICUs they reported these results after treating over 100 COVID-19 patients. There were two deaths in patients in their late 80’s, one with end stage liver cirrhosis and one with end-stage lung disease. The rest walked out alive.

In the UK the Intensive Care National Audit and Research Centre (ICNARC) collects the results from ICUs across the country. Back in April half of those entering ICUs, and two thirds put on ventilators, were leaving dead. A month on things have improved a little – overall mortality is 44 per cent and, for those on ventilators, down to 54 per cent.

What’s the difference? Vitamin C. The US ICUs reporting zero deaths are giving intravenous vitamin C, together with steroids and anti-coagulants. The UK ICUs shun vitamin C. Yet, even before the coronavirus had hit the British Isles medical experts in Wuhan, China, the epicentre of the first outbreak, had not only started using intravenous vitamin C, but had started a randomised placebo controlled trial, the gold standards of all research, at Zhongnan Hospital, part of the University of Wuhan. “We had seen vitamin C work with SARS patients” said Dr Zhi Yong Peng, in charge of the trial, registered with the National Institutes of Health, which meant it was in plain view of all medical experts in the field. Dr Peng gave critically ill, mechanically ventilated patients either a drip containing vitamin C or sterile water. “24 per cent of the vitamin C patients died, compared to 35 per cent of those given sterile water.” These preliminary results were released on April 6th. That’s more than half the mortality compared to the UK’s latest figure.

The results of the Chinese research, and the even better results of the American ICUs were given to NHS decision makers, also Public Health England, key cabinet ministers including Matt Hancock, the Minister of Health, and members of SAGE, the Scientific Advisory Group of experts. In fact, everyone in any position of influence. The response? Nothing. Instead of applying black box thinking it was as if anyone else’s findings disappear down a black hole.

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Same with the UK media. No paper or news channel picked up the story. The Mail ran a small piece on the Chinese trial results. In the US things were not much different. A couple of local papers picked up on the ICU successes. One of the group using vitamin C, Dr Pierre Cory, Chief of Critical Care in Wisconsin, was invited to present the results at the US senate. Did other ICUs follow suit? Did the media pick up on it? “It’s depressing. We’ve cracked the covid code and nobody wants to know about it.” Said Dr Paul Marik from East Virginia medical School.

Why? Because vitamin C doesn’t work for colds. ‘There is no evidence that taking vitamin C supplements could prevent or cure respiratory illness,’ reports Sky News ‘and limited evidence it can even prevent the common cold.’ Their dietician pointed out ‘We only needed 40 milligrams a day, which you can easily get from eating one large orange or a kiwi fruit’ The BBC reported the same thing in an article entitled ‘Can ‘boosting’ your immune system protect you? “A 2013 review by Cochrane – an organisation renowned for its unbiased research – found that in adults “trials of high doses of vitamin C administered therapeutically, starting after the onset of symptoms, showed no consistent effect on the duration or severity of common cold symptoms”. Another article quotes UK Professor Tim Spector “There’s some evidence that if you take large amounts just as you get a common cold, you can reduce the symptoms by about half a day. But you have to time it perfectly.” The Guardian’s expert, Dr Ali Khan puts readers off taking a vitamin C tablet from the chemist or supermarket. “ [it]won’t stop you getting an infection and it won’t help treat the infection”. Even researching vitamin C is described as ‘banal’. Vitamin C doesn’t work. You need a little to prevent scurvy, the serious vitamin C deficiency disease suffered by sailors in days of old, but half an orange or lime will sort it out. (That’s why they were called limeys.) Until this was discovered literally millions of sailors died from vitamin C induced pneumonia.

Most quote a review, in 2013, pooling the results of all studies on vitamin C and colds, done by Helsinki University’s Professor of Public Health Harri Hemila who is both a doctor and an expert in epidemiology and statistics. You could call him the Dr Spock of vitamin C. He’s been studying the evidence on vitamin C for over 40 years in meticulous detail. But he doesn’t agree with the critics citing his research. “Two controlled trials found a statistically significant dose–response, for the duration of common cold symptoms, with up to 6–8 grams a day of vitamin C. In those taking 8 grams in the first day 46 per cent had symptoms that only lasted for one day.” On average, these trials showed a 20 per cent reduction in the length of a cold. That’s about 1.5 to 2 days less. Is it a question of dose? “The negative findings of some therapeutic common cold studies might be explained by the low doses of 3–4 g/day.” says Hemila. In his 2013 review, pooling all studies, vitamin C did work, but not so well. Quoting the review “In adults the duration of infections was reduced by 8 per cent and in children by 14 per cent.” That works out at about half a day shorter cold in adults and a day in children. The severity is also less. As far as covid is concerned that would mean less going on to develop serious symptoms.

