Can vitamin C prevent heart disease?

vitamin C heart disease orange wearing stethoscope

Funnily enough, considering its many purported benefits, vitamin C (ascorbic acid) is one of the vitamins that doctors are least likely to prescribe to patients. Vitamin A is given to all small children in many countries, as is vitamin D. Vitamin D is of course also frequently prescribed to patients with osteoporosis. Vitamin B1 (thiamin) is regularly given to alcoholics, to prevent Wernicke-Korsakoff disease. B3 (niacin) was for years given to people with heart disease, on the assumption that it would be useful because it lowers LDL (“bad cholesterol”) and raises HDL (“good cholesterol”). It has since fallen out of favour, after multiple trials have failed to show benefit, but I still see the odd patient who takes it on a daily basis, “for their heart”. The same goes for vitamin E. B9 (folic acid) is recommended for all women seeking to get pregnant, because it decreases the risk of spina bifida in the child, and is also frequently prescribed to patients with anemia, as is B12 (cobalamin). I’ve seen all these other vitamins many times in patients’ charts. But not once have I ever seen vitamin C.

The one medical condition that vitamin C is widely agreed to be useful for is scurvy, common among 18th century sailors, due to the fact that their diet consisted almost entirely of dried meat and biscuits. Although vitamin C is present in small quantities in fresh meat, it is sensitive enough that it is destroyed by the process of drying. Scurvy is vanishingly rare today. The fact that even people on a “carnivore” diet, who eat nothing but meat, can go years without ever developing the slightest sign of scurvy, suggests that the amount of the vitamin needed to prevent the disease is tiny, far lower than the Recommended Daily Intake (RDA) of 90 mg for men and 75 mg for women.

The idea that vitamin C has a lot of additional beneficial health effects, beyond it’s ability to prevent scurvy, largely originates with Linus Pauling, the two time Nobel prize winner who developed an almost pathological obsession with the vitamin during his last few decades of life. He argued that it was effective against heart disease, cancer, and infection – in other words, most of the major causes of premature death!

A while back, I looked in to the claim that vitamin C is effective against upper respiratory tract infections. My conclusion back then, based on a meta-analysis produced by the Cochrane collaboration, was that it does appear to slightly shorten the duration, but not the frequency, of respiratory infections. However, that conclusion was based almost entirely on old studies, carried out in the 70’s and 80’s, before there was a general expectation that trials be pre-registered at clinicaltrials.gov. What that means is that there is a significant risk of publication bias, i.e. that trials that showed benefit were published, while those that failed to show benefit weren’t, and that this explains the entire benefit seen. Even if the effect is real, it’s questionable whether it’s worth taking a supplement every day of the year in order to shorten the duration of any colds you experience by one day.

In this article I’m going to focus on another of the three major claims about vitamin C, that it protects against heart disease. This has been the subject of two large randomized controlled trials. The first, the Womens Antioxidant Cardiovascular Study, was published in the Archives of Internal Medicine in 2007. This was a randomized double-blind placebo-controlled study that tested the effect of vitamin C supplements on women at high risk of cardiovascular disease. It was carried out in the United States and funded by the National Institutes of Health.

In order to be included in the study, apart from being a woman, you had to be over the age of 40 and either have a history of heart disease or fulfill at least three of the following risk factors for heart disease: high blood pressure, smoking, obesity, high cholesterol, type 2 diabetes, or parental history of heart disease. 4,087 women were randomized to receive the vitamin C supplement, while 4,084 were randomized to placebo. The average age of the participants was 61 years and average BMI was 30.3 (the cut-off for obesity is 30, so the women were mostly overweight or obese).

The dose of vitamin C given was 500 mg. Is this a high dose or a low dose?

As mentioned, the RDA for vitamin C is 75-90 mg, but the fact that people on a carnivore diet can get by on as little as 10 mg without developing scurvy suggests that the RDA might actually be set much higher than necessary. 500 mg is about the amount of vitamin C you would get from eating 80 apples, or six lemons. From that perspective, 500 mg seems like a very high dose. It is certainly much higher than our ancestors would have gotten from their diet on a daily basis. The average amount of vitamin C consumed by an adult American today is around 100 mg per day.

There are of course those who argue that much higher doses are necessary. By the end of his life, Linus Pauling was reportedly consuming several thousand mg per day of vitamin C. However, Pauling died in the early nineties, and research done after his death has found that 400 mg is enough to achieve saturation in the body, at least in healthy young adults, at which point any excess consumption beyond that will simply be peed out. A higher dose might be necessary for elderly people to reach saturation, but on the other hand, there is no evidence that saturation is necessary in order to achieve the full benefit from vitamin C (and when it comes to scurvy, we know it is avoided at a fraction of the dose necessary for saturation). So 500 mg should be enough to see at least some beneficial effect, if one exists, and should be enough to reach tissue saturation and thus the maximal benefit possible in most people.

Let’s get back to the study. The women were followed for an average of 9.4 years, which is an impressively long follow-up. Complicance was good, with 76% reporting taking their supplements as directed at least two thirds of the time at the four year mark. 68% were still doing so at the eight year mark.

So, what were the results?

Overall, 206 women died of cardiovascular disease in the vitamin C group, compared to 189 in the placebo group. This represents a 9% increased relative risk of cardiovascular death in the group treated with vitamin C. The difference was however not statistically significant. Nor was there any statistically significant difference between the groups in terms of frequency of heart attacks or strokes. Overall mortality was also similar, with 504 dead in the vitamin C group, compared with 491 in the placebo group.

In other words, there was no meaningful difference in outcomes between the groups in any of the variables studied. Considering the enormous size of the study (over 8,000 people) and the long follow-up time (over nine years), we can be pretty sure that means that a vitamin C supplement doesn’t impact risk of heart disease or overall longevity in any meaningful way, at least not in overweight middle-aged women.

