Systemic Antioxidant Use in the Treatment of a Severe Covid-19 Patient

Summary:

  1. We describe a case of severe Covid-19 (a man of advanced age and multiple comorbidities including diabetes mellitus, hypertension, obesity and active chronic hepatitis B) who improved quickly upon receiving the “systematic antioxidant” intervention” approach and was discharged from hospital 4 days after the implementation of the approach.
  2. Severe/critical cases of Covid-19 cases are characterized biochemically and pathologically by cytokine storm with rapidly rising oxidative stress, leading to severe oxidative damage of biologically important macromolecules, cells, and eventually multiple organ failure and death.
  3. Early, sufficient doses and systematic antioxidants administration, to block or reduce oxidative stress, cytokine storm, may be able to prevent or reduce the oxidative damages of biologically important macromolecules (especially poly-unsaturated fatty acids in bio-membranes, PUFA, lipid peroxide chain reaction) and multi-organ failure, death.
  4. The optimal efficiency of our body’s antioxidant systems requires all components to be present and in sufficient amounts. Inadequate or absent of one component antioxidant may render the entire antioxidant system less efficient or dysfunctional entirely.
  5. Due to the high safety and low-cost profile of antioxidant vitamins, nutrients, and the potential clinical utility of this approach, as demonstrated in the case presented here, further clinical research is clearly warranted as this may help many other patients, not only in severe Covid-19, but also other cytokine storm/oxidative stress cases caused by viral or other agents.

Case description: I recently consulted on a Manila (Philippines) Covid-19 patient: Robert, male, 60 years old, he is 176 cm in height (5’9), 90 kg, with type 2 diabetes, hypertension, and with a history of chronic hepatitis B. He developed cough, low fever, and pneumonia on chest X ray. He was admitted to the hospital on 9/1/21 and was given standard therapy. But his clinical conditions didn’t improve and instead worsened with rapidly increasing inflammatory/cytokine storm markers (ferritin rose from 997 on 9/1 to 2202 on 9/6; D Dimer rose from 0.27 on 9/1 to 0.99 on 9/6. His CRP was also very high at 33.97).

 

The family requested high dose Vit C (HDIVC), but the attending physician was hesitant due to very high levels of ferritin and also the hospital has a policy on Vit C use of up to 3,000 mg per day.

During a video consultation upon request, I pointed out that the poor health status with the comorbidities (diabetes mellitus, hypertension, obesity and active hepatitis B) and the rapidly rising levels of cytokine storm markers, make Robert at very high risk of imminent multi-organ failure and high mortality. The rapidly rising levels of cytokine storm markers suggest that Robert is on the brink of developing cytokine storm, if he is not already in one1–5. The family and the attending are concerned about the high ferritin and the possible side effects of HDIVC. I pointed out Robert’s high ferritin levels are more of an “acute inflammatory” response in nature and a marker for cytokine storm, rather than an indicator of true high iron storage. The priority is to quickly block/control the cytokine storm, to reduce oxidative pressure, to prevent/minimize oxidative damages to the cells, tissues and organs, to prevent multi-organ failure.

I recommend immediate large doses of systematic antioxidant intervention:

  1. Vit C vein 30 g/24 hours;
  2. Vit E, 400iu/day 3;
  3. Vit D3 (his D3 is only 28), 50,000iu, one-time, immediately.
  4. Magnesium 1000mg/day;
  5. Zinc 100mg/day x 7-10 days, then reducing to 30-50 mg/day;
  6. Glutathione (glutathione), 1-2 g/day, intravenous or Lipo, oral
  7. 3% hydrogen peroxide atomized inhalation, 15-30 minutes, 3-4 times/day (this however, wasn’t implemented due to hospital restriction);
  8. Other (e.g. CoQ10, alpha lipoic acid, melatonin).

However, due to the policy restriction and other factors, my suggestions weren’t implemented immediately.  A few days later, the patient’s condition deteriorated further. Upon the 2nd video consult, I was really worried of an imminent multi-organ failure and was literally begging the attending physician to implement my suggestions. I pointed out loudly the high safety profile of the agents that I recommended with literature references. We, the attending physician, the caring staff, the family and myself worked as a team to figure out a way to implement my suggestions.  The hospital limits the maximum amount of intravenous VCs to 3 g/24 hours, so I recommend to give HDIVC at 3 grams/24 hours, and then add liposomal VC (luckily, they were able to find Lipo-VC of LivOn Labs in Manila), 6 grams by mouth as a loading dose and followed by 2-3 grams every 6 hours by mouth. Hydrogen peroxide nebulization, however, was prohibited by the hospital and wasn’t implemented. The rest of my suggestions including Lipo-Glutathione, zinc, high dose Vit D3 were all administered as recommended.

The next day, the patient was beginning to improve, Mike (one of the patient’s brothers) told me. On the third day (September 13th), his clinical conditions as well as his chest R ray showed significant improvement and the oxygen mask was removed. Discharge was planned. On the fourth day after the antioxidants administration (September 14th), the patient was discharged from the hospital to home.


 

 

 

 

 

 

Robert’s Chest X ray on 9/13/21 improved significantly compared with CXR on 9/10/21.

I recommended the continued the systematic antioxidants administration for a few more weeks until clinical and laboratory markers all return to normal and then be placed on a maintenance plan for his chronic disease management. The family scheduled another consultation with me is later for the management of Robert’s ongoing recovery as well as the management of his underlying chronic diseases (diabetes, hypertension and obesity).

On 14 September, the patient was discharged from the hospital and returned home for treatment.

Brief discussion:

Soon after the outbreak of Covid-19, in my paper (3/1/20)4 and in my NIH presentation (4/8/20) 5,6, I (as well as others) pointed out that Cytokine storm/oxidative stress is a key pathological and biochemical feature of severe/critical Covid-19 and other acute respiratory distress syndrome and early and high dose Vit C intravenously should be implemented4. Cytokine storm/oxidative stress is also a common feature of severe cases of influenza7, viral hepatitis8–10, viral encephalitis11, AIDS/HIV12, Ebola13, etc. Oxidative damage of important bio-molecules caused by cytokines storm/oxidative stress is largely responsible for various clinical symptoms of Covid-19.

https://www.researchgate.net/publication/326637077_Redox_Biology_of_Respiratory_Viral_Infections/figures?lo=1

Cytokine storm/oxidative stress results in the rapid and significant oxidative damages of bio-important molecules, especially unsaturated fatty acids on cell membranes, in a process called lipid peroxidation chain reaction14–16. This lipid peroxide chain reaction oxidizes PUFA molecules on lipid membranes much more readily and rapidly. The dietary intake of omega-6 PUFA has increased several fold during the last several decades17,18, setting the stage for explosive lipid peroxidation among those with a high PUFA diet. This may be partially the reason of the high morbidity and mortality seen in patients with basic chronic diseases such as diabetes and other metabolic diseases since these patients tend to have a high omega-6 PUFA intake19,20.

There are several different types of oxidants (free radicals) and there are different antioxidant systems that neutralize or scavenge these oxidants21,22. These antioxidants systems require each and every member of a system to be present to be effective.  For example, vitamin E is required for the termination of lipid peroxidation chain reaction. In the absence of vitamin E, vitamin C’s is ineffective in termination of lipid peroxidation23.

 

http://www.robertbarrington.net

In conclusion, early and sufficient doses of some basic antioxidants  (such as vitamins E, C, CoQ10, glutathione, magnesium, selenium, NAD and NAD precursors) should be systematically implemented in order to prevent or to terminate cytokine storm which may lead to multi-organ failure and ultimately death. In addition to these antioxidants, other agents with natural antiviral or immune boosting effects should also be implemented including, but not limited to vitamin D3, zinc, and hydrogen peroxide nebulization24.

I introduced this concept in my presentation at the 50th Annual Conference of ISOM10.

