Vitamin C Saga: How a small expert group fought back against NHS misinformation

By Jerome Burne

Whenever government spokespeople announce fresh anti-viral initiatives, we are reassured they were justified because ministers were “following the science.” Not only for such decisions as ordering lockdowns or the wearing of masks but also to decide the types of treatments recommended for patients on the NHS  

But how reliably has the science been followed? This post is about one example of “science following” that is not at all reassuring. It’s unlikely to be an isolated case.

There are good reasons for claiming that vitamin C is a plausible treatment – reports produced by the NHS make the case – but for the last year, official NHS documents and spokespeople have declared that there just wasn’t enough evidence to use it.  However, they reassured us, they were keeping a lookout for new studies and would act on them. 

FOI requests prise out the truth

During the year a group of researchers and clinicians who know a lot about vitamin C, compiled several reviews that concluded that high dose vitamin C could significantly benefit seriously ill patients. These were all sent to the NHS bodies that were supposedly monitoring research. 

So, what happened to them? For months there was no response. Official statements continued claiming there was no good evidence, but they were looking out for it. Finally, a Freedom of Information request revealed what was really happening. Yes, they had had the papers. No, they hadn’t done any sort of review of the data.

This isn’t just a betrayal of Covid patients. The pandemic has made it clear that there are many other non-drug remedies that can help a wide range of conditions. In September the Department of Health and Social Care published a report titled “Good for you, good for us, good for everybody’ which found that the NHS relied too heavily on drugs, which put older patients in particular at risk of over-prescribing and that more attention needed to be paid to lifestyle approaches and traditional remedies.

If the changes recommended here are pursued with the same dilatory lack of interest that has been the response to vitamin C, little or nothing will change. 

Official: Vitamin C vital to fight virus

The stage was set for this scientific disagreement over  Vitamin C between the NHS and independent experts in September 2020, when a report was produced by an NHS body called, surely ironically. theRapid C-19 Oversight Group, described as being responsible for finding potential treatments as fast as possible. Its performance, as far as vitamin C is concerned, has been evasive and snail-like.

Remarkably, however, it begins by making a powerful case for why Vitamin C should be considered a front-line defender against invading viruses, especially Covid-19. 

‘Vitamin C has potential benefit in patients with severe and critical         COVID-19,’ it reads ‘because they are likely to experience oxidative stress (too many damaging free radicals) or severe inflammation. Vitamin C is an antioxidant and free radical scavenger that has anti-inflammatory properties, (So animpressive 3-in-one defender). 

It also influences cellular immunity (the part of the immune system that attacks invading viruses – even more useful) as well as vascular integrity (involved in protecting the lining of the arteries, one of the targets of Covid -19.) Could it be any more useful? Vitamin C is clearly a ready-made tool kit against this virus. 

But there is more, and this is something that many medics still seem not to understand: ‘Humans may require more vitamin C in states of oxidative stress, (too many free radicals) including COVID-19-related sepsis (inflammation) and acute respiratory distress syndrome (ARDS) (serious breathing problems). Three more directly relevant benefits. 

No vitamin C marketing manager could have made a more persuasive, and scientifically accurate case for getting vitamin C into patients as fast as possible. Unfortunately, it has been downhill, or rather a state of stasis and studied lack of interest, ever since.

Even so, there is no evidence of benefit

After this promising start, the report provided the “scientific evidence” that was quoted regularly for the next 12 months, saying that: ‘There is currently no trial evidence of benefit with Vitamin C in Covid-19,’ All they had found was just one preliminary report from a randomised placebo-controlled trial and was still recruiting patients. 

Now this is curious because there is a summary of this single trial in the report which points out that: ‘ the vitamin C group showed a significant reduction in 28-day mortality (P=0.05) in more severe patients’ and concludes:

‘The addition of HDIVC (high dose intravenous vitamin C) may provide a protective clinical effect without any adverse events in critically ill patients with COVID-19.’ At the times the trial had not cleared peer-review but that is not grounds for declaring absolutely no evidence.

But such positive indicators – and they are far from the only ones – were subsequently airbrushed out by the various NHS bodies. I’ve seen a copy of an email, sent nearly a year later in August by Jo Churchill MP, Parliamentary Under Secretary for Primary Care and Health Promotion, to an MP asking about vitamin C and Covid. 