Let’s move on to the next study, which was published in JAMA in 2008. This was the Physicians’ Health Study II. Like the previous study, it was big. And, like the previous study, it was randomized, double-blind, and placebo-controlled. All the good words I like to hear. 14,641 male physicians over the age of 50 were followed for an average of eight years. 7,329 of these received vitamin C, while 7,312 received placebo. The dose given was the same as in the previous study, 500 mg per day. The study was carried out in the US, and funded by the National Institutes of Health and BASF (a German chemical company that at the time sold vitamin C supplements).

Unlike the previous study, there was no requirement that the participants have a high cardiovascular disease risk to be included in the trial, so while the previous trial was mainly looking at secondary prevention (decreasing risk of further events in those who already have cardiovascular disease), this one was instead mainly looking at primary prevention (preventing cardiovascular disease from developing in the first place).

The average age of the participants at the start of the trial was 64 years, and average BMI was 26 (the cut-off for overweight is 25, so these men were very slightly overweight, on average). Only 5% had a history of cardiovascular disease and over 60% reported exercising at least once a week, so this was a pretty healthy group overall, although 42% had a history of high blood pressure.

As in the previous study, compliance was good. 78% of the participants were still taking the supplements as directed more than two thirds of the time at the four year mark, and 71% were still doing so at the eight year mark.

Ok, let’s get to the results.

There were 256 deaths from cardiovascular disease in the vitamin C group, compared with 253 in the placebo group. This represents a 2% increased relative risk of dying of heart disease among those treated with vitamin C, although, needless to say, the difference wasn’t statistically significant. Overall, 857 people died in the vitamin C group, while 804 died in the placebo group. As with the previous study, there were no statistically significant differences in any of the variables studied.

In other words, the results of the second study line up perfectly with the results of the first study. What can we conclude?

The best available evidence at this point in time suggests that Vitamin C does not have any beneficial effect on heart disease, or on overall longevity for that matter. Considering that these were very big, high quality studies, I think the conclusion can be considered definitive. One could always argue that a beneficial effect would have been seen with a much higher dose, but considering that tissue saturation is usually reached at just 400 mg, I doubt it. If anything, the signal from these two studies is that increasing the dose further might be harmful, since there were actually more deaths in the vitamin C group than in the placebo group in both studies.

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75 thoughts on “Can vitamin C prevent heart disease?”

  1. RE: and research done after his death has found that 400 mg is enough to achieve saturation in the body, at least in healthy young adults, at which point any excess consumption beyond that will simply be peed out.

    This research has the mistake of only giving 1.5g max. single dose, and extrapolating for all higher dose. However, there is a meanwhile old sudy and categorically overlooked by the academic world, which meassured levels of paricipants taking beween 0-20 g spread throughout the day. With no saturation at single doses of 400mg found.

    “Self-reported daily intake varied from 0 to 20 g/day. The plasma AA levels ranged from 11.4 to 517 µmol/L and correlated well with the reported intake. Regression analysis of their GHb and plasma AA values showed a statistically significant inverse association (eg, each 30 µmol/L increase in plasma AA concentration resulted in a decrease of 0.1 in GHb).”

    Ascorbic acid, glycation, glycohemoglobin and aging – Cheryl A. Krone, John T. A. Ely

    Personally had a 60% walking-disabilty from a 80% stenosis at my abdominal aorta (PAD). And experienced remission from the disabilty after 7 years on daily 25 g/d of ascorbic acid. And refusing any invasive intervention by conventional medicine, which considers it non-reversible. Investigate wisely, your life might depend on it. Doubt anything considered assured in medical science, especially when it comes to non-reversilbe and mercylessly advancing chronic dieseases.

  2. There’s lies, damn lies and statistics. I suspect that the one positive thing to come out of this ‘pandemic’, is a healthy disrespect for statistics, of any kind but especially the Delphic Oracle kind, predictions.

    1. Flaco, the current pandemic has left me with an even greater respect for “statistics”, but a much lower respect for those who claim to *use/understand* them–correctly. Those folk produce your “Delphic Oracle” pronouncements. In that observation, you are spot on.

      1. Hmmm… I think the sociopaths ‘in charge’ have done more damage to science in a year than Lysenko did in a lifetime. Science has been debased , distorted and undermined for political and economic gain. And what’s worse, is that the scientists themselves had actively participated in this gigantic deception, either for financial and/or egotistical gain.

        Ultimately however, I think this crime against humanity will be exposed no matter how much Google, Facebook, the BBC et al try to hide and falsify the facts.

  3. I find that here Sebastian is missing the point completely, though he cannot be unaware of the fact that we, among a small subset of mammals, are unable to manufacture ascorbic acid (AA) should our disease status require it – the case of Canis sp. being able to produce 10+gm/d AA when sick often being cited to show how the human recycling of L-dehydroascorbic acid (DHA) through erythrocytes is inadequate to produce the required destruction of rampantly multiplying pathogens.
    Few researchers have examined the ramifications of this in humans, let alone all other species (fruit bats, higher primates, and guinea pigs) who have lost this ability, but those who have have noted e.g. the effects of inadequate circulating (AA) on erythrocyte morphology, vascular damage, and blood glucose levels… see e.g. https://www.cell.com/cell/pdf/S0092-8674(08)00204-3.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740302/#!po=6.25000 https://academic.oup.com/aje/article/159/6/581/147664
    Then there are the ICU doctors successfully treating sepsis with high dose IV AA (MATH protocol).
    Considering that the levels of AA supplements used in the trials are so low compared to circulating AA in Canis sp. during illness it is unsurprising that no significant difference in death rates would have been noticed and this is without considering the cumulative damage caused by an AA deficient diet consumed for a lifetime before enrolling in the trials.