References:

  1. Melo, A. K. G. et al. Biomarkers of cytokine storm as red flags for severe and fatal COVID-19 cases: A living systematic review and meta-analysis. PLoS One 16, e0253894 (2021).
  2. Huang, I., Pranata, R., Lim, M. A., Oehadian, A. & Alisjahbana, B. C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis. Ther Adv Respir Dis 14, 1753466620937175 (2020).
  3. Hu, B., Huang, S. & Yin, L. The cytokine storm and COVID-19. J Med Virol 93, 250–256 (2021).
  4. Cheng, Richard Z. Can early and high intravenous dose of vitamin C prevent and treat coronavirus disease 2019 (COVID-19)? Medicine in Drug Discovery 5, 100028 (2020).
  5. Cheng, Richard. NIH Guest Speech: HDIVC on Covid-19. http://www.drwlc.com/Covid-19_talks.shtml.
  6. Cheng, R. Vitamin C in the Prevention and Treatment of Covid-19. (2020).
  7. Oldstone, M. B. A. & Rosen, H. Cytokine storm plays a direct role in the morbidity and mortality from influenza virus infection and is chemically treatable with a single sphingosine-1-phosphate agonist molecule. Curr Top Microbiol Immunol 378, 129–147 (2014).
  8. Mbachu, J., Bul, V. & Koppe, S. W. P. The Perfect (Cytokine) Storm: Autoimmune Hepatitis as a Catalyst for Macrophage Activation Syndrome: 1950. Official journal of the American College of Gastroenterology | ACG 111, S930 (2016).
  9. Xie, J. et al. Cytokine storms are primarily responsible for the rapid death of ducklings infected with duck hepatitis A virus type 1. Sci Rep 8, 6596 (2018).
  10. Richard Cheng MD PhD. Oxidative Stress, Ignored Key Pathology of Covid-19. (2021).
  11. Savarin, C. & Bergmann, C. C. Fine Tuning the Cytokine Storm by IFN and IL-10 Following Neurotropic Coronavirus Encephalomyelitis. Front Immunol 9, 3022 (2018).
  12. Muema, D. M. et al. Association between the cytokine storm, immune cell dynamics, and viral replicative capacity in hyperacute HIV infection. BMC Med 18, 81 (2020).
  13. Younan, P. et al. Ebola Virus Binding to Tim-1 on T Lymphocytes Induces a Cytokine Storm. mBio 8, e00845-17 (2017).
  14. Ayala, A., Muñoz, M. F. & Argüelles, S. Lipid peroxidation: production, metabolism, and signaling mechanisms of malondialdehyde and 4-hydroxy-2-nonenal. Oxid Med Cell Longev 2014, 360438 (2014).
  15. Mylonas, C. & Kouretas, D. Lipid peroxidation and tissue damage. In Vivo 13, 295–309 (1999).
  16. Ebrahimi, M., Norouzi, P., Aazami, H. & Moosavi-Movahedi, A. A. Review on oxidative stress relation on COVID-19: Biomolecular and bioanalytical approach. Int J Biol Macromol 189, 802–818 (2021).
  17. Shaikh, S. R. & Edidin, M. Polyunsaturated fatty acids and membrane organization: The balance between immunotherapy and susceptibility to infection. Chem Phys Lipids 153, 24–33 (2008).
  18. Guyenet, S. J. & Carlson, S. E. Increase in adipose tissue linoleic acid of US adults in the last half century. Adv Nutr 6, 660–664 (2015).
  19. Muhlhausler, B. S. & Ailhaud, G. P. Omega-6 polyunsaturated fatty acids and the early origins of obesity. Current Opinion in Endocrinology, Diabetes and Obesity 20, 56–61 (2013).
  20. Knobbe, C. Diseases of Civilization: Are Seed Oil Excesses the Unifying Mechanism?’. (2020).
  21. Phaniendra, A., Jestadi, D. B. & Periyasamy, L. Free Radicals: Properties, Sources, Targets, and Their Implication in Various Diseases. Indian J Clin Biochem 30, 11–26 (2015).
  22. Davis, U. 8.1: Introduction to Free Radicals and Antioxidants – Medicine LibreTexts. https://med.libretexts.org/Courses/Metropolitan_State_University_of_Denver/Introduction_to_Nutrition_(Diker)/08%3A_Nutrients_Important_as_Antioxidants/8.01%3A_Generation_of_Free_Radicals_in_the_Body.
  23. Sato, K., Niki, E. & Shimasaki, H. Free radical-mediated chain oxidation of low density lipoprotein and its synergistic inhibition by vitamin E and vitamin C. Arch Biochem Biophys 279, 402–405 (1990).
  24. Rapid Virus Recovery: Levy, Thomas E: 9780998312415: Amazon.com: Books. https://www.amazon.com/Rapid-Virus-Recovery-Thomas-Levy/dp/099831241X/ref=sr_1_2?crid=16DCZ0TP1XKB7&dchild=1&keywords=thomas+levy+books&qid=1632088062&sprefix=thomas+levy%2Caps%2C173&sr=8-2.

 

 

 

 

 

 

 

 

 

 

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The office will be closed on Monday, 07/04/2021, in observance of the July 4th holiday. Thank you and have a happy & safe long weekend.

The office will be closed on Monday, 07/04/2021, in observance of the July 4th holiday.
Thank you and have a happy & safe long weekend.
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You Can Protect Yourself from Covid-19 with a Better Health and Better Immune System

The best defense against diseases is our good health and our immune system. Our human body has a built in defense system. We the human race survived and thrived over the past hundreds of thousands of years if not millions of years before any antibiotic or vaccine was invented. The rapidly changing environment, particularly the pollution in our food, water, air and our personal health products and our unhealthy lifestyle have weakened our health and our immunity. 

I was recently interviewed on CCTV-English (CGTN) and with Dr. Ron Ehrlich, president of the AustralAsia College of Nutrition and Environmental Medicine (ACNEM) on China Covid-19 vaccine project and how to protect yourself from getting Covid-19 (Protected Population Immunity). 

In my interview with China Global TV Network (America.CGTN.com) Anchor Roee Rottenburg in Jun. 20th, 2021, I made it clear that vaccines are not the sole and complete solution to the pandemic problem. We need to take a multi-pronged approach to enhance our innate disease fighting mechanism and to promote consumer’s health and immune system via healthy lifestyle, diet and nutrition (what we call Protected Population Immunity at the International Society for Orthomolecular Medicine, ISOM).  I held this view over a year ago in my first CGTN interview and today, at  my 9th interview on CGTN, I am still holding this view. 

One billion doses of vaccines have been inoculated in China.  China’s massive and expensive vaccine project is truly amazing, especially in the eyes of westerners. With China’s unique social system, when China’s leader decides on a goal, he usually can muster all the resources and power that one needs to get the job done. I have to also add that the Chinese citizens, at least the ones I know of, seem to be quite compliant. While the volition and dedication of this gigantic project are applaudable, some burning questions beg some answers. 

There are media reports that some of Chinese vaccines have an efficacy of around 70%. A key question is when China reaches its goal of 70% or more vaccination rates of its population, will its leader be comfortable to reopen its borders and to relax its lockdown policy? I doubt it. News reports say that Chinese top experts are raising its “herd immunity” goal of vaccination from 70% by year end to 85%, a sign of inconfidence of its own vaccine project. Where did they get the magic 85% number? What if 85% is not “comforting” enough, will they raise it to 100%? What else to do once 100% is reached and the pandemic is not tamed? 

Putting all hopes on vaccines is like putting all eggs in one basket, let alone the problems of vaccines themselves. A vaccine only policy is an incomplete and shortsighted plan. It ignores and betrays the historical teachings of both traditional Chinese medicine (TCM) and that of western medicine. Both of these schools of medicine preach lifestyle, diet and nutrition.

Let thy food be thy medicine and thy medicine be thy food.

Top advisors (and leaders) are paid to think and plan in advance, to consider all possibilities and countermeasures, not to come up with this type of “knee-jerk reactions”.

