vitamin-c-pills_2471431b

Before I got sidetracked with a certain topic that’s consumed the blog, another topic that had popped up (albeit nowhere near as frequently) was the latest Ebola virus disease outbreak in Africa, the largest in history thus far. Indeed, as horrific as this outbreak is and as terrible a disease as Ebola is, with close to a 60% mortality even with the best treatment, it did produce one amusing bit of clownishness, and that’s that it revealed that there really is something too quacky even for Mike Adams of NaturalNews.com to tolerate.

I’m referring to an incident four weeks ago where a truly deluded Norwegian homeopath named Kjetill Oftedal posted on NaturalNews.com a recipe for a homeopathic remedy for Ebola that actually took the precepts of homeopathy seriously. What do I mean by that? Whereas previously discussed homeopathic remedies for Ebola used various snake venom that caused bleeding (you know, using something that causes one Ebola symptom in the healthy) as its starting material, Oftedal went one step farther and actually recommended getting blood or other bodily fluid from an Ebola victim as the starting material and then homeopathically diluting it away to nothing. He then recommended using it to prevent and treat Ebola virus disease. So quacky was this that Mike Adams, in an unprecedented bit of seeming responsibility, took it down. Still, it’s not too quacky for Oftedal, who promptly republished the post on his own blog. So it ever was with the unsinkable rubber duck of quackery that is homeopathy.

Although news about Ebola had faded to a dull roar in the background, the quackery for Ebola continues unabated, including colloidal silver, herbal remedies, and lots more. One feels for those poor leaders of west African nations who, in addition to having an outbreak of a highly lethal infectious disease within their borders to contend with, no doubt also have to contend with well-meaning quacks sending them letters about the glories of some nonsense or other that is touted as being able to save their people.

Take high dose vitamin C (please).

I don’t know how I missed this particularly irresponsible bit of quackery promotion, given that it’s in a blog in the Windsor Star, which is just across the river, but I did. About a week ago, there appeared a blog post entitled Dr. Gifford-Jones: Are West Africans needlessly dying from the Ebola virus? I don’t know if it also appeared in the Star print edition, but sincerely hope that it did not, although I do know that it apparently first appeared on Dr. W. Gifford-Jones’ website a couple of weeks before, a site that, not unexpectedly, contains a quack Miranda warning in Gifford-Jones’ bio page. One wonders what docs across the Detroit River are thinking, but I know a few and bet that they think this post is every bit as irresponsible as I think it is. For shame, Windsor Star!

I mean, get a load of what Dr. W. Gifford-Jones has to say:

But the great tragedy is that by failing to read history, researchers and doctors have, in the past, condemned millions to die from viral disease. Now it is happening again in West Africa. So what will happen if a case of Ebola disease occurs in this country?

Currently, Canada and other nations are scrambling to send untested drugs and vaccines to West Africa. Yet, in all the headlines and media stories surrounding this epidemic, not one word is spoken of the proven intravenous use of vitamin C as a cure.

One wonders why “not one word” is spoken of the “proven” intravenous use of vitamin C as a cure for Ebola. Could it be because it’s neither “proven” nor a “cure”? Nahhh. Couldn’t possibly be, could it? It couldn’t be because doctors generally don’t speak of quack cures in anything other than dismissive tones; that is, when they bother to mention them at all. It must be because physicians are ignorant or in the pocket of big pharma or both, right? Send those untested drugs over to Africa because the biotech company wants to make money. Oh, wait. There was a great deal of consternation among the CDC and the biotech company that makes the drug about using ZMapp, an experimental drug that was tried last month on two Americans who contracted Ebola, was reluctant to use it because it’s hard to make and because it had not even passed phase I trials yet.

But Dr. Gifford-Jones is just getting warmed up:

Medical history shows that ignorance, or arrogance, a better word, has been a common human trait of the medical community. One of the most flagrant examples is how Dr. Frederick R. Klenner was treated by his colleagues after saving polio patients from paralysis.

Klenner was a virtually unknown family doctor, in a small North Carolina town. He had no training in virology, no research grants and no experimental laboratory. But he had an open mind to new ideas.

In 1942 his wife suffered from bleeding gums and the local dentist suggested removing all of her teeth. Klenner justifiably considered this a Draconian solution. He recalled research that vitamin C had cured this problem in chimpanzees. Klenner gave his wife several injections of vitamin C. Her bleeding stopped.

Lovely. So apparently a dentist misdiagnosed scurvy. Or something. But this was only the start. Like all quacks with delusions of grandeur, for Klenner curing something as prosaic as bleeding gums wasn’t enough (although I must admit that removing all the teeth seems a rather radical treatment for bleeding gums). Too boring. Too…unimportant. Klenner moved on to viral pneumonia, allegedly curing a patient who was “near death” from the disease. But even that wasn’t enough. Oh, no. Klenner then went on to cure…polio! Of course! here’s the account:

During the polio epidemic of 1948, Dr. Klenner was placed in charge of 60 polio patients. He decided to prescribe large injections of vitamin C. None of his patients developed paralysis.

In 1949, Klenner related his findings at the Annual Meeting of the American Medical Association, and asked doctors to comment. One authority on polio ignored his monumental finding, instead promoting the need for tracheotomy in polio patients. Other polio specialists commented, but none referred to the use of vitamin C. It is almost unbelievable that this happened.

Has anyone ever noticed how quack claims are so difficult to track down. Many of them tend to involve events that happened many decades ago that have, over the many retellings, evolved into legends. Think Max Gerson and his “50 cases.” Think Cantron/Entelev/Procell. The list goes on.

A search for Klenner and his polio “cure” yields hits that nearly all come from pro-quackery sites, such as Whale.to and Orthomolecular.org. There’s also a chapter in a free book in which he describes his beliefs and evidence that vitamin C can cure polio. It is basically identical to this publication, represented as his actual presentation to the AMA in 1949. One aspect of his treatment that amazed me was that this was some truly high dose vitamin C. I mean, seriously. Klenner administered 2,000 mg (that’s 2 g, people) of ascorbate every six hours (8 g/day) supplemented with 1,000 to 2,000 mg by mouth every two hours (that’s 12 to 24 g). So basically, Klenner treated polio with 20 to 32 g per day of ascorbate. for the prototypical 70 kg man used in medical school as a teaching reference for drug doses, that’s nearly half a gram per kg body weight. In the Wikipedia entry on Klenner, which is remarkably skepticism-free, he is described as having administered up to 300,000 mg (300 g!) of ascorbate per day. For those who aren’t scientists in the US and therefore might be metric system-challenged, that’s 0.66 lb of ascorbate.

A search of Pubmed on F. R. Klenner reveals five publications, ranging from 1948 to 1952, all of them in the same journal, which doesn’t appear to be a particularly prominent journal, and unfortunately no abstracts available for any of them. (Whatever his other publications, I’m guessing, they must not be indexed in PubMed.) A review of the titles of the articles match the titles of chapters in a book, Injectable Vitamin C: Effective Treatment for Viral and Other Diseases. It includes titles such as: The Vitamin and Massage Treatment for Acute Poliomyelitis and Massive Doses of Vitamin C and the Virus Diseases, among others, all with the same theme, namely that massive doses of vitamin C will cure pretty much any viral disease that ails you. The other theme running through this is that there are no clinical trials. All there are are case reports and case series, all uncontrolled.

The biggest of these is the 60 patients with polio whom Klenner allegedly cured with his massive doses of vitamin C. Given how long ago this is and how little detail was given, coupled with the lack of any control group, we have no way of knowing whether his combined intravenous/oral vitamin C regimen did anything whatsoever. In any case, it’s not hard to figure out the reason why we don’t use megadose vitamin C for polio or other viral diseases now. In the case of polio, publications about vitamin C and polio petered out over the next couple of decades, at least as far as a search of PubMed indicates. In any case, in a review article about the use of megadose vitamin C in “complementary and alternative medicine” (CAM), it is noted:

Soon after its discovery and synthesis in 1932, parenteral vitamin C was shown to significantly decrease polio virus infections in primates [31], [32]. Although these findings were not repeatable [33], [34], one practitioner treated thousands of patients with parenteral vitamin C, primarily for infections, and popularized its use [2], [3], [5]. Such reports probably were a basis for continued use of parenteral vitamin C by other CAM practitioners [6], [7], [35].

The abstract of one of these early positive papers is particularly amusing to read:

The experimental evidence presented in this paper shows that multiple paralytic doses of poliomyelitis virus, when mixed with very small amounts of crystalline vitamin C (ascorbic acid), are rendered non-infectious as determined by intracerebral injection of such mixtures into rhesus monkeys.

In other words, crystalline ascorbic acid rendered viruses noninfectious? Who knew? Actually, what was done in this paper was to mix 0.1 ml of the supernatant of a 10 per cent poliomyelitis cord suspension (basically, they ground up spinal cords of monkeys with polio, centrifuged the, and used the supernatant containing the virus) with varying amounts of ascorbate neutralized to pH 6.6 to 6.8. This mixture was then injected intracerebrally. This mixture, with varying amounts of ascorbate, was then injected intracerebrally into rhesus monkey brains and the results checked. My guess here is that the virus was inactivated because the concentration of vitamin C in the actual mixture injected was very high (up to 100 mg/ml), and the virus/vitamin C mixtures were incubated overnight at 37° C. In other words, this study really didn’t tell us much.

It should also be noted that, contrary to Klenner’s claims, high dose vitamin C can indeed cause complications, such as oxalate nephropathy. In any case, Klenner became one of the “originators” of the quackery known as orthomolecular medicine, which has been discussed here many times and was popularized in the 1970s by Linus Pauling with his use of high dose vitamin C to treat the common cold and cancer. The central dogma of orthomolecular medicine seems to be that if some nutrient is good, megadoses of that nutrient are much better and can cure anything. Orthomolecular medicine has also been “integrated” into the quackery known as functional medicine.

That’s why it’s so depressing to see Dr. Gifford-Jones conclude:

What is appalling is that researchers and doctors should know that vitamin C has cured viral diseases like Yellow Fever, Crimean Congo Hemorrhagic Fever Dengue Fever and other viral diseases. But no expert has mentioned the possibility of using large doses of vitamin C to cure Ebola infection.

Klenner and Dr. Robert F Cathcart, an expert in viral diseases, have stressed that it’s the proper dosage that cures all viral diseases. This means giving massive doses of both oral and intravenous vitamin C. Cathcart estimates it would take 240,000 milligrams every 24 hours to beat the Ebola virus.

No. Cathcart was not an expert in infectious disease. He was an orthopedic surgeon who turned to the dark side of orthomolecular medicine and who now has his own page of praise on Whale.to. Vitamin C does not “cure all viral diseases” if only you give a dose high enough. And the Windsor Star should be ashamed for publishing this tripe, even on its blog.

Comments

  1. #1 Chris
    October 15, 2014

    Novalox, exactly. He was warping reality to fit his fantasy.

  2. #2 herr doktor bimler
    October 15, 2014

    Buy some reading glasses, Herr Bimler!!!

    I will have you know that these eyes are of finest Tleilaxu manufacture.

  3. #3 TBruce
    October 15, 2014

    I wouldn’t be alive today if it weren’t for IV vitamin C and bear testimony to it’s effectiveness.

    Testimony is next to worthless for evaluating the effectiveness of a treatment.
    Testimony is completely worthless when you don’t even mention the diagnosis.

  4. #4 Narad
    October 15, 2014

    [ObPossDup]

    If your lungs are full of Wite-Out it’s time to stop sniffing the Tipp-ex.

    If you insist.

  5. #5 Lawrence
    October 15, 2014

    If Bats are truly the “primary” reservoir for Ebola, then they wouldn’t be “severely affected” by it…..any good disease knows not the kill the host.

  6. #6 doug
    October 15, 2014

    “these eyes are of finest Tleilaxu manufacture”
    I’m envious. I gotta have a tear down and rebuild soon, and all I’m likely to get are some bits of acrylic.

    Paul Verse 192 is a total non-sequitur to Verse 184.

  7. #7 Narad
    October 16, 2014

    And Bat soup is most likely implicated in the latest spread of Ebola.

    I’d thank Gibran for the six-month-old heads-up about “LiveScience” apparently being completely brain-dead, but given that I’ve never heard of it, I suppose it’s more of a wash.

    Hint: Heating destroys the pathogen.

    I’d refresh my memory about certain key events, but that would only serve to obscure one rather serious issue with the whole “basically all animals that lack L-gulonolactone oxidase are severely affected [sic] by Ebola” routine:

    What’s the deal with the duikers, Gibran?

  8. #8 LW
    October 16, 2014

    @Gibran, all you’ve shown is that “basically all animals that lack L-gulonolactone oxidase” *get* Ebola. As Lawrence points out, bats can’t be severely affected if they are indeed the reservoir host. But you could equally well say that “basically all animals that lack L-gulonolactone oxidase” get rabies. It’s true (as long as we restrict “animal” to “mammal” as you appear to be doing) but it doesn’t prove anything about the connection between L-gulonolactone oxidase and rabies. Likewise you need to show that no other animals are severely affected by Ebola and you have not done that.

    @Paul, the homeopath wanted to use blood etc from Ebola *patients*; the real doctor used blood from Ebola *survivors*. There is a meaningful difference that makes the homeopath a quack and the real doctor not a quack. Besides everything else about homeopathy that makes the homeopath a quack.

  9. […] too, such as homeopaths seriously claiming that they can treat Ebola and quacks advocating high dose vitamin C to “cure” Ebola. The über-quack Mike Adams is selling a “natural biopreparedness” kit to combat Ebola and […]

  10. #10 Matt
    October 17, 2014

    “Has anyone ever noticed how quack claims are so difficult to track down.”

    @ORAC

    I would suggest you review the literature. Here is a good place to start:

    http://seanet.com/~alexs/ascorbate/

    Maybe after you get done with this you can provide me with a reference showing that high dose oral vitamin C (the protocol described by Dr. Cathcart) or high dose IV Vitamin C is ineffective in treating any viral disease? If not maybe you can explain why these studies have never been done? Surely with the billions of dollars that gets wasted on medical research every year someone could spare a little to study the claims of a man who was considered one most important scientists of the 20th century, Linus Pauling.

  11. #11 Matt
    October 17, 2014

    Also 60 Minutes has covered a story of a man who cured of Swine Flu by Vitamin C after he was left for dead by his doctors who wanted to turn off his life support.

    https://www.youtube.com/watch?v=vTXSTGGRvKY

    Is this still at least enough evidence to conduct a trial?