      1. I know this isn’t ‘scientific’ but I caught the ‘bug’ last December and fully recovered in 5 days from bacterial pneumonia, triggered, assume by the virus.

        I’m almost 76, I’ve have two heart attacks (5 stents) and an ex-smoker but otherwise not in bad shape (is that a contradiction?) but I’ve been taking Vits D3/K2 and Vit C for ages. And, I don’t get colds and the last time I caught the flu was 46 years ago! No connection? Who knows? More to the point, who cares? I’m still trying to figure out what those two studies actually prove, other than the fact that if you only look for one thing (eg heart disease) and don’t find it, it says absolutely nothing about the role of vitamin C.

      2. I think at the time this happened we used to get much more vit C from our fresher foraged diet, and I have read (can’t remember where!) that an evolutionary change can have beneficial as well as adverse effects and it is the balance of the two sides that determines whether the change persists.

      3. So how does sickle cell anaemia fit into this scenario? One positive mutation (resistance to malaria) results in another, negative mutation, sickle cell anaemia.

        People, Nature, are not machines but modern medicine [sic] treats us that way.

      4. The sickle cell gene is preserved because it improves survival in areas with endemic malaria. Are you saying that we lost the ability to produce vitamin C because we’re better off without it? 😉 Generally species only lose abilities if they don’t need them or do better without them.

      5. “The sickle cell gene is preserved because it improves survival in areas with endemic malaria. Are you saying that we lost the ability to produce vitamin C because we‘re better off without it? Generally species only lose abilities if they don‘t need them or do better without them.”

        No, I’m NOT saying we lost the ability to produce vitamin C because we‘re better off without it!

        I think you’ve got it backwards Dr Rushworth. A mutation occurred that gave African peoples protection against malaria but the downside of that protection was a mutation (as a result of the protection?) that made people with protection from malaria vulnerable to sickle cell anaemia. So Nature ‘made a trade-off’ so-to-speak. Isn’t that what evolution is all about?

      6. I think you misunderstand how sickle cell anemia works. It’s not something you can develop. It’s something you’re born with. People with one copy of the gene variant don’t have the disease, but they have greater protection against malaria. People with two copies have the disease. In other words, if you only have one copy of the sickle cell gene variant it’s beneficial but if you have two copies it’s harmful. As you say, it’s a kind of trade-off: if you’re a carrier then you and your children are more likely to survive inevitable malaria infections, but some of your children may be born with sickle cell anemia, in which case they won’t reach adulthood. Overall, however, your odds of passing on your genes to the next generation are improved.

      7. Dear Sebastian,
        I don’t think we have a disagreement here, but maybe my terminology was less than precise when I wrote:

        “… that made people with protection from malaria vulnerable to sickle cell anaemia…”

        when I meant exactly is what you wrote, that one mutation, led to another mutation, one positive, the other negative. The point is, it illustrates the complexity of life. Given that vitamins (some, like D are actually hormones) have been sorely neglected by the dominent medical orthodoxy, in fact often treated with disdain and thus inadequately and incorrectly examined, so who knows what’s really going on when all these chemicals start interacting synergistically, especially with the immune system.

        Another example of this complexity is the thyroid and how interacts with at least three crucial organs in the body, the hypothalmus, the pituitary and the adrenal gland. Thus in my case for example, an underactive thyroid, the standard treatment, thyroxine, doesn’t reach all these components which in turn can lead to the body producing too much cortisol and adrenaline, which then has consequences for my heart. Add in stress… There’s a ‘cascade’ effect, so who knows what vitamin C is really doing?

      8. With the advent of medicine, perhaps medicine is interfering with natural selection and we end up with genes for phenotypes which might be selected against were medicine absent.

  4. I have two follow up questions to your vitamin C article:

    I recall claims that the Chinese were using high dosages of vitamin C intravenously to help with patients suffering from coronavirus in hospital. Was any sort of analysis of the impact of vitamin C in these circumstances carried out?

    Is there anything in this:
    “At higher doses, with more vitamin C than needed just to prevent scurvy, each molecule of ascorbic acid can deliver 2 antioxidant electrons to the body, creating dehydroascorbate. Ascorbate + dehydroascorbate is excreted in the urine. The difference between the ascorbate absorbed and that excreted (not as dehydroascrobate) is the antioxidant potential added to the body. If the BBC experiment was serious about science it would have measured how much of the vitamin C was excreted as ascorbate and how much as dehydroascorbate, as well as knowing total intake from diet and supplements.

    The excretion of high doses is thus part of the mechanism of benefit. The body does not need to use energy trying to generate antioxidant electrons as it gets them for free from the high dose supplement.”

    From Patrick Holford’s blog

    1. Yes, man and woman, does not live by Vitamin C alone, any more than it does by anything we take in. Modern medicine tends to be singular in its approach to health. It can’t explain the placebo effect or the nocebo affect simply because it takes a unitary and reductionist approach to treatment.

      So for example, how positive versus negative ‘feelings’ affect health cannot be explained simply by chemistry, nor does acknowledge the power of ‘mind over matter’, that is to say, the complex relationship between the brain and the body (isn’t this what they teach in medical school these days, holistic medicine, or are they merely paying lip service to the idea?)

