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Romans 12:2

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Hilary's Desk

Professor Hemila shocks Sciblogs into silence.

Hilary Butler - Wednesday, September 08, 2010

 Professor Hemila quite rightly asks sciblogs why they blethered on about mice and cancer instead of actually DOING a literature review on vitamin C and Pneumonia....  Did Sciblogs...  actually put their brains into gear?  Professor Hemila's Finnish website is the BEST place on internet to find early and more recent published medical information on Vitamin C.  I'd like to think that Sciblogs might learn something from this airhead episode, but seriously, ...  I very much doubt it.  Here is Professor Hemila's post, for anyone interested:

Sins of omission in 60 Minutes ‘miracle’ story Peter Griffin Aug 20

1.    Harri Hemila 1 day ago

Serious omissions in the “Sins of omission”

Peter Griffin asked “what does the peer-reviewed literature say about this sort of [vitamin C] treatment for pneumonia-like symptoms?”

Proponents of evidence-based medicine (EBM) emphasize that conclusions about medical interventions should be based on controlled trials with clinically relevant outcomes. Why then did Griffin discuss mouse models of cancer, instead of controlled trials on pneumonia?

The most important EBM data base is the Cochrane Library. Had Griffin searched the Cochrane Library, he would have identified our systematic review on vitamin C and pneumonia. We found three prophylactic trials in which vitamin C prevented pneumonia and two trials in which vitamin C treatment was beneficial for pneumonia patients [1].

One of the two therapeutic trials was a randomized, double-blind, placebo-controlled trial with elderly patients with pneumonia or chronic bronchitis in the UK. In this trial, there were 5 deaths in the placebo group, but only 1 death in the vitamin C group. The abstract of the trial is available at MEDLINE [2] and I scanned the whole paper so that it is freely available at my home pages [3]. This and the the four other trials are discussed in our systematic review [1].

Thus, the peer-reviewed literature says that there is justification to test the effect of vitamin C on pneumonia patients. Although there is no basis to state that vitamin C has been proven to be effective against pneumonia, testing of vitamin C is justified because of its safety and low price, and the findings of the published controlled trials.

Griffin is concerned about the safety of intravenous vitamin C. Numerous urban legends about the potential harm of vitamin C have been circulating, but they have been shown to be unfounded [4]. For example, a recent pharmacokinetic study administered up to 100 g of vitamin C within a few hours without adverse effects, pointing out the safety of high doses for ordinary people [5].

I do not think there is evidence that an ordinary healthy person would benefit from taking more than some 0.2 grams per day of vitamin C. However, the situation for people who have infections can be quite different. The level of vitamin C in plasma decreases during various viral and bacterial infections, which gives a rationale for testing the therapeutic effects of vitamin C for patients with infections [6]. Controlled trials have found benefit of vitamin C against pneumonia [1] and the common cold [7]. It is clear that the effects of vitamin C are not restricted to preventing scurvy, although the significance of the non-scurvy effects is unsettled.

Prejudice against vitamin C is common and not limited to the urban legends about toxicity. I have shown that the most influential reviews on vitamin C and the common cold are severely biased so that there are errors in the extraction of data from the original study reports, errors in calculations, and inconsistent selection of trials for inclusion; see a summary and links to further documents at my home page [8].

I consider that Peter Griffin is irresponsible. He pretends to be familiar with the “peer-reviewed literature” on vitamin C and pneumonia-like symptoms. However, either he did not search the medical literature at all, or if he did, he intentionally omitted the controlled trials on vitamin C and pneumonia from his discussion.

Links:
[1] Vitamin C for preventing and treating pneumonia (Cochrane Review) http://www2.cochrane.org/reviews/en/ab005532.html
[2] The abstract of Hunt et al. (1994) http://www.ncbi.nlm.nih.gov/pubmed/7814237
[3] Hunt et al. (1994) http://www.ltdk.helsinki.fi/users/hemila/CP/Hunt_1994_ch.pdf
[4] Safety of Vitamin C: Urban Legends http://www.ltdk.helsinki.fi/users/hemila/safety/
[5] Padayatty et al (2004) http://www.annals.org/content/140/7/533
[6] Vitamin C metabolism during infections http://www.ltdk.helsinki.fi/users/hemila/metabolism/
[7] Vitamin C for preventing and treating the common cold (Cochrane Review) http://www2.cochrane.org/reviews/en/ab000980.html
[8] Meta-analyses on vitamin C and the common cold http://www.ltdk.helsinki.fi/users/hemila/reviews/

 

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