NHS Testing centre can’t find vitamin C

She wrote: ‘Based on the evidence currently available at this stage, we do not believe there is sufficient evidence to conclude that vitamin C is a safe and effective treatment for Covid-19.’ Jo was keen to reassure the MP, however, that the lack of evidence was not for lack of trying. 

Her department was kept up to date by the Rapid C-19, she told the MP, and they were working with multiple arms of the NHS – NIHR, NICE, MHRA, and NHSE to get treatments for Covid-19 ‘to NHS patients quickly and safely’. She explained that another acronym, REMAP-CAP, had been recruiting patients for a Vitamin C trial since November and should soon have the sort of reliable results that were needed.

But this was another curious claim. It’s hard not to conclude that Jo had not read up on what was happening with REMAP-CAP, described in the Rapid C19 report 11 months earlier. It certainly sounded impressive. 

It was a global project that would enrol 7,100 patients in ICUs (intensive care units) in various countries, 518 in the UK at 139 sites. But even back then the project hadn’t been going well. The problem was that the organisers couldn’t get any vitamin C and so the trial was “currently closed.” Couldn’t get vitamin C? Every chemist has it.

NHS licences treatment with no evidence it works

But buying cheap stuff wasn’t an option. Special injectable vitamin C was being trialled that could only be supplied to the NHS by a company called Phoenix. Unfortunately, Phoenix had a supply problem. Not an impressive way to start a contract. Still, presumably it’s been sorted by now and Rapid C-19 will soon be reporting results?

Well no. The only place running the trial by the end of August was the Royal Surrey County Hospital which was still dogged by the supply problem. ‘We don’t have any of the vitamin C that we need to open the domain,’ the clinician in charge emailed, ‘we’ve got very few COVID cases, and none enrolled into the trial recently.’  

Remarkable not to be able to find patients in the middle of a pandemic. Remarkable also, to do an exclusive commercial deal to supply vitamin C to the NHS and at the same time telling everyone there was no evidence it was beneficial.

Small expert team takes on NHS

Meanwhile, senior clinical nutritionist and Vitamin C campaigner Patrick Holford was raising funds via the site www.vitaminc4covid.com and assembling an impressive team of experts to pull together the high-quality evidence that was needed. They included Associate Professor Anitra Carr – Director of the Nutrition in Medicine Research Group at Otago University in New Zealand and Professor Paul Marik – head of the Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, VA USA. Exactly the sort of evidence the Rapid Covid-19 group was supposedly investigating but clearly wouldn’t or couldn’t. The response by the various NHS arms to this pro-active initiative has been depressingly ineffectual. 

The first paper produced by the VitaminC4Covid group was a review of research into the benefits of high dose vitamin C for seriously affected patients. It was published in December 2020 and reported the finding that the majority of patients coming into ICUs already had vastly depleted Vitamin C levels, often low enough to diagnose scurvy and that the vitamin C level predicted survival. A good enough reason to supplement with vitamin C without a major RCT? It is standard medical practice in cases of serious deficiencies to correct them. 

Vitamin C – an attractive candidate

The conclusion of the paper, after setting out benefits similar to those mentioned in the Rapid Covid-19 report a few months earlier, was that vitamin C was an ‘attractive therapeutic candidate in reducing viral load with oral supplementation in the range of 6-8 g/day to prevent the conversion to the critical phase of COVID-19.’  Again, more evidence it was worth investigating further.

But the group didn’t just gather favourable Vitamin C research, it also reported studies with negative findings that, when reanalysed, demonstrated clear benefits. This was done with one known as COVIDAtoZ (Using Ascorbic Acid and Zinc Supplementation), mentioned in the Rapid report. 

Randomized and involving 214 patients, it compared Vitamin C with standard treatment and reported no difference.  It had also been run at the respected Cleveland Clinic in America and so was a serious challenge to the Vitamin C hypothesis.

Negative trial had shortcomings  

The response of the Vitamin C group was to carry out a statistical reanalysis of CovidAtoZ, done by Anitra Carr and another very experienced vitamin C researcher, Professor Harri Hemila of the Department of Public Health at the University of Helsinki. It found various “methodological shortcomings” and was published in May. 

