Vitamin C Works for Sepsis. Will It Work for Coronavirus?

According to the most comprehensive global analysis^1,2,3 done to date, sepsis is responsible for 1 in 5 deaths worldwide each year, killing 11 million out of 56 million people in 2017 alone. The researchers call the finding “alarming,” as their updated figures are double that of previous estimates.

Sepsis is a life-threatening condition triggered by a systemic infection that causes your body to overreact and launch an excessive and highly damaging immune response.

Unless promptly diagnosed and treated, it can rapidly progress to multiple-organ failure and death, so it’s crucial to be on the lookout for its signs and symptoms^4,5,6 whenever you’re ill or in the hospital.

This includes cases of suspected influenza, as sepsis can mimic many of the signs and symptoms of flu. In fact, as discussed in “The Alarming Reason Some People Die From the Flu,” sepsis is one of the leading causes for influenza deaths.⁷

Vitamin C Protocol Lowers Sepsis Mortality

The good news is, a protocol of intravenous (IV) vitamin C with hydrocortisone and thiamine (vitamin B1) has been shown to dramatically improve chances of survival.⁸

This sepsis treatment protocol was developed Dr. Paul Marik, a critical care doctor at Sentara Norfolk General Hospital in East Virginia. His retrospective before-after clinical study^9,10 showed giving patients 200 mg of thiamine every 12 hours, 1,500 mg of ascorbic acid every six hours, and 50 mg of hydrocortisone every six hours for two days reduced mortality from 40% to 8.5%.

Importantly, the treatment has no side effects and is inexpensive, readily available and simple to administer, so there’s virtually no risk involved. More recent research,^11,12 published online January 9, 2020, found Marik’s sepsis protocol lowered mortality in pediatric patients as well.

The study was performed at Ann & Robert H. Lurie Children’s Hospital of Chicago, and as noted by Science Daily,¹³ the preliminary data from this study “supports the promising outcomes seen in adults.” Between January 2014 and February 2019, 557 pediatric patients with septic shock met the criteria for inclusion in the study.

Forty-three received Mariks’s vitamin C-B1-hydrocortisone protocol, 181 received hydrocortisone-only therapy, and 333 received neither of these treatments. The 43 patients receiving the vitamin C treatment were matched based on clinical status with 43 untreated controls and 43 hydrocortisone-only patients.

At the 30-day mark, controls and the hydrocortisone-only groups had a mortality rate of 28% while the treatment group had a mortality rate of just 9%. At 90 days, 35% of the controls and 33% of those receiving hydrocortisone-only had died, compared to just 14% of the treatment group.¹⁴

As noted by the authors, “Our results suggest that HAT [hydrocortisone, ascorbic acid and thiamine] therapy, when administered early in the clinical course, reduces mortality in children with septic shock.”

Vitamin C Put to the Test Against Coronavirus

In 2009, IV vitamin C was shown to be a potentially lifesaving treatment against severe swine flu. Even before that, many studies had demonstrated the usefulness of vitamin C against infections of various kinds.

For example, a randomized double-blind study¹⁵ published in 1994 found elderly patients given 200 milligrams of vitamin C per day while hospitalized for acute respiratory infection fared significantly better than those receiving a placebo.

According to the authors, “This was particularly the case for those commencing the trial most severely ill, many of whom had very low plasma and white cell vitamin C concentrations on admission.”

Now, vitamin C will be put to the test against coronavirus as well. The study,¹⁶ “Vitamin C Infusion for the Treatment of Severe 2019-nCoV Infected Pneumonia” was posted to ClinicalTrials.gov February 11, 2020, and has not yet started recruiting patients. According to the study description:¹⁷

“At the end of 2019, patients with unexplained pneumonia appeared in Wuhan, China … Subsequently, the World Health Organization officially named the new coronavirus that caused the pneumonia epidemic in Wuhan as 2019 new coronavirus (2019-nCoV), and the pneumonia was named severe acute respiratory infection (SARI).

