The Medical Emperor and the missing clothes

By Jerome Burne

It’s rapidly becoming a truism that the virus has been shining a light in some dark places that we all sort of knew about – massive wage inequality, zero-hours contracts, privatisation in the name of market efficiency and drug medicine treating symptoms not causes – but we preferred to look the other way. It’s going to be harder to do that in the future.

The virus not only made pharma medicine’s limitations painfully clear – a lack of safe and effective antiviral drugs and none that could improve the immune response, but it has also highlighted the remarkable sophistication of the nutritional approach, which mainstream medicine essentially ignores. I’ll come to that shortly. 

 In recent posts (do check them out if you have time) I’ve set out the case for using vitamin C as a cheap and safe ally in cutting the risk of infection and improving survival rates. Its central role in the immune response is a strong clue that it should be useful, but the NHS practitioners have shown zero interest in using it. This is despite reports from American clinical care experts who have so far treated over 100 patients and found it can dramatically cut deaths and length of stay in ICUs and/or on ventilation. 

The experience of USA clinicians along with others in Italy and Korea was sparked by reports of success with massive doses in China but this has all this has fallen on deaf ears in the UK, despite a desperate need to protect the elderly and frontline workers and to do something, anything that had even a chance of bringing down the UK’s alarmingly high death rates among Covid 19 ICU patients.

Vitamin C just a ‘magic potion’

The NHS’ position has been backed up by regular stories dismissing claims about vitamin C as myths. A recent BBC magazine feature, for instance, described vitamins and supplements as “magic potions for the modern age” that could be traced back to the “crackpot” remedies that surfaced during the flu pandemic of 1918 – “Antiseptic Snake oil” and “Mandrake Pills”. A hundred years later, it claimed, “not much had changed”. 

Current examples of this foolishness, the article claimed, were believing you should eat foods rich in antioxidants and that you could “boost the immune system”. This, the feature declared sternly, “doesn’t hold any scientific meaning whatsoever’ adding that not a single trial shows that high doses of antioxidants can boost the immune system.  In support, the article quotes a Yale immunologist: ‘Vitamin supplements aren’t beneficial to your immune system unless you are deficient,’

This isn’t a view shared by Dr Joanne James, an independent biopharma consultant with an Honorary Senior Lectureship in the Centre for Clinical Pharmacology, at the William Harvey Research Institute, Barts & The London School of Medicine. ‘Vitamin C is well known to play a role in supporting the immune system,’ she says. 

‘There is data showing that critically ill patients can have very depleted levels of vitamin C because the immune system uses large amounts in response to stress such as infections. It has been used in clinical studies (RCTs) on critically ill patients, and those with sepsis.’

Drug research scientist with grip on nutrition

James is unusual in that, while working in the pharmaceutical industry, she also has a strong interest in nutrition. She explains: ‘It’s the result of years spent studying patients with auto-immune/ inflammatory diseases, and others such as diabetes.’ 

 She supports her claim about vitamin C’s role in the immune system, with a paper published last year that begins: ‘Vitamin C is known to support immune function and is accumulated by neutrophils (important immune cells) … suggesting an important role for the vitamin in these cells.’ 

The idea that vitamin C  has little connection to the immune system also doesn’t square with research published two years ago by one of the top critical care experts in America, who found that nearly half of the of sepsis patients in his ICU had a vitamin C level so low that it would normally qualify for a diagnosis of scurvy.  He was giving them 20 grams a day – 400x the RDA.

None of this makes sense if you believe the daily amount we need equals a couple of oranges. It makes perfect sense, however, when you understand that there isn’t one set dose for vitamin C as there is for drugs, instead it depends on how much is needed. Having a serious infection is one of the times when demand for this key immune system player soars. 

