Any Role of High-Dose Vitamin C for Septic Shock in 2021?

2021 ◽  
Vol 42 (05) ◽  
pp. 672-682
Author(s):  
Ankita Agarwal ◽  
David N. Hager ◽  
Jonathan E. Sevransky
Keyword(s):  
Septic Shock ◽  
Vitamin C ◽  
Outcome Measures ◽  
Randomized Clinical Trials ◽  
Secondary Outcome ◽  
High Dose ◽  
Healthy Humans ◽  
Vitamin C Supplementation ◽  
High Dose Vitamin

AbstractWhile the use of vitamin C as a therapeutic agent has been investigated since the 1950s, there has been substantial recent interest in the role of vitamin C supplementation in critical illness and particularly, sepsis and septic shock. Humans cannot synthesize vitamin C and rely on exogenous intake to maintain a plasma concentration of approximately 70 to 80 μmol/L. Vitamin C, in healthy humans, is involved with antioxidant function, wound healing, endothelial function, and catecholamine synthesis. Its function in the human body informs the theoretical basis for why vitamin C supplementation may be beneficial in sepsis/septic shock.Critically ill patients can be vitamin C deficient due to low dietary intake, increased metabolic demands, inefficient recycling of vitamin C metabolites, and loss due to renal replacement therapy. Intravenous supplementation is required to achieve supraphysiologic serum levels of vitamin C. While some clinical studies of intravenous vitamin C supplementation in sepsis have shown improvements in secondary outcome measures, none of the randomized clinical trials have shown differences between vitamin C supplementation and standard of care and/or placebo in the primary outcome measures of the trials. There are some ongoing studies of high-dose vitamin C administration in patients with sepsis and coronavirus disease 2019; the majority of evidence so far does not support the routine supplementation of vitamin C in patients with sepsis or septic shock.

scholarly journals Vitamin C intake and susceptibility to the common cold

1997 ◽  
Vol 77 (1) ◽  
pp. 59-72 ◽  
Author(s):  
Harri Hemilä
Keyword(s):  
Vitamin C ◽  
Common Cold ◽  
Potential Effect ◽  
Dietary Vitamin ◽  
High Dose ◽  
Plasma Vitamin ◽  
Vitamin C Supplementation ◽  
The Common ◽  
The Uk

Although the role of vitamin C in common cold incidence had been studied extensively, the level of vitamin C intake has not been unequivocally shown to affect the incidence of colds. In the present study the six largest vitamin C supplementation (≥ 1 g/d) studies, including over 5000 episodes in all, have been analysed, and it is shown that common cold incidence is not reduced in the vitamin C-supplemented groups compared with the placebo groups (pooled rate ratio (RR) 0·99; 95% CI 0·93, 1·04). Consequently these six major studies give no evidence that high-dose vitamin C supplementation decreases common cold incidence in ordinary people. Nevertheless, the analysis was continued with the hypothesis that vitamin C intake may affect common cold susceptibility in specific groups of people. It was assumed that the potential effect of supplementation might be most conspicuous in subjects with low dietary vitamin C intake. The average vitamin C intake has been rather low in the UK and plasma vitamin C concentrations are in general lower in males than in females. In four studies with British females vitamin C supplementation had no marked effect on common cold incidence (pooled RR 0·95; 95% CI 0·86, 1·04). However, in four studies with British male schoolchildren and students a statistically highly significant reduction in common cold incidence was found in groups supplemented with vitamin C (pooled RR 0·70; 95% CI 0·60, 0·81). Thus, these studies with British males indicate that vitamin C intake has physiological effects on susceptibility to common cold infections, although the effect seems quantitatively meaningful only in limited groups of people and is not very large.

Protective Effect of Vitamin C on Oxidative Stress: a Randomized Controlled Trial

2008 ◽  
Vol 78 (3) ◽  
pp. 121-128 ◽  
Author(s):  
Sasazuki ◽  
Hayashi ◽  
Nakachi ◽  
Sasaki ◽  
Tsubono ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Vitamin C ◽  
Atrophic Gastritis ◽  
Dose Group ◽  
Controlled Trial ◽  
High Dose ◽  
Randomized Controlled ◽  
System A ◽  
Vitamin C Supplementation

Background: Although a number of reports regarding the role of reactive oxygen species (ROS) as the first step in cancer induction exist, few studies have investigated how vitamin C influences ROS in human plasma. Aim of the study: Using the ROS assay system, a method recently established by one of the authors, we aimed to evaluate the effect of vitamin C supplementation on serum ROS among subjects diagnosed with chronic gastritis. Methods: A total of 244 Japanese subjects with atrophic gastritis were randomized to take 5-year supplementation of either 50 mg or 500 mg of vitamin C. Results: The adjusted difference in the changes of total ROS between baseline and after 5-year supplementation was statistically significant between the intervention groups: 2.70 decrease (corresponds to 1.26% decrease) in the high-dose group and 4.16 increase (corresponds to 3.79% increase) in the low-dose group, p for difference = 0.01. Conclusion: Vitamin C was suggested to reduce oxidative stress among subjects with atrophic gastritis.

