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Early high dose intravenous vitamin C

To avoid modifying some scientific data, groups of words are not translated.

A version for healthcare professionals, at the end of the article was made available to them

Orthomolecular Medicine News Service,

16 February 2020

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

FOR IMMEDIATE RELEASE

Early high dose intravenous vitamin C is the treatment of choice for 2019-nCov pneumonia

Richard Z Cheng, MD, PhD; Hanping Shi, MD, PhD; Atsuo Yanagisawa, MD, PhD; Thomas Levy, MD, JD; Andrew Saul, PhD.

(omns 16 February 2020) The 2019-nCov epidemic (coronavirus) is from Wuhan, in China and now spread to many other continents and countries, causing public fear.

Even worse, no vaccine or specific antiviral drug for 2019-nCov is available. This adds to the public fear and bleak outlook.

Fast treatment, quickly deployable and accessible, effective and also safe is urgently needed not only to save these patients, to curb the spread of the epidemic, but also very important in psychological insurance for people around the world, and to the Chinese in particular.

Acute organ failure, especially pulmonary insufficiency (acute respiratory distress syndrome, SDRA) is the key mechanism for the death of 2019-nCov. A significant increase in oxidative stress due to the rapid release of free radicals and cytokines, etc. is the hallmark of ARDS which causes cell damage, organ failure and death.

The early use of high dose antioxidants, especially vitamin C (YOU), therefore plays a key role in the care of these patients. We call on all leaders and those who provide direct assistance to patients to courageously and quickly apply large doses of vitamin C (IVC) intravenously to help these patients and end this epidemic.

2019-nCov is a rapidly developing epidemic with high morbidity and mortality.

Wang et al report an admission rate of 26% in USI (intensive care unit) and a death rate of 4,3% in their 138 confirmed cases [1]. Chen and all report that on 99 patients confirmed for nCov 2019, 17 (17%) patients developed ARDS and, among them, 11 (11%) patients worsened in a short time and died from multiple organ failure.

The increase in oxidative stress, an "underlying cytokine storm", leads to ARDS which is the main pathology of the high mortality of these pandemic viral infections. ARDS induced by cytokine storms is the main pathology leading to the death of these patients [2]. Intravenous vitamin C effectively counteracts oxidative stress.

Storm Cytokine  

Coronaviruses and influenza are among pandemic viruses that can cause fatal lung damage and death from ARDS [3].   

Viral infections cause a "cytokine storm" which can activate lung capillary endothelial cells, leading to neutrophil infiltration and increased oxidative stress (reactive oxygen and nitrogen species) that further damage the lung barrier function [3].   

The SDRA, which is characterized by severe hypoxemia, usually accompanied by uncontrolled inflammation, oxidative damage and damage to the alveolar-capillary barrier [4].   

Increased oxidative stress is a major insult to lung damage such as acute lung damage (BUT) and acute respiratory distress syndrome (SDRA), two clinical manifestations of acute respiratory failure with substantially high morbidity and mortality [5,6].

In a report by 29 confirmed patients of patients with 2019-nCov pneumonia, 27 (93%) showed an increase in hsCRP, a marker of inflammation (and oxidative stress) [7].  

Transcription factor The nuclear factor linked to the erythroid “2-related factor 2” (Nrf2) is a major regulator of the expression of cytoprotective proteins driven by the antioxidant response elements (ARE).    Activation of Nrf2 signaling plays an essential role in preventing cells and tissues from damage induced by oxidative stress. Vitamin C is an essential part of the antioxidant system in the cellular response [8] .

Some of the biological effects of vitamin C in critical care management are well reviewed in a recent article by Nabzdyk and Bittner of Mass Gen Hospital at Harvard Medical School on the World's Journal of Critical Care Medicine [9] :

  • Antioxidant, radical oxygen scavenger protecting cells from the oxidative synthesis of steroids and catecholamines, catecholamine cofactor, vasopressin and steroid synthesis, improves hemodynamics, may speed up shock resolution
  • Function of immune cells. Increases phagocytosis and chemotaxis of neutrophils, affects macrophage migration, improves proliferation of T and NK cells, modulates their function, can increase antibody formation.
  • Function of endothelial cells. Decreases ICAM endothelial expression and leukocyte adhesion, improves endothelial barrier function, improves microcirculation
  • Carnitine production, modulates fatty acid metabolism, can improve microcirculation and heart function
  • Wound healing, cofactor of collagen synthesis, mitogen for fibroblasts

Antioxidants, especially at high doses of IV vitamin C (IVC) in the management of ARDS.  

It is clear that increased oxidative stress plays a major role in the pathogenesis of ARDS and death.

Cytokine storm seen in viral and bacterial infections [3]. Cytokine storm leads to increased oxidative stress, of ARDS and death appears to be a common and nonspecific pathway.

This is important in clinical management. Since prevention and management targeting increased oxidative stress with a high dose of antioxidants seems a logical step and can be applied to these deadly pandemics, without long waiting for pathogen-specific vaccines and drugs, as is the case with the current 2019-nCov epidemic .