  12. #12 Antaeus Feldspar
    October 17, 2014

    Maybe after you get done with this you can provide me with a reference showing that high dose oral vitamin C (the protocol described by Dr. Cathcart) or high dose IV Vitamin C is ineffective in treating any viral disease?

    What is with these vitamin C quacks? Where do they get so many people who have no concept of how science actually works? Did they grow up in Topsy-Turvy-Land, where an absolute absence of snow on the ground is the sign to start shoveling, dying of starvation is the indication to stop eating so much food, and science is about accepting every cockamamie idea until studies are done to prove the null hypothesis??

    Science is not an aristocracy, where a hypothesis is presumed to inherit the title of “scientific” because its Papa was Linus Pauling.

  13. #13 Matt
    October 17, 2014

    “The central dogma of orthomolecular medicine seems to be that if some nutrient is good, megadoses of that nutrient are much better and can cure anything. ”

    No, this is not the premise of orthomolecular medicine. From orthomed.org: “Orthomolecular medicine, as conceptualized by double-Nobel laureate Linus Pauling, aims to restore the optimum environment of the body by correcting imbalances or deficiencies based on individual biochemistry, using substances natural to the body such as vitamins, minerals, amino acids, trace elements and fatty acids.”

    You criticize the qualifications of doctors supporting orthomolecular medicine in this post. What are your qualifications that justify allowing you to criticize one of the most important scientists of the 20th century?

  14. #14 Matt
    October 17, 2014

    Antaeus, read all the research articles in the link I posted. If this isn’t enough to justify further research, could you please explain what is? Also watch the video I posted.

    For your knowledge, I have worked in academic research labs. The best method to validate a theory is by designing experiments which attempt to disprove it. If these experiments fail, the theory has validity. Medical trials seem to always take the opposite approach and design trials attempting to prove the latest drug is effective.

  15. #15 Orac
    October 17, 2014

    “The central dogma of orthomolecular medicine seems to be that if some nutrient is good, megadoses of that nutrient are much better and can cure anything. ”

    No, this is not the premise of orthomolecular medicine.

    In practice, it is, regardless of what the Orthomolecular website says. I can give many examples. Basically, orthomolecular medicine involves vitamins, minerals, supplements, etc., and, quite often, megadoses of these things.

  16. #16 JGC
    October 17, 2014

    A suggestion Matt, which would actually advance the shared dialogue.

    Rather than challenge everyone else to prove a negative–i.e., provide evidence demonstrating that that high dose oral vitamin C rt) or high dose IV Vitamin C is ineffective in treating any viral disease–simply share with us what you personally consider to be the single most credible, most compelling piece of evidence demonstrating high dose vitamin C is safe and effective at treating viral diseases and we’ll discuss it.

  17. #17 gaist
    October 17, 2014

    Matt, you just hit my pet peeve with

    What are your qualifications that justify allowing you to criticize one of the most important scientists of the 20th century?

    Question the first – What qualifications should a person have to be allowed to criticize Linus Pauling? Or Bob Hoskins? Or Confucius? Or Orac?

    Question the second – Is there a test I should take if I intend to criticize you for setting up imaginary restrictions on discourse?

    Question the third – How do we know you are qualified enough to criticize Orac’s criticizing of somebody else?

  18. #18 Matt
    United States
    October 17, 2014

    JGC the protocol described by Dr Cathcart is what you should read first: http://vitamincfoundation.org/www.orthomed.com/titrate.htm

    The 60 minutes video I posted is a good watch: https://www.youtube.com/watch?v=vTXSTGGRvKY

    The Ascorbate Historical Reference
    http://seanet.com/~alexs/ascorbate/

    Dr. Thomas Levy’s Book “Curing the Incurable: Vitamin C, Infectious Diseases, and Toxins” is very good and cites over 1,200 scientific references.
    http://www.amazon.com/Curing-Incurable-Vitamin-Infectious-Diseases/dp/1401069630

  19. #19 Matt
    October 17, 2014

    Gaist, I did not open the qualification door and start the discussion down that path. Orac did by questioning Dr. Cathcart’s qualifications.

  20. #20 Matt
    October 17, 2014

    JGC, also have a look at this study:

    “The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections.”

    http://www.ncbi.nlm.nih.gov/pubmed/10543583

  21. #21 gaist
    October 17, 2014

    I saw it more as pointing out errors in Dr. Gifford-Jones’s writing, rather than making a blanket statement about Dr. Cathcart’s qualifications. With insolence, though naturally.

    And also should remember to not post anything right after coming home from an annoying workday…

  22. #22 Matt
    October 17, 2014

    Also

    “Vitamin C Is an Essential Factor on the Anti-viral Immune Responses through the Production of Interferon-α/β at the Initial Stage of Influenza A Virus (H3N2) Infection”

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659258/

  23. #23 Matt
    October 17, 2014

    Or how about

    “Vitamin C deficiency increases the lung pathology of influenza virus-infected gulo-/- mice.”

    http://www.ncbi.nlm.nih.gov/pubmed/16988135

  24. #24 Matt
    October 17, 2014

    JGC, for some reason my original reply to you was not approved and posted. You should read Dr. Cathcart’s hypothesis first:

    “Vitamin C, Titrating to Tolerance”

    http://vitamincfoundation.org/www.orthomed.com/titrate.htm

  25. #25 Narad
    October 17, 2014

    Also 60 Minutes has covered a story of a man who cured of Swine Flu by Vitamin C after he was left for dead by his doctors who wanted to turn off his life support.

    It’s so cute when people who pop by with Very Serious Objections don’t bother to read what has gone before.

    Is there some reason that nobody ever bothers to clarify that this was the New Zealand “60 Minutes”?

  26. #26 Calli Arcale
    http://fractalwonder.wordpress.com
    October 17, 2014

    So, having scurvy makes it harder to fight influenza? Gee. Who’d’ve thunk it. Next you’ll be telling me that it’s harder to fight influenza if you’re dying of dehydration!

    Seriously, that mice with a vitamin C deficiency suffer more from lung infections than well-fed mice is not exactly evidence that vitamin C megadoses will cure influenza. A car factory needs to put four tires on every car for them to work properly, but giving them fifty tires for every car is not going to increase production — four per car is the maximum they can make use of. So the fact that vitamin C is necessary for production of immune system cells doesn’t mean there’s any value to giving you more than your body can actually use.

  27. #27 Matt
    October 17, 2014

    Narad it was posted that this was New Zealand 60 Minutes already. The video had not been posted so I posted the link.

  28. #28 Antaeus Feldspar
    October 17, 2014

    Antaeus, read all the research articles in the link I posted.

    An example of what I like to call “the haystack gambit”. “I hereby assert that the evidence proving me to be absolutely right is to be found somewhere here in this haystack. Now, simply by virtue of me asserting that, suddenly the burden of proof is on you to examine every single thing in that haystack which I might be considering to be my evidence, and refute each and every bit individually.”

    For your knowledge, I have worked in academic research labs.

    Provably, it didn’t do you any good.

    The best method to validate a theory is by designing experiments which attempt to disprove it. If these experiments fail, the theory has validity. Medical trials seem to always take the opposite approach and design trials attempting to prove the latest drug is effective.

    Even if it were true that medical trials do not follow the “attempt to disprove the null hypothesis” model, and frankly your word has no weight whatsoever in establishing that proposition, it would be irrelevant to what you are trying to assert, that mainstream science has the burden of disproving what you want to be true.

  29. #29 Narad
    October 17, 2014

    JGC, also have a look at this study:

    “The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections.”

    I was wondering what this entry was doing in the Journal of Manipulative & Physiological Therapeutics until I looked at the genuine item, which informs the reader that it was conducted by two chiropractors.

    Conclusion: Vitamin C in megadoses administered before or after the appearance of cold and flu symptoms relieved and prevented the symptoms in the test population compared with the control group.”

    Let’s compare with something a bit higher in the evidence hierarchy:

    “The failure of vitamin C supplementation to reduce the incidence of colds in the normal population indicates that routine mega-dose prophylaxis is not rationally justified for community use. But evidence shows that it could be justified in persons exposed to brief periods of severe physical exercise and/or cold environments. Also, the consistent and statistically significant small benefits on duration and severity for those using regular vitamin C prophylaxis indicates that vitamin C plays some role in respiratory defence mechanisms. The trials in which vitamin C was introduced at the onset of colds as therapy did not show any benefit in doses up to 4 grams daily, but one large trial reported equivocal benefit from an 8 gram therapeutic dose at onset of symptoms.”

  30. #30 Matt
    October 17, 2014

    Calli,

    Mice naturally produce their own Vitamin C unlike humans so Gulo (-/-) mice must be studied.

    “Who’d’ve thunk it. Next you’ll be telling me that it’s harder to fight influenza if you’re dying of dehydration!”

    Exactly Calli, this is the whole premise of Orthomolecular medicine. Patients with influenza have very low blood levels of Vitamin C. Large doses must be given to restore blood levels to a normal range when a person is very sick.

  31. #31 JGC
    October 17, 2014

    Matt, clearly you’ve misunderstood my request.

    I’m not asking for the statement of a hypothesis, or a proposed protocol for treating viral infections with high dose vitamin C, or for an archived 60 Minutes video, or the title of a popular press book which includes a list of multiple scientific references.

    I’m not asking for a historic review of ascobate references. That whole Gish-gallop approach to teh issue is a large part of what I’m trying to avoid to advance the discussion in a meaningful way.

    What I have asked you to identify is whatever you personally consider to be the single most credible and compelling piece of scientific evidence (presumably in the form of a peer-reviewed journal publication) demonstrating that high dose vitamin C is effective as a treatment for viral infection.

    I note you do directly cited an individual study, “Vitamin C deficiency increases the lung pathology of influenza virus-infected gulo-/- mice”, but I sincerely hope you don’t consider this to be that one best piece of evidence since it makes no attempt to evaluate the efficacy of high dose vitamin C in treating viral infection at all.

    I’m asking you to identify

  32. #32 Narad
    October 17, 2014

    Narad it was posted that this was New Zealand 60 Minutes already.

    No, it was not: “On 60 minutes, there was a segment on a man from new zealand who had H1N1 and leukemia.”

    The video had not been posted so I posted the link.

    Strange that you made no mention of addressing a lacuna when you trotted it out (or when you plugged it the second time):

    Also 60 Minutes has covered a story of a man who cured of Swine Flu by Vitamin C after he was left for dead by his doctors who wanted to turn off his life support.

  33. #33 Matt
    October 17, 2014

    “The trials in which vitamin C was introduced at the onset of colds as therapy did not show any benefit in doses up to 4 grams daily”

    4 grams daily is not enough to produce any benefits when a person has a cold. Like I said, you need to read Dr. Cathcart’s paper first.

  34. #34 Matt
    October 17, 2014

    Sorry Narad, I didn’t realize human physiology was different in New Zealand.

  35. #35 doug
    October 17, 2014

    Anyone have access (and the stomach for reading) the paper from the chiropractic journal?
    For openers, what is a “virus-induced respiratory infection?” Why “induced?” It gives me the impression of an infection where the original pathogen is no longer involved.
    The abstract is just full of fail. The “control” group appears to be from one year, the test group from another (’cause we all know cold viruses are the same every year.) All evaluation seems to be by self-reporting. Not a single mention of “placebo” is made. The language of the abstract is sloppy, e.g. “Overall, reported flu and cold symptoms in the test group decreased 85% compared with the control group after the administration of megadose Vitamin C.” Do they mean that the Vitamin C was only 85% as effective as the other treatment?

  36. #36 Matt
    October 17, 2014

    JGC I don’t think you can establish credibility from just one study or one source. This is the premise of how science works. Repeatable results from different sources establishes credibility. This is why I provided you with many different references from different sources.

  37. #37 Narad
    October 17, 2014

    Exactly Calli, this is the whole premise of Orthomolecular medicine. Patients with influenza have very low blood levels of Vitamin C.

    Would you care to demonstrate this?

  38. #38 JGC
    October 17, 2014

    JGC I don’t think you can establish credibility from just one study or one source.

    I’m not asking you to do that, however–I’m simply asking you to begin by identifying what you consider to be the best single study (not source, BTW, best study).

    If you can’t at the least identify a single study that’s documents credible and compelling evidence that high dose vitamin is an effective treatment, I don’t see what value offering multiple studies that fail to document such evidence would be.

  39. #39 Narad
    October 17, 2014

    4 grams daily is not enough to produce any benefits when a person has a cold.

    Then why did you cite a study that used 3 g daily after a single 6 g “induction”?

    Like I said, you need to read Dr. Cathcart’s paper first.

    Sorry, but I do not need to satisfy your imaginary prerequisites to point out that a systematic review trumps two chiropractors.

  40. #40 Matt
    October 17, 2014

    “Would you care to demonstrate this?”

    Narad start here:

    http://www.mv.helsinki.fi/home/hemila/metabolism/

  41. #41 Matt
    October 17, 2014

    “I’m simply asking you to begin by identifying what you consider to be the best single study”

    The problem is that governments and health organizations refuse to conduct the proper studies that need to be done.

    There are many good sources of clinical evidence which I have already posted links to.

  42. #42 Tim
    October 17, 2014

    @Narad #204,

    That fucking lamed. Are you a Hypnotist??
    http://www.youtube.com/watch?v=E-9mCAA1YYY

    {sublimaxions indeed …. go ask your {X} tomorrow… that ^^ shit breaks it for sure, though}

  43. #43 Calli Arcale
    http://fractalwonder.wordpress.com
    October 17, 2014

    Jim T:
    I apologize; I didn’t see your response from 10/13 until now.

    I had never heard anyone else’s story regarding WNV… there aren’t that many cases, thank goodness.

    I know exactly two people who have had it. Well, “know” might be a bit of a stretch, as one is a colleague of a relative that I met briefly at a party once. He did not fare well with it. He survived, but had long-lasting problems. My grandmother . . . we often joke that death must be scared of her, because she’s survived so many illnesses. I mean, she has really poor health with her lousy diet (she’s a picky eater), severe asthma, major problems due to heavy cortisone use . . . . Yet she came out of the WNV pretty much okay. We were all getting ready to say goodbye (again) and she survived. More on that in a moment….