scholarly journals Vitamin C Supplementation in Healthy Individuals Leads to Shifts of Bacterial Populations in the Gut—A Pilot Study

Antioxidants ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1278
Author(s):  
Antonius T. Otten ◽  
Arno R. Bourgonje ◽  
Vera Peters ◽  
Behrooz Z. Alizadeh ◽  
Gerard Dijkstra ◽  
...  
Keyword(s):  
Pilot Study ◽  
Vitamin C ◽  
Gut Microbiota ◽  
High Dose ◽  
Healthy Individuals ◽  
Microbial Composition ◽  
Bacterial Populations ◽  
Vitamin C Supplementation ◽  
Anti Inflammatory ◽  
High Dose Vitamin

Gut microbes are crucial to human health, but microbial composition is often disturbed in a number of human diseases. Accumulating evidence points to nutritional modulation of the gut microbiota as a potentially beneficial therapeutic strategy. Vitamin C (ascorbic acid) may be of particular interest as it has known antioxidant and anti-inflammatory properties. In this study, we investigated whether supplementation with high-dose vitamin C may favourably affect the composition of the gut microbiota. In this pilot study, healthy human participants received 1000 mg vitamin C supplementation daily for two weeks. Gut microbiota composition was analysed before and after intervention by performing faecal 16S rRNA gene sequencing. In total, 14 healthy participants were included. Daily supplementation of high-dose vitamin C led to an increase in the relative abundances of Lachnospiraceae (p < 0.05), whereas decreases were observed for Bacteroidetes (p < 0.01), Enterococci (p < 0.01) and Gemmiger formicilis (p < 0.05). In addition, trends for bacterial shifts were observed for Blautia (increase) and Streptococcus thermophilus (decrease). High-dose vitamin C supplementation for two weeks shows microbiota-modulating effects in healthy individuals, with several beneficial shifts of bacterial populations. This may be relevant as these bacteria have anti-inflammatory properties and strongly associate with gut health.

High-dose vitamin C supplementation accelerates the Achilles tendon healing in healthy rats

2008 ◽  
Vol 129 (2) ◽  
pp. 281-286 ◽  
Author(s):  
Suna Ömeroğlu ◽  
Tuncay Peker ◽  
Nurten Türközkan ◽  
Hakan Ömeroğlu
Keyword(s):  
Vitamin C ◽  
Achilles Tendon ◽  
Tendon Healing ◽  
High Dose ◽  
Vitamin C Supplementation ◽  
High Dose Vitamin

scholarly journals Long-term vitamin C supplementation has no markedly favourable effect on serum lipids in middle-aged Japanese subjects

2004 ◽  
Vol 91 (1) ◽  
pp. 81-90 ◽  
Author(s):  
Mi Kyung Kim ◽  
Satoshi Sasaki ◽  
Shizuka Sasazuki ◽  
Shunji Okubo ◽  
Masato Hayashi ◽  
...  
Keyword(s):  
Vitamin C ◽  
Dose Group ◽  
Low Dose ◽  
Favourable Effect ◽  
High Dose ◽  
Vitamin C Supplementation ◽  
The Mean ◽  
High Dose Vitamin ◽  
Β Carotene

Antioxidant vitamins have been reported to be associated with an improvement in blood lipid profiles, but results are not consistent. The present study was designed to determine whether long-term vitamin C supplementation could alter serum lipid concentrations in subjects who completed a 5-year population-based double-blind intervention trial. A total of 439 Japanese subjects with atrophic gastritis initially participated in the trial using vitamin C and β-carotene to prevent gastric cancer. Before and upon early termination of β-carotene supplementation, 134 subjects dropped out of the trial; finally, 161 subjects assigned to the high-dose group (500 mg vitamin C/d) and 144 subjects assigned to the low-dose group (50 mg vitamin C/d) were studied. No favourable effect of vitamin C supplementation on serum concentrations of total cholesterol, HDL- and LDL-cholesterol, and triacylglycerol was observed, although high-dose vitamin C supplementation increased serum vitamin C concentrations substantially. Among women, the mean change in serum triacylglycerol decreased (−0·12 mmol/l, 95 % CI −0·32, 0·09) in the high-dose group, but increased (+0·12 mmol/l, 95 % CI 0·03, 0·22) in the low-dose group. In addition, the mean change in serum triacylglycerol among women with hypertriacylglycerolaemia was statistically significant (−1·21, 95 % CI −2·38, −0·05) after high-dose vitamin C supplementation. The 5-year vitamin C supplementation had no markedly favourable effects on the serum lipid and lipoprotein profile. However, our present results do not preclude the possibility that vitamin C supplementation may decrease triacylglycerol concentrations among women with hypertriacylglycerolaemia.