In my interview with Dr. Erhlich, I went even further. What happened and is happening in America since the pandemic broke is disappointing. Our top medical and public health authorities have been failing us Americans. Dr. Fauci, America’s top medical advisor on Covid-19 management, was caught more than once lying to the public and lying to the US lawmakers. He even went on to say publicly “attacks on me, quite frankly, are attacks on science” . He thinks he represents Science! More and more are being revealed that he’s been corroborating with foreign forces (even anti-American forces). Public health is America’s national security issue. How can we trust our national security with such an arrogant narcissistic Liar!? Dr. Fauci should resign immediately.

In this fight against the pandemic, we not only need to apply (safe and effective) vaccines (unfortunately, none of the available vaccines meet the stringent standards of safety and effectiveness), drugs, we need to focus more on strengthening our immune system and improving our health. In addition to a healthy lifestyle, many vitamins and nutrients are designed by God or mother nature to enhance our health and disease fighting abilities. These include vitamins, nutrients and minerals (e.g., vitamins C, D), zinc and antioxidants. These natural agents have been protecting mankind (as well as the animal kingdom) ever since there is life on this planet earth. 

All and any of those who claim vitamins and nutrients are dangerous are simply ignorant. mortality due to Medical errors is the 3rd largest cause of death in the US, killing more than quarter a million people annually. Whereas CDC has never reported any case of death due to vitamin or nutrient overdose (7).  Should we worry more about the danger of vitamins and nutrients, or from the deaths from medical errors and drugs?

Trust your health to no one, but yourself.

References and Resources:

  1. CGTN interview: https://youtu.be/O9mjB7zMQEs
  2. ACNEM interview: https://www.youtube.com/watch?v=crA8sWgFKzs
  3. https://isom.ca/
  4. http://orthomolecular.org/resources/omns/index.shtml
  5. Yanagisawa A (2020) Protecting Population Immunity. J Orthomol Med. 35(1)
  6. Cheng, R. Z.  Protected Population Immunity, not a Vaccine, is the Way to Stop Covid-19 Pandemic. J. Clin Immunol & Immunotherapy May 20, 2020
  7. Anderson et al.  Stud Health Technol Inform.  2017;234:13-17. PMID:28186008.
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Office will be closed on Friday, 06/18/2021 and will Reopen on Monday ~

Our office will be closed on Friday, 06/18/2021. We will open on Monday 06/21/2021.

 

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High Dose Vit D for Autoimmune Diseases

Caution: This article is for scientific exchange only. Clinical application should be under a qualified physician’s supervision. Hypercalcemia may be a major concern raised against this protocol. However, as discussed in more detail below, the vitamin D resistance appears to confer an intrinsic protection against hypercalcemia. In addition, the therapy requires the patient to take some precautionary measures. Besides the avoidance of milk products and a minimum fluid intake of 2.5 l/day, patients will need to consistently monitor multiple blood parameters and undergo regular sonographic checks of their kidneys. Practically, this requires close and regular contact with a certified Coimbra practitioner.

In preparing for an international conference on Vit D and Integrative Orthomolecular Medicine, chaired by Prof. Dr. Jorg Spitz (of Germany), of which I am honored to assist him in organizing and also providing a keynote lecture, he shared with me their recent publication: Vitamin D Resistance as a Possible Cause of Autoimmune Diseases: A Hypothesis Confirmed by a Therapeutic High-Dose Vitamin D Protocol (Lemke et al 2021 PMID: 33897704). 

This international conference is scheduled for Nov. 2021, available to the public online with a very low cost. I’ll provide updates in the future on this conference. Multi-language simulcast translation to include German, Chinese (and possibly Spanish, French, and Japanese) are being considered. Stay tuned.

I summarize here the key points of their paper on high dose Vit D on autoimmune diseases.

Highlights:

  • Vitamin D3 is metabolized in various tissues to the biologically most active vitamin D hormone 1,25(OH)2D3 (calcitriol). Vit D3 is metabolized in the liver to vitamin D hormone, 1,25(OH)2D3, which has multiple effects, particularly within the immune system. 
  • Acquired and hereditary vitamin D resistance exists, including blockade of vitamin D receptors. This paper focuses on acquired Vit D resistance.
  • Elevated PTH is a hallmark of Vit D resistance. One key role of 1,25(OH)2D3 is to enhance intestinal calcium absorption. If ionized calcium concentrations in blood are low, the parathyroid glands release PTH which stimulates calcium release from bones. Furthermore, PTH increases the conversion of 25(OH)D3 into 1,25(OH)2D3 in the kidneys with subsequent release into circulation. PTH also inhibits the tubular reabsorption of phosphate which in turn lowers the amount of water-insoluble calcium-phosphate salts and thus increases ionized calcium concentrations. In this way, PTH constitutes a direct feedback mechanism within the vitamin D system. A physiological 25(OH)D3 level should thereby be able to suppress PTH into the lower third of the reference range. In other words: If 25(OH)D3 levels are high, PTH should be low and vice versa. In patients with autoimmune diseases this negative feedback loop is disturbed. Based on these observations, Prof. Coimbra proposed the hypothesis of vitamin D resistance.
  • Coimbra protocol: daily doses up to 1,000 IU/kg body weight daily of vitamin D3. (This can go even as high as 300,000 IU daily for 3 months, if PTH is not low enough, Dr. Spitz told me and also per Coimbra Protocol). For approximately 15 years, patients with autoimmune diseases, particularly MS (multiple sclerosis), have been successfully treated using Coimbra’s high-dose vitamin D protocol.
  • Doses for various autoimmune diseases are listed in Table 1.   
  • Using parathyroid hormone (PTH) serum levels as an indicator for the right dose. PTH target: lower third of the normal range.
  • Not only in autoimmune diseases, high dose Vit D therapy is also suggested in cancer management due possible Vit D resistance in various cancers.
  • The German Coimbra Protocol network physicians have been collecting Effectiveness and safety data and will be published in the future. 
  • Many patients with various diseases seem to have significantly improved with this protocol (https://www.coimbraprotocol.com/testimonials-1).
  • The authors summarized: we have reviewed evidence for the hypothesis of an acquired form of vitamin D resistance, developing on the basis of a genetic susceptibility from certain SNPs within the vitamin D system and its interplay with chronic stress and/or pathogen infections that are able to partially block the VDR. Other factors that have been associated with autoimmune diseases such as low sun exposure, aging or environmental toxins could easily be integrated into this hypothesis since they would further exacerbate developing vitamin D resistance arising from the described mechanisms (Figure 2 of original paper). The hypothesis of acquired vitamin D resistance thus provides a plausible pathomechanism for the development of autoimmune diseases. We consider its therapeutic exploitation by high-dose vitamin D administration as a promising approach. Our key messages reflecting the knowledge about vitamin D resistance and its treatment are summarized in Table 2.
  • Table 1. Doses of Vit D Used in Various Autoimmune Diseases:

Vitamin D3 (cholecalciferol) is a secosteroid and prohormone which is metabolized in various tissues to the biologically most active vitamin D hormone 1,25(OH)2D3 (calcitriol)

 

Table 2. Key points discussed in their paper.

Vitamin D3 (cholecalciferol) is a secosteroid and prohormone which is metabolized in various tissues to the biologically most active vitamin D hormone 1,25(OH)2D3 (calcitriol)

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Reversal of Coronary Artery Heart Disease with Dietary and Nutrition Therapy, A Case Report

Summary: a 62 years old man with coronary artery heart disease with CT confirmed coronary artery stenosis. After 8 months intervention on low carbohydrate/ketogenic diet, intermittent fasting, and nutritional supplementation (vitamins C, D3, K2, magnesium, nutrients for liver detox, other vitamins and antioxidants, as well as mitochondrial nutrients), his coronary stenosis significantly improved or disappeared.

Mr. H is a 62 years old man from Chengdu, China. He came to my service in the summer of 2020. He had a history of coronary artery disease with angina pectoris requiring nitrites from time to time. He had a CT angiogram in August 2020 which showed mild stenosis in the near end of LAD and moderate stenosis of the mid portion of LAD at 50-69% (see below).