    As an afterthought, next time you talk with your grandmother, ask her if she recalls any distinctive odor being released in her sweat while she was ill. I swear I could actually smell the results of the virus on my skin… anywhere — the back of my hands, my arms, etc. My wife could not perceive it, but she does not possess a very sensitive sense of smell.

    I don’t recall any strange smells when visiting her in the hospital. Mind you, if you were the only one smelling it, the sensation might not have been due to an actual odor — WNV affects the brain, after all, so it would be plausible it could temporarily derange your senses. (Or permanently, if you are less fortunate; there are people who came out of it with significant brain damage, like the other guy I know who had it.)

    Unfortunately, I can’t ask her. She won’t remember. She’s still alive (death is scared of her, I swear!) but a couple of years ago suffered a stroke. We all got ready to say goodbye then, and visited her one at a time in the ICU. She did a lot better than doctors expected, but she never regained the use of her legs or the ability to swallow most foods. She was released to a nursing home, and has been bouncing around from home to home; now, after a couple of escape attempts she’s in a memory care unit. She’s been gradually declining. Two years ago, she still recognized everybody. Last year, she was a bit more hit-or-miss, and often mixed up people’s identities (she drifts in a time a bit, so she’d often think I was her daughter, while she’d think my mom was *her* mom). This year, she usually doesn’t even try to guess who we are. We’re just people who visit. She likes it when we visit; she’s s social butterfly and has always loved meeting people. That’s the good part; she loves meeting people, so thanks to her memory problems she gets to do it all the time. 😉 But it’s hard to watch. And between her picky eating and her serious difficulties in swallowing, she’s lost a tremendous amount of weight. Before she lost her marbles, she worked out a living will saying she did not want a feeding tube placed for any significant length of time, so it seems likely she’ll ultimately starve to death, when she stops eating altogether.

    One cool bit, though: they usually say that if someone is like this, you shouldn’t stress them by taking them to parties. Well, she’s the opposite. She’s a massive extrovert, so taking her to parties is the best thing for her — and it never really bothered her to go to a party where she didn’t know anybody, so having forgotten people was no problem for her. My cousin’s wedding last summer, she didn’t really recognize very many people, but she did recognize a few! First time I’d seen her do that in a long time; the party atmosphere had energized her. And she clearly was having a grand time. They didn’t bring her to the reception; just the ceremony. She really doesn’t have the stamina for anything longer than that. But she felt like the queen of the ball all the same. My grandfather’s funeral the previous summer was like that too, though she was remembering people better, and was actually able to remember that it was her husband’s funeral for the whole time. (She handled it very well. But she didn’t have to go through much grief. This silver lining of memory loss is that within a week, she’d forgotten that he had passed, and instead was convinced he was on a business trip. These days, I’m not sure she even remembers him at all, which is very sad; they had an amazing love, those two.)

  44. #44 Calli Arcale
    http://fractalwonder.wordpress.com
    October 17, 2014

    Matt:

    Exactly Calli, this is the whole premise of Orthomolecular medicine.

    You’re being disingenuous. I’m calling you out on using a trivially obvious finding (that your body doesn’t work as well when you’ve got a vitamin deficiency) as evidence that you can cure diseases other than vitamin deficiency with vitamin megadoses. But it doesn’t follow. The genetically engineered mice, who need vitamin C in their diets, suffer from scurvy; they demonstrated how this makes them more vulnerable to influenza, but this isn’t a feature unique to scurvy. Asthma also makes people more vulnerable to influenza. So does a history of smoking or occupational exposure to fine particles. This is useful information from a scientific standpoint, but it doesn’t mean there is a value to orthomolecular medicine — which does NOT say merely that having a vitamin deficiency is bad for you. You are misrepresenting it here, probably to give it a veneer of respectability.

    Orthomolecular medicine claims that most disease is caused by nutritional imbalance, and can be treated by correcting the imbalance with vitamin megadoses (far beyond what is actually needed in the diet). But it’s obviously not true that all disease is caused by deficiencies. In fact, very few diseases are caused by nutritional deficiencies, and consequently very few can be remedied by supplementation — and even in those cases, megadosing is not generally helpful.

    The average American does not have scurvy, and isn’t even anywhere near having scurvy. If they get influenza, giving them lots of vitamin C is not going to do any good. It’s a waste of time and money. If you want to give them vitamin C, give them an orange. At least it tastes good.

  45. #45 JGC
    October 17, 2014

    The problem is that governments and health organizations refuse to conduct the proper studies that need to be done

    Are you now saying that you can’t provide a citation to a creadible and compelling study demonstrating high doses of vitamin C safely and effectively treats viral infections, because no studiesdemonstrating this have been done?

    There are many good sources of clinical evidence which I have already posted links to.

    Why not go to one of those good sources, then and select a representative report documenting clinical evidence that high dose vitamin C is effective?

  46. #46 herr doktor bimler
    October 17, 2014

    Sorry Narad, I didn’t realize human physiology was different in New Zealand.

    Certainly the phenomenon of ignorant, credulous headline-chasing journamalists — willing to present only one side in their eagerness to create a Miracle Cure story — is not restricted to New Zealand.
    The 60 Minutes story was widely ridiculed at the time by media critics as sensationalist, opportunistic tripe, free advertising for the supplement industry.

  47. #47 Narad
    October 17, 2014

    Narad start here

    You do realize that Hemilä is one of the authors on the Cochrane review, right?

    Keep in mind the original assertion:

    Patients with influenza have very low blood levels of Vitamin C.

    Influenza isn’t mentioned. But let’s assume the obvious: infection leads to elevated mobilization of neutrophils from the bone marrow, and they’re going to need to accumulate ascorbate. Naturally, one is going to see a fall in plasma levels. This doesn’t get you to “very low levels.”

    If one were to look instead at the common cold, the citations seem to be PMIDs 222262 (with a broken PDF link) and 4355208. In PMID 1547201, Hemilä’s take on the latter is “a common cold episode significantly decreases the vitamin C concentration in leucocytes (Hume & Weyers, 1973; Wilson, 1975), and may also decrease it in plasma (Schwartz et al. 1973).”

    Next time you’re asked to defend an assertion, I suggest that – rather than tossing out a random Web page and expecting other people to do your homework for you (and find that the defense isn’t even there) – you get off your ass and pony up an actual reply.

  48. #48 Narad
    October 17, 2014

    Sorry Narad, I didn’t realize human physiology was different in New Zealand.

    I will take this as a concession of my original point.

  49. #49 Tim
    October 17, 2014

    @Calli Arcale #242.

    I’ve heard tell that coconut milk and hemp oil can temporarily renew cognitive function (+nicotinamide riboside for the mitochondria????) — GLAs and other good stuff which is supposed to be able to cross BBB and be converted to energy directly there…

  50. #50 Matt
    October 17, 2014

    “Why not go to one of those good sources, then and select a representative report documenting clinical evidence that high dose vitamin C is effective?”

    JGC I will post these again for you. Here are the two best:

    http://vitamincfoundation.org/www.orthomed.com/titrate.htm

    http://seanet.com/~alexs/ascorbate/198x/smith-lh-clinical_guide_1988.htm

  51. #51 Krebiozen
    October 17, 2014

    Matt,

    Maybe after you get done with this you can provide me with a reference showing that high dose oral vitamin C (the protocol described by Dr. Cathcart) or high dose IV Vitamin C is ineffective in treating any viral disease?

    I don’t have a reference, but I have had the personal experience of getting a very nasty cold after I had been experimentally* taking 5 grams of vitamin C three times a day for several months. Not only did I get the cold despite the vitamin C, but taking enough vitamin C to cause diarrhea and painful gas had no effect on my symptoms at all, but did make me even more miserable. An infection is supposed to dramatically increase ‘gut tolerance’, but didn’t in my case. That effectively destroyed my faith in vitamin C, and taught me a useful, though humbling, lesson about confirmation bias.

    It’s anecdotal I know, but if vitamin C couldn’t get rid of that cold, I doubt very much it would cure ebola.

    * I had an intractable sinus problem that led me to resort to increasingly desperate and implausible measures to get rid of it.

  52. #52 Matt
    October 17, 2014

    “Orthomolecular medicine claims that most disease is caused by nutritional imbalance”

    Calli this is not true at all. Orthomolecular medicine claims that disease causes addition demand for nutrients. Many of which can only be restored through supplementation.

    An analog to this would be a hurricane causes additional demand for nails in a city. The hurricane was not caused by a lack of nails, rather more nails are required in the city after the hurricane to repair the damage.

  53. #53 Dangerous Bacon
    October 17, 2014

    Matt does not understand what orthomolecular medicine advocates themselves are claiming.

    “Orthomolecular medicine describes the practice of preventing and treating disease by providing the body with optimal amounts of substances which are natural to the body. ”

    http://www.orthomolecular.org/

    Orthies* believe that massive amounts of supplements are needed to prevent or treat cancer, psychiatric disorders, Parkinson’s disease, bowel complaints, pneumonia and a host of other common ailments.

    http://www.cancer.org/ssLINK/orthomolecular-medicine

    *just in case I invented the term “orthies”, I now should get royalties whenever anyone else uses it.

  54. #54 squirrelelite
    October 17, 2014

    @Calli Arcale,

    It’s tough when the mind gradually goes, but it sounds like she’s coping reasonably well. I remember the last few years I would visit my grandmother. She knew who I was, but would often call me by my uncle’s name (her son). The last few months, though, my mother told me not to bother seeing her because she didn’t even recognize my mother (her daughter).

    Some people don’t die easily. A friend of ours just visited a mutual friend in Colorado whose mother fell and broke her neck, but is still alive and well and staying in a nursing home. They tried to put a neck brace on, but she wouldn’t let them make it tight enough to be useful and it just irritated the skin, so they finally gave up and took it off.

    Her favorite saying seems to be, “you can’t make me do that. I’m a hundred and six!” I guess she has a point.

  55. #55 Matt
    October 17, 2014

    “Next time you’re asked to defend an assertion, I suggest that – rather than tossing out a random Web page and expecting other people to do your homework for you (and find that the defense isn’t even there) – you get off your ass and pony up an actual reply.”

    See if this will satisfy you Narad.

    Abstract
    Plasma concentrations of the antioxidant vitamin ascorbic acid were measured by high-performance liquid chromatography in critically ill patients in whom the excessive generation of reactive oxygen species could compromise antioxidant defense mechanisms. Median concentrations of both total vitamin C (ascorbic acid and dehydroascorbic acid) and ascorbic acid in these patients were < 25% (P < 0.001) of the values found in healthy control subjects and in subjects in two other disease groups (diabetes, gastritis) in which reactive oxygen species are reported to be increased. The low values could not be explained by age, sex, intake, or treatment differences, but were associated with the severity of the illness and were not prevented by the use of parenteral nutrition containing ascorbic acid. In addition, the vitamin was less stable in blood samples taken from critically ill patients than in similar samples from subjects in the other groups. The findings indicate that antioxidant defenses could be considerably compromised in these very sick patients. If this reduces the patient’s capacity to scavenge reactive species, then the potential of these species to damage DNA and lipid membranes could be increased and compromise recovery.

    http://www.ajcn.org/cgi/reprint/63/5/760.pdf

  56. #56 Matt
    October 17, 2014

    Ascorbic acid dynamics in the seriously ill and injured

    Conclusion. We confirmed extremely low plasma levels of ascorbic acid following trauma and infection. Maximal early repletion of this vitamin requires rapid pool filling early in the post-injury period using supraphysiologic doses for 3 or more days.

    http://www.journalofsurgicalresearch.com/article/S0022-4804%2802%2900083-5/abstract

  57. #57 Matt
    October 17, 2014

    High-dose antioxidant administration is associated with a reduction in post-injury complications in critically ill trauma patients.

    CONCLUSIONS:
    Implementation of a high-dose AO protocol was associated with a reduction in respiratory failure and ventilator-dependence. In addition, AO were associated with a marked decrease in abdominal wall complications, including ACS and surgical site infections.

    http://www.ncbi.nlm.nih.gov/pubmed/20149369

  58. #58 Matt
    October 17, 2014

    The beneficial effects of antioxidant supplementation in enteral feeding in critically ill patients: a prospective, randomized, double-blind, placebo-controlled trial.

    There was a significantly reduced 28-day mortality after antioxidant intervention (45.7% in the antioxidant group and 67.5% in the regular-feeding group; P < 0.05).

    http://www.ncbi.nlm.nih.gov/pubmed/15333422

  59. #59 Narad
    October 17, 2014

    Calli this is not true at all. Orthomolecular medicine claims that disease causes addition demand for nutrients.

    You should tip off the folks at orthomolecular.org to the embarrassing errors in their Hall of Fame,* then. E.g.,

    “Moerman, a passionate pigeon-fancier, observed that healthy birds did not develop cancer, whereas the weak and malnourished ones did. He argued, based on his own experiments with his pigeons, that cancer was a derangement of metabolism, a deficiency of iodine, citric acid, B-vitamins, iron, sulphur, and the vitamins A, D, E and later C.”

    It’s surprisingly absent of notions of disease causing much of anything, except for the basis of “genetotropic disease,” in which an in-built error causes some sort of nutritional disability which then causes disease.

    An analog to this would be a hurricane causes additional demand for nails in a city.

    No, I’m taking away “an ‘imbalance’ of the hardware microenvironment causes hurricanes.”

    * Getting on them about Gerson, would help, too.

  60. #60 Matt
    October 17, 2014

    So I provide the references to the scientific studies you guys requested and the response is to attempt to change the subject to what the definition of Orthomolecular medicine is now?

  61. #61 Narad
    October 17, 2014

    Indeed, doctoryourself-dot-com is Andrew Saul, who can hardly be considered anything but a true Scotsman (PDF). I see no hesitation on his part in setting forth this: “Malnutrition causes muscular dystrophy? The short answer is, Yes.”

  62. #62 herr doktor bimler
    October 17, 2014

    So I provide the references to the scientific studies you guys requested

    Matt, the papers you provided in comments #255-258 make a good case for vit-C depletion in critically-ill patients (trauma, multiple organ failure, etc.), but you present them to support the claim that “Patients with influenza have very low blood levels of Vitamin C.”

  63. #63 Narad
    October 17, 2014

    See if this will satisfy you Narad.

    What will “satisfy” me is your defending your original claim, rather than throwing unrelated abstracts against the wall in the hope that they will somehow stick well enough to obscure it. Let me remind you:

    Patients with influenza have very low blood levels of Vitamin C.

    Did you get past the abstract?

