An Update on Oral and IV Vitamin C in Viral Infection with Dr. Paul Anderson

In this episode of The Modern Vital Podcast, Dr. Ben Reebs is joined by renowned educator, naturopathic physician, and cancer specialist, Dr. Paul Anderson. We deep dive into the vast benefits of vitamin C, unpacking its antioxidant properties, its significant impact on the Renin-Angiotensin-Aldosterone System (RAAS), and its role in enhancing the differentiation and proliferation of certain leukocytes like macrophages and lymphocytes. Dr. Anderson sheds light on the initial strategy adopted by three Wuhan hospitals during the early phases of the pandemic. To reduce hospital admissions, they administered oral doses of ascorbic acid powder, with promising outcomes.

Expounding on vitamin C's pivotal role, Dr. Anderson articulates how it is the linchpin among the three primary antioxidants in our body. Vitamin C's interplay in recycling both glutathione and vitamin E is integral for tissue health, especially when inflammation is present in organs such as the heart, lungs, or kidneys. The discussion then progresses to the vitamin's direct modulation of immune cytokines, which are instrumental in combating severe cases of SARS-CoV-2. Moreover, its influence on ACE-2 receptors impacts viral uptake and the overall RAAS system. As the conversation wraps up, the dose-response relationship of vitamin C is touched upon, with a nod to Linus Pauling's groundbreaking research on optimal dosing. Concluding the episode, Dr. Anderson shares his online resources, making it easier for listeners to access evidence-based information on the topic.

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Transcript

Dr. Ben: On today's episode of The Modern Vital Podcast, our topic is Vitamin C in the treatment of SARS-CoV-2 or COVID-19. And today's special guest is Dr. Paul Anderson, naturopathic physician and recognized educator and clinician and integrative in naturopathic medicine with a focus on complex infectious, chronic, and oncologic illness. And in addition to three decades of clinical experience, he also was head of the interventional arm of a US NIH-funded human research trial using IV and integrative therapies in cancer patients. He's co-author of the book, Outside the Box Cancer Therapies, and co-author with Jack Canfield in the Anthology Success Breakthroughs, as well as the Lioncrest Publishing book Cancer, the Journey from Diagnosis to Empowerment. Welcome to the show, Dr. Anderson.

Dr. Paul: Thanks for having me.

Dr. Ben: It's great to have you. Huge fan of yours. I know you have some important updates for us, you know, on vitamin C and IV vitamin C. But let’s just start with what do we know? What's the data? What do we know about vitamin C in general and intravenous vitamin C, in patients with COVID?

Dr. Paul: Yeah, I think that's a great place to jump in. I think as the setup, because there are probably, you know, 10 or 15 ways you could take why it might be helpful. But one of the most critical things, I think, which we've seen in other acute illnesses as well, but COVID kind of has some unique immunologic problems that may match up with the need for vitamin C. As soon as you put a human under stress, whether it's illness or another type of stressor, their vitamin C levels go down. And we, unlike most other animals, we don't make our own vitamin C. We're lacking one enzyme to do that. So if you take most other animals and stress them, get 'em sick, they make more vitamin C, we can't do that. So we have to get whatever we do by what we eat or drink.

And if you pair the fact that we tend, it's water soluble, you know, what comes in goes out, for the most part. There's tiny bits stored, but not much. But if you pair that fact that we're only working on kind of what we get today and tomorrow dietarily, and then we stress ourselves, especially with an acute illness, we can decrease the level of vitamin C that we really need for our body to work to zero, basically. In the case of virus infections and other acute problems, one of the things that helps us to not, not as much just sort of fight hard or whatever, but what helps us modulate our immune system is that we want a good robust immune response to go up in the beginning of an infection grade. But what helps us have that not go up too high and hurt us is our natural antioxidants that kind of temper the immune response.

Vitamin C is the one antioxidant in the middle of three important antioxidants that that goes away when we get sick. So one of the things that I think is really important is just at the base level, like there's lots of other mechanisms, but at the base level is our inability to deal with the overwhelming inflammatory drive, which is what we saw earlier versions of COVID create a lot of disease. Part of that is burning out vitamin C, and, and then we kind of can spin out of control, which is what we see with the so-called cytokine responses, et cetera. So at a real base level, vitamin C's critical.