I advised him to start a low carbohydrate ketogenic diet (energy ratio: ~80%fat, 10-12% protein and 8-10% carbohydrate). I also specifically advised him to avoid high omega-6 polyunsaturated fats (most of the vegetable oils) and instead using animal fat (lard, butter etc) that are rich in healthy saturated fats, supplemented with omega-3 fats. I also advised him to cautiously and gradually (to his comfort level) take moderate exercise to the degree of sweating 2-3 times a week. Sweating is a great way for our body to get rid of some of the fat soluble toxins that we have been accumulating in our body. Also intermittent fasting (he eats 2 meals a day within ~8 hours with ~16 hours without calorie intake) was also advised.

In addition to these lifestyle changes, high dose vitamin C, nutrients to help liver detox and TotoCell Nutrients (containing sufficient doses of vitamins, antioxidants and mitochondrial nutrients as well as lysine and proline). I also specifically told him to avoid any calcium supplements.

Extensive research of Drs. Thomas Levy and Ron Hunninghake1–5 as well as that of Drs. Joe Mercola6, Chris Knobbe7 and Paul Saladino8, and others were quite impressive, convincing and led me to the above recommendation. Dr. Levy and I also co-authored a paper describing the mechanisms of atherosclerosis and our integrative orthomolecular approach to the management of atherosclerosis.9

Mr. H has been sticking to the regimen quite strictly. In the first few weeks, he experienced some adjustment issues which I told him was expected and not to worry. Gradually he felt better and his overall health improved. He never had an angina attack and he was even able to swim in the ocean.

Recently he had another CT coronary angiogram at the same hospital which showed the near portion of the LAD showed no evidence of stenosis (it was 25-49% stenosis 8 months before) and mid portion of the LAD showed a significant reduction from 50-69% down to 1-24% (image below).

Mr. H and his radiologist couldn’t believe the report. Mr. H was obviously quite exhilarated with his better-than-expected results. I explained to him that reversal of coronary atherosclerosis (and other chronic diseases) is difficult but not impossible. Dr. Willis reported as early as in 1954 that atherosclerosis can be reversed with vitamin C10. Dr. Linus Pauling reported in 1993 the reversal of coronary atherosclerosis cases11,12. Drs. Rath and Niedzwiecki also reported nutritional therapy appears to be able to slow down the progression of atherosclerosis (via coronary artery calcium score)13,14. Reversal of atherosclerosis has been even reported as early as in the 1950s.

It’s well studied and generally accepted in the literature that coronary atherosclerosis is an inflammatory disease, which I described in more detail elsewhere15.

References:

  1. Levy, T. E. & Gordon, G. Primal Panacea. (Medfox Publishing, 2011).
  2. Levy, T. E. Stop America’s #1 Killer: MD JD Levy, MD Julian Whitaker: 9780977952007: Amazon.com: Gateway. https://www.amazon.com/Stop-Americas-Killer-MD-Levy/dp/0977952002/ref=sr_1_1?crid=2GE3D8VO3QMJL&keywords=stop+america+s+%231+killer&qid=1562416934&s=gateway&sprefix=stop+america%2Caps%2C428&sr=8-1.
  3. Levy, M., JD Thomas E. & Hunninghake, M. R. Death By Calcium. (Medfox Publishing, 2013).
  4. Levy, T. & 成长. 隐形杀手补钙剂(中文版): 补钙无助于骨质疏松, 反而促进血管硬化, 心脏病(中文版). (Kindle Publisher, 2017).
  5. Levy, T. & 成长. 万应灵丹: 关于维生素C的百科全书. in (Kindle Publisher, 2017).
  6. Fat for Fuel: A Revolutionary Diet to Combat Cancer, Boost Brain Power, and Increase Your Energy: Mercola, Joseph Dr.: 9781401954246: Amazon.com: Books. https://www.amazon.com/Fat-Fuel-Revolutionary-Combat-Increase/dp/1401954243/ref=sr_1_1?dchild=1&hvadid=77790583945869&hvbmt=be&hvdev=c&hvqmt=e&keywords=fat+for+fuel&qid=1619541649&sr=8-1.
  7. Home – Cure AMD Foundation. https://www.cureamd.org/.
  8. Carnivore Code: Unlocking the Secrets to Optimal Health by Returning to Our Ancestral Diet: Saladino, Paul: 9780358469971: Amazon.com: Books. https://www.amazon.com/Carnivore-Code-Unlocking-Returning-Ancestral/dp/035846997X/ref=sr_1_3_sspa?dchild=1&keywords=carnivore+diet&qid=1619541702&sr=8-3-spons&psc=1&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUExTjVXVUQzT0xNSk1WJmVuY3J5cHRlZElkPUEwODUwMjk3MUY1Ulg4SktKTkRXQiZlbmNyeXB0ZWRBZElkPUEwMTI3NjY4MlRWUUZETlJIODMxSyZ3aWRnZXROYW1lPXNwX2F0ZiZhY3Rpb249Y2xpY2tSZWRpcmVjdCZkb05vdExvZ0NsaWNrPXRydWU=.
  9. 成长 & Levy, T. 冠状动脉粥样硬化病因病理及功能医学临床干预探讨–《肿瘤代谢与营养电子杂志》2019年03期.
  10. Willis, G. C., Light, A. W. & Gow, W. S. Serial arteriography in atherosclerosis. Can Med Assoc J 71, 562–568 (1954).
  11. Pauling, L. Case report: lysine/ascorbate-related amelioration of angina pectoris. J of Orthomol Med 6, 144–146 (1991).
  12. Pauling, L. Third case report on lysine-ascorbate amelioration of angina pectoris. Orthomolecular Medicine 8, 137–138 (1993).
  13. Rath, M. Reducing the risk for cardiovascular disease with nutritional supplements. J of Orthomol Med 7, 153-162) (1996).
  14. Rath, M. & Niedzwiecki, A. Nutritional supplement program halts progression of early coronary atherosclerosis documented by ultrafast computed tomography. Journal of Applied Nutrition 48, 68–78 (1996).
  15. Cheng, D. ATHEROSCLEROSIS. Dr. Richard Cheng, Cheng Integrative Health Center https://www.drwlc.com/blog/2019/05/03/atherosclerosis/.
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Is “Covid-19 Consumer Protection Act” Protecting the Consumers or Hurting Them?

 

Soaking in some badly needed sunshine to boost my Vit D level, an important immune-boosting measure, on my way to badminton games. 

Common sense and both western and Chinese medicine tell us that eating a healthy diet, exercise, and balanced nutrition is a major part of disease prevention measures, Covid-19 included.

The warm April southeastern US sunshine and breeze caressed my face when I drove to my badminton games, with the top down to absorb as much sunshine as possible, to boost vitamin D level to protect my health, to boost my immune system against viral infections, esp. SARS-Cov-2. I thought to myself.

In addition to Vit D, I have also been taking Vit C, zinc, quercetin, other vitamins, and antioxidants as part of my routine immune boosting and health maintenance measures. As a result, my health today is a lot better than 10 years ago.

I just received an invitation again as a guest on a TV network (CGTV, the English channel of China’s Central TV network) to talk about the integrative medical approach (traditional Chinese medicine) to Covid-19 (April 26th at 9:30 pm EST at CGTN.com/america/livenews). I have been a regular guest on their shows for over a year now. This is one of the few media outlets that I can share my views on medicine and health. I have been censored numerous times on other social media platforms for sharing my scientific research and patient management experience.

This (the integrative approach) is also part of the topics of my invited presentation at the 50th Annual Conference of the International Orthomolecular Medicine (https://isom.ca/event/50th-conference/): most people who catch the SARS-Cov-2 virus don’t develop diseases or at most have mild to moderate diseases. Only a very small percentage of those infected with SARS-Cov-2 develop clinically severe or critical diseases.

Why do some people develop serious diseases while most don’t? We all know that the elderly and people with chronic diseases tend to have higher mortality rates and more serious diseases of Covid-19. The bottom line is that it’s one’s health status that determines the outcome when one catches a pathogen. To prevent oneself from catching an infection, or to reduce the severity of an infection, one needs to boost his/her immunity. This is simply common sense. Do we really need to quote the abundantly available research data to support this conclusion?