    “[The patients] were in need of intensive treatment for a variety of reasons, including accidental injury, recovery from surgery, sepsis, and major-organ failure. The only common feature of the patients was that they needed the critical care provided by the ICU to sustain life and were all therefore critically ill.”

    Do not try to backtrack to New Zealand.

  64. #64 Narad
    October 17, 2014

    So I provide the references to the scientific studies you guys requested and the response is to attempt to change the subject to what the definition of Orthomolecular medicine is now?

    Jesus Fυcking Christ, you’re having a tantrum about not receiving replies in your desired order?

  65. #65 Krebiozen
    October 17, 2014

    Very sick people do have low ascorbate levels; they have low albumin and cholesterol too. It doesn’t mean that giving them either will cure their primary illness. I think it’s a bit like adidosis, which is a symptom, not a cause, of disease. Restoring normal values is beneficial, but more than that not so much.

    This discussion reminded me of something I read about about Linus Pauling some years back. According to this article one of Pauling’s collaborator’s, Art Robinson, did an experiment that found that mice given vitamin C developed more cancer than controls. Pauling’s response was to blackmail him with invented.”damaging personal information”, demanding that he kill the mice and cover up these unwanted results.

    Art Robinson seems a bit eccentric, perhaps, but I see no motive to make up something like this, and no other signs that this is something he would do. It does, however, ring true as the actions of someone suffering from premature certainty with co-morbid Nobel Prize Syndrome.

  66. #66 Matt
    October 17, 2014

    What is one of the main symptoms of Ebola virus?…
    Hemorrhaging

    This is caused by the a severe vitamin C depletion. Just as scurvy causes hemorrhaging.

    Thomas Levy MD does a great job of explaining this in this video: http://youtu.be/GpptUsJFCEY?t=9m15s at the 10:57 mark

    I’m sorry there are not any studies that I am aware of looking at Vitamin C levels specifically in influenza patients.

  67. #67 Matt
    October 17, 2014

    “Very sick people do have low ascorbate levels… It doesn’t mean that giving them either will cure their primary illness. ”

    Except for that it has been done thousands of times and it does improve their condition, often times curing them. Here is a double-blind, placebo-controlled trial:

    http://www.ncbi.nlm.nih.gov/pubmed/15333422

  68. #68 Narad
    October 17, 2014

    What is one of the main symptoms of Ebola virus?…
    Hemorrhaging

    Wrong.

    “Bleeding is not universally present but can manifest later in the course as petechiae, ecchymosis/bruising, or oozing from venipuncture sites and mucosal hemorrhage. Frank hemorrhage is less common; in the current outbreak unexplained bleeding has been reported from only 18% of patients, most often blood in the stool (about 6%). Patients may develop a diffuse erythematous maculopapular rash by day 5 to 7 (usually involving the neck, trunk, and arms) that can desquamate. Pregnant women may experience spontaneous miscarriages. The most common signs and symptoms reported from West Africa during the current outbreak from symptom-onset to the time the case was detected include: fever (87%), fatigue (76%), vomiting (68%), diarrhea (66%), and loss of appetite (65%).

    “Patients with fatal disease usually develop more severe clinical signs early during infection and die typically between days 6 and 16 of complications including multi-organ failure and septic shock (mean of 7.5 days from symptom-onset to death during the current outbreak in West Africa).”

    This is caused by the a severe vitamin C depletion.

    Wrong again.

    “Hemorrhagic manifestations occur as a result of thrombocytopenia or severe platelet dysfunction along with endothelial dysfunction.”

    See also, e.g., PMID 16982079.

    Just as scurvy causes hemorrhaging.

    Does EVD also cause corkscrew hairs? What kind of hemorrhaging does scurvy cause?

  69. #69 Calli Arcale
    http://fractalwonder.wordpress.com
    October 17, 2014

    Matt:

    You’re upset with us arguing over the definition of orthomolecular medicine? Well, I suggest you not use your own personal, private, and undeclared definition, then. Keep inventing your own definitions and you’re going to keep running into this problem.

    You use studies that don’t support your argument; when this is pointed out to you, you point to them again as if somehow mentioning them again will fix the fact that they do not support your case. And your new claim, that ebola causes hemmorhaging by depleting vitamin C? That’s a pretty remarkable claim. I’d love to see if you have anything vaguely resembling evidence for it. Ideally something that actually involves ebola, rather than trauma or genetically engineered mice.

  70. #70 Calli Arcale
    http://fractalwonder.wordpress.com
    October 17, 2014

    Tim:

    I’ve heard tell that coconut milk and hemp oil can temporarily renew cognitive function (+nicotinamide riboside for the mitochondria????) — GLAs and other good stuff which is supposed to be able to cross BBB and be converted to energy directly there…

    That might be plausible if cognitive decline were due to a lack of energy in the brain, but as with other stroke victims, her problem is actual brain damage. No amount of dietary supplementation can stand in for the lost brain tissue, and if she was gonna regrow any, it would have happened by now. But thank you for the sentiment. 😉

    squirrelelite:
    Thank you for the kind words as well. Yeah, I’ve been saying for a while now that if I ever lose my marbles, I want to lose them the way she did. She’s genuinely happy, and that’s the silver lining to all of this. She doesn’t know anybody around her, and is often confused, and can no longer lecture about Hemingway — but she can still recite Annabel Lee. 😉 (She used to teach American Lit.)

    Her favorite saying seems to be, “you can’t make me do that. I’m a hundred and six!” I guess she has a point.

    Hah! I like her spirit. 😉 She does have a point. My grandfather, before he died, was on warfarin because of a history of blood clots, and he wasn’t supposed to drink alcohol because of that. He did anyway (not heavily, just occasional wine, martini, scotch, or aqavit), and we all figured that at this point, it was more important for him to be happy than compliant. He never did have any more bleeding problems, and what killed him was just a stupid random accident. Slipping in the shower.

  71. #71 Narad
    October 17, 2014

    And your new claim, that ebola causes hemmorhaging by depleting vitamin C? That’s a pretty remarkable claim. I’d love to see if you have anything vaguely resembling evidence for it.

    Thrombocytopenia does not seem to be a promising angle (PDF) on the “just as scurvy” front:

    “Vitamin C deficiency can also lead to platelet adhesion defects. This deficiency diminishes the synthesis of hydroxyproline and therefore of collagen, leading to defective platelet adhesion to the vessel wall. However, platelet in vitro function is normal.

    But, wait! Commenter “Nacho.Libre” at ZeroHedge has taken care of this:

    “The virus causes acute scurvy in a shorten time frame. Where regular scurvy might take months to appear, the oxidative load caused by the infection causes the depletion of vitamin C, the body looks to collagen for vitamin C and breaks down the collagen, hence the bleeding (the hemorrhagic fever) which is also what happens with regular scurvy. That is also why the virus infects only those animals that do not have the capacity to produce their own vitamin C.

    That’s right, scurvy has nothing to do with collagen production; instead, Jell-O is a rich source of Vitamin C.

  72. #72 Narad
    October 17, 2014

    ^ Two missing close quotes, one at the end of each paragraph that started with a quotation mark.

  73. #73 doug
    October 18, 2014

    That is also why the virus infects only those animals that do not have the capacity to produce their own vitamin C.

    Like pigs. And duikers. I hear they get their vitamin C from Big Pharma through some sort of grey-market channels.

  74. #74 Matt
    October 18, 2014

    Narad I think it is almost comical that you would try to debate that hemorrhaging is not major symptom of Ebola virus when Ebola virus is also called “Ebola hemorrhagic fever”.

    The first line in http://www.webmd.com/a-to-z-guides/ebola-fever-virus-infection
    “Ebola is a rare but deadly virus that causes bleeding inside and outside the body.”

    I think this discussion has turned to the point where it is appropriate to insert my favorite Max Planck quote:

    “A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.”

  75. #75 Narad
    October 18, 2014

    Narad I think it is almost comical that you would try to debate that hemorrhaging is not major symptom of Ebola virus when Ebola virus is also called “Ebola hemorrhagic fever”.

    Leaving aside that (1) you failed to address the direct point presented to you and (2) the nonsensical “Ebola virus is also called ‘Ebola hemorrhagic fever” demonstrates exactly how much thought you’ve put into this, no, the ICD-10 didn’t come out of nowhere.

    I think this discussion has turned to the point where it is appropriate to insert my favorite Max Planck quote:

    “A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.”

    Sadly, it’s far too late to try to leaven your perfomance with a humorous aside featuring an ironic misinterpretation of Quang Duc.

    Or: see above.

  76. #76 Krebiozen
    October 18, 2014

    I wrote:

    “Very sick people do have low ascorbate levels… It doesn’t mean that giving them either will cure their primary illness. ”

    Stu replied:

    Except for that it has been done thousands of times and it does improve their condition, often times curing them. Here is a double-blind, placebo-controlled trial:

    You entirely miss my point. Restoring low ascorbate levels to normal will help reduce symptoms due to low ascorbate, of course, but it won’t cure whatever caused the low ascorbate (the primary illness). The study you cited shows a decrease in oxidative stress when ascorbate and vitamin E were added to the feeds of critically ill patients, and a barely statistically significant reduction in mortality. This is why antioxidants are routinely added to enteral and parenteral feeds in very sick patients.

    I have little doubt that a serious illness like ebola will deplete ascorbate levels, and that restoring those levels will be beneficial. I also have little doubt that these patients are given plenty of IV ascorbate when they are on an ITU.

    What I do doubt is that giving more than 200 mg/day ascorbate IV (the amount recommended in the Guidelines on Parenteral Nutrition I linked to), and/or elevating ascorbate levels above normal is beneficial.

  77. #77 herr doktor bimler
    October 18, 2014

    you would try to debate that hemorrhaging is not major symptom of Ebola virus when Ebola virus is also called “Ebola hemorrhagic fever”.

    By the same token, it follows from the name of the West Nile Virus that no-one ever catches it outside of Africa, so Jim T. upstream must have been misdiagnosed.

  78. #78 Matt
    October 18, 2014

    Krebiozen, please read:

    http://seanet.com/~alexs/ascorbate/198x/smith-lh-clinical_guide_1988.htm

    http://vitamincfoundation.org/www.orthomed.com/titrate.htm

    200 mg/day of ascorbate will in no way come close to restoring ascorbate to normal level in someone very ill with influenza, 200 g/day is closer to the dose required.

    If you and health organizations don’t agree, how hard is it to measure ascorbate levels in someone that is sick? This is all I am asking for. Once this is done you will see much larger doses are required.

    Also you consider a 32% reduction in mortality rates to be barely statistically significant? Also I’m sure the results of this study would greatly improve if the doses recommended by Cathcart and Stone were given.

  79. #79 dingo199
    October 18, 2014

    At the risk of incurring some vitriol for a (slightly) off topic comment, may I say how very disappointed I am that organisations like “Homeopaths without Borders” have not launched fullscale missions into Liberia or Sierra Leone to cure the menace of Ebola.

  80. #80 dingo199
    October 18, 2014

    Matt,
    coming into this discussion late (as always) it seems from the comment stream so far that your claim consists of the following:
    – Critically ill people get low ascorbate levels
    – Replacing ascorbate sometimes helps them get better

    What you still haven’t done is generate any data/evidence that superdose Vitamin C cures diseases like influenza or Ebola.

    It is sad to see you resort to fallacious arguments like “People with scurvy may haemorrhage, People with Ebola may haemorrhage…therefore Vitamin C will cure Ebola!”

    That claim displays a dreadful misunderstanding of the pathogenesis of the diseases, and is about as useful as my saying “Lack of sunblock makes your skin burn, Radiation makes your skin burn….therefore sunblock will cure radiation sickness!”

  81. #82 Krebiozen
    October 18, 2014

    Matt,
    I am very familiar with the literature on vitamin C, as I used to be a believer (more accurately a temporarily suspended disbeliever). These days I think the idea that because humans don’t make vitamin C we require vast doses is flawed. We, or rather a small furry mammal ancestor with little resemblance to humans, lost the ability to make ascorbate about 60 million years ago. That’s a long time to survive with a major inborn error of metabolism (as some describe the lack of L-gulonolactone oxidase), and a long time in which to develop ways of recycling ascorbate and alternative ways of carrying out its metabolic roles (uric acid, for example).

    200 mg/day of ascorbate will in no way come close to restoring ascorbate to normal level in someone very ill with influenza, 200 g/day is closer to the dose required.

    This was 200 mg/day IV, remember. This study used 500 mg/day in critically ill patients (far sicker, and older, than the average flu patient):

    In the current study, outstanding concentrations of vitamin E and C were found in the supplemented group, showing that the doses prescribed were enough, not only to maintain adequate plasma concentrations of such nutrients but to reduce oxidative stress.

    Perhaps 500 mg/day might be better than 200 mg/day, but it seems to be saturation of neutrophils, monocytes, and lymphocytes that is important, and in healthy people this can be established with just 100 mg orally. It may well be that 200 mg/day is quite enough to saturate WBC’s in even critically ill people, even if normal plasma levels are not restored.

    Anyway, I do agree that restoring normal ascorbate levels is important and may require more than 200 mg/day to do so rapidly, but I don’t see much evidence that restoring levels rapidly has any benefits over restoring them slowly. Neither do I see much evidence that doses of hundreds of grams per day are useful.

    If you and health organizations don’t agree, how hard is it to measure ascorbate levels in someone that is sick? This is all I am asking for. Once this is done you will see much larger doses are required.

    Ascorbate levels have been measured many, many times in people with varying degrees of sickness, but they aren’t often done routinely (I spent several decades working in a biochemistry lab, but ascorbate requests were so rare we sent them to another specialist lab). There is lots of evidence for the amounts required to restore normal levels and the benefits of this, which is why the care of sick people includes supplying adequate nutrition.

    Personally I don’t think enough attention is paid to ascorbate levels in very sick people, and I would like to see more vitamin C given to restore normal levels. However, I consider the claims for the benefits of doses over and above those that restore normal plasma levels to be hyperbolic and unsupported by good evidence.

    Claims that high dose IV vitamin C can successfully treat cancer, for example were being tested in two clinical trials, but they haven’t been published, so I strongly suspect they found no benefits (I’ll try to dig out the details if you’re interested).

    Also you consider a 32% reduction in mortality rates to be barely statistically significant?

    Statistical significance is not the same as effect size, which I make a 21.8% lower mortality in the supplemented group, not 32%.

