High Dose Intravenous Vitamin C and Influenza: A Case Report by Journal of Orthomolecular Medicine

OPEN ACCESS VOLUME 33, NUMBER 3 PUBLISHED: JUNE 2018 REVIEW ARTICLE CASE REPORT

High Dose Intravenous Vitamin C and Influenza: A Case Report

Michael J Gonzalez, DSc, NMD, PhD, FANMA, FACN¹; Miguel J Berdiel, MD²; Jorge Duconge, PhD³; Thomas E Levy, MD, JD4; Ines M Alfaro, MD5; Raul Morales-Borges, MD6; Victor Marcial-Vega, MD7; Jose Olalde, BEE, MEE8 1.University of Puerto Rico, Medical Sciences Campus, School of Public Health, San Juan PR; 2.Berdiel Clinic, Ponce, PR; 3.University of Puerto Rico Medical Sciences Campus, School of Pharmacy, San Juan PR; 4.Riordan Clinic, Wichita KS; 5.Alpha Institute of Preventive Care,Caguas, PR; 6.Integrative Optimal Health of Puerto Rico, San Juan PR; 7.Universidad Central del Caribe School of Medicine, San Juan PR; 8.Centro Medico Adaptogeno (CMA), Bayamon PR.

Introduction

recognized for treating influenza, or viral diseases in general.

Influenza, commonly known as “the flu”, is an infectious disease caused by an influenza virus. Symptoms can be mild to severe. The most common symptoms include: a high fever, runny nose, sore throat, muscle pains, headache, coughing, and feeling tired. These symptoms typically begin two days after exposure to the virus and last about a week. The cough, however, may last for more than two weeks. Three types of influenza viruses affect people, called Type A, Type B, and Type C (Longo,2012).

There have been a number of reports in the literature documenting that infectious disease processes rapidly accelerate vitamin C depletion and greatly increase vitamin C requirement (Pauling, 1971; Levy, 2002).

Influenza kills as many as 50,000 to 70,000 people annually in the United States alone. Of even greater concern is that annual influenza deaths have been on the rise, increasing substantially over the last two decades (Thompson et al., 2003). However, vitamin C in high enough doses has already been shown to be very effective at eradicating the influenza virus, sometimes after serious complications such as encephalitis have arisen along with many other viral syndromes (Klenner, 1949; Vargas-Magne, 1963). In spite of this information, vitamin C is still not routinely utilized against this infectious disease, and none of the various forms of vitamin C are included in the formularies of nearly all US hospitals. To date no generally effective therapeutic measures have been

Vitamin C is an essential nutrient for humans, with pleiotropic functions related to its ability to donate electrons. Vitamin C contributes to immune defense by supporting and directly stimulating various cellular functions of both the innate and adaptive immune system. Consistent with this documented ability of vitamin C to upregulate the immune system, the scientific literature has abundant documentation of the ability of vitamin C to cure a number of viruses (Klenner, 1951; Stone, 1972; Levy, 2002, Gonzalez, 2014, Gonzalez, 2016). In this particular case report, the viral infection had reached the point of being life-threatening, even though it was afflicting a young man who previously had always been in exemplary good health. Case Report Presentation M.G., a 25-year-old forensic psychologist from Ponce, Puerto Rico, was in his baseline state of excellent health

High Dose Intravenous Vitamin C and Influenza

when he began to notice classical flu-like symptoms, including fever, chills, muscle aches and pains, headaches, and nausea. This syndrome began in Orlando, Florida, during a vacation trip. He fought these symptoms as best as he could for a week by trying to continue his vacation activities. However, by the time this period had passed, he only had the energy to stay in bed. He remained in bed for the next five days, unable to regain enough energy to take any more than the handful of steps needed to get to the bathroom and back to bed. He noted that when he even attempted any greater level of activity, he would subjectively get a return of fever along with a worsening of the near-constant headaches and body pain. As it was, he had already lost 15 pounds, (went from approximately 170 pounds down to 155 pounds) from the time when he was first evaluated and treated. His initial physical examination was only really remarkable for the obvious loss of fat and muscle mass. There was no evidence of enlarged lymph nodes or enlarged liver, as is often seen in infectious mononucleosis. Routine blood work that included a complete blood count and biochemistry profile was within normal limits, including the basic liver function tests. A rapid flu swab test was done which turned out positive. The rapid flu swab test is a relatively fast and accurate method for diagnosing influenza. We treated him with Intravenous Vitamin C (IVC) therapy which consisted of 1,000 cc of lactated Ringer’s solution containing 50 grams of sodium ascorbate, a pH-neutral form of vitamin C. This was infused over about one and a half hour. This same regimen was repeated for a total of 3 infusions over 3 days. All of the infusions were clinically uneventful and without discernible side effects. The morning following the first IV, the patient noted that his body strength had improved dramatically. He also noticed that his headaches were gone. The morning after the second IV his appetite was improving and he was eating more as well. All of the IVC infusions were given at the patient’s home. On day four he felt normal, but Vitamin C was continued to be given orally (2 g tid). The patient was also instructed to start taking a high potency multivitamin and mineral (1qd) in addition to CoQ10 (100mg qd) on a regular basis orally. In addition to Echinacea (500 mg bid for ten days). Discussion Vitamin C accumulates in phagocytic cells, such as neutrophils, and can enhance chemotaxis, phagocytosis, generation of reactive oxygen species, and ultimately bacterial and viral killing. In monocytes, which are usually the first immune cells mobilized in the immune response to inflammation, vitamin C has been documented to concentrate 80-fold (8,000%) above plasma levels (Evans et al., 1982).

