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Monthly Archives: March 2020

New York Listens as Vitamin C Intravenous Becomes a Treatment Tool in COVID-19.

March 24 2020

It has been released today in the New York Post that vitamin C given by intravenous injection becomes a treatment tool for COVID-19.  The preliminary data from China on how patients did better sparked an interest to US physicians on how to better help out their patients during this pandemic.  In addition to some of the known drug treatments such as hydroxychloroquine and azithromycin being explored plus other current standard supportive approaches used in the management of COVID-19, vitamin C has now been officially added to the experimental toolbox (i.e. similar in approach to the Shanghai Protocol in China). Congratulations to New York pulmonologist and critical-care specialist Dr. Andrew Weber and team for putting politics aside, and to do whatever it takes to help patients during this critical time in a  hospital setting.  We will now be able to try and assess how treatment outcomes compares to China in the management of COVID-19 with the addition of this popular and yet controversial vitamin.  Some would have used a higher dosing model than what is being used in New York.  Time will tell.

https://nypost.com/2020/03/24/new-york-hospitals-treating-coronavirus-patients-with-vitamin-c/

As everyone talks about Chloroquine, including President Trump, to potentially help in the treatment of novel coronavirus COVID-19, again, where is vitamin C?

March 22 2020

There has been preliminary research from China suggesting that the anti-malaria and anti-inflammatory drug hydroxy-chloroquine (i.e. Plaquenil) may have value in the treatment of COVID-19.  People are now stock pilling this drug. However what has been missed in the mainstream media, which has also been utilized in the management of COVID-19, is vitamin C given by intravenous injection.  In fact it has been suggested from China that vitamin C should be used early on in treatment and that it appears to decrease hospital stay and support recovery.  There is a medical protocol from China known as the “Shanghai Protocol” that details both the conventional (i.e. using drugs, ventilators, etc.)  plus vitamin C intravenous in addition to Traditional Chinese Medicine in the management of COVID-19.  The document is written in Chinese and is by the Shanghai Medical Association entitled “Expert consensus on comprehensive treatment of coronavirus disease in Shanghai 2019”. All combined this approach may also help to support the weakened body and immune system recover which may be an important missing piece.  Does this help improve survival? Again this may also help decrease the load in the overloaded hospitals such as Italy and other potential regions of the world.  Drugs have limits and especially when the body is tired and overloaded – an observation repeatedly seen in our cancer care practice throughout the years. I have not heard of other European, Canadian or US hospitals utilize this potential tool as of yet but rather only the drugs have been emphasized (besides ventilators, ECMO, etc.).  I have observed that China is not polarized in this area but rather integrates whatever may help.  In my experiences using vitamin C intravenous in cancer, the earlier integrated in care the better and I would assume the same would apply in COVID-19 treatment as in what has been suggested in China.  And once again, vitamin C is a low cost and relatively low side-effect tool with a long history of use.

Intravenous Vitamin C and the Treatment of Acute Respiratory Distress Syndrome? – A Case Report

March 11 2020

I recently learned about a published case report from the United States in 2017 on the use of intravenous vitamin C involved in the treatment of virus-induced acute respiratory distress syndrome (ARDS) similar to what the Coronavirus can do in select groups (see reference below). When reading the details of this case I was reminded about my home roots and the poor unfortunate people of Italy with the current COVID-19 outbreak and the lives lost. Our hearts go out to them in support.

In particular, this case involved a 20-year-old, previously healthy, female who contracted respiratory enterovirus/rhinovirus infection in central Italy while on an 8-day spring break from college. During a return flight to the United States, she developed increasing shortness of breath and low blood oxygen that rapidly developed into acute lung injury that led to acute respiratory distress syndrome. When hospitalized and support with mechanical ventilation failed, extracorporeal membrane oxygenation (ECMO) was initiated. ECMO can be used in late-stage respiratory failure to try and oxygenate the blood using a machine outside the body. Twelve hours after beginning ECMO, high dose intravenous vitamin C began and administered every 6 hours, 24 hours per day. The patient’s recovery was rapid. ECMO and mechanical ventilation were discontinued by day-7 and the patient rapidly recovered with no long-term ARDS after-effects. She was discharged home 12 days following hospitalization, requiring no oxygen therapy. Follow-up exam 1 month after the patient’s initial hospitalization revealed her to have completely recovered. Again no complications.

While this is a single case report and there can be levels of criticism, it also involved a younger patient with no known health conditions vs. a senior that typically has other diseases, a different virus than the Coronavirus, it nonetheless was used to treat a similar presentation of a virus-related acute respiratory infection that could have been deadly. China has been public about integrating intravenous vitamin C in the treatment of COVID-19 acute respiratory infection that I have discussed in a previous article. It would be unfortunate to later learn that something as simple as vitamin C given by intravenous injection may have helped to offset some of the deaths or complications reported in the media.   I hope Italy will be as pro-active as some of the centres in China in taking bold measures in helping out their citizens and explore vitamin C. In my opinion, intravenous vitamin C should be given a chance in the evolving experiment of treating COVID-19 and the acute respiratory problems that may occur.

References:

https://www.wjgnet.com/2220-3141/full/v6/i1/85.htm

https://www.lemmo.com/with-the-growing-fears-of-coronavirus-covid-19-where-is-vitamin-c/

With the growing fears of coronavirus COVID-19 where is vitamin C?