    There was a significantly reduced 28-day mortality after antioxidant intervention (45.7% in the antioxidant group and 67.5% in the regular-feeding group; P < 0.05).

    It’s the p<0.05 that I consider to be barely statistically significant, especially given a relatively small sample (105 patients in the supplemented group).

    Also I’m sure the results of this study would greatly improve if the doses recommended by Cathcart and Stone were given.

    Sure on what basis? I don’t have access to the full study, so I don’t know what dose Crimi et al used. I also note that they didn’t just use ascorbate, but “antioxidant vitamins C and E in enteral feeding”. For all I know they may have used 200 mg/day or less.

  82. #83 Mephistopheles O'Brien
    October 18, 2014

    Neither do I see much evidence that doses of hundreds of grams per day are useful.

    But that’s because nobody will do the study. If only someone would do the study, they’d find that massive doses of vitamin C provide benefits second only to healthy and diverse gut flora.

  83. #84 Tim
    October 18, 2014

    Anybody happen to have a condensed list of other compounds the vita C may be a cofactor for?? What else may be involved that vitamin C is gettng burned in the sick?

    For me, some diverse conditions that were already going downhill absolutely seemed to have had been given a ‘fullon burn of an Atlas V Heavy’ { melatonin):

    zinc
    B6
    magnesium
    vitamin C

    for instance.

  84. #85 MadisonMD
    October 18, 2014

    But that’s because nobody will do the study. If only someone would do the study, they’d find that massive doses of vitamin C provide benefits second only to healthy and diverse gut flora.

    Actually 30C homeopathic Vitamin C works best. But nobody will do the study because big pharma won’t fund it! Anyway, it needs to be individualized to everyone to work so I’m not sure you can actually study it with RCT. A ‘proving’ study will work better.

  85. #86 Tim
    October 18, 2014

    ^^ Umm… apparently, one should not use ‘ <– ' anywhere inside ' { ' (now the inputs are sanitized, dammit … but still wrongly.)

    The rest was supposed to read something like <– (the most phallic-looking rocket I can think of offhandedly… there is even one with 'balls'. The Koreans would have no trouble getting it up with that Type of Dong) …

    I surmized zinc was missing. My reasoning was that it began the thrust halfway through a course of Cipro (zinc depleating) and went 'full on' after a second dose of 5-HTP which went from *this is really great* to *this is exactly opposite what the sales girl told be to expect* — It got real fucking fickle real bad real fast.

    I surmized this because of

    heavy alcohol intake
    lack of zinc containing food
    my other staple, milk (zinc depleting)

    The 5-HTP goes to seratonin and requires the aforementioned cofactors. The seratonin goes to serum melatonin. I *think*.

  86. #87 Narad
    October 18, 2014

    200 mg/day of ascorbate will in no way come close to restoring ascorbate to normal level in someone very ill with influenza, 200 g/day is closer to the dose required.

    It’s interesting that you can provide no quantitative estimate whatever of the effect, but a specific dose to correct it is no problem. By the way, just how many leukocytes do you think are involved? Here we find a value of 7639 ± 3476 mm⁻³ during acute influenza A infection (which seems high, but whatever). That’s about (4–11) × 10¹², viz., the normal reference range. At the low end, you want to throw 0.05 ng of ascorbate at each and every one, or 28 mmol per 10 cells. Ignoring the implausibility of 200 g being absorbed orally no matter the dosing schedule, that’s 3 orders of magnitude more than normal levels. Where do you think they’re going to put it?

  87. #88 Narad
    October 18, 2014

    ^ I guess <code> doesn’t do what I thought it would here.

  88. #89 Tim
    October 18, 2014

    Narad, the C is probably stored in the appendix and released/pumped as needed by some sort of medical Maxwell’s Demon … Those with appendectamies are, naturally, doomed atypical outliers fucked.

  89. #90 Richard Calhoun
    Pittsburgh, PA
    October 18, 2014

    Vitamin C has been around for millions of years. Goats make 100 GRAMS in their liver when sick. Read more you fool. I wish you to eat only a processed food diet, no crazy supplements or antioxidants like that vitamin C, and be allowed only conventional allopathic non quackery methods of treatment when your disease will arise. Good luck God bless.

  90. #91 Chris
    October 18, 2014

    Mr. Calhoun: “Read more you fool.”

    Strange words to come from someone who obviously did not read the article. Or if he did, he did not understand it.

  91. #92 lilady
    October 18, 2014

    Narad @ 271: Thanks for the link to that article. It provided a refresher course for me on bleeding disorders (Von Willebrand’s Disease which my sister has and the ITP and platelet adhesion and aggregation disorder my son had). My sister and my son never had Vitamin C deficiencies or scurvy.

  92. #93 Narad
    October 19, 2014

    Vitamin C has been around for millions of years.

    Hey, given how well things have gone so far, there’s no reason not to hope for vastly more.

    Goats make 100 GRAMS in their liver when sick.

    Do goats really eat tin cans?

  93. #94 herr doktor bimler
    October 19, 2014

    Richard Calhoun, Health Coach grifter (ill-wisher and God-Blesser) appears to be a real person, and not a parody of the mannerisms of moronhood. I am disappointed.

  94. #95 herr doktor bimler
    October 19, 2014

    There are only a handful of mammalian species that cannot produce their own Vitamin C, humans and fruit bats among them.

    It occurred to me to check this statement, on the theory that if a claim is widely accepted among Alt-Healthers then it’s probably wrong.
    Turns out that some species of fruit bats cannot produce Vitamin C; African fruit bat can.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206078/#pone.0027114.s001

  95. #96 herr doktor bimler
    October 19, 2014

    Goats make 100 GRAMS in their liver when sick.

    The primary and indeed only source for this story seems to seems to be Chatterjee’s work in the 1970s — he measured a range of 2,280 – 13,300 milligrams.

    Stone, the inventor of “universal subclinical scurvy”, ignored the whole “range” part and promoted a figure of 13 grams per day for a 70-kg goat (and more when stressed).

    Naturally that figure was amplified over the years, depending how far you are down the human centipede, so one alt-health website tells us that

    Pauling further goes on to say that just a small goat automatically and internally produces 12 grams of vitamin C on average per day and in times of stress can up that amount to 18 grams a day.

    …but alternatively,

    Even a 140lb goat makes 5 grams a day in its liver and up to 60 grams a day when sick or injured

    So now it’s up to 100 grams. OK, if I get scurvy I’ll eat a sick goat.

  96. #97 Narad
    October 19, 2014

    I am disappointed.

    I suspect that Mr. Calhoun is as well, all things considered.

  97. #98 Krebiozen
    October 19, 2014

    Vitamin C has been around for millions of years.

    As I pointed out above, we (humans and our ancestors) have had about 60 million years to adapt to being unable to make vitamin C. We have developed very efficient ways of utilizing very small amounts, partly through mechanisms to concentrate ascorbate in tissues that require large amounts, up to 100 times higher than plasma levels. Uric acid, which most other animals metabolize to the more soluble allantoin, substitutes for many of ascorbate’s roles in humans.

    Goats make 100 GRAMS in their liver when sick.

    Ignoring the exaggeration, that’s because they break down uric acid to allantoin, so they don’t have the benefit of its antioxidant properties and, I believe, they are unable to regenerate and concentrate ascorbate in specific tissues as efficiently as humans and some other primates.

    Liver is a good source of vitamin C, by the way. Fried lamb liver contains more vitamin C, gram for gram, than many fruits (grapes, apricot, plums, watermelon, bananas, crabapples…).

  98. #99 Mephistopheles O'Brien
    October 19, 2014

    Goats make 100 GRAMS in their liver when sick.

    And how does that work out for the goats? Are goats never sick? Do they recover more quickly than animals that don’t produce “100 GRAMS” (or more realistically, between 2 and 13 grams) of ascorbate a day? Are they immune to viral infections?

  99. #100 doug
    October 19, 2014

    From Calhoun’s FB page:
    You are what you eat. As your body digests food, it becomes the red blood cells that becomes the cells of your body.

    Here endeth the lesson.

  100. #101 herr doktor bimler
    October 19, 2014

    Now I am wondering how this Health Coaching business works for Richard Calhoun. No doubt there are some people willing to pay a retainer to receive dietary and supplement advice he’s scraped from Null and Mercola and Miley Adams’ websites, because that way it’s more authoritative then reading that advice *directly* for free… but how many?.

  101. #102 Krebiozen
    October 19, 2014

    Goats make 100 GRAMS in their liver when sick.

    The implication is that they make extra ascorbate to combat their sickness, which seems plausible, since white blood cells (and other tissues and organs) require extra ascorbate when fighting infections.

    However, I wonder if it is as simple as that. Maybe high ascorbate is a symptom of sickness, not an attempt to cure it. High blood glucose is a symptom of diabetes, but we don’t assume that a diabetic’s body is increasing glucose levels to combat the diabetes. In fact cells are starved of glucose because it can’t get into them without insulin; ‘starving in the midst of plenty’ as it is sometimes put. Restoring low glucose levels to normal is beneficial; hyperglycemia is damaging. Could something similar be happening in sick animals?

    Is it possible that infection disrupts the normal feedback mechanisms that control ascorbate synthesis? Ascorbate is made from glucose, which sick goats presumably require plenty of; perhaps converting it to ascorbate most of which is promptly excreted in the urine is a bug, not a feature.

    The hypothesis that we require similar amounts of ascorbate when we are sick depends on a number of assumptions, at least some of which are undoubtedly wrong.

  102. #103 herr doktor bimler
    October 19, 2014

    I confess that my expertise in goat physiology is limited to Bengali-style curry.

  103. #104 Tim
    October 19, 2014

    Ascorbate is made from glucose, which sick goats presumably require plenty of; perhaps converting it to ascorbate most of which is promptly excreted in the urine is a bug, not a feature.

    Like a too high a fever in humans? Sounds plausible. I’d call it a *hypothesis*. Perhaps it could have started from some past and pathogen that also relied on glucose — ‘starve a cold’? Do any microbes also use glucose?

    I don’t know goat biology but I’ve a friend who had a goat. A very friendly goat that grew up with a very friendly chow dog. While that thing would not eat tin cans, he would make off with my Copenhagen only to *sometimes* bring it back… He didn’t seem to like it. He’d eat a dollar bill though. The most unique thing I remember about *Lawrence* was how doglike and personable he’d become — They’re pretty smart when you get to know them. If one went to take a leak behind the woodpile then the goat was there beside you actually hiking his leg just like a dog and peeing; Always careful to hike opposite the humans and looking up and seeming to ‘grin’ as he did so.

  104. #105 herr doktor bimler
    October 19, 2014

    The primary and indeed only source for this story seems to seems to be Chatterjee’s work in the 1970s — he measured a range of 2,280 – 13,300 milligrams.

    Turns out that I got that wrong. Chatterjee published results of test-tube vitamin-C production from “incubat[ing] tissue homogenates with precursors of ascorbic acid”, for a number of mammals.

    I don;t know whether it was Chatterjee’s idea to extrapolate from homogenised enzymes up to total production from a functioning goat liver in situ (Science hasn’t digitised its back issues as far back as 1973); or Stone’s idea in his 1979 paper (says “13,000 mg”); or if Patrick Holcroft (a familiar name) calculated his own extrapolations in 1997 (“2,280 – 13,300 mg”).
    (that goat range is at the high end of the scale; cats, for instance, are about 1/10 as productive).
    http://www.vitamincfoundation.org/forum/viewtopic.php?f=3&t=10528&p=30978

    Along the way someone decided that sick goats must generate more Vtamin C — no experiments were needed — and from then on, the main requirement for pulling an estimate out of the air has been that it must exceed previous estimates.

  105. #106 Tim
    October 19, 2014

    is a bug, not a feature

    Like too high a fever in humans?? Sounds like a hypothesis. Perhaps some remaining response to a past pathogen that eats glucose — ‘starve a cold’? Do germs use glucose?

    I had a warm and affectionate story about *Lawrence* the friendly goat that would actually hike his leg like a dog and pee next to one (never on him) when visiting behind the woodpile. He’d look up at you the whole time seeming to *grin*. He grew up with my friends’ friendly chow dog and would not eat tin cans. Though he would run off with my Copenhagen… sometimes bringing it back. He didn’t seem to like it. He’d eat dollar bills though. Other than that, I don’t know goats.

    (I’d posted earlier but am truely heavily moderated or I had noscript blocking the site… so )

  106. #107 Krebiozen
    October 19, 2014

    doug,

    From Calhoun’s FB page: You are what you eat. As your body digests food, it becomes the red blood cells that becomes the cells of your body.

    That’s pure Robert O. Young. I’m not sure anything can prepare you for this webpage, where Young claims, among other equally untrue things, that red blood cells are made in the intestine, and that having any enzymes in your GI tract is bad – your food should digest itself, apparently (he literally does claim this).

    I had wondered in the past how Young reconciled his claim that our stomachs should be alkaline with the fact that gastric enzymes work at an optimum pH of about 3 (I had to find the optimum pH of pepsin for one of my practical biochemistry exams). Now I know, he neatly side-steps the problem by denying these enzymes exist.

    Either Young is some sort of performance artist, a brilliant*, though utterly immoral, con man, or he is raving bonkers. What kind of person makes up their own ‘New Biology’ and makes up his own facts to fit his grand theory?

    * Brilliant in terms of parting marks from their money, I mean, and apart from getting arrested, of course.

  107. #108 herr doktor bimler
    October 19, 2014

    What kind of person makes up their own ‘New Biology’ and makes up his own facts to fit his grand theory?

    ALL OF THEM.

  108. #109 doug
    October 19, 2014

    Krebiozen,

    Thanks. I had a suspicion the claim had come from someone other than Calhoun. I’ve seen bits and pieces of Young’s nonsense, but I didn’t know of his beliefs about digestive processes and cell generation. I’d never been to his web site before. Yeesh! I feel like I should be paying someone to run a plumber’s snake through the intertoobz.
    I really do wonder how some of these people are “made.” Sometimes I think that a large fraction of them know that what they are pushing is nonsense, but they have come to realize that becoming rich and famous by gulling the rubes is far easier than doing it by being really good at “conventional” things. Toss in credulous fools like Oprah to promote them, and there is no turning back.
    Calhoun, I fear, is probably one of gulled rubes.

  109. #110 MadisonMD
    October 19, 2014

    Goats make 100 GRAMS in their liver when sick.