In fact, vitamin C (IVC) high dose intravenous has been used clinically with success in viral ARDS and also in influenza [10]. Fowler et al described a woman from 26 years having developed viral ARDS (rhinovirus and enterovirus-D68) [3].   

She was admitted to intensive care. After failure of routine standard care, it was placed on ECMO on the day 3. A high dose IVC (200 mg / kg of body / 24 hours, divided into 4 doses, one every 6 hours) was also started on ECMO day 1.

His lungs showed significant improvement by day 2 high-dose IVC infusion on radiographic imaging. She continued to improve on ECMO and IVC and ECMO was discontinued during the day 7 ECMO and the patient recovered and left the hospital on the day 12, without the need for additional oxygen.

A month later, the x-ray of his lungs showed complete healing. Gonzalez et al (including one of the authors, Thomas Levy) recently reported a severe case of influenza successfully treated with a high dose IVC [10].   

MG of 25 years old developed flu-like symptoms which quickly deteriorated to the point that, about 2 weeks later, the patient barely had the energy to go to the toilet. He was placed on a high dose IVC (50 000 mg of vitamin C in 1000 ml de solution de Ringer, infused on 90 minutes).   

The patient immediately reported significant improvement the next day. To day 4 de la perfusion IVC, he felt normal. The a continued the oral CV (2 000 mg twice daily) [10].   

Another story circulated widely on social media that a high-dose CVI was used in 2009 to save a New Zealand farmer, Alan Smith (Primal Panacea). One of us (Thomas Levy) has been consulted in this matter [11] [12].   

Hemila et al reported that vitamin C shortens ICU stay in their meta-analysis 2019 of 18 clinical studies with a total of 2004 ICU patients in the journal Nutrients [13].   

In this report, VC shortened the ICU stay by 97,8% in a subgroup of 1766 patients. Marik et al reported their use of IVC in 47 intensive care cases of sepsis. They found a significant reduction in the death rate in the IVC group of patients [14] .

Dietary antioxidants have been shown to (Vitamin 100 and sulforaphane) reduce acute inflammatory lung damage induced by oxidative stress in mechanically ventilated patients [15]. Other antioxidants have also been shown (curcumine) have promising anti-inflammatory potential in pneumonia [16] .

High-dose IVC has been used clinically for several decades, and a recent paper from the NIH Expert Panel makes it clear that high-dose IVC (1,5 g / kd of body weight) is safe and free from major side effects [17] .

Summary  

2019-nCov pneumonia is a rapidly developing disease with a high morbidity and mortality rate. The key pathogenesis is acute lung injury causing ARDS and death.

Coronaviruses, influenza viruses and many other pandemic viral infections are generally associated with increased oxidative stress due to oxidative cell damage resulting in multiple organ failure.  

The administration of antioxidants therefore has a central role in the management of these conditions., in addition to standard conventional supportive therapies. Preliminary clinical studies and case reports show that early administration of high-dose IVCs can improve clinical conditions in intensive care patients, ARDS and influenza.

It should be noted that pandemics like 2019-nCov will occur in the future. R-specific vaccines and antiviral drugs & D take a long time to develop and are not available for the current nCov outbreak and will not be ready for the next pandemic.  

IVC and other antioxidants are universal agents for ARDS that can be quickly applied clinically. Since a high dose CVI is safe and may be effective, we call on the management and the health professionals involved to study high dose CVI without further delay.   

More clinical studies on CVI and oral CV (like CV encapsulated in liposomes) are needed to develop standard protocols for current use, and future uses are urgent.

We hope that during the next pandemic, we will not be so helpless and we will be ready. Since a high dose CVI is safe and may be effective, We call on the leaders involved and the healthcare professionals to study high-dose CVI without further delay.

– High dose vitamin C (PDQ (r))

– Version for healthcare professionals – National Cancer Institute [Internet]. [cited on 9 February 2020].

Available on: https://www.cancer.gov/about-cancer/treatment/cam/hp/vitamin-c-pdq


For further reading

Coronavirus Patients in China to be treated with high dose of vitamin C http://orthomolecular.org/resources/omns/v16n10.shtml the date of publication of Orthomolecular Medicine Thie News Press Service, Dr Cheng is in Wuhan to facilitate IVC treatment of coronavirus hospital patients.

Vitamin C and its application to the treatment of the nCoV coronavirus
http://orthomolecular.org/resources/omns/v16n09.shtml

Intravenous vitamin C treatment in hospital settings for coronavirus and related diseases
http://orthomolecular.org/resources/omns/v16n07.shtml

Coronavirus nutritional treatment
http://orthomolecular.org/resources/omns/v16n06.shtml

Vitamin C protects against the coronavirus
http://orthomolecular.org/resources/omns/v16n04.shtml

http://orthomolecular.org/resources/omns/v16n11.shtml


The references

1. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X |, Peng Z. Clinical features of 138 hospitalized patients With new pneumonia infected with coronavirus 2019 à Wuhan, in China. JAMA. 2020 7 February;

2. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of novel coronavirus pneumonia 2019 à Wuhan, in China: a descriptive study. Lancet Lond Engl. 2020 30 January;

3. Fowler III AA, Kim C, Lepler L, Malhotra R, Must OR, Natarajan R, Fisher BJ, Syed A, DeWilde C, Priday A, Kasirajan V. Intravenous vitamin C as an adjunct for acute respiratory distress induced by enteroviruses / rhinovirus syndrome. World J Crit Care Med. 4 feb 2017; 6 (1): 85-90.