  5. Hi Sebastian
    Your article talks about vitamins as if they are drugs, they are not! For example, you state that giving folic acid in pregnancy reduces the risk of spina bifida, I suggest that it is more accurate and useful to state that a deficiency of folic acid in pregnancy increases the risk of spina bifida. There is a problem that many trials treat vitamins as drugs, missing the point entirely that there needs to be a deficiency for there to be a beneficial effect. There is also the issue that the RDAs are based on the amount required to prevent the end stage obvious deficiency as in vit C for scurvy or vit D for rickets, the research to tell us what the optimum levels are, and what conditions might be due to a lower level of deficiency, just hasn’t been done in humans. It has been done for zoo primates though, also don’t make their own, optimum intake for vit C is 60 – 70 mg PER KILO of body weight, approx 50 times more that our RDA, interesting? We also know that animals who can make their own make huge amounts (10+ grams) when sick or injured. Trials of vitamin C just don’t use enough, even if we knew the optimum level if well, the body needs much more when ill. I wouldn’t agree that 500mg is a high dose, if it was given orally, depending on formulation, only 25% will be absorbed. I used to think it wasn’t worth taking supplements of vit C until I read ‘The Healing Factor’ by Dr Irwin Stone, available free here, http://vitamincfoundation.org/stone/ and followed up with some confirmatory research. Dr Stone researched vitamin C for 40 years, it is an interesting read, I’ld love you to read it and to hear what you think Sebastian! I have come to the conclusion (along with medical services in China, the Westminster and Chelsea Hospital and some US hospitals) that vitamin C could have prevented much suffering during the pandemic, in SUFFICIENT DOSES it is anti inflammatory, anti microbial (including viruses), cheap and non toxic. Nothing to dislike there unless you are looking for a profit. But, posting anything to connect vitamin C and COVID will attract a fake news sticker, you have to wonder why. A large group of physicians and others have set up a project to try and get some discussion and acceptance , see https://www.vitaminc4covid.com. As for its effect on heart disease – who knows! I think a deficiency would make any illness worse as vitamin C is needed for so many processes in the body. As for the carnivore diet, it is my understanding that there is vitamin C in meat, (especially the adrenal glands as well known by so called primitive races).

    1. Yes, all that.

      It has been speculated that the carnivore diet changes your biochemistry such that one needs much less vitamin C than a normal carbohydrate person.

      1. Yes, but a common objection to the carnivore diet, which for some reason helps cure everything, is there is no Vitamin C. Actually there is some small amount in fresh meat. But it does seem to readjust your nutrient requirements. That is an interesting statement. It implies that the carbo persons as we all are have abnormally affected our chemistry so we now need all these nutrients to compensate.

  6. I have no idea about the importance of vitamin C for cardiovascular health, but I have personal exerience of how supplements can be very helpful. I suffered from

    My “faith” in supplements became strong after having suffered from allergy in my esophageus, eosinofil esofagit, which constrict my esophagus severly. At times I had a hard time swallowing even after chewing carefully. Twice I had to be operated on to remove food that got stuck. I noticed that my pollen allergy became much less of a problem when I used MSM, organic sulphur, in combination with vitamin C; then I noticed that if I took not one but two doses a day the symptoms didn’t return in the evening. But what was even more interesting was that the problems with my esophagus (almost) disappeared when I increased the MSM and vitamin C dosage (about 1 teaspoon per day MSM and perhaps 6 gr Vitamin C, spread across the day). Vitamin C and MSM are supposed to have a synergistic relationship. I was so happy not to be forced to use the standard medicine, a type of cortisone (Flutikasonpropionat, Flutide Nasal). I told my gastro doctor about my supplements and how the postive effect, but of course he recommended me to use the standard meds. But at the local clinic where they performed an allergy skin prick test, the nurse told me that a number of other patients had told her that MSM reduced their pollen allergy symptoms.
    Regardin why our ancestors lost their ability to produce vitamin C, it may have happened because it was a benefit in the short run – perhaps they lived in an environment with plenty of vitamin C rich fruits, and it may have been an advantage not having to produce it yourself. I’m also very impressed by dr Paul Marik’s sepsis protocol which, includes IV vitamin C. But here in Sweden the authorities prefer to let people die of sepsis, rather than allowing that protocol.

    1. I was hospitalized with pneumonia/UTI sepsis in Marik’s hospital system in Virginia. It was my 9th time with sepsis. The protocol was used on me. Interesting thing is that I’ve never had another serious infection since then. Why?

  7. I really thought you were a breath of fresh air yet find this blog to be similar to your last in as much that the terminology you use is clearly biased against orthomolecular medicine and loading doses. For vitamin C “some argue that”. Against, “research shows”. Both of these statement are sweeping and very simplistic. There is a huge amount of very good research out there to support claims gir orthomolecular medicine and loading doses. Neither do you explain the parameters of the research against vit C etc. It is good to remember that most horse supplements give a loading dose and a maintenance dose. It may be wise to spend some time engrossing yourself in the wvidence fir and matbe trying it simetimes. Fyi, I have personally taken 70,000 mgs in one day when I was very poorly and did not reach bowel tolerance. Vit C in massive doses, if needs be, is extremely effective.

  8. “The steroid Methylprednisolone is a key component, increasing numbers of studies (see https://flccc.net/medical-evidence) show its profound effectiveness in COVID-19, which is made more potent when administered intravenously with high doses of the antioxidant Ascorbic acid given that the two medicines have multiple synergistic physiologic effects”

    https://covid19criticalcare.com/wp-content/uploads/2021/01/FLCCC-Alliance-MATHplus-Protocol-ENGLISH.pdf

    Methylprednisolone boosts vitamin C saturation by many times, and vitamin C does the same with Methylprednisolone. That’s the cure for covid, by the way.

    As for the Cochrane collaboration, I trust Pauling over them. Pauling undoubtedly, I speculate and assume, had a mechanistic cause-and-effect reason for going with vitamin C. The Cochrane collaboration only has iffy statistics.