    And they still get viral infections. Fancy that… vitamin C doesn’t prevent viral infections after all. Hypothesis dead.

  110. #111 herr doktor bimler
    October 19, 2014

    Calhoun, I fear, is probably one of gulled rubes.

    Multi-level marketing of Stupid.

  111. #112 squirrelelite
    October 19, 2014

    @Tim 304,

    E coli normally feed on glucose and I suspect lots of other ones do as well. But, you can cause them to evolve to feed directly on citrate.
    http://blogs.discovermagazine.com/loom/2012/09/19/the-birth-of-the-new-the-rewiring-of-the-old/#.VER-EPl4qXs

  112. #113 zawy
    October 23, 2014

    You should look into Klenner’s contemporary Irwin Stone, who’s 1972 book “Vitamin C: The Healing Factor” which has 50 pages of references from 1930 to the 1960’s. He’s the one who got Pauling interested in Vitamin C. The chapter on viruses is 7 pages with 3 pages of 37 references by 29 researchers. 4 papers by Klenner were in 3 different journals with names sounding as good as any journals of the time. His paper on viruses can be found in many places such as http://www.whale.to/v/c/klenner3.html and change the number “3” to “1” and “2” to see two other papers. As an example, Stone’s chapter on viruses mention 3 papers describing intramuscular vitamin C curing 100% of herpes shingles, one of which was 327 patients. Polio, measles, hepatitis, and flu (45 grams) are also discussed. Greer and McCormick were the only ones to replicate Klenner’s high doses in polio and they got similarly astonishing results. There is no data to the contrary to these author’s who can be found in pubmed. From 2010 paper on I.V. vitamin C averaging 28 grams in a single sitting: “Of 9,328 patients for whom data is available, 101 had side effects, mostly minor, including lethargy/fatigue in 59 patients, change in mental status in 21 patients and vein irritation/phlebitis in 6 patients. “

  113. #114 Ben
    Orlando, FL
    October 23, 2014

    I appreciate objective scientific information on ascorbate, but I don’t think ad hominem attacks or reflexive assumptions that the nutrient is “quackery” further the discourse, nor its conviviality. Also, I’m not so sure that Linus Pauling – one of the ‘founders’ of quantum physics, one of the “most influential chemists of the 20th century, and a 2 time Nobel Prize winning scientist could rightly be called a “quack”. I’d like to see definitive studies that disprove his claims and the vitamin’s efficacy as an antiviral in the doses recommended by proponents. Meanwhile, I’ll go right on treating my own colds and the flu with successfully administered, high dose regimens of ascorbate as I’ve been doing for years – “best evidence” notwithstanding. My own personal results have been nothing short of amazing.

  114. #115 Ben
    October 24, 2014

    CORRECTION: I meant Pauling was *only* one of the founders of “quantum chemistry”, not physics. Sorry. My bad.

  115. #116 Antaeus Feldspar
    October 24, 2014

    Also, I’m not so sure that Linus Pauling – one of the ‘founders’ of quantum physics, one of the “most influential chemists of the 20th century, and a 2 time Nobel Prize winning scientist could rightly be called a “quack”.

    If John Jones were to bring peace to the Middle East, rescue every occupant of a burning skyscraper, and end famine in Africa, and then he went and stabbed a man through the heart, he would be a murderer. All those good things he did don’t make that last act non-existent, or unimportant.

    Linus Pauling was a brilliant scientist and then towards the end of his life he turned to quackery. All his years of brilliance do not transform the quackery of his end years into science.

  116. #117 Lawrence
    October 24, 2014

    Just because someone is smart, doesn’t mean they can’t also be an idiot….

  117. #118 Antaeus Feldspar
    October 24, 2014

    I’d like to see definitive studies that disprove his claims and the vitamin’s efficacy as an antiviral in the doses recommended by proponents.

    And, someone who wants to believe in Bigfoot would surely like to see definitive studies that disprove his existence. Crystal healers would surely challenge science to produce definitive studies showing that ruby quartz is NOT an effective healing tool.

    But science doesn’t work that way, homeslice. The obligation is on those who believe an extraordinary claim to PROVE IT, before science has any obligation to produce “definititve studies” disproving it.

  118. #119 TBruce
    October 24, 2014

    My own personal results have been nothing short of amazing.

    Several colds and the flu and you have survived? That is amazing!

  119. #120 squirrelelite
    October 24, 2014

    A basic principle behind science is that you can’t prove a negative. What you can do is disprove or tentatively confirm a positive claim, such as that large doses of vitamin C can cure cancer.

    And, many studies have been done testing those positive claims. The results are very underwhelming.

    It takes huge doses to get even a modest effect in real patients. And, it doesn’t work very well in conjunction with other chemotherapy drugs, which have been proven to be more effective.

    Similarly with colds and other viral illnesses.

    So, there’s just not much basis to expect that it would work for Ebola either.

  120. #121 Julian Frost
    Gauteng East Rand
    October 24, 2014

    @zawy:

    His paper on viruses can be found in many places such as [link to whale.to]

    HAHAHAHAHAHAHAHAHAHAHAHAHAHA!
    I invoke Scopie’s Law. “In any argument involving science or medicine, citing whale.to as a credible source loses you the argument immediately, and gets you laughed out of the forum.”
    HAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA!

  121. #122 Ben
    October 24, 2014

    Squirrelelite – sensible points you make. Let me add that, in my own reading, I haven’t seen an abundance of studies disproving ascorbate’s efficacy as an antiviral, or in cancer. The ‘definitive’ study that’s most often cited is that of Charles Moertel from 1985 who found ineffectiveness in advanced cancer. Pauling, however, issued a rebuttal and noted flaws in Moertel’s study, citing, for example, evidence of “test cheating” among control patients. But that’s water under the bridge. In a recent meta analyses from 2014, results are still “inconsistent” concerning supplemental (not therapeutic) use, but not *definitive* and a call for more research is recommended (seeL Int J Cancer. 2014 Oct 21. doi: 10.1002/ijc.29277. [Epub ahead of print]
    Dietary supplement use and colorectal cancer risk: A systematic review and meta-analyses of prospective cohort studies). Investigators in a separate and very recent analysis recommend paraemters on the use of bolus ascorbate in cancer for the benefit of “future clinical trials” (Basic Clin Pharmacol Toxicol. 2014 Sep 12. doi: 10.1111/bcpt.12323. [Epub ahead of print]
    Elimination of Ascorbic Acid After High-Dose Infusion in Prostate Cancer Patients: A Pharmacokinetic Evaluation.
    Nielsen TK1, Højgaard M, Andersen JT, Poulsen HE, Lykkesfeldt J, Mikines KJ.). The above investigators remain open to future clinical trial, and research testing, and that certainly appears a sensible position.

  122. #123 Lawrence
    October 24, 2014

    @Ben – so where are all of the studies that show “effectiveness” for Vit. C for Cancer?

  123. #124 Krebiozen
    October 24, 2014

    Since vitamin C and cancer has come up again, the clinical trials of high dose IV ascorbate in cancer patients I mentioned at #22 above, for anyone who is interested, are:

    1. NCT00441207, a Phase I study which included patients with solid tumors, This has now been published (it was a couple of years ago I last looked), though ClinicalTrials.gov doesn’t seem to know, here. They managed to achieve very high plasma ascorbate levels; up to 49 mmol/L, which should satisfy the most enthusiastic orthomolecular enthusiast, but none of the patients responded with tumor regression:

    One patient was withdrawn from the study and hence could not be evaluated for tumor response. Of the remaining 16 patients, no one experienced an objective tumor response. Three patients had stable disease, while 13 had progressive disease.

    2. This Phase II study which included patients with lymphoma, which is flagged as completed but has not been published. The primary author has since published this study looking at high dose vitamin C in combination with conventional chemotherapy, which also has less than spectacular results, and implies that the earlier study just using ascorbate was unsuccessful.

    It seems that even high dose IV ascorbate does not achieve
    the sort of results reported by Cameron and Pauling in their 1978 study (PMC336151 – another link will put my comment into moderation):

    The ascorbate-treated patients were found to have a mean survival time about 300 days greater than that of the controls. Survival times greater than 1 yr after the date of untreatability were observed for 22% of the ascorbate-treated patients and for 0.4% of the controls. The mean survival time of these 22 ascorbate-treated patients is 2.4 yr after reaching the apparently terminal stage; 8 of the ascorbate-treated patients are still alive, with a mean survival time after untreatability of 3.5 yr.

    The IV ascorbate solid tumor study I cited above looked at tumor size, not survival, but since 13 out of 16 patients had progressive disease despite vast amounts of vitamin C I’m still unimpressed, and disappointed to be honest.

  124. #125 Krebiozen
    October 24, 2014

    All three links in my comment work, despite my failure to close the first link tag. I thought I would get away with 3 links, but apparently not – it’s currently in moderation.

  125. #126 Ben
    October 24, 2014

    Lawrence – there aren’t a lot of studies either way – that’s my point. I don’t think I can yet say the vitamin is “definitive quackery”. I cite the recent peer-reviewed recommendations of science investigators (my last post) who recommend further testing and remain open to the chemical’s potential. In my view, that would ideally mean conducting multi-institutional, multi-phase double blind trials on large cohorts of patients in *varying* stages of cancer, not only “last resort” patients with large infusion doses well exceeding Paulings’ recommendation of 10gr oral. It would be fascinating if a vitamin – which is less toxic than antibiotics or cytotoxics – would tip the scales, therapeutically speaking.

  126. #127 Ben
    October 24, 2014

    Also treating the vitamin C question with a fair degree of openness and reporting some modestly good results in several studies is The National Cancer Institute; I’m not getting a definitive “no effectiveness, worthless quackery” vibe from the Institute: http://www.cancer.gov/cancertopics/pdq/cam/highdosevitaminc/patient/page2

  127. #128 Ben
    October 24, 2014

    I was actually surprised to read this in NCI’s report since it is generally assumed, the NCI deems the vitamin ‘worthless’:

  128. #129 Ben
    October 24, 2014

    Laboratory studies

    Many laboratory studies have been done to find out how high-dose vitamin C may cause the death of cancer cells. The anticancer effect of vitamin C in different types of cancer cells involves a chemical reaction that makes hydrogen peroxide, which may kill cancer cells.

  129. #130 Chris
    October 24, 2014

    Ben: “Many laboratory studies have been done to find out how high-dose vitamin C may cause the death of cancer cells.”

    http://xkcd.com/1217/

  130. #131 Lawrence
    October 24, 2014

    @Ben – it is incredibly easy to kill Cancer cells in a petri dish, but much harder in the human body…..

  131. #132 Ben
    October 24, 2014

    May very well be true. My stance has never been ‘sold’ on vitamin C in cancer – only open. Though its use as an antiviral in high infused doses, I’m not sure clinically. Anecdotaly, it does work for me.

  132. #133 Krebiozen
    October 24, 2014

    I’ll try this comment again, since it seems to have vanished. Since vitamin C and cancer has come up, the clinical trials of high dose IV ascorbate in cancer patients I mentioned above, for anyone who is interested, are:

    1. NCT00441207, a Phase I study which included patients with solid tumors, This has now been published (it was a couple of years ago I last looked), though ClinicalTrials.gov doesn’t seem to know, here. They managed to achieve very high plasma ascorbate levels; up to 49 mmol/L, which should satisfy the most enthusiastic orthomolecular enthusiast, but none of the patients responded with tumor regression:

    One patient was withdrawn from the study and hence could not be evaluated for tumor response. Of the remaining 16 patients, no one experienced an objective tumor response. Three patients had stable disease, while 13 had progressive disease.

    2. This Phase II study which included patients with lymphoma, which is flagged as completed but has not been published. The primary author has since published a study (PMID: 22272248) looking at high dose vitamin C in combination with conventional chemotherapy, which also has less than spectacular results, which implies the study using ascorbate alone was a failure.
    It seems that even high dose IV ascorbate does not achieve the sort of results reported by Cameron and Pauling in their 1978 study (PMC336151):

    The ascorbate-treated patients were found to have a mean survival time about 300 days greater than that of the controls. Survival times greater than 1 yr after the date of untreatability were observed for 22% of the ascorbate-treated patients and for 0.4% of the controls. The mean survival time of these 22 ascorbate-treated patients is 2.4 yr after reaching the apparently terminal stage; 8 of the ascorbate-treated patients are still alive, with a mean survival time after untreatability of 3.5 yr.

    The IV ascorbate solid tumor study I cited above looked at tumor size, not survival, but since 13 out of 16 patients had progressive disease, it seems fair to say survival would also have been disappointing.

  133. #134 Krebiozen
    October 24, 2014

    Now my previous one had reappeared, but awaits moderation. Apologies for the duplication. Orac, if you happen to notice this, please feel free to delete the first at #324 which has a botched link.

  134. #135 Tim
    near an airport international hub at a friend's who smokes like a rolling coal diesel and won't air the place out...(he's kinda dee sometimes)
    October 24, 2014

    The resulting syndrome of symptoms (fever, body-aches, headache, and gastrointestinal symptoms) is common to many viral infections, and is due to non-specific immune activation and cytokine storm

    http://www.scilogs.com/in_scientio_veritas/quack-ebola-cure-drinking-urine/

    Ebola studies have concluded that the virus kills by cytokine storm which fatally affects the human body’s immune system. Medical cannabis advocates believe the anti-inflammatory and antiretroviral properties of the substance can reduce the severity of cytokine storm.

    http://au.ibtimes.com/articles/570201/20141021/marijuana-cannabis-ebola-outbreak.htm
    =============================

    I *think* it’s getting down to the wire, doctor dudes. Please don’t give me “…no studies to show…”. No shit, Sherlocks (and idk why?).

    ^^ I don’t want 5000 words of that. I want to know what ya’ll *think*, if that were possible. Is reduction of that said ‘storm’ in any conventional treatments and is it really that plausible??

    What I do *know* is that our mandatory exposure to the initial DARE program taught us that ‘marijuana suppresses the immune system’. Well, it ‘mediates’ it giving it a little time to ‘think it through’ and then concentrate on more pressing issues. I *think*.