And then you can kind of go forward from just that basic understanding to, well then what do we know from research that's been done about vitamin C potentially helping in that respect. But I really think it's important to start with our bodies need it. We don't make it on our own. And when we get stressed with an illness, especially something like SAR-CoV-2, we burn it up really, really quickly and, and that doesn't help us in the long run.

Dr. Ben: And is it also that we don't absorb it as well? Or is it just literally we burn through it?

Dr. Paul: The absorption does go up and down, but basically we generally don't keep enough around in our system where there's a reserve, like there would be with other nutrients. So, most of it is, as soon as we start to get sick, we burn it up, at a much faster rate than normal.

Dr. Ben: Well, I know you've had a lot of hands-on experience and you were part of various trials as well as setting up protocols, during the pandemic. Maybe you could talk a little bit about what you saw and also what we know in that context with regard to how much, like how much do we need, how much, how much vitamin C does a person need, you know, intravenously, uh, while having a COVID infection?

Dr. Paul: Yeah, I think that's a really good next point. So, bottom line is if people can take vitamin C orally, during their acute illness, often that's enough to kind of keep things going. The problem occurs if we get either too much inflammation or respiratory issues, et cetera, we wind up in the hospital, we're not gonna get that level of vitamin C that we need. And so very early on in March of 2020, I was asked to do an update for physicians. It turned out to be a worldwide thing. I didn't realize I was doing that. And we had close to 9,000 physicians on from all over the world, and they had asked me to do it because of my history with vitamin C research in cancer. And so what I did in preparation for that was I got the records from the Wuhan hospital system and looked at what they were doing in the ICU with vitamin C.

And basically the people they gave intravenous vitamin C to in the intensive care tended to stay in the hospital shorter amounts of time and to have better survival. And what the slam on that was, well, it's not a randomized controlled trial, which okay, it's, it's what we had at the moment. And so why would that even work? Well, what they did, which is later, not too much later, I published a hospital protocol, which sort of mimicked what we had done elsewhere, which basically was a moderate dose of vitamin C, but given throughout a 24 hour period. So if you're in the ICU, you're not going anywhere anyway. And so the idea is we're gonna put more than you would get from your diet in you, but not a crazy amount more. And we're gonna put it in persistently throughout the day so that your vitamin C levels never crash.

And when your body needs that balance to the inflammatory immune response we want, but we also want the counterbalance of antioxidant activity. It has what it needs. Okay. So we started to do that, and I'll talk in a minute maybe about some personal experience with that, but about a year or so later, there were a number of randomized controlled trials that were started on Vitamin C. Two of them did get published. We'll put a link in that gives a little review about that. But in both of them, they did similar to what I just recommended, you know, kind of a steady persistent dose of vitamin C intravenously. And in both of them, not everything, 'cause the numbers were not, you know, it wasn't thousands of people. There was I think 75 in each arm on one, and about 30 in each arm.

On the other things that reached statistical significance were the vitamin C groups tended to stay in the hospital a shorter amount of time. Mortality was lower. And there were a couple of other good endpoints that did reach significance. One of the more important ones, and they didn't measure everything the same in both trials. But a super important one people now have heard about is interleukin 6, IL-6. The vitamin C group, the one that measured the interleukin 6…it was eight times lower than the placebo group that was just getting saline IV and not vitamin C. Interleukin-6 was the trigger, one of the many triggers in the earlier types of COVID that we saw that would trigger a lot of cardiopulmonary inflammation. And, you know, they get people on ventilators and stuff.

So I think there's a lot of mechanisms of why it would work. There's a difference. So there is research now, and I think some of the other trials will publish at some point. So there's that, but there's a difference between what you do as someone who's stuck in a hospital bed, where you're controlling, you know, IVs going into them for 24 hours a day. It's one thing. And then what we did during the earlier variance of COVID where people would get very high fever, and often I would go and I would do a house call 'cause they were isolated and give them an IV. Well, in those cases we would do a higher dose because I wasn't gonna be with them for 24 hours giving them, you know, a low steady dose. And this is not tracked data.

