No, High-Dose Vitamin C Does Not Treat Coronavirus! FDA Approval Is Limited to Scurvy

Without doubt, COVID-19, caused by the novel coronavirus, has become the world’s most important issue, and the world is buzzing with discussion of COVID-19 treatments.

The truth is that we have no specific, effective treatment for COVID-19, but thousands of scientists are working tirelessly day and night to find one.

Today, we will examine just one of the supposed treatments being actively promoted on social media and many websites: high-dose vitamin C.

For those who want the conclusion immediately: high-dose vitamin C does not help prevent or treat coronavirus infection. We wish there were such a simple solution; unfortunately, there is not. Furthermore, contrary to claims in videos circulating on social media, high-dose vitamin C has no FDA approval for treating the novel coronavirus disease or any other condition, with one exception: scurvy!

- Link: FDA approval:ASCOR (ascorbic acid injection), for intravenous use

In fact, in 2017, the FDA sent a strongly worded warning letter to The Vitamin C Foundation over its highly exaggerated claims about vitamin C’s therapeutic potential.

Similarly, the Australian Therapeutic Goods Administration (TGA) announced on 27 March that there was no scientific evidence supporting intravenous high-dose vitamin C for COVID-19 treatment.

- Link: The Therapeutic Goods Administration (TGA): No evidence to support intravenous high-dose vitamin C in the management of COVID-19

What Is Vitamin C, and What Does It Do?

Also known as ascorbic acid and ascorbate, vitamin C is an essential water-soluble compound. Most animals and plants can produce vitamin C, but humans cannot and must obtain it externally. Vitamin C plays an important role in collagen synthesis. Collagen is a protein forming the basic structure of connective and supporting tissues such as skin, cartilage, bone, tendons and ligaments. Severe vitamin C deficiency therefore causes scurvy, also known as the sailors’ disease, characterized by receding gums, weakness, lethargy, and easy bleeding and bruising.

Let Us Go Back a Little

Why Do Some People Think Vitamin C Might Treat This Novel Coronavirus?

Vitamin C is an essential nutrient that everyone needs, but most people obtain plenty of vitamin C through their normal diet. Today, both vitamin C deficiency and scurvy are extremely rare. Furthermore, as we have written before, although high doses carry a risk of kidney stones, they are generally regarded as harmless, and taking vitamin C supplements is unnecessary (see here).

Beyond scurvy, the craze for vitamin C treatment began with the chemist and two-time Nobel laureate Linus Pauling. Late in his career, he wrote a book promoting vitamin C as a miracle treatment for many diseases, including influenza. He had little evidence to support this claim, but his assertions prompted hundreds of studies testing whether vitamin C worked for various conditions, particularly cancer.

The conclusion was: "vitamin C does not prevent or cure influenza or other diseases." In fact, Arthur Robinson, who worked with Pauling for 16 years, was forced to resign after reporting in 1978 that high-dose vitamin C increased skin cancer in mice 2-fold. Robinson, whose scientific career was ended, sued the Linus Pauling Institute, won his case in 1983, and received 575 thousand dollars in compensation.

Are You Ready for a Surprise?

The institute established in the name of Linus Pauling, the two-time Nobel laureate who pioneered high-dose vitamin C treatment and tried to prove its claimed benefits for numerous diseases, including cancer—the Linus Pauling Institute—chose scientific integrity over opportunism in this serious global crisis and clearly announced that high-dose vitamin C had no place in COVID-19 treatment.

Below, we share the introduction to the Linus Pauling Institute’s statement on using vitamin C for COVID-19, presented on its official homepage, together with a translation:

- Link: Vitamin C and COVID-19: A Special Statement From The Linus Pauling Institute

Translation: "The Linus Pauling Institute is closely following clinical trials of intravenous vitamin C for COVID-19-related pneumonia. However, there are currently no data showing that vitamin C can prevent or successfully treat COVID-19 infections. After reviewing trial data, LPI (the Linus Pauling Institute) will comment on vitamin C’s efficacy in COVID-19".

Alexander Michels is a research associate at the Linus Pauling Institute who has spent 20 years studying how vitamin C affects the body. An excerpt from Alexander Michels’s interview on this subject is translated below:

"I have seen many things online saying that vitamin C will destroy coronavirus. Recently, I have been encountering more of this pseudoscience. In the scientific literature, there is absolutely no evidence for it.

I am among those who want to see vitamin C do incredible things. However, until findings are published in a scientific journal, I cannot comment on its efficacy against coronaviruses—especially this COVID-19."

Why Do High-Dose Vitamin C Advocates Persist?

"What about the studies saying high-dose vitamin C works for influenza?" The answer is that when hundreds of studies investigate a treatment that does not work, a few will show a small positive effect purely by chance. This is what has happened with vitamin C. Negative studies are difficult to publish; positive ones are published more easily.

Today, everyone is seeking a treatment for COVID-19. Unsurprisingly, many people—even some doctors—claim vitamin C is the answer. A widely shared video made by a doctor in our country even claims that high-dose vitamin C will cure coronavirus. I will not share the video, because it has already caused enough harm.

Anyone claiming a treatment works should also be able to provide evidence that convinces the scientific community

During a pandemic, as a disease spreads globally, a treatment recommendation that will affect millions cannot be based on assumptions and biased observations.

A common tactic among pseudoscience advocates is: "Say that a treatment works, then expect someone else to prove otherwise."

For example, someone might claim that ginger tea helps prevent coronavirus infection. If challenged, they ask us to prove otherwise, although, as the person making the claim, they bear the responsibility for presenting real evidence first. This is where presenters of supposed treatments dressed up with scientific evidence use a sleight of hand: they try to make all evidence appear equally valuable. The reality, however, is this:

Evidence that vitamin C supplements work for any disease apart from scurvy—including colds, influenza or cancer—is not provided by randomized controlled clinical trials or meta-analyses. On the contrary, many clinical trials show, for example, that they do not work in cancer.

To know confidently that a treatment works, we need good, large-scale human clinical trials. Some doctors at Wuhan University have begun a vitamin C clinical trial to see whether high-dose vitamin C benefits COVID-19, but results will take months. We would like to share two sentences, unchanged, from the introduction to a placebo-controlled phase-II clinical trial involving COVID-19 patients in intensive care in China, followed by their translation.

“... Among patients with sepsis and ARDS, patients in the high-dose vitamin group did not show a better prognosis and other clinical outcomes. There are still some confounding factors in the existing research, and the conclusions are different.”

Translation: “... Among patients with sepsis and ARDS (acute-onset respiratory failure syndrome), those in the high-dose vitamin group did not show a better disease course or clinical outcomes. Confounding factors remain in the existing research, and the conclusions differ.” Dozens of trials of new COVID-19 treatments are now being launched at remarkable speed because of the urgency of the pandemic. The World Health Organization (WHO) has begun trials of 4 noteworthy existing drugs for COVID-19. Vitamin C was, of course, not among these 4 drugs. The 4 treatments include the experimental antiviral remdesivir; hydroxychloroquine, an antimalarial; a combination of two HIV drugs, lopinavir and ritonavir; and that combination with interferon-beta added...

Conclusion

In conclusion, we must hope and wait for one of the ongoing reasonable efforts to yield an effective treatment. Along the way, we have no time to lose on alternatives such as high-dose vitamin C, and, based on past scientific experience, we can say that high-dose vitamin C is very unlikely to be effective in treating COVID-19.

Below, it can be seen that high-dose vitamin C is not included in national or international COVID-19 treatment guidelines: