Sunday, October 1, 2017

Treating sepsis with vitamin C


Treating sepsis with vitamin C
Could vitamin C help treat sepsis? Some medical experts in Norfolk, Virginia, think so.
A recent study from Eastern Virginia Medical School saw surprising success with a treatment plan combining vitamin C with steroids. The outcomes were so stunning that the National Institutes of Health (NIH) gave the researcher $3.2 million to dig in a little deeper.
Sepsis, a condition caused by infection, is responsible for 258,000 deaths each year. Seniors and babies are at greatest risk. Symptoms range from shivering and fever to breathlessness and confusion. If untreated, it could lead to septic shock or death.
Ordinarily, sepsis is treated with IV fluids, antibiotics, vasopressors or steroids. The Eastern Virginia study found that the effectiveness of steroids improved when combined with high doses of intravenous vitamin C. It’s a revelation that shot ripples of hope through medical communities worldwide.
“This study is very new,” says Dr. Joseph Bellezzo, chair of emergency medicine at Sharp Memorial Hospital, noting that the doctor behind the study is well-regarded in medical circles and that new clinical trials may begin as a result of his work.
Given in very high doses, vitamin C can have negative effects — some as extreme as renal failure. But according to Bellezzo, “Vitamin C in doses suggested by the study has no negative impact at all. And unlike previous treatment trends, the cost is close to nothing.” So the question now is: What’s the harm in trying?
“Sepsis patients are very vitamin-depleted,” says Dr. Bellezzo. “Knowing this, and knowing that vitamin C does no harm, and weighing the success of the study, it seems like something we should be actively looking at.”
As an ER physician, Dr. Bellezo can’t administer vitamin C unless his ICU counterparts continue the treatment post-ER. So he plans to work with them on establishing a protocol. “I want to test it out and measure outcomes,” he says. “It can only help the patient, not harm them.”
But Ashkan Khabazian, PharmD, a pharmacist at Sharp Memorial Hospital, is reluctant to call it a cure. He’s seen trends like this one rise (and fall) before, and sees a need for more thorough, in-depth research. “I’m not saying we should rule it out,” says Khabazian, “because vitamin C has benefits. But one single-center study isn’t enough to completely change our practice.”
When taken orally, vitamin C doesn’t have much effect on the body; but administered intravenously, it can. By protecting the lining of your blood vessels and assisting chemicals that force your blood vessels to “squeeze,” vitamin C can play a role in improving blood flow to the vital organs — a key element in the treatment of sepsis. Its role in clinical bedside medicine has been under-examined, and it hasn’t been a major player since treating scurvy back in the day.
Although some hospitals are trying the protocol, Khabazian would like to see larger, randomized, controlled multi-center trials confirm the benefit found in the initial study before making vitamin C a regular part of sepsis treatment at Sharp.
We may have a ways to go before vitamin C shows its true value. But if proven successful, it will be worth the wait. A treatment that’s low-risk, low-cost and effective? Seems too good to be true. And it just may be. But like any new medical breakthrough, we need to start somewhere.