Up to February 4, 2020, over 20,000 cases have been diagnosed in China, 406 of which have died, and 154 cases have been discovered in other countries around the world. Most of the deaths were elderly patients or patients with severe underlying diseases …

Statistics of the 41 patients with SARI published in JAMA initially showed that 13 patients were transferred into the ICU, of which 11 (85%) had ARDS and 3 (23%) had shock. Of these, 10 (77%) required mechanical ventilation support, and 2 (15%) required ECMO support. Of the above 13 patients, 5 (38%) eventually died and 7 (38%) were transferred out of the ICU.

Viral pneumonia is a dangerous condition with a poor clinical prognosis … Vitamin C, also known as ascorbic acid, has antioxidant properties. When sepsis happens, the cytokine surge caused by sepsis is activated, and neutrophils in the lungs accumulate in the lungs, destroying alveolar capillaries. Early clinical studies have shown that vitamin C can effectively prevent this process.

In addition, vitamin C can help to eliminate alveolar fluid by preventing the activation and accumulation of neutrophils, and reducing alveolar epithelial water channel damage. At the same time, vitamin C can prevent the formation of neutrophil extracellular traps, which is a biological event of vascular injury caused by neutrophil activation.”

The researchers intend to treat patients with 24 grams of IV vitamin C per day for seven days at a speed of 7 milliliters per hour. The placebo group will receive an IV of normal saline.

The primary outcome measure will be the number of days without ventilation support during 28 days of hospitalization. Secondary outcome measures will include mortality, ICU length of stay, the rate of CPR required, vasopressor use, respiratory function, sepsis-related organ failure and more.

Time will tell what the outcome will be, but chances are it will be favorable. Back in 2003 during the SARS pandemic, a Finnish researcher called for an investigation into the use of vitamin C, stating:¹⁸

“Recently, a new coronavirus was identified as the cause of the severe acute respiratory syndrome (SARS). In the absence of a specific treatment for SARS, the possibility that vitamin C may show nonspecific effects on several viral respiratory tract infections should be considered.

There are numerous reports indicating that vitamin C may affect the immune system, for example the function of phagocytes, transformation of T lymphocytes and production of interferon. In particular, vitamin C increased the resistance of chick embryo tracheal organ cultures to infection caused by an avian coronavirus.¹⁹”

He goes on to cite research showing vitamin C also protects broiler chicks against avian coronavirus, cuts the duration and severity of common cold in humans and significantly lowers susceptibility to pneumonia. Unfortunately, it doesn’t appear as though vitamin C was ever studied in relation to SARS, but it’s encouraging that China is now investigating its use against 2019-nCoV.

Health Benefits of Vitamin C Are Vastly Under Appreciated

Vitamin C has two major functions that help explain its potent health benefits. First, it acts as a powerful antioxidant. It also acts as a cofactor for enzymatic processes. One of the most famous forerunners of high dose vitamin C treatment for colds and other disease was Linus Carl Pauling (1901-1994), a biochemist who won the Nobel Prize in chemistry in 1954.

Despite that, many felt he was too far out of his field of expertise with his research into nutrition, and his advocacy for vitamin C was largely ignored or mocked by mainstream medicine and nutritional science — with medical bloggers leading the pack as self-appointed judges of Pauling’s findings.²⁰

Others, however, have picked up on what Pauling was trying to point out, and are now trying to awaken the world to just how important vitamin C is for good health and vitality.²¹ As explained by the Linus Pauling Institute:²²

“Vitamin C is the primary water-soluble, non-enzymatic antioxidant in plasma and tissues. Even in small amounts vitamin C can protect indispensable molecules in the body, such as proteins, lipids (fats), carbohydrates, and nucleic acids (DNA and RNA), from damage by free radicals and reactive oxygen species (ROS) that are generated during normal metabolism, by active immune cells, and through exposure to toxins and pollutants …”

According to Dr. Ronald Hunninghake, an internationally recognized expert on vitamin C who has personally supervised tens of thousands of IV vitamin C administrations, vitamin C is “definitely a very underutilized modality in infectious disease,” considering “it’s really a premiere treatment” for infections.

