Vitamin C and COVID-19

covid-19 public health Mar 12, 2020

Global pandemics are infrequent–thankfully–but there are certain characteristics that stand the test of time:

1. People who are unaffected in the early stages almost always underestimate the threat, increasing the overall risk, and

2. People come out of the woodwork claiming they have exclusive knowledge of secret cures that "they" are hiding from you. 

The first is dangerous. As we know, prevention is worth far more than cure. At the same time, it is at least understandable; within the routine stress of life, it is easy to dismiss warnings about things we have never personally experienced. 

The second, however, is downright nefarious. And unfortunately, it is only amplified in the era of social media. While the pandemic has only recently even been classified as a pandemic, the FDA has already had to send a series of warning letters to companies who have pounced on the opportunity to capitalize upon global suffering. 

And companies with physical products to sell are not the only source of pandemic snake oil. With the advent of the online influencer, many embrace such health events as a shortcut to establishing credibility in the absence of any legitimate expertise. This further feeds into the misinformation campaign as individuals who are not directly selling products are still loudly declaring that secret cures are being hidden from us as a way to build their personal brand. 

Nowhere is this more profound than in the case of vitamin C. 

On Feb 11, a clinical trial was registered at ClinicalTrials.gov, one of the major clinical trial registries. This clinical trial will recruit 140 participants and test 24g of IV-administered vitamin C against a placebo for the treatment of severe COVID-19. The trial is currently recruiting and expected to be complete in September. 

To be clear, this clinical trial was hardly the only COVID-19-related study registered within the last 30-60 days. Scientists have jumped to test numerous existing antiviral treatments against this virus. (And that link only reflects one registry; hundreds of studies are currently in the works.) From pharmaceuticals to traditional Chinese medicine... a new disease means a blank slate when it comes to treatment. Since we know nothing, everything is a trial. 

But context is as pesky as facts when it comes to a good conspiracy theory. All that really matters is that vitamin C–a NATURAL PRODUCT–is being tested against COVID-19. Therefore, experts agree, this is the secret cure Big Pharma doesn't want you to know about. Everyone's saying it. (Please read my sarcasm there.)

So... what about those facts? 

Is vitamin C a potential cure for the virus? And can we protect our families by mega-dosing this nutrient? Unlikely. Here's why. 

1. Vitamin C was first promoted in the 70s as a cure for the common cold. While it has gained a lot of attention since that time, evidence hasn't exactly supported the marketing hype. Currently, any belief that vitamin C will be the substance that treats COVID-19 is purely speculative; many other agents hold much more potential. 

2. Oral intake of vitamin C does not reach the same saturation levels (dosing) achieved by intravenous administration. Twenty-four grams of vitamin C per day is a LOT. Intravenous administration results in greater bioavailability, so an oral dose would need to be much higher. Meanwhile, the current RDA for adults is 90mg. The upper tolerable intake is 2,000mg. Trying to replicate this at home is no different from trying to self treat with borrowed pharmaceuticals.

And if we did achieve success at reaching such high doses, the end result would include the known side effects of excessive vitamin C intake, including gastrointestinal complaints, malabsorption of certain nutrients, and excessive absorption of other nutrients. Vitamin C may also act as an oxidizing agent in the body, leading to poor health outcomes. And most importantly, it can interact with prescription meds and is contraindicated for many underlying conditions.

But what about the clinical trial? 

It's always exciting to see a wide range of possibilities reflected in the clinical trials registries. COVID-19 is no different. Pharmaceuticals, dietary supplements, traditional herbal remedies, nutrients... this reflects a widespread search for substances that can alleviate human suffering. It's a good thing. 

However, we have to temper that excitement with the reality that most clinical trials fail to find a benefit from the substance tested at the dose tested. That's just the reality of scientific research. Advancing from in vitro tests to conclusive findings of efficacy is a journey that few substances actually complete. 

Right now, there are dozens, if not hundreds of substances being tested. With a new disease like COVID-19, we can expect the earliest studies to utilize substances that are already being used in medicine. Because the illness contains many unknowns, we want to begin with substances that have far more knowns when it comes to actions and safety. 

To get a clinical trial approved by ethics committees, we have to demonstrate that we have reason to expect the substance to be reasonably safe. Vitamin C meets that criterion. So naturally, we see it in the first round of studies. Newly developed COVID-19-specific drugs will not be tested in humans for many months, if not years, because the drug development process starts in the lab, not the clinic. 

The goal of this process is to test everything we suspect will be effective, in the hopes we rapidly find something that delivers. No researcher expects everything on the vast and diverse clinical trials registry to deliver results. Experience tells us that many of these substances will be completely ineffective and worse, some will even be harmful. 

Until we have that knowledge, everything is speculative–including any and all claims you read from social influencers or supplement companies claiming that they can keep you healthy during this pandemic. 

What does work?

Hand washing. Social distancing. 

Sure, it's not fun. And yes, it sounds simplistic. It's far more enticing to believe we can buy some product that grants us magical protection from a very real threat. But the solution is rarely so exotic. 

This disease spreads through respiratory droplets. An infected person sneezes or coughs, those droplets are propelled into the air and fall on surfaces such as doorknobs, elevator buttons, light switches, card payment key pads, etc. Then we touch those devices and rub our noses or eat our next meal. 

Stopping the spread means wearing gloves. Washing our hands. Staying away from highly trafficked areas. And prompt treatment includes rapid testing, observation, and medical care as required. 

When a new pandemic sweeps the globe, our greatest threat is not the virus itself, but misinformation. Stopping the viral spread of pseudoscience is a key part of the strategy to protect human lives. 

 
 
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