    Furthermore,

    In July 2018, Cochrane researchers Peter Gøtzsche, Lars Jørgensen and Tom Jefferson published a scathing critique of the Cochrane collaboration HPV review, pointing out methodological flaws and conflicts of interest.

    In September, the Cochrane governing board expelled Gøtzsche from the board. Four other board members resigned in protest.

  9. Hello
    It would be nice to hear your comments on the following.
    There has been a renewed interest in the benefit of vitamin C. An American doctor Dr. Klenner was a pioneer around the time of the second world war. Penicillin appeared at the time and all of what he had ackomplished with IV megadoses of vitamin C just more or less fell into oblivion.

    And this is in spite of the enormous success he had with handling different virus sicknesses, among which polio. A little about it is shown in the enclosed files. The first one is by Dr. Klenner himself from 1971 and the following ones are about him in present time.

    US National Library of Medicine
    National Institutes of Health

    The summary of the article was:
    4. Discussion and conclusions

    Over the past century, the opinion that Vit-C can be used to treat cancer and viral infection has shown promises and controversies. There are cases where high dose Vit-C has shown benefits. In some cases, there have been no benefits. However, new knowledge regarding the pharmacokinetic properties of Vit-C, and recent preclinical studies, have revived interest in the utilization of high-dose Vit-C for cancer treatment [[132], [133], [134], [135], [136], [137], [138], [139], [140], [141], [142], [143], [144], [145]]. Similar is the case of using IV Vit-C as antiviral, especially for the recent Covid19 [[146], [147], [148], [149], [150]]. It is believed that IV Vit-C has been particularly effective by inhibiting the production of cytokines storm due to Corvid19.

    Covid19 pneumonia is an extremely rapidly developing disease with a high mortality rate. The main pathogenesis is the acute lung injury that causes ARDS and death. Antioxidants should have a role in the management of these conditions. Appropriate clinical studies and reports demonstrate that a timely administration of high dose IV Vit-C improves the outcome of Covid19 infection.

    Additional studies detailing the use of IV Vit-C for the treatment of severe Covid19 infected pneumonia are definitively warranted. Covid19 may continue to happen in the future. Since the development of clinically active vaccines or antiviral drugs targeting specific diseases may take a long time to develop, the use of IV Vit-C as a universal agent for ARDS may have benefits behind Covid19. Additional clinical studies of the IV Vit-C and oral VC (such as liposomal-encapsulated VC) targeting other situations through different mechanisms are required to develop as soon as possible.
    VIDARE NEDANSTÅENDE ARTIKEL FRÅN 1971
    Journal of Applied Nutrition Vol. 23, No’s 3 & 4, Winter 1971
    Observations On the Dose and Administration of Ascorbic Acid When Employed Beyond the Range Of A Vitamin In Human Pathology
    Frederick R. Klenner, M.D., F.C.C.P.
    ________________________________________
    Comment by Robert F. Cathcart, M.D.: This paper repeatedly refers to intravenous ascorbic acid. My personal experience, my talking with Klenner, and with his wife, Annie Klenner, who served as his nurse, would indicate that he means sodium ascorbate. See my article on how to make intravenous C solutions. I am especially indebted to Annie Klenner for her descriptions of how Fred made the intravenous solutions of sodium ascorbate.
    ________________________________________
    Editor’s Note:
    Because of the unusually high amounts of ascorbic acid used in Dr. Klenner’s treatment as reported in his paper, we asked him to verify amounts mentioned. Following is his answer:
    “To the Editor of the ICAN Journal: This will confirm that all ‘quantity’ factors given in my paper are correct and can be confirmed from hospital and medical office records. The notation relative to 150 grams represents the amount used for reversing pathology in a given case and was the amount given over a period of 24 hours. (The I.V. was continuous.) This was given in three bottles of 5D water, decanting only enough from 1000 c.c. to be replaced by the ‘C’ ampoules.
    “Recently the FDA has published a ‘warning’ that too much soda-ascorbate might be harmful, referring to the sodium ion. In reply to this I can state that for many years I have taken 10 to 20 grams of sodium ascorbate by mouth daily, and my blood sodium remains normal. These levels are checked by an approved laboratory. 20 grams each day and my urine remains at or just above pH 6.”
    Signed:
    Fred R. Klenner, M.D.

    1. All this is set out in Dr Irwin Stone’s book ‘The Healing Factor’ which easily can be found free on the internet. Dr Klenner’s work is amazing!

      1. Yes it is indeed sad that it was forgotten and that it does not seem to have be taken up again. From what I have read in his book (which I have lost since then) it seems he had great success through his work curing very difficult virus illnesses, like polio and lepresy etc. with massive IV dosis of vitamin C. But then again there would not be any interest in the pharmaceutical industry to promote it to the detriment of their products.

    2. Dr. Rushworth, could you comment on the various mechanisms by which covid kills?

      “Covid19 pneumonia is an extremely rapidly developing disease with a high mortality rate. The main pathogenesis is the acute lung injury that causes ARDS and death.”

      This statement is false, based on what I have read. Only about 25% of covid deaths are due to ARDS. The rest are due to systemic organ failure and blood vessel blockage resulting in stroke, myocardial infarction, and pulmonary embolism.

      1. Well as someone who actually caught the virus and developed bacterial pneumonia (in my left lung), two kinds of penicillin were administered for 5 days and as you can see, I’m alive and well. My understanding is that the really dangerous pneumonia is the viral kind.

        BTW, I’m 76 year-old an ex-smoker and I’ve had 2 heart attacks but otherwise and not in too bad (physical) health.

      2. If you really want to know how C19 kills you need to go down the molecular pathways and that requires biochemistry. In the following video Tyler explains all from start to finish:

        https://www.youtube.com/watch?v=-oh9Ztgjm4A

        Note minutes 2 to 4 where actual patients are cured.

        He details exactly how to Cure a Covid cytokine storm and re-regulate your immune system so it is not dysregulated.

    3. This may be the video to end all videos – everyone must watch it. It describes an overlooked factor that may be the underlying cause of just about all disease, and certainly the top two cancer and heart disease.

      This video may put Dr. Rushworth out of business.

      Dr. Levy also has a ebook you can download on this for free.

      Vitamin C is also mentioned and the biochemistry is detailed. You need to have hydrogen peroxide in there which synergizes with C, possibly by increasing the uptake the way steroids do.

      I believe C on it’s own may not saturate so well because it absolutely needs synergistic helpers to become therapeutic, and this is why simplistic studies find only minor benefit.

  10. Dr Rushworth,
    Thank you for your book and some thought provoking posts.
    However, I think that the last couple have been disappointing. I don’t even understand the question which forms the title of this one.
    To me vitamin C is not a magic bullet which fights an evil foe, it is a building block of an integrated healthy terrain. If people have a heart attack, they have a problem or problems with their terrain. If vitamin C is not the problem then no amount of it will rescue the situation.
    It must be very difficult for you to live in the parallel universes of your reductionist medical training and a broader holistic mindset but I get the feeling that I am not alone in needing you to try to do this if I am to get value from following you.
    Thank you again.

  11. Ascorbic acid is different from whole food vitamin C, and then there’s liposomal vitamin C. Is it possible that the form of vitamin C consumed is just as important as the dose when assessing for efficacy? Is there a potential for different results from supplemental whole food vitamin C as opposed to ascorbic acid? Seems reasonable to me to at least consider the possibility since whole food provides a more complete source which may affect results.

    1. Dr. Klenner is a key success factor when it comes to health. That link I presented above mentions him.

    1. With a few exceptions, evolution is based mostly on non-empirical guesses which _cannot_ be checked.

      Imagine if people applied RCT-level scrutiny to evolution–it would wither and die in a month.

      (This is not to imply that natural selection isn’t operating.)

      1. I could detail why RCTs are often bogus but let me just mention “Replication Crisis.”

        One problem with an RCT is you assume it is correct based on statistics so you assume the statistics are correct although there is no normal average person anywhere. And the problem with that problem is you don’t know if any specific study actually suffers from that problem. You never know, exactly like you never know in biochemistry if you have controlled for all the confounding variables. Could be a thousand or a million more variables distorting your results and you will never know. That’s why so-called “evidence-based” medicine is bunk. Much better is “experience-based” medicine developed as a working hypothesis out of many anecdotes (data points) over time by a clinician with exceptional pattern recognition skills. That’s how they did it in the old days and some of them were amazing doctors.

        The ballyhooing of evidence-based medicine and RCTs is well designed to program and trick young doctors so they take it all on faith and passionately parrot and defend academic medicine – they assume there’s nothing better, nor can their be so they stop thinking about even the possibility of something else. This makes academic medicine a faith-based ideology, a religion that becomes an unexamined sacred assumption. Only conspiracy theorists (OMG!) would think outside that holy box.

      2. Experience based medicine is what we had up until the 1950’s. It probably harmed ten patients for every one it helped. It has been shown again and again that doctors own anecdotal experience is not a reliable source of knowledge, and often leads to faulty and harmful conclusions. There are countless examples of doctors doing something because logic or experience told them it worked, yet when tested was actually found to be harmful. RCT’s and evidence based medicine are not perfect, but they are infinitely better than the alternatives.

      3. I have posted about RCT’s strengths and limitations on my blog. Prometheus had a brother who was always cleaning up Prometheus’ disasters.

        For example, retrospectives caught problems with HRT being given to women approaching menopause that RCTs missed.

        Both RCTs and retrospectives are needed. RCTs are _not_ some sort of gold standard.

        There are plenty of disastrous RCTs, like RECOVERY’s test of HCQ and SOLIDARITY as well and a recent trial of an Alzheimer’s drug.

        There are ways to game RCTs to achieve a desired result or avoid an undesirable result.

        1) End the study prematurely to avoid showing significance in benefit for a competitive drug.

        2) Study the wrong hypothesis.

        3) Claim early treatment for an acute disease while hiding treatment delays.

        4) Omit limitations of a study (interpretive fraud).

        5) Keep your participant count low in order to avoid a benefit achieving significance.

        Pharma has learned much from the tobacco industry about controlling research.

      4. None of those five things are problems with the RCT methodology itself. Any study can be manipulated or gamed. Observational studies are even easier to manipulate than RCT’s.

        That Alzheimer drug trial was negative, as is obvious to anyone who reads it. So from that sense the RCT did what it was supposed to do, it showed that the drug doesn’t work. Then the pharmaceutical company ”interpreted” the data in a favourable light, and this was supported by the FDA, which is clearly utterly bought and paid for by the pharmaceutical industry.

        When it comes to HRT, my understanding is that it is the other way around. Observational studies showed benefit in terms of a reduction in cardiovascular disease. Then a large RCT (the Women’s Health Initiative) was conducted which showed that long term HRT actually increases cardiovascular risk. Here’s a summary from wikipedia:

        ”The United States Preventive Services Task Force, though initially endorsing hormone replacement, in their most recent published recommendation in 2017 discouraged its use. When they first evaluated the impact of HRT in 1996, the USPSTF assigned a “B” grade to hormone replacement therapy for use in primary prevention of chronic conditions in postmenopausal women, basing their results on observational studies and short-term trials. A score of “B” carries an official message of, “The USPSTF recommends the service. There is high certainty that the net benefit is moderate, or there is moderate certainty that the net benefit is moderate to substantial.” In light of subsequent results from the Heart and Estrogen/progestin Replacement Study (HERS) and the WHI trials, the USPSTF downgraded the scoring to a “D,” which corresponds to a message of, “The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits,” and discourages health providers from offering the service or treatment.”