Something obvious is being missed, and seemingly even by medical experts in charge of saving lives, and that is that viruses expend vitamin C at an alarming rate and what you might need when seas are calm is completely different to what you need when you’re fighting an infection and a viral storm is raging. A giant clue that this might be true comes from animals who make vitamin C – all do except for primates, the guinea pig and fruit-eating bats. They make in the order of ten times more when under viral attack. That, by the way, is why the guinea pig became the experimental animal of choice – because it shares our vulnerability to infections and inability to make vitamin C.

Dr Anitra Carr is an expert in vitamin C and pneumonia. She does medical research in the Department of Pathology at New Zealand’s University of Otago. She’s been measuring vitamin C levels in their pneumonia patients and most, indeed all the most seriously ill, have vitamin C levels that would diagnose scurvy. The same is true in patients suffering with ‘sepsis’, a bacterial infection which, like COVID-19, triggers a massive inflammatory reaction that kills people if it isn’t rapidly brought under control. That’s Professor Paul Marik’s speciality – saving the lives of sepsis patients in his ICU. “Almost all my sepsis patient we’ve tested have scurvy levels of vitamin C. My colleagues have been testing their covid patients in ICU and they almost all have undetectable levels of vitamin C – undetectable.” They too, like the sailors of old, are dying in their thousands of pneumonia and cytokine storm. “It’s not the virus that’s killing them but the acute inflammation. That’s why we have to use both intravenous vitamin C and steroids to bring down the inflammation. These people have a virally-induced scurvy.” He also gives anti-coagulant drugs because one of covid’s nastiest effects is blood clots in the lungs that make it hard for people to breathe.

Massive inflammation? Disease-induced scurvy? These would be big clues for our black box detectives. The key, however, starts with an experiment in 1927 at Cambridge University by a Hungarian scientist called Albert Szent-Györgyi, who was later awarded the Nobel Prize for discovering vitamin C, highly concentrated in the adrenal cortex. The middle (medulla) of the adrenal glands in the small of your back make adrenalin, the fast-acting stress hormone. The outer part, the cortex, makes cortisol which is a fast-acting anti-inflammatory hormone. It also stores vitamin C. When stimulated by stress, or acute infection, the adrenals not only secrete the steroid hormone, but also vitamin C, raising blood vitamin C levels by about a hundred times more than normal. But if a person has run out of vitamin C that can’t happen. They’ve run out of defences. The body’s innate ‘fight’ doesn’t kick in and the person dies. So what doctors like Marik are doing by giving both vitamin C and steroid hormones that copy cortisol’s anti-inflammatory effects is in effect mimicking what the body would do if it had vitamin C reserves. It also makes sense of why animals that make vitamin C make a lot more when put into acute stress situations. A goat, for example, will normally make 15 grams a day – that’s 250 oranges worth – but when under stress can increase production to 100 grams a day. Now that’s a long way off the ‘eat an orange to prevent scurvy’ zone.

By now any black box detective would realise that the same rules regarding vitamin C for preventing scurvy in healthy people to those actively fighting a potentially life-threatening infection don’t apply. But why don’t our frontline doctors know this?

Professor Harri Hemila wrote to the British Medical Journal, and the Lancet, back in March pointing this out. His letter said “Because the disease caused by the new coronavirus is much more severe than the ordinary virus infections.. [this] may justify a regular increased daily intake of vitamin C for the period when the prevalence of the virus is high. Furthermore, the major cause for concern about COVID-19 is the high frequency of ICU treatment that is needed. A meta-analysis of 12 trials with 1766 patients found that vitamin C had shortened ICU stay by 8%. Another meta-analysis of eight trials found that vitamin C shortened the duration of mechanical ventilation in patients who needed longest ventilation…when a patient suffers from a virus infection there may be a vitamin C dose response for up to 6-8 g/day. Vitamin C is a safe and inexpensive essential nutrient and therefore even small to moderate benefits may be worthwhile.” They refused to publish his letter. It went into the black hole and doctors stayed in the dark.

Meanwhile back in China, on February 2nd a truck arrived in Wuhan from the DSM vitamin C factory carrying 50 tons of vitamin C, that’s 50 million grams, which was then distributed to hospitals where it was handed out to hospital workers and patients, and given intravenously in most ICUs. By March this had become a state mandated treatment policy as issued by the Shanghai Medical Association. By early March, a month since the vitamin C delivery, there’s virtually no new covid patients entering ICUs. The lack of patients is so dramatic that Dr Peng has to stop his trial early because he’d run out of patients. It seems that experts there were applying black box thinking.

All this information too, was shared with all medical and political influencers, and mainstream media in the UK. What happened? It went into the black hole of vitamin C. Only one ICU in the UK that we know of gives vitamin C, a mere 2 grams, a fraction on the dose used by the ICUs in China and the US that are reporting the best results. “That’s not enough to save lives.” Says Marik.

So here we are, six months later, counting almost 40,000 deaths, roughly the same level of monthly deaths reported back in the 16th and 17th century when sailors set out across the globe unknowingly under-supplied with vitamin C. Are we really back in the Dark Ages? Isn’t it time someone took vitamin C out of the black hole and looked inside the black box? We clearly need a quantum paradigm shift.