  135. #136 squirrelelite
    October 24, 2014

    @Ben,

    You could start by reviewing all the links on this page:
    http://www.cancer.gov/cancertopics/pdq/cam/highdosevitaminc/patient/page2

    Also, please note:

    Patients with acute myeloid leukemia, refractory metastatic colorectal cancer, or metastatic melanoma treated with vitamin C combined with other drugs had serious side effects and the disease got worse.

    and also

    A drug interaction is a change in the way a drug acts in the body when taken with certain other drugs. High-dose vitamin C, when combined with some anticancer drugs, may cause them to be less effective. So far, these effects have been seen only in some laboratory and animal studies. No clinical trials have been done to further research these drug interactions in humans.

    Combining vitamin C with an anticancer drug called bortezomib has been studied in cell cultures and in animal models. Bortezomib is a targeted therapy that blocks several molecular pathways in a cell, causing cancer cells to die. Several studies showed that vitamin C given by mouth made bortezomib less effective, including in multiple myeloma cells. A study in mice transplanted with human prostate cancer cells, however, did not show that giving the mice different doses of vitamin C by mouth made bortezomib therapy less effective.
    An oxidized form of vitamin C called dehydroascorbic acid has been studied in cell cultures and in animals with tumors. Several studies have found that high doses of dehydroascorbic acid can interfere with the anticancer effects of several chemotherapy drugs. Dehydroascorbic acid is found in only small amounts in dietary supplements and in fresh foods.

    Or, for a short answer, read this:
    http://www.mayoclinic.org/diseases-conditions/cancer/expert-answers/alternative-cancer-treatment/faq-20057968

    Before you assert that substance A cures condition/disease X, you need clear evidence that shows it does so.

    The best we can say about Vitamin C and cancer at the moment seems to be that it may reduce some of the side-effects of chemotherapy.

    Anything else is putting the cart before the horse, or in the case of Ebola, the cart is so far in front of the horse that the horse is no longer even hitched to the cart.

  136. #137 Ben
    October 24, 2014

    thanks squirrelelite. I will read your links – and am a little familiar with the studies of high dose C that weren’t so hot. It’s important to pursue the truth about anything as per the Socratic tradition.

  137. #138 Ben
    October 24, 2014

    Krebiozen – thanks for the phase I trial link. It notes no objective responses in a very small trial of treatment-refractory patients for whom no therapy was beneficial. I also note the investigators in this trial concluding:

    They’re recommending ‘further evaluation’.

    On the other hand, I have also read that oxidative pathways of ascorbate might interfere with some cytotoxics etc. Clearly, more research is needed.

  138. #139 Ben
    October 24, 2014

    My citation of above-mentioned phase I didn’t post above. Sorry – please see here:

    “Further support for a potential role of i.v. ascorbic acid is provided by the work of Verrax and Calderon [33] who demonstrated that ascorbic acid completely kills a variety of tumor cells, T24 (bladder), DU145 (prostate), HepG2 (liver), MCF7 (breast), and Ishikawa (cervix), with EC50 values of 3–7 mM. They also showed that 1 g/kg/d i.p. ascorbic acid significantly inhibited TLT tumor growth in mice without any obvious toxicity. Notably, orally dosed ascorbic acid had no effect on tumor growth. In addition, this group demonstrated that ascorbic acid significantly potentiated the antitumor activity of several chemotherapeutic agents including etoposide, cisplatin, 5-fluorouracil, doxorubicin, and paclitaxel and in all three tumor lines tested (MCF7, DU145, and T24).

    The use of i.v. ascorbic acid in combination with cytotoxic chemotherapy is further encouraged by a recent report showing that ascorbic acid potentiated the antitumor activity of gemcitabine against seven human and one murine pancreatic cancer cell lines [35]. The observation is of particular interest as two of the human lines were resistant to gemcitabine. Synergistic antitumor activity occurred in tissue culture and in vivo studies with implanted tumors in mice. This and other reported preclinical investigations provide encouragement for additional exploration of i.v. ascorbic acid to improve therapeutic outcomes [36]. A recently published phase I clinical trial by Monti et al. evaluated i.v. ascorbate combined with gemcitabine and erlotinib in nine patients with stage IV metastatic pancreatic cancer. Potentially biologically and clinically active ascorbic acid concentrations were achievable in all treated individuals, and primary tumor size decreased in eight out of nine patients [21]. The findings of the current study coupled with the collective evidence from the available literature suggest that the combination of i.v. ascorbic acid with gemcitabine to treat pancreatic cancer is an attractive approach that deserves further evaluation.”

  139. #140 herr doktor bimler
    October 24, 2014

    Linus Pauling was a brilliant scientist and then towards the end of his life he turned to quackery. All his years of brilliance do not transform the quackery of his end years into science.

    John Wheeler used to point out that if you are an aging scientist, successful in your field, garlanded with honours, it is your professional obligation to espouse really out-there ideas. Someone’s got to do it, because science needs contrarian theories — if only to keep the right theories on their toes — and it can’t be younger scientists with careers to sacrifice.
    So kudos to Pauling, even if he turns out to be wrong.

  140. #141 Krebiozen
    October 24, 2014

    Ben,

    Krebiozen – thanks for the phase I trial link. It notes no objective responses in a very small trial of treatment-refractory patients for whom no therapy was beneficial. I also note the investigators in this trial concluding: They’re recommending ‘further evaluation’.

    I still see the Pauling/Cameron clinical trials held up as examples of what could be achieved in terminal (i.e. intractable) cancer cases if only those ignorant allopathic doctors would use very high doses of IV ascorbate. They complain that the Mayo Clinic study that attempted to replicate Pauling and Cameron#s results didn’t use high enough doses. This trial certainly used high enough doses, but not a single patient showed signs of remission.

    There may be some benefits of high dose ascorbate in very sick patients over and above the benefits of restoring normal levels, though I don’t see much compelling evidence, but I don’t think the miraculous results that some people claim in cancer are panning out, sadly.

  141. #142 Ben
    October 24, 2014

    Krebiozen – I’d like to see what the as yet, unpublished phase II result shows. But let me add, the phase I trial I reference above (as per your link) wasn’t exploring the therapeutic potential of C – it was testing safety and pharmacokinetics. The conclusion “no objective response” doesn’t tell me much one way or another, since no other chemical agent would have proved effective (i.e. the patients were end-stage and “refractory”. That’s why they were in this trial in the first place). Yes, I agree with your view on ‘miracles’ not being achieved and for myself, find it a turn off when conspiracy theorists float grandiose and unscientific accusations. If anything, high dose ascorbate might – and I emphasize MIGHT – help in some patients when used as an adjuvant with conventional therapies, but I’d like to see more research done, one way or another. I don’t see this as case closed yet. Just my two cents.

  142. #143 Krebiozen
    October 24, 2014

    Ben,

    Yes, I agree with your view on ‘miracles’ not being achieved and for myself, find it a turn off when conspiracy theorists float grandiose and unscientific accusations. If anything, high dose ascorbate might – and I emphasize MIGHT – help in some patients when used as an adjuvant with conventional therapies, but I’d like to see more research done, one way or another. I don’t see this as case closed yet. Just my two cents.

    I agree. I’m not ready to close the door on high-dose ascorbate either, especially in very sick people whose requirements may (or may not) be very high. In cancer patients it may not lead to regression but it may alleviate some of the problems in late-stage cancer, such as sepsis. I think this may be an area where cranks have muddied the waters somewhat (like research into gut problems in autistic individuals). It would be nice to see some more research to settle it once and for all.

    That said, I do think we can safely conclude that the miracles that many people have claimed for high dose ascorbate are hyperbolic. That nasty cold I got despite being saturated with ascorbate that I mentioned above convinced me (viscerally, literally) of that.

  143. #144 Krebiozen
    October 24, 2014

    Oh good grief. Maybe it’s time to quit HTML.

  144. #145 Alex
    October 25, 2014

    I am not against or for allopathic medicine but what really irritates me about badly written blogs like this is that you quote these people and offer NO scientific reason why they’re wrong. It’s just constant bashing, the way a scared bully would act.
    I don’t know what the answer is, but the “dark side” presents a more compelling idea than you.
    The other thing is the word “quackery”. How can anyone possibly take you seriously if you talk like a 3rd grader?
    Vitamin C or any of the other “cures” are inexpensive. So, don’t make a case that someone writing a free blog is suggesting you go to vitamin shop and buy some vitamin c. The pharma companies are the real ones that need to defend themselves as to why use their product since it costs $1000’s.

  145. #146 thomas ichim
    San Diego
    October 25, 2014

    intravenous vitamin c would work on Ebola in part by protecting the endothelium…endothelial damage is a major cause of the hemorrhagic fever…intravenous vitamin c protects from endothelial damage http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3061919/pdf/1479-5876-9-25.pdf

  146. […] Science blogs have felt compelled to combat the misinformation, describing one effort to pump up sales of the vitamin as a “particularly irresponsible bit of quackery promotion.” In a Los Angeles Times story about purported Ebola “cures,” Gerald Weissmann, editor-in-chief of the Federation of American Societies for Experimental Biology and professor of medicine at New York University, said that while Vitamin C is part of a healthy diet and helps build up one’s immune system, “there’s no evidence it has any effect on infectious disease” when taken in higher doses. What’s more, “all this quack stuff takes money and effort away” from legitimate research devoted to coping with Ebola and other health dangers. […]

  147. #148 Helianthus
    October 28, 2014

    offer NO scientific reason why they’re wrong.

    In most cases, we don’t know if they are wrong. But we don’t have evidence they are right, so why should we believe their fantastic claims? Talk is easy.
    I know human babies have a tendency to put anything and everything in their mouth, but I would prefer grow-ups to use a more cautious approach when considering taking a medical treatment.

    In some cases, we do have scientific reasons to believe they are wrong. Name a specific treatment, we will see.
    Well, see below for one.

    Vitamin C or any of the other “cures” are inexpensive.

    But not free. Some people, (including pharma companies – it’s a small world) still make good profits from vitamin sales. Why do you think supermarkets dedicate a few meters of shelves for nutritional supplements?

    You are missing the point, anyway.
    We don’t care if it’s inexpensive. We want something which works.
    Especially with an infection like Ebola. Patients don’t really have the time for a trial-and-error process.

    endothelial damage is a major cause of the hemorrhagic fever…intravenous vitamin c protects from endothelial damage

    You forget the part where the Ebola virus is the cause of the endothelial damage in the first place.
    During a virus infection, cells don’t die because they are lacking vit C, they die because there is an alien which is busy proliferating inside them and will emerge by busting through the cell. Unless a white cell comes by and kill the infected cell – it helps that the infected cell is broadcasting “kill me” signals.
    But you will notice that, no matter what, an infected cell dies.

    Also, from the abstract of the article you linked to:

    Patients with advanced cancer are generally deficient in AA [ascorbic acid]

    The article is about preventing sepsis by providing vit. C to patients which are lacking it. It’s a medium- to long-term strategy.
    Vitamin C is needed both for the building of strong epithelial tissue and for the working of the immune system. If you are missing some, it increases your risk of infection.

    The context is a bit different with an active infection from Ebola virus.
    Sure, if you are low in vitamin C, it’s a good idea to take some.
    But if the Ebola virus is already here, invading and busting your epithelial cells by 1000’s at a time, AFAIK high doses of vitamin C won’t do much to stop the damage.

  148. #149 JGC
    Where the devil is, sadly, still in the details
    October 28, 2014

    <blockquote.endothelial damage is a major cause of the hemorrhagic fever…intravenous vitamin c protects from endothelial dama

    Ebola virus codes for a glycoprotein which activates endothelial cells, and that activation results in decreased barrier function (PMID:16051836). While ascorbic acid does seem effective at suppressing some activation pathways in endothelial cells (for example, activation mediated by TNF-alpha) there’s no evidence I’m aware of that AA at any dose would block Ebola GP1,2 mediated activation.

  149. #150 JGC
    October 28, 2014

    Sigh–borked the blockquote again…

  150. #151 Calli Arcale
    http://fractalwonder.wordpress.com
    October 28, 2014

    But if the Ebola virus is already here, invading and busting your epithelial cells by 1000’s at a time, AFAIK high doses of vitamin C won’t do much to stop the damage.

    I’m a software engineer, not a doctor, but it seems to me that if vitamin C deficiency made it easier to get infected, then giving vitamin C after one is desperately ill is a bit like closing the barn door after the cows have left. Yes, it should be done, but there’s a much bigger problem now which the supplementation will not address.

  151. #152 herr doktor bimler
    October 28, 2014

    Some people, (including pharma companies – it’s a small world) still make good profits from vitamin sales.

    Whackyweedia informs me that Merck and BASF and other big Western pharmaceutical / chem-industry giants left the Vitamin-C business because Chinese industrial refineries (unrestricted by concerns of “environmental impact” or “making a profit”) were able to undercut them. Followed by the Chinese industrial refineries acting as a cartel to put the price up.
    http://en.wikipedia.org/wiki/Vitamin_C#Industrial_synthesis

  152. #153 herr doktor bimler
    October 28, 2014

    what really irritates me about badly written blogs like this

    I am disappointed that Alex offers no specific examples of the blog’s bad writing. Corrections to minor points of syntax or spelling always go down well.

  153. #154 doug
    October 28, 2014

    Suppose some real research scientists were convinced that massive (or any) doses of vitamin C would improve the outcome for ebola patients. In a scenario such as that currently in western Africa, is is possible to ethically do trials?
    If you are dealing with people who are already infected, is it even ethical to ask them to consent to being in a trial? It would seem to me that simply asking for consent is almost certainly going to get most people to say yes – asking the question is perhaps nudging toward being coercive. Maybe that’s OK. Maybe it isn’t. I would want people far wiser than I to consider the ramifications. I would want opinion sought from healthy people in the target community.
    What happens to a placebo-controlled trial of IV vitamin C if the supply of basic IV solutions (water, saline, Ringer’s, etc.) runs low? It’s not like you can easily get Purchasing to lean on the B. Braun rep to toss a few cases in his BMW SUV and pop over with them first thing in the morning.
    There are also questions about the impact on the researchers. Can you maintain sufficient detachment to be objective in an environment where there is great suffering and a lot of death around you, especially where ordinary supplies and skilled people are in short supply? Can you cope with lounging around collecting data when so many around you are running themselves ragged caring for the sick? Can you jump in and help with care without messing up the trial? Can you live with it if you can’t?

  154. #155 Mephistopheles O'Brien
    October 28, 2014

    doug asks, “In a scenario such as that currently in western Africa, is is possible to ethically do trials?”

    I am not a medical ethicist, nor do I play one on TV. But I’d have to think that the short answer would be “of course it’s possible.”