Major global Vitamin C trial gets underway 

This something well understood by the organiser of a major global RCT, known as LOVIT, designed to see if Vitamin C can reduce the damaging and often fatal effects of sepsis in patients seriously affected by Covid.  It has just started, will involve 770 patients and go on for two years. Is this really only founded on a belief in ‘magic potions for the modern age’? Or does the BBC need some urgent fact-checking? 

About all that can be said in their defence is that it is not really the fault of immunologists because they aren’t taught properly. This was a point made in a recent web talk organised by the Nutrition Collective (ref) on nutrition and the immune system by Dr Robert Rountree, a physician in Boulder Colorado, who runs educational courses for doctors at the Institute for Functional Medicine (IFM). 

‘Immunology textbooks have no information about the role of nutrition and lifestyle on the immune system.’ he says. ‘As a result, most conventional immunologists have zero interest in what goes into making a healthy immune system.’ 

His account of what makes for a poorly functioning immune system perfectly describes the condition of many of those in care homes – getting old, stress, a loss of muscle mass, regular junk food and a deficiency of various minerals and vitamins. 

‘You need adequate amounts of the basic A, B, C, D, E vitamins, along with minerals such as iron, copper, zinc and selenium for its basic jobs. These involve defending against microbes, getting the right balance between the damaging oxidants created to fight the virus during an invasion and the antioxidants that damp then down and reduce inflammation.’  

Food and immune system in constant contact

He also gives another reason why claiming nutrition plays no role in the effectiveness of the immune system is simply wrong. ‘The gut is the largest immune organ in the body,’ he says. ‘All the most common and active immune cells are at work there – dendritic, T and B cells, CD4 cells and macrophages. 

‘They all interact with the beneficial microbes lining the gut and of course with all the food coming in, checking it for invaders. So, the idea that food has no influence on immune function can’t be right, they are intimately interacting all the time.’

Rountree also explains what some of the individual players, such as vitamin E do. ‘It can reverse various effects of ageing and provides protection against Upper Respiratory Tract Infections (URTIs). While ageing lowers immune function, vitamin E improves the effectiveness of fighting cells such as macrophages and lowers the inflammation that causes damage if it lasts too long.’ 

Rountree also describes some of the lifestyle factors that can reduce or improve immune system effectiveness. Obesity, for instance, can lower the effectiveness of the important natural killer cells, while building muscle mass can improve the production of a type of anti-inflammatory cell known as IL15. But it’s a balance. Very strenuous exercise can reduce the effectiveness of the crucial cleanup process – phagocytosis – that keep cells working well.  

So, a very complex system but one that trained nutritionists can directly modify with lifestyle, diet and fasting in ways that go far beyond the conventional medical mantra about avoiding fat and having a healthy balanced diet. Keeping nutrition on the side-lines has not benefitted Covid 19 patients and going to leave doctors without the tools needed to tackle the ongoing crisis of metabolic disorders.

How the ketogenic diet has been kept in the corner

One of these tools is the ketogenic, low carb diet that is effective for weight loss and can reverse diabetes. But just as information about vitamin C’s immune system benefits has been misrepresented or closed down, so America regulators have long been denying there is evidence for ketogenic benefit for diabetics. This was highlighted in an article in the Wall Street Journal last week by long-time campaigner for reliable evidence-based nutrition Nina Teicholz. 

It was triggered by a Chinese study which found that over 7000 diabetic patients had ‘markedly less mortality’ when following a ketogenic diet. 

The article explains how applying this and other evidence for the ketogenic diet is actually blocked by the American governments’ dietary guidelines which, similar to the UK’s, continue to recommend a diet high in grains with half the calories coming from carbohydrates. Favourable low carb studies have been simply excluded from official dietary reports

‘This stands in the way,’ she writes ‘of making low carb diets a viable option for the 60% of Americans with at least one chronic disease.’ This is also a group at raised risk of viral infection.