In my interview with him, Hunninghake suggested one of the reasons why conventional medicine has been so slow to recognize the importance of vitamin C has to do with the fact that they’ve been looking at it as a mere vitamin, when in fact it’s a potent oxidizing agent that can help eliminate pathogens when given in high doses.

There are also financial factors. In short, it’s too inexpensive. Conventional medicine, as a general rule, is notoriously uninterested in solutions that cannot produce significant profits.

However, considering sepsis is now the most expensive condition treated in the U.S., costing $23.6 billion annually,^23,24 the need for an affordable solution is becoming critical. This is particularly true for lower income nations, where an estimated 85% of sepsis-related deaths occur.²⁵ Global pandemics like the coronavirus also call for lower-cost treatments that actually work.

Recognize the Symptoms of Sepsis

When it comes to sepsis, which can result from just about any infection, time is of the essence. It’s really important to familiarize yourself with its signs and symptoms, and to take immediate action if you suspect sepsis.

While the signs can be subtle at first, sepsis typically produces the following signs and symptoms:^26,27,28 Many of these symptoms may be confused with a bad cold or flu. However, they tend to develop quicker than you would normally expect.

The Sepsis Alliance recommends using the acronym TIME to remember some of the more common symptoms:²⁹

• T — Temperature higher or lower than normal?
• I — Have you now or recently had any signs of an infection?
• M — Are there any changes in mental status, such as confusion or excessive sleepiness?
• E — Are you experiencing any extreme pain or illness; do you have a “feeling you may die?”

Another acronym you could use to memorize the signs and symptoms is SEPSIS, described in the video above:

• S — Shivering (fever, cold)
• E — Extreme pain
• P — Pale, clammy skin
• S — Shortness of breath
• I — “I feel like I might die”
• S — Sleepy (confused)

Educational Resources for Your Doctor

Marik’s sepsis protocol can be a lifesaver, so you’d be wise to discuss it with your doctor any time you’re hospitalized. Remember, sepsis is often the result of a secondary infection contracted while in the hospital, so it’s prudent to be prepared.

This way, should you develop sepsis while you’re admitted, your medical team already knows your wishes and can act swiftly. According to Marik, the best results are obtained when the concoction is administered within the first six hours of presentation of symptoms.³⁰ The longer you delay treatment, the less likely it will be successful.

If your doctor refuses to consider it offhand, convince him or her to review the studies cited here.^{31,32,33,34,35,36,37,38,39} While there are certain situations in which the hospital may still deny this treatment, if you are an adult who is sick, you will usually have the right to insist on it. I will actually be interviewing Marik shortly and hope to work with him on developing a process to make it easier for patients to implement this strategy in their local hospital.

In most cases, you’d probably just need to sign an “Against Medical Advice — Acknowledgment and Waiver” form (samples of which can be found in the references⁴⁰), which states you’ve elected to not follow the standard of care recommended by your doctor.

Contraindication for IV Vitamin C Treatment

The only contraindication to high-dose vitamin C treatments such as Marik’s sepsis protocol is if you are glucose-6-phosphate dehydrogenase (G6PD) deficient, which is a genetic disorder.⁴¹ G6PD is required for your body to produce NADPH, which is a cousin of NAD+ and necessary to transfer reductive potential to keep your antioxidants, like glutathione and vitamin C, functional.

Because your red blood cells do not contain any mitochondria, the only way it can provide reduced glutathione is through NADPH, and since G6PD eliminates this, it causes red blood cells to rupture due to inability to compensate for oxidative stress.

Fortunately, G6PD deficiency is relatively uncommon, and can be tested for. People of Mediterranean and African decent are at greater risk of being G6PD deficient. Worldwide, G6PD deficiency is thought to affect 400 million individuals, and in the U.S., an estimated 1 in 10 African-American males has it.⁴²