March 1 2020

There is now constant social and news media outlet reports regarding the spread of coronavirus COVID-19, its pandemic or rising global concerns, the search for a vaccine, the fears on the complications it can have (i.e. which can include death), where even here in Vancouver, Canada upcoming spring-break trips involving families are being cancelled, people are stocking up on home supplies in droves at Costco, all the while there is an interesting simple experiment in the works in China which involves vitamin C and COVID-19.

At ground zero, in the Wuhan province of China, a hospital is exploring the use of simple vitamin C given by intravenous injection to help treat those infected with the COVID-19 virus and the complications that it causes (i.e. severe acute respiratory infection). A legitimate clinical trial has been created and is listed at the US National Institute of Health (NIH) database. To my knowledge this is a first in the modern global era on the use of vitamin C as a potential immune, body supportive, anti-viral agent integrated into conventional hospital protocols targeting a population group with a potentially contagious virus on the verge of becoming a global pandemic. Personally, I am not too surprised about the progressive stance of China as I have been seeing growing noteworthy trends from the scientific literature on the use of intravenous vitamin C applied in the surgical, oncology, and hematology hospital settings. A PhD by the name of Dr. Andrew Saul here in North America has been talking about this COVID-19 and vitamin C issue for quite sometime on social media and reports to be in regular contact with researchers in China on the matter.

It has been repeatedly reported in the historic literature that vitamin C may play an active role in the fight of infection (i.e. a non-specific anti-viral, anti-microbial agent). For example a 2017 study from Finland by Dr. Harri Hemila MD PhD from the Department of Public Health discusses this potential use of vitamin C and is free to read online which is also listed on the NIH database called PubMed and where dosing information can be found (references below). Furthermore Dr. Hemila and colleague also published in the highly respected Cochrane in 2013 on how vitamin C supplementation could have a role and how it could prevent and treat pneumonia in those high-risk groups and in those who have lower blood levels of vitamin C. Interestingly how many people do you know where their vitamin C levels have been checked when not feeling well? Do you know if you are low or borderline? Are such persons more vulnerable? I don’t know personally from myself either as it is not a routine blood test. Regardless while there is no known or approved anti-viral agent or agents or protocol known to help treat COVID-19 many drugs are rightfully being used regardless in hospital for such positive and potentially life threatening cases. So why isn’t the rest of the world (besides China) also exploring vitamin C into the mix of treatments for COVID-19? I have not heard one word.

What would be the harm with even a more general oral supplementation in those who are worried as a preventative or those who feel weak or are vulnerable for even short-term use (i.e. a few months)? Overall vitamin C can be quite a benign vitamin with perhaps the chance of looser stools / diarrhea-like symptoms for those who take too much orally or have sensitive bowels. The value of the intravenous route is it can bypass the gut and is thus 100% absorbed (i.e. no stomach upset).

People are wearing masks all over the world in fear, in the hopes of protection, and we are uncertain if this approach helps. Can a relatively gentle oral vitamin C program assist here? We know some people are carrying the virus without any obvious signs or symptoms. Is this because their immune system is keeping it controlled? Do they have good vitamin C stores in the body? We need to learn from these people. In one recent 2019 paper from the U.K. by Dr. Myint and team, higher blood vitamin C levels which was used as a marker for higher fruit and vegetable consumption was linked with reduced risk of respiratory illnesses including non-smoking-related cancer incidence and death. A good diet most likely does not hurt along with being physically active. Moreover, fundamental good hygiene principles such as hand washing and protecting / respecting others if you personally do not feel well, are sick, or are feverish are of importance.

Vitamin C has also been shown to help with stress too as its involved with the hypothalamic pituitary (HPA) axis and neurotransmitter function. We know people are scared. From personal clinical experience, in helping patients with challenging medical conditions, vitamin C can have a role. We know that older more senior populations perhaps those with pre-existing health conditions may be a target population for this virus and the potentially serious complications it can cause. Perhaps they should be pro-actively supplemented with oral vitamin C while we learn more.

What people do not understand, including most healthcare providers, is that a person does not need to have “scurvy”, or more severe signs of vitamin C deficiency, to be low or marginally deficient for yet to demonstrate beginning signs or symptoms of inadequate vitamin C levels in the body. People seem to forget that one of the first symptoms of vitamin C deficiency is fatigue (i.e. a sign of the body not running optimally). I know there are many roads to fatigue but lower vitamin C can also be one and especially in those with pre-existing medical conditions. If you are tired your immune system can be too.

I hope to hear more about vitamin C and its potential roles with COVID-19 in the news media and considerations of an experimental pro-active prevention model in more vulnerable population group using supplemental vitamin C. British Columbia has been proactive in its response and testing for COVID-19 and should be congratulated. It would good to also hear about how vitamin C, simple, readily available, cheap, and with minimal risks overall may also play in those affected with COVID-19 but also for its potential applications in prevention while an effective safe vaccine waits. A lesson can be learned from the Chinese model in thinking outside the standard box. This has become a much more concerning global public health matter and no stone should be left unturned.

Dr. Walter Lemmo, N.D.

References:

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5409678/

https://www.cochrane.org/CD005532/ARI_vitamin-c-for-preventing-and-treating-pneumonia

https://www.ncbi.nlm.nih.gov/pubmed/30705384

https://www.ncbi.nlm.nih.gov/pubmed/11862365

https://www.ncbi.nlm.nih.gov/pubmed/25010554