    This is, after all, the search for a cure. If you’re going to cure someone, that person needs to be sick. Asking healthy people to participate in your trial is great if you’re testing a vaccine; it’s useless if you’re testing a cure.

    Admittedly, a diagnosis of Ebola is a coin flip away from a death sentence. You would need to be extremely careful for how you worded your request for consent to avoid giving the appearance of coercion. And of course, you run the risk of being accused of opportunism or downright ghoulishness – which is another reason to be very careful and very public in how you conduct your research.

    As to the concerns about the toll on the people conducting the trial – how is that different from any other trial or any other medical situation?

  155. #156 Narad
    October 28, 2014

    In a scenario such as that currently in western Africa, is is possible to ethically do trials?

    Sure. If your drug supply or distribution ability is limited anyway, it’s amenable to a cluster-randomized/stepped-wedge design.

  156. #157 Narad
    October 28, 2014

    ^ (See, e.g., here for the stepped wedge.)

  157. #158 squirrelelite
    October 29, 2014

    @doug (354).

    In effect, this is exactly what has been done with Zmapp.
    http://www.cnn.com/2014/08/04/health/experimental-ebola-serum/

    This, and other drugs, were already under development and had passed some initial safety testing, so it was felt worthwhile to try it, especially in patients who were not responding to the standard treatment.

    http://www.bbc.com/news/health-28663217

    It will still take proper trials and testing to learn whether these drugs in fact work. But, at least Kent Brantly and Nancy Writebol responded well and are alive.

  158. #159 prn
    sigh...
    October 30, 2014

    One aspect of [Klenner’s] treatment that amazed me was that this was some truly high dose vitamin C. I mean, seriously. Klenner administered … 2 g, people) of ascorbate every six hours (8 g/day) supplemented with 1,000 to 2,000 mg by mouth every two hours (that’s 12 to 24 g).

    That’s from his early work in the 40s, still relatively “low dose”. For speed and reliability his IV vitamin C recommendations got higher. For serious infection situations before Ebola, people were talking about IV treatment of 700-1100 mg C per kg body mass, several times a day, tapering off.

    Heavy doses of IV vitamin C seem to whack a lot of the virus and symptoms even on the first infusion, like massive pustules drying up, turning brown and crunchy over the next 6-12 hours. The virus infections likely recur if you don’t do several IVs to clean out all the compartments in the first 24 hours.

    As for scientific comprehensiveness, mainstream medicine has managed to avoid addressing the 400 mg – 1250 mg C per kg range per infusion for human infections, since 1937 with Sabin’s careless dismissal.

    Some modern caveats about G6PD, electrolyte balances (especially potassium, magnesium), iron and high oxalate kidney patients apply but most people can do it.

    The lethality of Ebola and production of C reactive products (histamine, ROS) should be separated from the cidal requirements of the virus itself. One question about Ebola virus itself is whether it is a comparative wimp analogous with syphilis to penicillin, “average”, or a resistant freak like TB to almost everything.

    As for JGC on Ebola’s lethal proteins, that would suggest better to kill the virus sooner than later. Intuitively, starting at first fever would be better, or perhaps even on exposures.

  159. #160 Shay
    October 31, 2014

    Squirrelelite, of the seven Ebola victims who were treated with zMapp, the survivors were two Americans and a nurse from the UK. The four who died were three Liberians (gawd’elp me, I almost typed “three librarians”) and a 75 year old Spanish priest.

    Given that the average American/European’s baseline standard of health is higher than the average west Africans, I would be concerned that this drug only works when there’s something there to work with…if I’m making any sense.

  160. #161 Shay
    October 31, 2014

    “African’s.”

  161. #162 Narad
    October 31, 2014

    sigh…

    *plonk*

  162. #163 Helianthus
    October 31, 2014

    @ prn

    One question about Ebola virus itself is whether it is a comparative wimp analogous with syphilis to penicillin, “average”, or a resistant freak like TB to almost everything.

    Before wondering if a virus is resistant to molecules with viricidal properties, maybe one should ascertain that these molecules have viricidal properties.

    Also, it looks like you are mixing up resistance and insensitivity. In the former case, the bug has evolved and acquired defenses against the drug – like MRSA. Fighting the bug has become an evolution marathon, but you can try modifying the existing drugs.
    In the latter case, the drug isn’t effective to start with on this specific bug because the bug is lacking the usual target (e.g., mycoplasms aren’t affected by penicillin, as they are lacking the typical bacterial wall). In this case, better switch to another drug class altogether.
    Tuberculosis bacteria belong to the both cases, thanks to their atypical cell membrane, and having sometimes developed resistances to the few molecules working on them.
    It’s splitting hairs, but it’s not the same concern, or the same strategy to address it. Let’s cross this bridge once we are there.

    As for JGC on Ebola’s lethal proteins, that would suggest better to kill the virus sooner than later. Intuitively, starting at first fever would be better, or perhaps even on exposures.

    Any other pearl of deep wisdom you care of sharing? Like, I don’t know, if it’s raining and you carry an umbrella, better open it?
    “This patient has a virus which is deadly half the time when under care, and up to 90% of the time if untreated. Let’s let the virus multiply a bit before doing anything.”

    Apart for the screw-up in Dallas, I wasn’t under the impression that the medical teams fighting the outbreak were delaying care when confronted with a potential new case.
    If anything, delays in treatment have more to do with logistic issues (i.e. limited human and material resources) and patients typically coming when already feverish and sick, than with the health workers being too dumb to tie their shoes themselves, as you seem to imply.

  163. #164 prn
    October 31, 2014

    Helianthus@363: …Like, I don’t know, if it’s raining and you carry an umbrella, better open it?

    Well, most medicos seem to have mistaken the umbrella for a broken cane these past ~75 years and seem to like splashing around in the rain and mud…

    Still waiting to see one actually figure out how to open the umbrella.

  164. #165 LW
    October 31, 2014

    It’s a good thing there are real smart people like prn around to set straight those arrogant doctors with their decades of education, training, and experience.

  165. #166 Krebiozen
    October 31, 2014

    prn,

    As for scientific comprehensiveness, mainstream medicine has managed to avoid addressing the 400 mg – 1250 mg C per kg range per infusion for human infections, since 1937 with Sabin’s careless dismissal.

    You mean this study? How was it careless? He was trying to replicate a previous study by Jungeblut that found vitamin C prevented paralysis from polio, and used similar and higher doses, but found no effects of vitamin C on monkeys with polio, even if they had scurvy to begin with.

    The author of the paper he was trying to replicate was unable to replicate his own findings in this study which found small and inconsistent results, again with monkeys infected with polio. The author concluded, “Certainly, the therapeutic or preventive action of this substance is too limited, irregular, and complex to permit one to regard it in any sense as a true chemotherapeutic agent in experimental poliomyelitis.” It seems it wasn’t Sabin’s “careless dismissal” that ended this line of enquiry, but Jungeblut’s failure to replicate his own results.

    Much of the evidence for the beneficial effects of vitamin C in infections is from one maverick doctor (Klenner), and we don’t really know how accurate his reports are, or if he omitted to report failures. He reported spectacular results, but I’m not aware of anyone successfully replicating them. I also wonder about some of his case histories, such as his successful treatment of 60 polio patients. Since only 1% of polio victims develop paralysis, uneventful recovery of all 60 after high dose ascorbate isn’t particularly convincing.

    As I mentioned above, I experienced a very nasty cold, despite having taken large oral doses of sodium ascorbate for months, which didn’t respond to oral doses above gut tolerance. Maybe IV ascorbate would have worked, but it wasn’t as if I was in a deficient state to start with. That experience seriously damaged my hopes for high dose ascorbate and antioxidants supplementation in general.

    I still wonder a bit about high dose ascorbate and infections, as I used to about high dose ascorbate and cancer, but I suspect that if anyone ever does a study that uses high IV doses to treat infectious diseases, the results will be as disappointing as those in cancer. This is certainly very thin gruel to support giving high dose IV ascorbate to Ebola patients.

  166. #167 Krebiozen
    October 31, 2014

    BTW, a bit OT, but here’s another Phase I RCT, this time using continuous high dose IV ascorbate of up to 710 mg/kg/day for 8 weeks in terminal cancer patients. They found this was safe (except in one patient who developed renal calculi that may have been pre-existing), but none of the patients responded with regression. One patient’s tumors stopped progressing, but the other 23 showed progression. If ascorbate does have any promise in treating cancer, it certainly isn’t as miraculous as some have claimed, even in heroic* doses that surely even prn cannot claim are too low.

    * I can’t resist using this term, which always amuses me; what else would a brave maverick doctor use?

  167. #168 Helianthus
    France
    October 31, 2014

    @ prn

    Still waiting to see one actually figure out how to open the umbrella.

    Well, if it looks like a cane, walk like a cane and quack like a cane…
    Maybe the “medicos” have good reasons to believe they don’t have an umbrella.
    Do you have any evidence that your stuff is working?

    Actually, belay that, because you completely missed my point.
    I was not criticizing you for daring to propose some odd treatment (although I will really be convinced when some evidence is produced to sustain your opinion).

    That I was reacting too is your whole “better start treating people when they show the first symptoms, or even better treat them proactively on suspicion of contamination”.
    Do you really think people on the field need to be told this?
    Every microbiologist, and I hope most physicians know this, if they paid any attention during their training.
    And the fact that African countries are starting to get the epidemic under control seems to indicate to me that, indeed, a critical number of medical workers know how to handle infectious diseases.

    If you show that your miracle cure work, competent health care workers won’t need you to tell them how to use it.
    But you have to give them a good reason to use the stuff first.

  168. #169 squirrelelite
    October 31, 2014

    Thanks for the info, Shay.

    I wasn’t aware of the 3 Liberians or the Spanish priest.

    As for the early treatment issue, you can’t just treat anyone whether they have symptoms or not. When we have an Ebola vaccine, that will change somewhat.

    And sometimes symptoms can be difficult to recognize.

    My mother is in the hospital with a UTI that is resistant to antibiotics, so she is on IV antibiotics for 10 days or so. She’ll also be doing some therapy to build up her strength.

    My sister, who is an endocrinologist, had visited her a couple weeks before and reported she was getting weaker. But, the infection wasn’t diagnosed until the start of this week. But, she’s older than the priest Shay mentioned and is staying in an assisted living facility, so weakness per se is not necessarily a reason to seek a doctor.

  169. #170 prn
    November 1, 2014

    Helianthus

    That I was reacting too is your whole “better start treating people when they show the first symptoms, or even better treat them proactively on suspicion of contamination”.
    Do you really think people on the field need to be told this?

    Of course it would be a no brainer for the in-country medical personnel but the field decision about the population, on possible/probable exposure vs initial febrile (many non-Ebola false uses) vs normal (late) Ebola presentation, would be a major strategic decision and commitment, using major resources for every step earlier.

    Advertising, door-to-door campaigners, more on-site actvities. Such a decision could be changed either way dependent on choke points of supplies, like infusion supplies or injectable vitamin C, too.

  170. #171 …dez…
    Oregon
    November 11, 2014

    Healthy 83, 52 years, on vitamin ‘C’and supplements. No colds, flu, diseases, health issues, no drugs and no doctor. Make a joke out of that! My house is filthy. Go in a hospital no and hell no. No vitamin ‘C’ is allowed in hospitals making them death traps. …dez…

  171. #172 Narad
    November 12, 2014

    Make a joke out of that! My house is filthy.

    OK.

    My house is filthy. Make a joke out of that!

  172. #173 Antaeus Feldspar
    November 12, 2014

    Healthy 83, 52 years, on vitamin ‘C’and supplements. No colds, flu, diseases, health issues, no drugs and no doctor. Make a joke out of that!

    Okay.

    Did you hear the one about the nut named Desmond Throatwarbler-Mangrove who thought an anecdote with an N of 1 was meaningful and pointed the way towards future practice?

    He tried to get everyone to change their names to “Desmond Throatwarbler-Mangrove”, since there was such a clear association between having that name and living to be 83.

  173. #174 Mephistopheles O'Brien
    November 12, 2014

    @Antaeus Feldspar – its pronounced “Desmond Throatwarbler-Mangrove” but it’s spelled “Raymond Luxury-Yacht”.

  174. #175 Krebiozen
    November 12, 2014

    No vitamin ‘C’ is allowed in hospitals making them death traps. …

    That’s a flat lie. All patients are given a diet with more than sufficient vitamin C, including those fed by NG tube or IV.

  175. #176 Denice Walter
    November 12, 2014

    But Kreb, their definition of ‘sufficient vitamin C’ and that of SBM (reality) are several orders of magnitude apart.

  176. #177 JGC
    November 12, 2014

    Des, you forgot to include the part where you also smoked a pack of unfiltered Camels and drank a pint of whiskey every day since you were 12 and the bit where you tell us how many doctors you’ve outlived.

  177. #178 Krebiozen
    November 12, 2014

    Denice,

    But Kreb, their definition of ‘sufficient vitamin C’ and that of SBM (reality) are several orders of magnitude apart.

    But dez specifically wrote “No vitamin ‘C’ is allowed in hospitals”. I had visions of a special machine at the entrance to each hospital that sucks vitamin C out of food, TPN solution, patients, visitors etc.. That would, indeed, make them death traps.

  178. #179 Krebiozen
    November 12, 2014

    I’m reminded of the joke about the wrinkled bald, bent-over old man telling someone he smoked a pack of cigarettes a day, drank a quart of bourbon etc., and when asked his age replies, “35”.

  179. #180 squirrelelite
    fleeing the tobacco smell
    November 12, 2014
  180. #181 Tim
    November 22, 2014

    @Mark Thorsen #8

    5-methyltetrahydrofolate (the form of folate in vegetables) also has been demonstrated to reverse endothelial dysfunction in vivo, so that also seems like something worth trying which has very low risk.

    Well. That is interesting. Of course, it’s hard to just stumble across accurate info on the difference between ‘folic acid’ and ‘folate’ .

    A G-search takes one to the ‘folic acid’ Wiki page and the ‘Folate deficiency’ page has been edited to remove the words “(not to be confused with the related synthetic compound, folic acid)”

    http://en.wikipedia.org/w/index.php?title=Folate_deficiency&direction=prev&oldid=631899311

    The layperson, such as myself, would have to luck into http://en.wikipedia.org/wiki/Levomefolic_acid to find out about (6S)-5-methyltetrahydrofolate.

New comments have been temporarily disabled. Please check back soon.