Simple, science-based steps to boost your immunity can help prevent or moderate infection - including challenging the conventional wisdom about Vitamin C.
What’s this mysterious substance? The same vitamin C that mainstream media dismiss as having little or no benefit against viral respiratory infections! Based on modern studies and recent rigorous evaluations, vitamin C is far more than just a “vitamin”; it is a foundational molecule that protects and regulates every cell, and actually seems to be the most effective antiviral agent known. So why do some say to take none a day?
The medical evidence cited (also by NIH) as supposedly debunking the use of vitamin C in respiratory illness - the 2013 Cochrane Review of 64 clinical trials - actually found consistent curative value, especially at higher doses and in children. Its senior author concluded that “all 21 placebo-controlled studies published since 1970” using at least one gram per day of vitamin C reported milder or shorter colds. He also wrote the papers cited above on ventilator and ICU savings, and the citations above on pneumonia prevention and mitigation. “[I]nertia and prejudices against vitamin C” persist, as his excellent review paper explains, based largely on outdated and poorly performed studies demolished decades ago. Indeed, his Cochrane Review recom¬mended that “consistent effect of vitamin C on…duration and severity…and low cost and safety” may make it “worthwhile for common cold patients to test on an individual basis whether thera-peutic vitamin C is beneficial for them. Further therapeutic… [trials] are warranted.” That’s hardly a description of a myth.
Doubts whether vitamin C can also help to prevent colds confuse evidence of absence with absence of evidence: NIH rightly found “not enough evidence,” and a Danish review agreed the clinical trials available by 2010 (nearly all even today) are “largely irrelevant.” Why? Evidence-based medicine requires large, controlled, usually randomized and double-blind, clinical trials - but industry and govern¬ment won’t fund their high cost for unpatent¬able over-the-counter supplements. Such trials are especially difficult to perform rigorously for vitamin C. Further, that Cochrane Review rested on deeply flawed clinical trials. Nearly all doses were far too small or infrequent to trigger the threshold effects that practitioners claim and science predicts. Unreport-ed quality of the vitamin C used may have made doses severalfold less effective. Outcomes were linked to whether subjects took any C, but only rarely to how much or how often. And decisively, “none of the iden¬ti¬fied controlled trials directly test[ed]” the preventive claims that the Review supposedly refuted.
With no better evidence, then, what should we do? Cochrane Review, NIH, and CDC agree vitamin C is generally safe (minor exceptions are clear). Even top-quality C (fully buffered, fully reduced l-ascorbate, described and sourced in a medically vetted lay user’s guide) is cheap and ubiquitous. Seventy-odd years’ unrefuted observations, buttressed by hundreds of basic-science papers, show that at least 3–5 grams per day, spread through the day, largely protects against known viruses. That’s equivalent to about 40–70 medium-sized oranges per day. Taking more, nearly to stool-loosening level, is even better. (A 2018 trial with 1,444 Korean Army recruits given 2 grams three times a day found 20–40% fewer colds.) Therefore:
>> Even if no supplement worked, we should take better care of ourselves in all other ways that boost immune and repair competence. Public-health strategy should combine reducing exposure to the virus with making any infections fewer, shorter, and milder.
>> The Cochrane Review found that even little and infrequent vitamin C did make colds shorter and milder. Various viruses, including corona¬viruses, cause colds, so taking vitamin C should make COVID-19 illness shorter and milder too, and the pandemic less severe, even if vitamin C doesn’t prevent infection. It may still make the course of the illness less severe, reducing the burden on our healthcare system.
>> So shouldn’t at least healthcare, EMS, grocery-store, pharmacy, delivery, and other frontline workers, and groups most at risk of severe illness (old, sick, poor, homeless, refugees, prisoners), be encouraged and helped to start using this safe, cheap, easy, and available substance now?
>> Simple question: Is it riskier to take enough high-quality vitamin C that may keep you well and seems to help cure you if you get sick, or to take none?
With or without supplements, stronger community immunity is a low-risk, equity-enhancing, socially mobilizing way to do no harm, do much good, and buy precious time. Immunity will become even more vital if no universal-vaccine miracle emerges and if this single-strand RNA virus’s rapid mutations outpace specific vaccines. Not hedging that bet may soon look negligent.
Thirteen years ago, when Lovins co-keynoted the annual meeting of the Institute for Healthcare Improvement for its founder, Harvard Med’s Don Berwick MD MPP (later head of Medicare and Medicaid), Dr. Berwick rephrased the medical dictum primum non nocere - “first, do no harm” - thus: “When harm is underway, proceed urgently to learn how to stop it, and act urgently on the learning.”