      5. So, the anecdotal story from Dr. Bryan Tyson at the El Centro Clinic that he treated over 2,000 patients for covid without a single death and only one hospitalization is just garbage?

        Give me a break.

        Anecdotal stories from physicians are still based on expert observation and the evidence is empirical. There are obvious vulnerabilities to various biases, of course. That does _not_ mean that there is no knowledge to be gained from anecdotal evidence.

        Our belief that the sun rises in the east is based on anecdotal evidence.

        In physics, often experimental results are based on a single observer. There is a check because other researchers in the subfield will also try the same methods and see if similar results are obtained.

        As regards HCQ, I have seen an IM doc and an ED doc say that they have tried HCQ and found it doesn’t work (late treatment, obviously). I am still waiting for a report from a GP who has tried treating covid early with HCQ and found it doesn’t work. Just like I am waiting for a report from someone who claims that he saw the sun rise in the west. Sometimes a lack of negative evidence is powerful positive evidence.

        Dr. Rushworth, do you know anyone who has actually tried treating covid patients by giving HCQ early (within three days of symptom onset) and found it doesn’t work?

      6. No, it isn’t garbage. Anecdote can be hypothesis generating. But it is not usually able to produce evidence of a cause and effect relationship.

        Anecdotal evidence from primary care providers will make pretty much any treatment you care to give in relation to covid look good, because only a tiny minority of those with covid actually end up in the hospital regardless of what treatment they get. Additionally, there are lots of examples of people lying and fabricating data, which is easier for a lone physician than it is for a pharmaceutical company.

      7. 2% of covid patients are eventually hospitalized.

        Tyson had 1 hospitalized out of 2,000, where we should have expected around 40. Tyson did refer the sickest patients to the hospital without treatment and they are not counted in the 2,000. Is this cherry picking data? Let’s consider the facts…

        The sickest patients are those who are a week out from symptom onset. The hypothesis is that _early_ antiviral treatment will reduce hospitalization. So Tyson’s triage was quite appropriate and so was his data triage.

        If Tyson had had 30 patients admitted to the hospital, then we might reasonably argue that his treatment might not have had significant benefit or that observer bias might be in play. But only one patient was admitted. That is a 97.5% reduction in hospitalization. There are other retrospective antiviral treatment studies that show around 80% reduction in hospitalization, so Tyson’s experience has corroboration.

        The data is _very_ clear that Tyson did a lot of good. Maybe he just excelled at followup and that explains his improvement from the 80% benefit that others reported…but he’s a black swan that contradicts the assertion that HCQ doesn’t work.

        Retrospective studies have a larger burden than prospective studies–they have to show a great deal of benefit in order for their evidence to have weight because of various biases inherent in them. They are far more than merely hypothesis-generating machines. As has been shown before, retrospectives have corrected prospectives.

        RCTs are expensive and are run by pharma. Buying into the RCT “gold standard” nonsense puts us all at the mercy of pharma.

        I highly recommend that you read the Philosophy of Medicine article at Stanford Encyclopedia of Philosophy if you haven’t yet done so. (Philosophy has done so much to enhance my understanding of the hard sciences as well as medicine.)

        https://plato.stanford.edu/entries/medicine/

        43 page downs to read the entire article

      8. Dr. Rushworth,

        Retrospectives found a problem with HRT therapy causing cancer in women approaching menopause that RCTs missed. You are correct that RCTs showed cardiovascular benefit for HRT therapy.

        http://www.dcscience.net/Vandenbroucke_2009_The-Lancet.pdf

        Vandenbroucke’s analysis looks very good. Observational studies originally suffered a blow to reputation, but there was nothing wrong with their data, which was realized (by some) after further analysis was done. The breast cancer risk to near-menopausal women found by observational studies was real and RCTs eventually confirmed the risk that RCTs originally missed. It took several years for this to occur.

        “The resolution of the discrepancies between randomised and observational evidence is not just important for our insight into the merits of both types of research. It directly enlightens our knowledge about HRT by confirming that the cardiovascular risk is real, and slightly stronger in older women, while the breast cancer risk is equally real, and is stronger in women closer to menopause. It was a long and difficult debate, but we owe a tribute to the persons who inspired and have led these reanalyses.”

        Observational studies are important for gathering evidence just as much as RCTs–on an equal basis. Observational studies excel at providing external validity, while RCTs excel at providing internal validity. Observational studies suffer from problems with external validity and there was an overreaction to this upon discovery of it leading to an overreliance on RCTs.

    2. Circular reasoning is correlation reasoning and is not always so bad. Consider, “I think, therefore I am.”

  12. We need to differentiate between using a nutrient such as Vit C to support healthy cell function and its use in cases of combating disease. These are very different.

    Seldom, in Nature, does a single nutrient work on its own. Usually, it has many synergists. If any are lacking, the benefits of the single nutrient will disappoint.

    Nutrients also have their antagonist as well as synergists. For example, high doses of C is antagonistic to Cu. If high doses of C are given for anything other than a short period of time, it may deplete Cu stores and lead to a raft of Cu-deficiency related health problems, including inflammatory arthritis, unhealthy cholesterol profile and connective tissue-related cardiovascular diseases. Here is an example: https://www.garymoller.com/post/copper-deficiency-other-minerals-and-rheumatoid-arthritis

    This may be why some people experience joint pain if they megadose with Vitamin C.

    1. RE: If high doses of C are given for anything other than a short period of time, it may deplete Cu stores and lead to a raft of Cu-deficiency related health problems, including inflammatory arthritis, unhealthy cholesterol profile and connective tissue-related cardiovascular diseases.