While enjoying the ride and organizing my thoughts on my CGTV interview, I can’t shake off the disturbing email I just received. One of my friends sent me an email about the “Covid-19 Protection Act” and its first victim. It read:

And the first victim to suffer under this new law is a St. Louis chiropractor who was recommending Vitamin D and zinc supplements to his clients and is now charged as a criminal…

More lunacy from the federal government threatens doctors with $10,000 fines if they tell you the science about how vitamins and minerals can help with COVID. (https://healthimpactnews.com/2021/covid-natural-remedies-banned-as-doj-and-ftc-seek-to-silence-doctors-promoting-vitamin-d-c-zinc-etc/).

This morning, I also received a completed video from Dr. Susan Downs who interviewed me on my thoughts on censorship (https://vimeo.com/536631433). In this video, Susan and Kevin Sorbo interviewed many doctors (myself included), scientists, patients, and others on Big Media’s censorship. I remember the moment during the interview when I got a bit emotional because I simply couldn’t believe that this final “land of freedom”, my adopted country is rapidly looking more and more like the land where I escaped from 35 years ago.

Where else can I escape to?

Finished my badminton games, sweated, feeling relaxed, comfortable, and tired, I had a good night’s sleep. This morning, while I try to finish this short commentary, I read an email from one of my heroes, Dr. Joe Mercola whose article “Wake Up! COVID Is a Setup to Destroy Human Liberty” (https://articles.mercola.com/sites/articles/archive/2021/04/25/naomi-wolf-the-end-of-america.aspx) sent another chill down my spine. In Joe’s interview of Naomi Wolf, Wolf listed 10 steps towards tyranny and we are at Step 10.

We are rapidly approaching the “point of no return” towards tyranny.

So what’s going on in America?

Educating the public about living a healthy lifestyle with balanced and optimal nutritional support to boost our immune system to protect or prevent Covid-19 or other diseases becomes illegal and could be prosecuted?

Do we need RTC data to support Vit C, Vit D’s effect in Covid-19 protection and treatment, otherwise whoever promotes these will be prosecuted? Then what about a healthy lifestyle and exercise? If I educate and promote a healthy lifestyle, eat a healthy diet, and exercise to improve our health to prevent or reduce the severity of Covid-19, am I violating this “Covid-19 Consumer Protection Act”? I have not seen any clinical trials that are specifically designed for Covid-19. So without clinical trial data, we can’t tell our patients of these common-sense approaches? Otherwise, I may be prosecuted?

All of a sudden, I suddenly feel I don’t know how to practice medicine anymore, after 40+ years in medicine. Is this “Covid-19 Consumer Protection Act” really helping the consumers or hurting the consumers? 

My medical career, along with my Ph.D. in biochemistry and my deeply rooted traditional Chinese medicine philosophy has taught me that to prevent diseases, to achieve optimal health and longevity, one needs to take an integrated approach of what I call “3 New View of Health/Medicine”, Integrative, Natural and Balanced views.

This is also going to be a topic of my CGTN interview and my ISOM presentation.

The focus of ISOM presentation is on the true understanding of Covid-19: the key mechanism leading to severe Covid-19 in the small number of patients is the cytokine storm/exuberant oxidative stress, which I (and others) pointed out over a year ago (https://pubmed.ncbi.nlm.nih.gov/32328576/).

To prevent the cytokine storm/oxidative stress with early and sufficiently dosed antioxidants, esp. lipid membrane-associated antioxidants system(vitamins E, C, glutathione, lipoic acid, CoQ10, etc) will help to stabilize cell membranes and prevent lipid oxidation. There has been abundant basic research and clinical data to support this before the Covid-19 Pandemic. If this “antioxidant” approach was adopted as we (and others) proposed early in the pandemic, we may not be in the position we are in today.  In a little over a year, more research (more than 2500 papers in Pubmed.gov to be specific) appeared on this topic, providing direct research and clinical data on Covid-19. What more do we need?

Antioxidants for prevention and treatment are Safe, Inexpensive, and Effective (with early and sufficient dosing). The benefit/risk ratio for patients clearly dictates the wide application of this approach.  This approach is not only not widely used, but now the education/promotion/recommendation of this approach under the “Covid-19 Consumer Protection Act” is even illegal and may be prosecuted?

What world do we live in today?

I remember an old Chinese saying: 忍无可忍便不再忍 (If I can’t bear it, I won’t bear it anymore).

 

Richard Cheng, M.D., Ph.D.

4/26/2021

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Another Rapidly Recovering Covid-19 Case

Another Covid-19 Case: Dec. 5th, 2020. a 47 years old Chinese lady from Texas with Covid-19 sought my consultation. She complains of low grade fever, around 100, or lower, chilly, nausea, sweat, no sore throat no cough, for 2 weeks. Was tested and telephone reported to be Coivd-19 positive. The first week she could still function normally, but this week she is getting worse, in bed nearly all the time. She’s been taking Tylenol, 2 tablets, 3 times/day. The first week she didn’t take VC regularly due to nausea. This week, starts taking VC Vit C 2,000 -3,000 mg a day, feeling a bit better this week, with less nausea. PMH: none. Meds: none other than Tylenol and VC now. Her husband also had Covid-19 (telephone report positive), 3 days before she got sick and recovered in 1 week.
She was recommended to follow my Coivd-19 regimen(Vit C, D, Zinc, Quercetin, Melatonin and Hydrogen Peroxide) and follow up with me daily. The next day (Dec. 6th), she reports “already feeling much better, but still feeling a bit tired and can‘t smell and taste much“. I told her is doing wonderful and recovering fast and is recommended to continue her current course.


另一个新冠肺炎病例:2020年12月5号,一位47岁的来自德克萨斯州的,患Coivd-19中国女士Y,来找我咨询。她主诉有从2周前(11/22)开始低烧,约100F,发冷,恶心,出汗,无咽痛,不咳嗽。在当地诊所检测,Covid-19阳性(电话报告)。第一周她还能正常工作,但这周越来越糟,几乎一直卧床不起。她一直在服用泰诺,2片,3次/天。第一周,她因为恶心没有定期服用VC。本周开始服用VC维C 2000-一天3000mg,这周感觉好一点,恶心也少了。过去史:Y女士平时注重健康,无基础疾病,体重正常。药物:最近开始泰诺和VC。她的丈夫比她早3天出现症状(也确诊为Covid-19,电话报告阳性),但1周后恢复。
她被推荐遵循我的Covid-19方案(维生素C,维生素D,锌,槲皮素,褪黑激素和过氧化氢),每天向我汇报进展。第二天(12月6日),她汇报:已经感觉好多了,但仍有些累,味觉与嗅觉仍然不正常。我告诉她,她做得很好,继续目前方案。味觉,嗅觉的恢复可能要些时间。

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Hydrogen Peroxide, a potent anti-viral agent

Tom E. Levy, M.D., J.D., is a prolific medical author and thinker, a long time friend of mine, an international expert on Vit C. He has published 13 medical books. He’s now working on a new book on hydrogen peroxide and its health (esp. anti-viral effects). The book is expected to be completed in a few months. But due to the Covid-19 pandemic and the cold winter we are in now (with flu and other viral infections), I want to share the overview and the major characteristics of H2O2, with his permission, with you and hope this can help you, your family and your friends.

***

Overview of Hydrogen Peroxide:

There are few molecules in the body, if any, that are singularly more important for optimal health than hydrogen peroxide (HP). It is essential for the ongoing defense against pathogens while also playing a pivotal role in the regulation of normal metabolism. HP is present throughout the body, continually generated both inside and outside of all cells (Boveris and Chance, 1973; Bao et al., 2009; Rice, 2011). HP is literally a naturally-generated antibiotic “designed by nature” to give the body its best chance at preventing an infection or at resolving an infection once contracted. It is also intimately involved in vital messaging and signaling functions between different cells as well as inside the cells themselves in order to sustain normal metabolic function. Furthermore, HP is present in the body in significant amounts, with some data indicating that as much as 5% of oxygen intake is utilized in the generation of HP (Arnaiz et al., 1999). An extremely simple molecule, HP presents no toxicity to the body except when arbitrarily administered in very high doses and concentrations, conditions that can literally make any substance toxic.