These are anecdotes from my own experience, but, in all of the cases where I was able to do that in the first 48 hours of, of their, you know, febrile infection, we didn't have any of those folks need to go to the hospital and they tended to recover reasonably well. There were a few cases because I published the hospital protocol, that didn't get a whole lot of press in North America. There were a few cases though, where families had kind of pushed the issue. And so the hospitals called and said, How do we do this? And that's why I wrote the protocol in the handful of cases where the hospitals in North America did do the IV Vitamin C similar to the Wuhan protocol, which I adapted for the US. All of those patients got off the ventilators and went home alive. There were, you know, a number of other cases I was involved in where the hospital refused to do it, and most of those patients, unfortunately, did pass away. So again, those aren't, you know, real data, that's just anecdotes. But,  it was pretty compelling to watch it kind of play out face-to-face as it were.

Dr. Ben: That's incredible. I was looking at the paper you shared with me and reading through those two studies, and it was amazing to see. The first one was about three and a half grams of vitamin C. The second was about 24, I think, and still seeing a statistically significant improvement in both studies, but then seeing a much greater one in the, in the higher dose it, it appears anyway. Could you speak to that a little bit? I mean, are we looking at…do we need 10 or 20 grams?

Dr. Paul: Yeah, I think that's a really good question. I think the real answer is we, we may not know. I think the first study, at least the way I wrote the summary with the lower dose, the fact that it had some statistically significant benefits, even at three and a half grams, let's say, was pretty impressive, really. And I think what that speaks to is the fact that the body normally runs on fairly tiny amounts of vitamin C. So if we're trying to just replace that, we might get there with just a few grams. I think in the case of a very ill person, you know, such as what they did in Wuhan originally, or they did in the second paper or what I published, where you kick it up a little higher, so they're getting an average of a thousand milligrams or a gram every hour.

I think that makes more sense with a more critically ill person. And like I said, when I would do a house call with somebody that had 103 or 104 fever and they just got COVID, we would give them, you know, twice or three times that much, because then it would be in their body a longer amount of time. 'Cause again, I wasn't at their house giving 'em IVs every day like the hospital could. So I do think there is a dose response. And I do think you see it between those two studies. Although one issue with studies is if your endpoints can be very different for each study, so that, you know, the two they had that crossed over were general survivability and shorter hospital time. I think those were the two that crossed over the biochemical changes. I think you'd see more as, as they did in the second study with the higher dose where the interleukin-6 went way down, et cetera. So I do think that's of note.

Dr. Ben: Yeah. And can you maybe give three or four, like mechanisms, you know, reasons you think it, it, you know, it, it's working.

I mean, I know we, we know that vitamin C recycles vitamin E for example, we know that it's a potent antioxidant. We know that, you know, it can an impact on the RAAS, the, the renin angiotensin aldosterone system. We know it can do all these different things, and as well as improve the differentiation and proliferation of certain leukocytes like macrophages and lymphocytes, neutrophils. Um, but like, what are two or three reasons you think it's, it's so impactful?

Dr. Paul: Yeah, I mean obviously all of those things are, are on the list. And just to, you know, give it a little broader exposure. In the original plan with the three Wuhan hospitals, their biggest goal was to keep people out of the hospital. And so they literally had train cars full of ascorbic acid powder brought in and everybody was just taking it orally, which really appeared to help. So the fact that if you're not that sick yet, or you're prepping for people being sick around you, you just increase your oral dosing, that on its own may or may not be preventive, but will be supportive during the thing, during the infection. I think the one huge core is that vitamin C is in the middle of the three primary antioxidants that our body uses. All other antioxidants are subservient to these three.