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Vitamin C (ascorbic acid) possesses anti-viral activity. It has been shown that vitamin C is an essential factor in the production of the anti-viral immune response during the early phase of viral infection through the production of type I interferons (Kim et al. 2013), which up-regulates Natural killer (NK) cell and cytotoxic T-lymphocyte activity (Madhusudana et al. 2004). Also, studies have indicated that ascorbic acid can be used as an inactivating agent for both RNA and DNA viruses, lessening viral infectivity (Jariwalla and Harakeh, 1996; Byun and Jean,2011). In addition, ascorbic acid can detoxify viral products that produce pain and inflammation (Harakek et al.1990). High dose IV Vitamin C has been shown to be effective against viral infections such as the common cold rhinovirus (Hemila and Herman,1995); avian virus H1N1 (Ely, 2007); Chikungunya (Gonzalez, et al. 2014; Marcial-Vega, et al. 2015); Zika (Gonzalez, et al. 2016) and influenza (Zarubaeva, et al. 2017). Also oral supplementation with vitamin C (doses over 3g) appears to be able to both prevent and treat respiratory and systemic infections (Carr and Maggini, 2017). Conclusion All of this evidence confirms the effectiveness of ascorbic acid against viral infections. Based on the positive outcome in this case, we propose that Intravenous Vitamin C should be studied as a vital component of the treatment protocol for acute viral infections. References: Byun SH, Jean Y. Administration of Vitamin C in a Patient with Herpes Zoster –a case report. Korean J Pain, 2011; 24:108–111. Carr AC, Maginni S. Vitamin C and Immune Function. Nutrients, 2017; 9: 1211-1236. Ely JT. Ascorbic acid role in containment of the world avian flu pandemic. Exp Biol Med, 2007;232(7):847-51. Evans RM, Currie L, Campbell A. The distribution of ascorbic acid between various cellular components of blood, in normal individuals, and its relation to the plasma concentration. Br J Nutr, 1982; 47:473-482. Gonzalez MJ, Miranda-Massari JR, Berdiel MJ, Duconge J, Rodríguez-López JL, Hunninghake R, Cobas-Rosario VJ.High dose intraveneous vitamin C and chikungunya fever: A case report. J Orthomolec Med, 2014;29(4):154156. Gonzalez MJ, Berdiel MJ, Miranda-Massari JR, Duconge J, Rodríguez-López JL, Adrover-López PA. High dose intravenous vitamin C treatment for zika fever. J Orthomolec Med, 2016;31(1):19-22. Harakek S, Jariwalla R, Pauling L. Suppression of human immunodeficiency virus replication by ascorbate in chronically and acutely infected cells. Proc Natl Acad Sci USA, 1990; 87:7245–7249.

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Hemilä H and Herman ZS. Vitamin C and the common cold: A retrospective analysis of Chalmers’ review. J Am Coll Nutr, 1995;14(2): 116-123. Jariwalla RJ, Harakeh S. Antiviral and immunomodulatory activities of ascorbic acid. Subcell Biochem, 1996;25:213-31. Kim Y, Kim H, Bae S, Choi J, Lim SY, Lee N, Kong JM, Hwang Y, Kang JS. Vitamin C Is an Essential Factor on the Anti-viral Immune Responses through the Production of Interferon-α/β at the Initial Stage of Influenza A Virus (H3N2) Infection. Immune Network, 2013;13(2):70-74. Klenner FR. The treatment of poliomyelitis and other virus diseases with vitamin C. South Med J, 1949; 3(7):209214. Klenner FR. Massive doses of vitamin C and the virus diseases. South Med J, 1951;113(4):101-7. Levy, TE.Curing the Incurable: Vitamin C, Infectious Diseases, and Toxins by Henderson, Nevada; Livon Books, 2002. Longo DL . Chapter 187: Influenza. Harrison’s principles of internal medicine (18th ed.). New York: McGraw-Hill. 2012. Madhusudana S, Shamsundar R, Seetharaman S. In vitro inactivation of the rabies virus by ascorbic acid. Int J Infectious Dis, 2004; 8:21–25. Marcial-Vega V, Gonzalez- Terron I, LevyTE. Intravenous ascorbic acid and hydrogen peroxide in the management of patients with chikungunya. Boletín de la Asociación Médica de Puerto Rico, 2015; 107(1):20-4. Pauling L. The significance of the evidence about ascorbic acid and the common cold. Proc Natl Acad Sci U S A. 1971;68: 2678–2681. Stone I. The Healing Factor: Vitamin C Against Disease. Grosset and Dunlap, New York, 1972. Thompson WW, Shay DK, Weintraub E, Brammer L, Cox N, Anderson LJ, Fukuda K. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA, 2003;289(2):179-86. Vargas-Magne R.Vitamin C in treatment of influenza, El Dia Med, 35: 1714, 1963. Zarubaeva VV, Slitaa AV, Lavrentyevaa IN, Smirnovb VS. Protective activity of ascorbic acid at influenza infection. Russian J Infection and Immunity, 2017; 7, (4): 319–326.