4. Meng L, Zhao X, Zhang H. HIPK1 interference alleviates inflammation and oxidative stress in acute lung injury by autophagy. Med Sci Monit Int Med J Exp Clin Res. 29 January 2019; 25: 827-35.

5. Yan X, Fu X, Jia Y, My X, Tao J, Yang T, Has H, Liang X, Liu X, Yang J, Wei J. Nrf2 / Buy1 / ARE Signaling Mediated an Antioxidative Protection of Human Placental Human Mesenchymal Stem Cells of fetal origin in alveolar epithelial cells. Oxid Med Cell Longev. 2019; 2019: 2654910.

6. Hecker L. Mechanisms and consequences of oxidative stress in lung disease: therapeutic implications for an aging population. Am J Physiol Lung cell Mol Physiol. 2018 01; 314 (4): L642-53.

7. Chen L, Liu HG, Liu W, Liu J, Liu K, Shang J, Deng Y, Wei S. [Analysis of clinical characteristics of 29 patients with novel coronavirus pneumonia in 2019]. Zhonghua Jie He He Hu Xi Za Zhi Zhonghua Jiehe He Huxi Zazhi Chin J Tuberc Respir Dis. 2020 6 February; 43 (0): E005.

8. Liu Q, Gao Y, Those X. Role of Nrf2 and its activators in respiratory diseases. Oxid Med Cell Longev. 2019; 2019: 7090534.

9. Nabzdyk CS, Bittner EA. Vitamin C in serious illnesses – indications and controversies. World J Crit Care Med. 16 October 2018; 7 (5): 52-61.

10. High-dose vitamin C and influenza: case report – ISOM [Internet]. [cited on 9 February 2020]. Available at: https://isom.ca/article/high-dose-vitamin-c-influenza-case-report/?from=groupmessage&isappinstalled=0

11. Levy T. Primal Panacea. MedFox Edition; 350 p. (Kindle Edition).

12. Levy TE. Primitive panacea. Medfox Pub, 2012. Kindle, 2017.

13. Hemilä H, Chalker E. Vitamin C may shorten the length of stay in intensive care: a meta-analysis. Nutrients. 27 mars 2019; 11 (4).

14. Marik PE, Khangoora V, Rivera R, Hooper MH, Catravas J. Hydrocortisone, vitamin C and thiamine for the treatment of severe sepsis and septic shock: a retrospective before-after study. Chest. 2017; 151 (6): 1229-38.

15. Patel V, Dial K, Wu J, Gauthier AG, Wu W, Lin M, Espey MG, Thomas DD, Jr CRA, Mantell LL. Dietary Antioxidants Significantly Alleviate Hyperoxia-Induced Acute Inflammatory Lung Damage by Improving Macrophage Function by Reducing Airway Buildup HMGB1. Int J Mol Sci. 2020 1is February; 21 (3).

16. Zhang B, Swamy S, Balijepalli S, Panicker S, Mooliyil J, Sherman MA, Parkkinen J, Raghavendran K, Suresh MV. Direct Pulmonary Administration of Solubilized Curcumin Reduces Severity of Fatal Pneumonia. FASEB J Off Publ Fed Am Soc Exp Biol. 2019 Dec; 33 (12): 13294-309.

17. High dose vitamin C (PDQ (r)) – Version for healthcare professionals – National Cancer Institute [Internet]. [cited on 9 February 2020]. Available on: https://www.cancer.gov/about-cancer/treatment/cam/hp/vitamin-c-pdq

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Source: Early high dose intravenous vitamin C is the treatment of choice for 2019-nCov pneumonia


Information +:

“… it takes more than logic and clear demonstrations to overcome the inertia and the dogma of established thought. ” – Irving Stone

Irwin Stone was one of the early thinkers and writers on vitamin C (its scientific name is ascorbic acid).

He knew changing the way the medical profession viewed vitamin C would be an uphill battle. in cancer management.

There is actually a wide range of medicinal uses for vitamin C. There is evidence that it is the best antiviral agent currently available … IF used in the right dose .

Vitamin C can neutralize and eliminate a wide range of toxins.

Vitamin C will increase the resistance of the host, greatly increasing the ability of the immune system to neutralize bacterial and fungal infections.

Now, the National Institutes of Health have published evidence demonstrating the anticancer properties of vitamin C.

With so many medical benefits, why do so few doctors know about it?

CF: INTRAVENOUS VITAMIN C and CANCER

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