So vitamin C can recycle glutathione and vitamin E as you mentioned, and then the two of them can recycle vitamin C. So vitamin C is the weakest member of that because we don't synthesize it ourselves. And that is so important because if you look at the level of tissue inflammation, whether it was in the vasculature or the brain or the lungs or the heart, the kidneys, that's the trigger when those three, if those three go down, because one of them is weak, which the vitamin C, then the inflammatory trigger, can be sort of unbridled in any tissue you would like. Now, then you can go out to the next level, which is it directly slow. It doesn't stop like say steroids would, but it slows down the overproduction of certain immune cytokines that are also related with hospitalization and death in SARS-CoV-2, like IL-6, et cetera.

So it's not stopping them 'cause we need that for good immune response, it's modulating them. So vitamin C is directly doing that, on its own as ascorbate or together as those three antioxidants. And then, you know, as you mentioned, the ACE receptors, which are going to be, you know, implicated in viral uptake, which then have to do with the renin angiotensin system that you were talking about. They're sort of all heading in the same direction. Biochemically, it turns out that vitamin C is very necessary in the sort of the maintenance, but also the balance of those biological functions. So, there's many other things you'd mentioned. White blood cells, the primary fighting forms of white cells that help us with antigen presentation and production of interferon and all sorts of other things with viruses.

They tear through vitamin C and other nutrients. So, you know, there's a support there. There's also a support on the other side of the immune cell milieu, where the ones that help us with immune memory and response, you know, require ascorbate and other nutrients as well. So I think, you know, they all seem like kind of picky little biochemical areas, but really if you figure this goes on in your whole body, they're fairly important. And if I run myself out of vitamin C, I'm gonna have a harder time pulling off all those processes.

Dr. Ben: Well, uh, just one final quick question for you. I was combing through Linus Pauling's website on vitamin C, and there was a study about how we need 30 to a hundred grams orally a day to get a really steep increase, you know, in our extracellular intercellular vitamin C. Do you, have you found that to be true clinically experientially, or do you think that we just need, you know, a couple thousand milligrams a day?

Dr. Paul: Well, and this is something that, and at this point, I've done so many…I can't remember which class it was I was teaching, but there, there actually is newer data about the, the ability of the body to take up vitamin C, especially when sick, et cetera. And the answer with Vitamin C is, if you're super healthy and your diet is intact, you're only gonna absorb a few hundred milligrams during the day anyway. That is, if there's enough coming in through your diet, take some extra vitamin C. So for most of my patients, you know, a baseline, they might do 500 milligrams twice a day, something like that. As soon as you get sick or as soon as you get exposed to toxicants or as soon as you get any other stressor, it could be emotional stress, any other stressor on your body, but certainly toxicants, infections, you know, all the other stressors, your vitamin C just believes you and your absorption will go up.

So what Pauling and, and then later folks, working with him observed was that a sick person could take Vitamin C all day long and over the course of 24 hours could take 10 to 30 or more grams of Vitamin C and not get diarrhea, which means they were probably absorbing it. What I always tell patients is your body generally will let you know when you don't need the big dose anymore, because you'll start to get loose stools and then you just back off on the dose. I know that, like Linus Pauling and some of his associates, that you can upregulate your intake transporters, and so they were taking, you know, 20 to 50 grams a day or more orally. I think for maintenance, you don't, you know, in a healthy system…I don't think you need that, exposed to illness, maybe a little more.

Dr. Ben: Well, Dr. Anderson, thank you so much for joining us today. Where can people find you? I mean, we're gonna link to your website on the show notes, but where can people reach out, find you online?

Dr. Paul: Yeah, um, so if you go on the, the easiest is consultdranderson.com. And the primary way I do education for patients is on YouTube. Now I have a link to my YouTube, which is just Doctor A Online, and then you guys are gonna reshare the kind of Vitamin C summary, which has the actual studies and things in it. So that might be of interest to folks too.

Dr. Ben: Well, that concludes this episode of The Modern Vital Podcast. We'd love to hear from you. We value your feedback, and if you have any questions or suggestions, please reach out to me at ben@modernvital.com. Also, please leave us a review on Spotify or Apple if you enjoyed this episode, and we look forward to having you join us next week for another exciting episode of The Modern Vital Podcast.