When the virus has passed on, we are still going to be left with an epidemic of metabolic diseases – obesity, Alzheimer’s, diabetes and cancer – widely acknowledged to be linked to poor nutrition and lifestyle. However, a medical system that is demonstrably ignorant of nutrition has no chance of effectively dealing with it. There is at the moment little sign that the tanker of the NHS has even begun making a turn,

Betting the farm on genes to fight the virus

The result is a big hole at the centre of the mainstream medical appraoch to infections and metabolic disease. As an article in New Scientist at the beginning of May made clear, the focus will continue to be more drug research and more genetic research to uncover genes that could then be targeted with drugs and vaccines. 

You can see the logic attempting to identify the genes that make people resistant or more vulnerable to infection and use that information to improve treatment and to identify new groups at raised risk. One such project involves gathering genetic data from young Covid 19 patients, who had, unusually, become badly infected. Their genes could hold the secret of why.  

The researchers admit, however, that even genes clearly linked to infection are individually likely to only have only a small impact on the disease. And that to find reliable connections they have to look at around t10,000 genomes.  “We are operating in the dark” commented one. 

Strategically this official approach seems very unbalanced. At the micro end is close and expensive attention to genes that increase or reduce the risk of infection.  At the macro end is a search to understand how each interacts with the environment. What effect does smoking, pollution or living in crowded spaces have? 

At the centre, however, is a large hole. What happens at the cellular level? What can people do to improve their immune responses? What about the effect on infection risk of diet, sleep, obesity, exercise and, let’s not forget, the gut, where 80% of the immune system is to be found? If you were looking for quick wins this would definitely be the place to start. But it is ignored. 

Vitamin C to the rescue in the blood vessel

Nutrition has long been regarded as the poor relation of real pharmaceutical medicine. Yet it is remarkably sophisticated and can offer a more flexible range of treatments than just relying on drugs. Vitamin C, for instance, doesn’t just support the immune system, it is also involved in cardiovascular defence, particularly reparing damage to the lining of the blood vessels (endothelium) following viral attack. 

Damage to the endothelium can trigger sepsis or the ‘cytokine storm’ leading to dangerous excessive blood clotting, now recognised as an effect of Covid 19 infection. Normally the endothelium has its own protector – nitric oxide – which keeps it working smoothly. But if sepsis knocks it out, blood clotting can spin out of control, oxidants further damage the endothelium and nitric oxide isn’t available for repair. 

At this point vitamin C can come to the rescue, stimulating the production of nitric oxide and reducing oxidant damage. There is a paper that describes the range of functions Vitamin C is involved in to support the endothelium. Its title is ‘Role of Vitamin C in the function of vascular endothelium’ and it was published in 2013. 

Patients are being failed by a medical system that continues to ignore or dismiss the nutritional approach to disease. Something good will come out of the pandemic if it leads to that changing. 

Jerome Burne

Jerome Burne

Jerome Burne is the editor of HealthInsightUK. He is an award-winning journalist who has been specialising in medicine and health for the last 10 years and now works mainly for the Daily Mail. His most recent book “The Hybrid Diet” was written with nutritionist Patrick Holford, published 2018. Award: 2015: Finalist for 'Blogger of the Year' Medical Journalists' Association.


  • Nowadays you always have to look out for the weasel words and phrases. Make a game of it!

    “In support, the article quotes a Yale immunologist: ‘Vitamin supplements aren’t beneficial to your immune system unless you are deficient…’”

    Note those last four words: “unless you are deficient”.

    Surely getting enough of any nutrient implies making sure that you are not deficient.

    The RDA of Vitamin C is around 50 milligrams, which as many experts have pointed out may be just the does needed to avoid obvious symptoms of scurvy.

    According to Linus Pauling, most animals produce Vitamin C internally in amounts that are equivalent to about 6 grams per day for an adult human. (Human beings cannot make their own Vitamin C).

    So surely anything less than 6 grams a day is deficiency. I prefer to take 10-12 grams a day to be on the safe side, as no serious harm has ever been recorded from large doses. (Although loose bowels can be annoying and embarrassing while they last, and render one quite immobile).