      My anecdotal experience is different. I took 25 g/d for 13 years. Cholestorol profile improved remarkably, and no health problems but remissions (PAD, COPD, ME/CFS symptoms, NAFDL, cystistis..). However during this long time correcting my bottom low zinc with 50 mg/d, I mistaken by the advise to balance with at least a bit of copper did just that and still regret. Haven’t been able to bring copper down again, dispite that much zinc (still bottom low in serum, and again in whole blood) and ascorbate for that long.

      1. pamojja, while we all need nutrients such as C, your experience reinforces the case against “one-size-fits-all” prescribing of nutrient. One might say, “we all the same, while all being different”.

      1. Adacanumab -sounds a bit to much like abracadabra and numerology, but I guess that comparison isn’t so farfetched.

        😉

      2. That’s not correct. Adacanumab works very well. It produces very good profits. So-called efficacy is rarely the reason for a new drug. Harvard’s Safra Center research finds the 90% of all new drugs do next to nothing ( 1% to 2%) better than the old drugs, except they goose up Pharma profits.

  13. I think it’s pretty clear now that the ‘regulatory’ authorities are now completely compromised! They’ve become the wholy owned properties of Big Pharma, the CDC, the WHO and Bill Gates!

    BTW, completely off target but Wikileaks have just done a complete DATA DUMP of every file they have! 100s of 1000s of PDFs.

    https://file.wikileaks.org/file/?fbclid=IwAR2U_Evqah_Qy2wxNY12FMqFC5dAFUcZL5Kl4FIfQuMFMp8ssbM46oHXWMI

    What do they know that we don’t I wonder?

  14. Interesting data, however, I think they are somehow misleading and the real conclusion is that (even wrong) usage of vitamin supplementation is fairly safe.
    Regarding supplementation there is one important issue:
    One should consider a bunch of vitamins/minerals or proper order of single supplements being introduced.
    I would like to give examples on the later one:
    Higher vitamin D body levels increases demand for magnesium (and decreases demand for calcium), thus one should first start supplementing magnesium then vitamin D (or UV exposure) otherwise one could experience vitamin D “side effects” (especially if he/she is already magnesium deficient). On the other hand – one can easily get rid of magnesium excess (if only have a good hydration).
    Supplementing zinc can likely speed up metabolism which increases demand for magnesium i B vitamins, so one should first start from magnesium i B-complex then (after some time) add zinc.
    Supplementing vitamin C can likely speed up detoxification which increases demand for hydration and magnesium (it escapes with urine).
    So one should start with supplementing:
    1. magnesium and B-complex, then after some time
    2. zinc, vitamin C and UV exposure (and always a good hydration).

    1. Apparently, Vitamin D(3) is best absorbed when taken with Vitamin K2, in fact that’s how my version is supplied.

  15. Yes, my understanding is that vitamin C is a necessary co-factor for many nutrients. I’d say that with so many genetic variations in nutritional transport it’s simply prudent to make sure you have as much nutritional coverage possible.
    I have beriberi and almost died because everyone assumed I was absorbing the oral thiamine—I’m using IV B1 with mag su now. The cardiologist who missed this was mightily embarrassed because my rapid improvement was shocking.
    You just never know.

  16. An adequate intake of vitamin C is hardly limited to the need to avoid scurvy, is not it?
    I am of the opinion that a human should approximate his diet to the diet of his ancestors. A human of the Late Paleolithic consumed ~ 600 mg / day of vitamin C, which is 8 times higher than the recommended today. In comparison with modern man, he consumed more: carotene – 1.7 times; vitamin A – 2.7 times; riboflavin – 3.6 times; folate – 1.5 times; thiamine – 2.6 times; ascorbate – 8.4 times; vitamin E – 3.1 times https://pubmed.ncbi.nlm.nih.gov/9104571/. Perhaps such dosages are excessive, but not excessively excessive.

  17. The seasonal nature of ILIs is a smoking gun showing the need for vitamin D supplementation in winter in latitudes temperate and colder. And it shows the need for everyone to get enough “vitamin D” sun when they can.

    1. I can sense the tumbleweed rolling across the UK MSM as I type 😉

      Elsewhere in the burgeoning dystopia the Indian state of Goa has caved to pressure and instructed the State’s medical authorities to remove ivermectin etc from the kits they were supplying to those with covid symptoms. [so far Uttar Pradesh is holding out against the murdering bastards in Delhi who are pressuring then to follow suit]

  18. For those interested in the time line of Vitamin C throughout evolutionary history, this https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145266/ is very interesting. It does, to some extent, support Sebastian’s conclusions, but the caveat is always “events, dear boy, events”, and that while there is thought to be neutral evolutionary pressure on whether Vitamin C needs to be produced, there are no examples of a lost ability to produce Vitamin C in animals whose diet contains none.

  19. Don’t fail to watch this new video with dr Kory, one of the most prominent representatives of FLCCC Alliance, talk about his experience with IV vitamin C, especially with sepsis patients, starting at 22 min 55 sec, and the importance of commencing Dr Paul Mariks sepsis protocol quickly, at least within 6 hours.. The first half of the video is about dr Korys personal experience of the pandemic, and is also highly recommended.
    https://youtu.be/9J9fu3KOTR8

  20. Well, this one sure brought out the “supplementers”. I am reminded of an aunt, now dead, who had about 20 bottles of pills that she dosed herself and her husband with every day. She also kept him on a very low fat/whole grain diet, doled out so that he was always hungry – very good for longevity. However, as he became more than a bit addled, he started stealing food, things like a gallon of ice cream from a community dinner. He died of sepsis consequent to a scraped hand while escaping with bananas from a market stall.

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