Nebulization with HP is truly an ideal therapy for dealing with a number of conditions, but especially acute respiratory viral infections. This therapy has five characteristics that no other treatments fully share, although there are a number of therapies that have two or three of these characteristics. Such an ideal therapy is:

  • Highly effective clinically
  • Completely nontoxic when used as recommended
  • Inexpensive, but optimally of inconsequential cost to even the poorest of patients
  • Readily available, and not requiring prescription
  • Very easy to administer and not requiring assistance.

***

Here is what I use for myself and my family to prevent Covid-19, flu and other viral infections, and for general health maintenance.

  • Vit C, 5,000 – 10,000 mg/day, in divided doses,
  • Vit D, 5,000 IU/day,
  • Zinc, 30-50 mg/day,
  • Mg, 500 mg/day,
  • Quercetin, 1,500 – 2,000 mg/day, in divided doses.
  • I also take our TotoCell Nutrition (our own formula with multivitamins, antioxidants and mitochondrial nutrients.
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Covid-19 Highlights the Shortcomings of Evidence-Based Medicine

Cheng RZ (2020) COVID-19 highlights the shortcomings of evidence-based medicine.

The Spanish Flu of ~100 years ago took over the world and infected one third of the world’s population (~500 million people) worldwide, and killed ~50 million (~3% of the world’s population). Most of us probably didn’t know or didn’t care much about the Spanish Flu until Covid-19. With today’s advanced hygiene, economy and technology compared to a century ago, most of us probably thought pandemics of that scale are long gone. Well, I did.

What a shock, here we are, ~10 months later, we are still immersed in the Covid-19 panic and chaos, with >1 million people killed and trillions of dollars lost. The world is still in a locked down mode, many people, if not affected by Covid-19 directly, are most definitely affected by the hardship due to lock-down.

Since the Spanish flu, the world has seen many epidemics and pandemics, but none at the scale of Covid-19. One would expect that the leadership in our public health systems, the medical establishment and worldwide governments have learned how to deal with such a public health hazard. Needless to say, we all have been sadly disappointed, particularly at the responses from the leadership in the public health and the medical establishment.

Covid-19 provided a litmus test for the politicians, their top medical advisors, leaders in various industries including social media and other societal activists. I am sure many global citizens share with me the view that most of them have failed us miserably in this Covid-19 global fight!

Covid-19 is a major crisis, but it also presents a great opportunity. In Chinese, crisis is translated into 危機, which is consisted of 2 characters, Danger (危) and Opportunity (機). Great disasters often call for deep reflections and soul searching, which may bring about great reforms. We, the global villagers (the consumers, the healthcare professionals, industrial leaders and the politicians), all need to reflect on Covod-19: what we have done right, and what we have done wrong and how could we improve in the management of Covid-19 down the road and future public disasters. Yes, Covid-19 won’t be the last one, epidemics and pandemics are on the rise1.

Digging deeper, Covid-19 is revealing more problems in our current medical system, “Evidence-Based Medicine” (EBM), than just a catastrophic pandemic!

In this article I’ll discuss briefly some key problems in EBM, followed by a summary review of the common pathological features of viral infections including those of Covid-19, to point out the key underlying biochemical and pathological mechanism: disturbance in redox homeostasis, concluding with an analysis of redox therapy including antioxidants such as vitamin C in Covid-19 intervention.

Shortcomings of Evidence-Based Medicine, revealed in Covid-19 management

One of the major problems of EBM is the gradually increasing bias in what constitutes as “evidence” in EBM. Another is the lack or insignificant role of mechanistic reasoning, or lack of “logical reasoning” in EBM. The third is what I consider as the “Nobel Prize Mentality” dominance in today’s clinical medicine, i.e., using the narrowly focused basic science research principles and tools to address complex and holistic clinical problems. The management (or better mismanagement) of Covid-19 illustrates these problems. The mismanagement is causing more problems than the problems directly due to Covid-19 per se.

Evidence-based medicine (EBM) movement, started in the 1990s, has gradually become the central dogma of today’s medical practice. Of course, this doesn’t mean the medicine practiced in the past thousands of years is not evidence based. Even today, ~50% of what a clinician does in the clinic is still so-called empirical medicine (or experience based), despite the dominance of EBM. Medicine practiced in the past thousands of years, if not longer, has always been “evidence” based. The key question here is what is considered as evidence.

What is Evidence-Based Medicine (EBM)?

Evidence-based medicine is interpreted as the integration of best research evidence with clinical expertise and patient values2. EBM aims for the ideal that healthcare professionals should make conscientious, explicit, and judicious use of current best evidence in their everyday practice”2.

Randomized controlled clinical trials (RCTs) are only part of the evidence in EBM. There are several levels of evidence in EBM.

There is no doubt that evidence is important. The center of EBM is “evidence”. There are generally 4 different levels of evidence, from RCTs to case studies to clinical expert experience (empirical)3. It’s clear here that, although RCTs have the highest weight in “evidence”, RCTs are not the only evidence in EBM. However, all the scientists and medical doctors whom I know and have communicated with view RCT as the only evidence. They seem to think that if there is no RCT data, then it’s not EBM. They have no idea that EBM has several levels of evidence. To be honest, I didn’t know what EMB exactly is either until I looked it up in the literature. I venture to say that this is quite common among scientists and clinicians.

Another major problem of EBM is the lack of clinical or mechanistic reasoning. RCT results and treatment guidelines contain limitations and financial conflicts which may result in bias. We clinicians must still reason through the best choices for an individual patient even in the absence of full and secure knowledge4, as is in this Covid-19 pandemic. Covid-19 is a new disease, but it doesn’t mean we knew nothing in the treatment and prevention of Covid-19. Even without thorough research, there is plenty we already know about viral infections, Covid-19 included, that we can apply in prevention and treatment.

Disturbingly increasing trend of biased “Evidence” favorable to for-profit patentable drugs in EBM.

Publicly funded RCTs have been declining, while for-profit industry funded RCTs are on the rise, a trend with a deep and potentially biased and unfair influence on our healthcare policy, with potentially grave consequences.

There is no doubt that RCTs are important. Well-designed RCT results are considered the strongest evidence in EBM. But RCTs are very costly and are becoming more and more limited to organizations with strong financial backings. A 2015 Johns Hopkins University study found the number of clinical trials funded by for-profit industry increased 43% while those funded by the NIH decreased by 24%, between 2006 and 20145. While the goals of NIH-funded RCTs are not to make a profit on the market, the for-profit industry funded RCTs are clearly for profit.

There is no doubt that lifestyle and nutrition play fundamentally important roles in our health maintenance and disease prevention and treatment. However, lifestyle and nutrition research results are usually not patentable. There is no financial incentive in doing RCTs by for-profit industry, leading to a bias towards low representation of lifestyle and nutrition medicine in the “evidence database” that EBM relies on. But can anyone tell me that lifestyle and nutrition medicine is not important?

With a growing dominance of for-profit industry sponsored RCTs making up the “best evidence” in EBM, no wonder, medical practice today is biased and heavily influenced by the big pharma.

Some other facts:

  • For profit Industry doesn’t fund trials most important for public health due to lack of financial incentive.6 This includes the lifestyle and nutrition medicine discussed above.
  • The Johns Hopkins University’s Comprehensive Cancer Center found conflicts of interest in more than one-third of 1,500 cancer studies published in prominent medical journals in 20066.
  • As many as 70% of approved drugs are not new drugs, wasting billions of dollars of unnecessary clinical trials.7

Today’s clinical medicine has been dominated by the basic science mentality (“Nobel-prize mentality”).