Taking the shortcomings into account, the report concluded that the rate of recovery with vitamin C, far from being no different to the standard treatment, was actually 70% better.  I can’t claim to follow the statistical reasoning, but this is the way real science is done: scientists testing each other’s conclusions. There is no sign that Rapid C-19 has done anything of the sort. 

NHS simply ignores favourable evidence FOI reveals

These and other studies were sent to Rapid C-19 but by June Holford had had no response to any of them. The official line was that the Rapid C-19 group was on the case, tracking new developments to make sure patients got promising new treatments as fast as possible. But was this actually happening? Had anyone done a review of the growing body of evidence which, to date, includes a dozen intervention trials specifically testing vitamin C on covid patients? 

One, the original randomised placebo-controlled trial, now through peer review, showed a statistically significant 80% reduced mortality in critically ill patients  (the stats are complex, the key evidence is contained in Table 2 :outcome in a trial of HDIVC )– which was better than the 30% reduced mortality in similar patients in the widely accepted dexamethasone steroid trial. The only way to find out was with Freedom of Information requests. 

It took until September for an answer to come back. Yes, they had received the studies but No, neither NICE nor Rapid C-19 had done a review of vitamin C since the previous September. A failure that proved no bar, however, to continuing to tell anyone who was interested that there was no evidence for benefit. 

NICE assured Holford, they would keep on monitoring for evidence, although it hardly seemed worth it since “no scientific evidence’ actually meant ‘can’t see any evidence, even when it is literally under our noses.’ 

NHS blatant bias risks losing public trust

But despite being ignored and disparaged the Vitamin4Covid 19 team is continuing to do what Rapid C-19 should be doing. Anitra Carr has co-authored another paper, this time with Dr Marcela Vizcaychipi, head of research at the Chelsea & Westminster hospital ICU where she has been giving up to 6g of Vitamin C to infected patients since the start of the pandemic.

Titled ‘Vitamin C Intervention for Critical Covid-19: A Pragmatic Review of the Current Level of Evidence’ it makes several striking and supportive claims in the undramatic style of scientific reviews.   

Intravenous Vitamin C for sepsis and pneumonia: ‘appears to decrease severity.’ Five of the 12 vitamin C and Covid-19 published RCT trials suggest that: ‘intravenous vitamin C may improve oxygen level parameters, reduce inflammatory markers, days in hospital and mortality.’ No adverse events have been reported in published trials.  

The paper, (Due to be published Monday Nov 1))  then goes on to analyse each of the trials in detail and point out various practical clinical findings. This is sensible careful science that deserves to be taken seriously not ignored and stored in a bottom drawer,

The big promise of the evidence-based medicine movement to those advocating non-drug treatments was effectively: come up with the evidence and we’ll treat you like any other medicine. What this sorry saga shows is that the NHS is content to ignore evidence, however promising, and claim it doesn’t exist.

Medical authorities are outraged and vindictive when the public ignores or doesn’t trust claims that official treatments, notably vaccines, are evidence-based. This saga suggests the public is right to be sceptical and that one way to regain trust would be to start being honest about the evidence it has and what it shows. 

 

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.

2 Comments

  • I take both vitamins C and D, and I have been impressed just how much of these vitamins seem to be on Tesco’s shelves nowadays.

    Then on a trip down south in September, I saw a number of large advertisements for C, D, and zinc supplements. It didn’t say why these were particularly important (presumably this was not permitted) but clearly they were aimed at warding off COVID. I am hoping that maybe enough people are taking C and D now to blunt the COVID pandemic this winter and maybe stop a lot of flu as well.

  • I am an elderly old codger who has had no flu or even a cold for as long as I can remember, quite likely because I have been taking Vit D & zinc. I have known about their effectiveness, together with Vit C for 25 years or so and read extensively about their history, going back to Pauling and Klenner curing all manner of ills, including polio and TB using megadoses of IV C. Their work was “replicated” by the drugs companies using oral instead of IV and in much smaller doses, “proving” that it didn’t work. They had the clout and their “Science” won out. And so it goes on still!

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