scholarly journals Vitamin C therapy for patients with sepsis or septic shock: a protocol for a systematic review and a network meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033458 ◽  
Author(s):  
Tomoko Fujii ◽  
Alessandro Belletti ◽  
Anitra Carr ◽  
Toshi A Furukawa ◽  
Nora Luethi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Septic Shock ◽  
Vitamin C ◽  
Meta Analysis ◽  
Scientific Journal ◽  
Favourable Effect ◽  
Vitamin B ◽  
High Dose ◽  
Reference Selection ◽  
High Dose Vitamin

IntroductionVasoplegia is common and associated with a poor prognosis in patients with sepsis and septic shock. Vitamin C therapy in combination with vitamin B1 and glucocorticoid, as well as monotherapy in various doses, has been investigated as a treatment for the vasoplegic state in sepsis, through targeting the inflammatory cascade. However, the combination effect and the relative contribution of each drug have not been well evaluated. Furthermore, the best combination between the three agents is currently unknown. We are planning a systematic review (SR) with network meta-analysis (NMA) to compare the different treatments and identify the combination with the most favourable effect on survival.Methods and analysisWe will include all randomised controlled trials comparing any intervention using intravenous vitamin C, vitamin B1 and/or glucocorticoid with another or with placebo in the treatment of sepsis. We are interested in comparing the following active interventions. Very high-dose vitamin C (≥12 g/day), high-dose vitamin C (≥6 g/day), vitamin C (<6 g/day); low-dose glucocorticoid (<400 mg/day of hydrocortisone (or equivalent)), vitamin B1 and combinations of the drugs above. The primary outcome will be all-cause mortality at the longest follow-up within 1 year but 90 days or longer postrandomisation. All relevant studies will be sought through database searches and trial registries. All reference selection and data extraction will be conducted by two independent reviewers. We will conduct a random-effects NMA to synthesise all evidence for each outcome and obtain a comprehensive ranking of all treatments. We will use the surface under the cumulative ranking curve and the mean ranks to rank the various interventions. To differentiate between the effect of combination therapies and the effect of a component, we will employ a component NMA.Ethics and disseminationThis SR does not require ethical approval. We will publish findings from this systematic review in a peer-reviewed scientific journal and present these at scientific conferences.PROSPERO registration numberCRD42018103860.

High-dose vitamin C supplements diminish the benefits of exercise in athletic training and disease prevention

2014 ◽  
Vol 44 (2) ◽  
pp. 95-101 ◽  
Author(s):  
Robert Benjamin Adams ◽  
Karen Nkechiyere Egbo ◽  
Barbara Demmig-Adams
Keyword(s):  
Chronic Disease ◽  
Physical Exercise ◽  
Vitamin C ◽  
Athletic Training ◽  
Antioxidant Vitamin ◽  
High Dose ◽  
Human Metabolism ◽  
Content Type ◽  
High Dose Vitamin

Purpose – The purpose of this review is to summarize new research indicating that high-dose supplements of the antioxidant vitamin C can interfere with the benefits of physical exercise for athletic performance and the risk for chronic disease. Design/methodology/approach – This article reviews current original literature on the regulation of human metabolism by oxidants and antioxidants and evaluates the role of exercise and high-dose vitamin C in this context. The presentation in this article aims to be informative and accessible to both experts and non-experts. Findings – The evidence reviewed here indicates that single, high-dose supplements of the antioxidant vitamin C abolish the beneficial effects of athletic training on muscle recovery and strength as well as abolishing the benefits of exercise in lowering the risk for chronic disease. In contrast, an antioxidant-rich diet based on regular foods apparently enhances the benefits of exercise. These findings are consistent with an updated understanding of the critical importance of both oxidants and antioxidants in the regulation of human metabolism. While more research is needed to address the role of timing and level of antioxidant consumption, it is clear that a balance between oxidants and antioxidants is essential. Practical implications – The information presented in this review is important for both athletes and the public at large in their efforts to choose nutrition and exercise regimes appropriate to maximize the outcome of their training efforts and lower their risk for chronic disease. Originality/value – This article provides accessible and comprehensive information to researchers, nutritionists, and consumers interested in optimal nutrition during athletic training and for obtaining the full benefit of physical exercise in lowering the risk for chronic disease.

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