Nobel prize is the crown jewel that attracts the top medical and biological scientists. Those who reach the top of various medical specialties have spent most of their careers in basic research. There is a dichotomy between those who lead in medicine and those who actually practice medicine. Those influential medical experts, who write “disease management guidelines” and influence healthcare policies, are mostly attracted and dominated by the “Nobel-prize mentality”. This disturbing trend is partly illustrated in the gradual decrease of Nobel prizes awarded to clinicians over the past 100 years (Fig. 1).

The proportion of clinicians to win Nobel prize in physiology and medicine have been steadily declining over the past 100+ years, from 65%-90% ~100 years ago to a merely ~20% in the 21st century.8  While basic research is important, only ~1% of the highly promising basic research is translated into clinical medical practice.9 Today’s Nobel prizes may not be what Mr. Alfred Nobel intended in his will. The Nobel committee over 100 years ago interpreted Mr. Nobel’s will as: “the domain of physiology or medicine” was understood to encompass the theoretical as well as the practical medical sciences8,10.

Fig. 1. Nobel Prizes in medicine: are clinicians out of fashion? Source: Ashrafian, H., Patel, V. M., Skapinakis, P. & Athanasiou, T. J R Soc Med 104, 387–389 (2011).

The approaches to clinical medicine and to basic medical research are and should be different. Basic research is to dissect complex problems into smaller and unit level questions, often looking at a particular molecule or a mechanism, irrespective of the whole system, and try to find answers. Whereas clinical medicine should teach how to integrate knowledge learned from various aspects into one holistic treatment plan for a particular patient. Clinical medicine should view a patient as a whole, trying to understand not only the clinical manifestations, but also the root causes as well as the processes connecting the root causes and the clinical presentations (Fig. 2). Only when we address the root causes, the disease processes and the clinical manifestations, the it becomes possible for us to cure the patients.

All diseases have their root causes, which, via certain pathological mechanisms or processes, lead to clinical signs and symptoms (Fig. 2). Research into disease root causes and management are usually not patentable, whereas specific agents (drugs) to manipulate pathological mechanisms are. As a result, the medical literature is full of research papers studying the biological processes, which may lead to new drug discoveries and handsome financial rewards. But we know clearly, interfering only at the mechanism level, not at the root cause level, is only part of a disease management plan, not a complete solution. But this is what medicine is teaching our doctors today: one or a few drugs based, incomplete treatment plan, without addressing the root causes of diseases. As a result, although the market is full of redundant drugs for common chronic diseases such as diabetes mellitus and hypertension, none of these chronic diseases are curable with these existing drugs. More and more clinical research shows that chronic diseases such as diabetes and hypertension are reversible with lifestyle changes including dietary changes11–14. We have helped numerous diabetic or hypertensive patients to go off their drugs in our clinics with this integrative approach. This simple logic, unfortunately, is forgotten and not mentioned in today’s medicine.

Fig. 2. The root causes, processes and clinical manifestations of diseases.

Disturbance of redox homeostasis, or increased oxidative stress, is the key underlying pathology of viral infections, including Covid-19.

              A common feature of many viral infections, including the upper and lower respiratory infections caused by respiratory viruses is the disturbance of redox homeostasis, or increased oxidative stress. Redox homeostasis describes the balance between the production of reactive oxygen or nitrogen species (ROS, RNS, respectively, or RONS, collectively) and their scavenging. Redox biology plays a critical role in various cellular processes, including proliferation, differentiation, signaling, and metabolism. Redox homeostasis and the disturbance thereof plays an important role in pathology and may lead to oxidative stress, chronic activation of immune responses, and inflammation15,16. Chronic elevation of ROS may lead to oxidizing damages to DNAs, proteins, lipids and resulting in dysfunction of organelles and apoptosis17.

The group of viruses that may cause respiratory infections include influenza, human respiratory syncytial, human rhino, human metapneumo, parainfluenza, adeno and coronaviruses (SARS-Cov), the latter includes the virus responsible for Covid-19, SARS-Cov-2, a new member of the coronaviruses.

A large body of evidence exists in the literature that demonstrates the correlation between the significant increase in ROS and most, if not all, viral respiratory infections18. Moreover, elevated ROS is not only a feature of respiratory infections, but is also present in other viral infections such as hepatitis B, C and many others. Covid-19 is no exception. Early research shows SARS-Cov-2 infection, Covid-19, is associated with significantly increased oxidative stress, often described as “cytokine storm”.

Key pathologies of Covid-19 and mechanisms of vitamin C in the treatment of viral infections.

“Cytokine storm” or significant oxidative stress plays a significant role in Covid-19 pathology. Oxidative stress is actually a common mechanism in many viral infections. Vitamin C is a prototypical antioxidant. Vitamin C’s powerful antioxidant effect probably explains the clinical improvement observed in pneumonia, sepsis and respiratory distress19–22.

A review of worldwide reactions to and the management of Covid-19 reveals a few severe problems.

  1. Covid-19 management worldwide has been severely politicized. This is reflected both internationally and domestically. Covid-19 pandemic is a huge challenge to the mankind and we, of all nations and races, should have united to face the common enemy. But instead, international and domestic politics have mostly hijacked this public health crisis and caused unnecessary chaos and mismanagement with severe consequences.
  2. The medical advisors to governments worldwide including WHO have been providing incomplete medical advises which may have been misleading to government leaders. These public health officials carry the major responsibility of assessing and analyzing the pandemic problem, reviewing the knowledge we learned in the past and synthesizing comprehensive (and contingency) plans to combat the pandemic. However, the responses from the public health officials we have seen worldwide have been incomplete and disappointing. This probably reflects much deeper problems rooted in the contemporary medicine.

What have the public health officials, top medical agencies and advisors and governments done worldwide to fight Covid-19 pandemic? What we have seen and heard mostly is nothing but a lot of fighting, arguments and expectation of vaccines, especially in the US. I don’t hear any of these top experts or medical agencies talk about prevention, particularly nutritional importance in prevention and treatment of Cvoid-19. Our health depends on nutrition. This is simply logical and a common sense. In the absence of specific “anti-Covid” drugs, our own immunity is all we have to hold the virus at bay. Even with specific drugs, our immunity still plays a major role in disease fighting.  But why don’t we hear much about it? Why don’t the top experts recommend it? It’s too “low tech”? Many conscientious healthcare professionals and others stand out and promote healthy lifestyle and nutrition to prevent Covid-19 or fight against it once one gets it, including vitamin C and vitamin D.  Dr. Anthony Fauci, the top medical advisor to the Trump Administration, is reportedly taking vitamins C and D privately, but I never heard him recommending it publicly23.  Are vitamins C and D good enough for him, but not good for the public? Not only didn’t we hear these public recommendations, those science based nutritional recommendations, like the ones Dr. Fauci was taking, have been mostly censored by the major media. I am one of the victims of the censorship.

When faced with the common enemy, Covid-19 pandemic, we should have united to fight against it. But we all have been sourly disappointed and felt betrayed by those politicians, top medical experts and the media as well. Some of these interest groups have hijacked this global tragedy for their hidden agenda. I have never seen medicine to be so politicized in my 40 plus years in medicine.

I came across Dr. Linus Pauling’s work on vitamin C 20 some years ago. In recent years, I spent more time researching vitamin C.  I was amazed that as a tiny molecule, vitamin C has a wide variety of biological effects on nearly every aspect of our life, including, but not limited to, antimicrobial, antioxidant, and as an essential cofactor in collagen synthesis24,25. You may be surprised to learn that vitamin C even plays a critical role on your mood.26 Most people probably don’t really realize the importance of collagen in our body. But we won’t discuss that here. What’s relevant to Covid-19 pandemic is vitamin C’s antimicrobial and antioxidant effects.

The ignorance or suppression of vitamin C reflects the lack of logic or “common sense” in mainstream medicine.

  • Vitamin C can prevent and improve pneumonia.

A meta-analysis of 148 animal studies show that vitamin C can alleviate or prevent bacterial, viral and protozoan infections. Vitamin C cuts the risks of colds by 50% in physically active adults. Two randomized and controlled studies (RCT) show a dose-dependent response in the therapeutic effects of vitamin C in common colds. Three RCTs demonstrate that vitamin C can prevent pneumonia and 2 RCTs show vitamin C can improve pneumonia treatment. One RCT shows vitamin C is beneficial in the treatment of tetanus27.

