Is it time to subject Vitamin C to serious scientific scrutiny?

Ever since 1970 when the Nobel Laureate Linus Pauling claimed that gram dose vitamin C supplementation could prevent and alleviate the common cold, the argument has rumbled on – how effective can vitamin C supplementation be for respiratory infections both mild (such as the common cold) or more acute (pneumonia and, maybe, COVID19).

The evidence for supplementation preventing one getting a cold is not strong unless one’s normal intake of the vitamin is low or one is under acute physical stress. However, the evidence to suggest that the duration and symptoms of common colds is reduced by vitamin C supplementation is much stronger as is the evidence of efficacy with pneumonia sufferers. (See an overview here in Trends in Immunology, a review here in the JRSM and an evaluation of Vitamin C as a treatment in a wide range of critical illnesses.) In each case the evidence suggests that supplementation is especially effective if patients were already vitamin C deficient or if they were under physical stress – both conditions that are particularly prevalent in groups such as the elderly who are at high risk from both pneumonia and COVID19.

Vitamin supplementation is generally regarded as very safe even by those who believe it to be ineffectual. It is also cheap (Vitamin C bought in bulk as ascorbic acid costs less that £15 per kilogram and that is at retail prices), easily available and very easy to administer. So it in not surprising that there are an increasing number of calls for further research into the utilising vitamin supplementation in the fight against the pandemic. Such as this article from the BMJ Nutr Prev Health in June.

Meanwhile, a new campaign is based on the assumption that populations vulnerable to COVID19 (the old and those with pre existing health conditions) will be Vitamin C deficient and under significant physical stress and will therefore gain therapeutic benefit from supplementation. It is supported  by a literature review in Nutrients pulling together the evidence in favour of vitamin C use not only for mild respiratory infections but in ICU units and where patients spend time on mechanical ventilators.

The campaign is calling for:

• All COVID-19 patients to be tested for vitamin C status and treated accordingly.
• Vitamin C to be given to all COVID-19 patients as early as possible on hospital admission.
• GPs, doctors and nutrition practitioners to be allowed and actively encouraged to recommend vitamin C supplementation for anyone with cold symptoms or coronavirus infection to reduce duration and severity of symptoms as an allowable health claim.
• The government, NHS, health care and medical associations to recommend to all citizens to supplement vitamin C during this viral epidemic, based on the available evidence.

It also calls for more research:

• The government and its public health and nutrition agencies to thoroughly assess the evidence and fund studies of this inexpensive and safe nutrient.
• Intravenous vitamin C to be trialled as a standard adjunctive treatment for all critical COVID patients in Intensive Care Units. (Trials such as this one in Hubei in China which completed in September are already assessing its efficacy in critical care.)

and for media intervention to ensure that:

• Content on ‘vitamin C for COVID-19 or corona’ is no longer classified as false information in both digital, broadcast and print media

For more information on the campaign – VitaminC4COVID see their website here. You can sign up to support the campaign. You can also donate to allow the campaign to:

• Publish and circulate review papers supporting the use of vitamin C for COVID-19. With randomised controlled trial (RCT) evidence that vitamin C reduces hospital stay, ventilation time and mortality as well as shortening duration and severity of viral infections in the early stage.
• Build and maintain an educational website to spread this life saving message internationally collecting sign ups from doctors, health experts and scientists.
• Maintain an outreach team to get the message in print, broadcast and digital media and raise global awareness around the importance of vitamin C in COVID-19 and all viral infections with the goal of changing policy in public health and teaching people how to support their own immunity.