    • Vets assure me Guinea Pig (around 1kg) needs 30mg of C per day, and their pet-food will generally supply that.
      But stress, overweight, smoking etc all steeply increase the requirement… so how on earth can a 100kg / 220 lbs male human exist on the same dose as an obese, worried fur-ball ?
      Don’t forget Vit. D which best comes from the sun, the same sun we diligently screen against or avoid, also necessary for our immune system health.

      • Editorial

        Absolutely. One of the problems critics have is the idea that the high doses can be beneficial. Needing lots more in an emergency doesn’t generally fit with the pharma model where doses are standard and carefully calibrated. But the animal link – guinea pigs are among the few, along with humans – who can’t make Vit C and so have to get it from diet. While that is fine if you are healthy, it is totally inadequate if you are at the peak of a viral infection.

  • The BBC article was written by a dietitian, a member of a group of people who still, for some unknown, probably financial, reason, insist that diabetics continue to kill themselves by eating a high carbohydrate diet.
    It’s also probably nothing to do with the fact that the main sponsors of the dietitians are food and pharmaceutical companies.

    • Editorial

      Seems to me that dietitians are required to beleive several very unhealthy things before breakfast. That a breakfast of cereals and sugar is a good way to start the day, that fat is bad and that calories in should equal calories out. Who will fund a firm but fair re-education program that they will all be required to attend before making any more public pronouncements.

  • Down Under here, I recently surfaced from several days/nights of an induced coma, to be greeted by being fed my first meal.. sweet custard (?) and BANANAS. Yes, they knew I am T2Diabetic, for later on they tried to aggressively manage my glucose levels… checking every hour and injecting insulin… until I was strong enough to stop them.

    - I don’t dare express my opinions !

    “If hospitals are places to make you better, why do they serve ‘Hospital Food’ ?”

  • The late Hugh Riordan was involved in a study where his blood was tested regularly for Vitamin C. At one point during the study he was bitten by a spider. At his next test he received a call from the lab: they couldn’t find ANY detectable level of C in his blood. Hugh thought “I’ll fix that” and had the ward infuse 15gms of C intravenously. Tested next day: zero blood levels of C, so another 15gms IV. Following day’s test still zero so another 15gms. This went on for a week before finally the levels became detectable and began a slow climb back to normal. Similarly a goat with the same body mass as a man will produce up to 14gms/day of C when stressed or fighting infection. This clearly indicates that when the body is fighting toxins or infections its requirement for C increases dramatically, yet the medical profession still insists that you only need miniscule amounts of these nutrients and generally doesn’t bother monitoring the levels in patients. This despite Dr Fred Klenner and other doctors reporting dramatic results in patients with polio, rabies and viral pneumonia over 70 years ago! AFAIK there has never been any attempt to replicate Klenner’s work.

    The more I know about the medical profession’s beliefs and practices the more obvious it is that they are not merely unscientific but actively anti-scientific and wilfully ignore actual evidence whenever it suits them. The ridiculous dietary advice given to diabetics is one such, the notion that eating fat makes you fat is another. Do they also believe that the sun and the stars revolve around the Earth? Because that is the same simplistic level of reasoning. (Or do they simply believe that they themselves are the centre of the Universe?) The resistance to evidence is staggering – take the way the role of homocysteine in Alzheimer’s and the benefit of B-vitamin therapy has been comprehensively ignored. IMO the resistance to vitamins by the medical profession is not simply Big Pharma protecting their lucrative drug profits but also the medical profession seeking to protect and extend their monopoly position as gatekeepers to health. Why else do they agitate for restrictions on availability of vitamins (eg Paul Offit) while safe non-toxic medications like injectable B12 are made prescription-only in the UK.

Leave a Reply

WP-Backgrounds by InoPlugs Web Design and Juwelier Schönmann