  • High dose intravenous vitamin C (HDIVC) shortens mechanical ventilation.

HDIVC improves severe pneumonia patients. A recent meta-analysis pooled the data from 9 qualified clinical trials and found strong evidence that high dose IV vitamin C shortens patient time on mechanical ventilation by 14-25% with only relatively small vitamin C doses (1,000 mg – 6,000 mg)28.

  • HDIVC reduces mortality in patients with acute respiratory distress syndrome (ARDS) and in Covid-19 patients

In a clinical trial of 32 ARDS patients, HDIVC (1,000 mg + N-acetyl cysteine + selenium + vitamin E, every 6 hours IV) showed a 47% reduction in mortality rate compared to the 71% mortality rate in the control group29. Another recent study of 96 septic patients with HDIVC (6,000 mg of vitamin C + hydrocortisone + thiamine, every 6 hours IV) cut the mortality rate by ~32%30. HDIVC for the treatment of Covid-19 was first reported in China.  In a clinical study of 54 severe to critically ill Covid-19 patients shows HDIVC (24,000 mg/24 hours IV) reduced 28-day mortality and significant improvement of oxygenation and inflammatory status31. In a separate clinical series study of 12 severe and critical Covid-19 patients, HDIVC showed significant clinical oxygenation improvement with reduction in inflammatory markers and organ failure (SOFA) score31.

  • Oral high dose vitamin C can prevent common cold.

Several studies in the past have shown that vitamin C prevents common cold and reduces the disease severity once catching the cold including one earlier this year, a randomized controlled trial of 1444 young army recruits. This Korean study showed that vitamin C at doses as high as 6,000 mg daily reduced the odds of developing common cold32.

  • Vitamin C deficiency is more common than we realized, both in sick patients and in the general population.

Vitamin C deficiency is common among patients with acute and chronic diseases. 40% of ICU patients with septic shock have blood levels of vitamin C near zero, diagnostic of scurvy (Vit C < 11 umol/L), with the remainder of ICU patients have hypovitaminosis C (Vit C < 23 umol/L). ~50% of non-septic ICU patients also show hypovitaminosis C33.  Low plasma vitamin C levels are associated with more severe organ failure and increased mortality34,35. Hypovitaminosis C is relatively common in Western populations and vitamin C deficiency (VC < 11 umol/L)  is the 4th leading nutrient deficiency in the US33. The 2007-2010 U.S. National Health and Nutrition Examination Survey of approximately 16,000 children and adults found that almost 40% had low levels of vitamin C, while 88% of the U.S. population did not meet the daily requirement for vitamin E (noted to enhance the effects of vitamin C)36.

  • Covid-19 patients have undetectable or very low blood levels of Undetectable Vitamin C.

Vitamin C was not detectable in 17 out of 18 Covid-19 patients with ARDS, a Spanish study reports, with the remaining patient showing very low blood vitamin C level37.

  • Vitamin C is safe and is without significant side effects, even at very high doses.

An NIH expert panel consensus document (updated in February 2020) clearly states that HDIVC is safe even at very high doses38. Early clinical studies show HDIVC is highly promising in Covid-19 treatment1,19,38–40. Based on these and their clinical experience of HDIVC, the governments of Shanghai and Guangdong officially included HDIVC in their Covid-19 treatment protocols41,42. The science and rationale for HDIVC in treatment of Covid-19 were reviewed and presented in my NIH guest speech43. These early Chinese experiences in HDIVC on Covid-19 caused worldwide interest which was in part kicked off by my new associates at ITM Ltd. and The First Dragon Foundation™ Ltd. (In organization)  who issued a global release44 that also included introduction to the New USA Federal “Right to Try Act”:  According to the peer-reviewed Orthomolecular Medicine News Service, vitamin IVs can be arranged in virtually any hospital, anywhere in the world, and the new federal “Right to Try Act” gives patients the power to demand IV vitamin C treatment45.

Are vaccines the answer to the Covid-19 pandemic?

As I clearly stated previously, it’s clear that the epidemics and pandemics are on the rise1. Covid-19 is just a wake-up call. Due to the nature of vaccine research and development, there is always a significant delay between the outbreak of an epidemic and the clinical wide availability of effective vaccines. Eight months into the Covid-19 pandemic, there is still no SARS-Cov-2 specific vaccines available. And yet, the only universally accepted and recommended “miracle” that nearly all governments worldwide are hoping is a magic vaccine(s). Clearly this “vaccine” only Covid-19 strategy is incomplete. An integrative approach is clearly indicated to include healthy lifestyle with sufficient nutrition, esp. vitamins C, D and minerals like magnesium and zinc1,46.

Protected Population Immunity with vitamin C and other nutrients and healthy lifestyle should be part of the integral strategy to the prevention and treatment of Coivd-19 and future such epidemics1.

Where is “common sense” in evidence-based medicine?

Various organizations, doctors and citizens alike worldwide have been calling for their local and national governments on vitamin C’s potential effects on Covid-19. Some conscientious doctors at the highest level of the US department of Health and Human Services have also tried to call attention to vitamin C. It should be plain common sense to try HDIVC in Covid-19 treatment. The FDA even allows “compassionate drug use” which stipulates the use of new and unapproved drug to treat seriously ill patient when no other treatments are available47.

An ounce of prevention is worth a pound of cure, as the old saying goes. Have those top medical advisors (and medical agencies) forgotten the old wisdom? Why are they so much against antiviral nutrients such as vitamin C and vitamin D?

In summary, vitamin C, taken both orally or intravenously, is very safe and is effective in the prevention and treatment of both mild and severe viral infections. There is nothing to lose, but a lot to gain with vitamin C use in Coivd-19. But why such great remedies are being suppressed?

Another problem that Covid-19 has highlighted is that the medical establishment views Covid-19 as a totally new disease and ignores what we learned from the previous research on viruses and disease. Yes, Covid-19 is a brand-new disease caused by a brand-new virus, SARS-Cov-2 virus. However, many viral infections, particularly the family of coronaviruses including the viral agents that caused 2003 SARS pandemic and MERS pandemic in 2013, and Covid-19 now share much in common, particularly the significantly elevated oxidative stress (or cytokine storm)1,19. Most, if not all, of the pathologies seen in Covid-19 can be traced to the oxidative damages induced by SARS-Cov-2. This is the rationale for why antioxidants have shown promising results in the treatment of Covid-19 including HDIVC, vitamin C being a prototypical antioxidant.

The current medical system views diseases at from their symptoms and often fails to recognize their root causes and common biological features and pathways.  Of course, this view of diseases is conveniently compatible with the needs of the medical establishment for publications and research grants: more diseases, more research grants and more research dollars. This view is also conveniently compatible with the pharmaceutical interests where more drugs can be developed and more drug sales.  Of course, all these are at the expense of consumers and their health. This scenario is common in the management of most chronic diseases. Top diabetes experts are very eloquent on the complicated mechanisms of antidiabetic drugs when a simple measure of significantly reducing the carbohydrates in the diet along with supplements of essential nutrients could return blood sugar to normal levels.

Evidence based medicine is the main school of thought that guides the clinical medicine today. A review of the definition of EBM finds the lack of logics or “common sense” having any place in EBM2,3. What’s presented in this article makes it quite clear that there is a lack of common sense in EBM and that vitamin C should have a place in the treatment of Covi-19 pandemic.

Many consumers and healthcare professionals may not realize these problems ordinarily, but now with the outbreak of Covid-19, and huge losses in lives and economies with nearly everyone in every corner of the world affected, this distorted and incomplete view of diseases by the medical establishment should serve as a wake-up call to all of us, healthcare professionals and consumers alike. Many lives could have been saved.  Many lives would be saved should the governments start incorporating HDIVC into the Covid-19 fight, just like Shanghai and Guangdong did. Entire cities don’t have to be locked down. The economy can be revived more rapidly.

But are they listening?

 

References

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