SORRY, I'M GOING OFF TOPIC on my own thread, but this is all in response of the idea of using vitamin C to show how even brilliant nobel prize winning scientists can be wrong. And Greg, your point is well taken on that. But I think you might agree- based on your response- that, yes, though just because these 2 men seem to strongly see intelligent design in the universe, that does not mean they are right. But it does show ( I think you agree with this) that there are actually men who rank way high in the world of science who do see it the same as I do, and also proves that not every one who feels the evidence points to design is a knucklr dragging, unscientific flat earther. In fact, far from it.
Now back to Vitamin C and whether or not the 2 time Nobel prize winning Linus Pauling was way off re: benefits of vitamin C. This is a better summary of the promise that vitamin C has been showing in recent critical care practice for severely ill patients:
http://pulmccm.org/main/2017/critical-c ... es-sepsis/
( from a site that claims: All the best in pulmonary and critical care )
After hundreds of trials failing to show benefit of drug treatments for sepsis, could a simple, cheap and effective treatment -- high-dose vitamin C -- be hiding in plain sight? A respected leader in critical care medicine thinks so, and his hospital system is all in...................................
The Case for Vitamin C Treatment In Sepsis
Vitamin C is believed generally safe at high doses, but can rarely cause acute renal failure through oxalate crystal deposition. Small studies have found high-dose IV vitamin C during critical illness safe and beneficial:
In Tanka et al (2000), among 37 patients with major burns, those randomized to receive infusion of vitamin C at high doses (e.g., 4-5 grams an hour) for 24 hours on admission required less fluid resuscitation and had fewer ventilator days than those who got usual care.
Fowler et al (2014) found less organ dysfunction among the 24 patients with severe sepsis randomized to vitamin C infusion vs placebo, with a significant dose-response (up to a maximum dose of ~3-5 grams IV every 6 hours). No safety issues in this Phase I trial.
Zabet et al (2016) randomized 24 post-surgical patients with septic shock to vitamin C infusion (~1.5-2.5 grams IV every 6 hours) or placebo; the vitamin-C treated patients had significantly lower mortality and need for vasopressors.
The renowned Dr. Paul Marik et al will soon publish in Chest their own small before-and-after unblinded cohort study, born of an anecdote that should intrigue any intensivist: three patients with "fulminant sepsis ... almost certainly destined to die" from shock and organ failure, infused with vitamin C and moderate dose hydrocortisone out of desperation. All three patients recovered quickly and left the ICU in days, "with no residual organ dysfunction".
Inspired by that experience, they went on to enroll and treat 47 septic patients with a cocktail of 1.5 g vitamin C IV every 6 hours, hydrocortisone 50 mg IV every 6 hours, and thiamine 200 mg IV every 12 hours (thiamine inhibits oxalate production and has potential benefits in septic shock). Controls were 47 patients matched in baseline characteristics.
Hospital mortality was 4 of 47 (8.5%) in those treated with the cocktail, compared to 19 of 47 (40%) in those not. Vasopressors were weaned off all cocktail-treated patients, usually in <24 hours (vs. 4 days for the controls). Renal function reportedly improved in all patients with acute kidney injury.
These are exciting preliminary findings, and a large randomized trial seems warranted, but a look at clinicaltrials.gov shows no studies of any size in progress testing vitamin C in sepsis. (There is one, n=170, testing vitamin C for acute lung injury, which is often due to sepsis.)
Dr. Marik and the hospitals associated with Eastern Virginia Medical School aren't letting that get in the way of following their own data and experience. The vitamin C-steroid-thiamine cocktail is now part of their standard therapy for patients with sepsis, often initiated in the emergency department. They're even doing PR, spreading the word with TV interviews, well-produced video testimonials, and a spot on NPR's Morning Edition:.......................................
Vitamin C for Sepsis: A "Cure?" Cue the Controversy
A spirited discussion on this can be found over on Josh Farkas's PulmCrit blog, along with additional commentary from Dr. Marik himself:
We have now treated over 150 patients with severe sepsis and septic shock. We have had only one patient die from sepsis ... [w]hile a few of the treated patients have died, none died from progressive organ failure related to sepsis. Our CEO and CMO has confirmed our results (shorter LOS and fewer deaths) and has requested that the protocol be instituted throughout our hospital system."
Since (if clinicaltrials.gov is accurate) no randomized trials are going to answer this question for years, it will be fascinating to see how this anecdotal therapy is adopted and future results reported and shared. Dr. Marik's stature and the dramatic findings will grant it credibility and a wide audience. The therapy's apparent benignity will lead reasonable physicians to consider it ethical in severe septic shock, or even an ethical imperative under a "compassionate use"-like philosophy.
Now I want you to consider what the above means. Notice no new trials are under way as of the print of this article. Now, why wouldn't every one be all over this to either prove or disprove it? Because if it is truly this beneficial, as it appears to be, IF SO that means that science failing to adequately, and WITHOUT BIAS ( that can be the real trick in studies ) has cost thousands and thousands of lives over the decades. And I'm convinced this would be because no one had any interest in what a simple vitamin might be able to do compared to a whiz bang drug by way of which billions can be made.
As far as I am concerned, when looking at any study, whether for my views or against them, the bias of the investigator or his/her sponsors must always be taken into account, as far as it is possible to do so.
Now what about the bias of these guys in the above mentioned clinical studies? What is their bias? Do they have a corner on the Vitamins C and thiamine market? Or do they just want to save lives, and are going to do what is required academic studies be damned? And in my experience, don't hold your breath waiting for the large randomized studies to prove or disprove this. This will not bring billions into the pockets of the usual folks doing the studies. In fact, it might even hurt their bottom line.