Effect of high dose vitamin C on Epstein-Barr viral infection, 2014, Mikirova et al

[forestglip]

Effect of high dose vitamin C on Epstein-Barr viral infection

Nina A Mikirova, Ronald Hunninghake

Background
Many natural compounds were tested for the ability to suppress viral replication. The present manuscript details an analysis of high dose vitamin C therapy on patients with EBV infection.

Material/Methods
The data were obtained from the patient history database at the Riordan Clinic. Among people in our database who were treated with intravenous vitamin C (7.5 g to 50 g infusions) between 1997 and 2006, 178 patients showed elevated levels of EBV EA IgG (range 25 to 211 AU) and 40 showed elevated levels of EBV VCA IgM (range 25 to 140 AU). Most of these patients had a diagnosis of chronic fatigue syndrome, with the rest being diagnosed as having mononucleosis, fatigue, or EBV infection.

Results
Our data provide evidence that high dose intravenous vitamin C therapy has a positive effect on disease duration and reduction of viral antibody levels.

Plasma levels of ascorbic acid and vitamin D were correlated with levels of antibodies to EBV. We found an inverse correlation between EBV VCA IgM and vitamin C in plasma in patients with mononucleosis and CFS meaning that patients with high levels of vitamin C tended to have lower levels of antigens in the acute state of disease.

In addition, a relation was found between vitamin D levels and EBV EA IgG with lower levels of EBV early antigen IgG for higher levels of vitamin D.

Conclusions
The clinical study of ascorbic acid and EBV infection showed the reduction in EBV EA IgG and EBV VCA IgM antibody levels over time during IVC therapy that is consistent with observations from the literature that millimolar levels of ascorbate hinder viral infection and replication in vitro.

Link | PDF (Medical Science Monitor) [Open Access]

 

[forestglip]

The data were obtained from the patient history database at the Riordan Clinic, a nutritional medicine treatment and research clinic. Among people in our database who were treated at the clinic with intravenous vitamin C (7.5 g to 50 g infusions) for various illness, we found 178 patients who showed elevated levels of EBV IgG (range 25 to 211 AU) and forty who showed elevated levels of EBV VCA IgM (range 25 to 140 AU). These subjects, all being treated between 1997 and 2006, formed the basis of our study. Most of these patients (110 subjects) had a diagnosis of chronic fatigue syndrome, with the rest being diagnosed as having mononucleosis, fatigue, or EBV infection.

These charts look the most interesting, though they'd be more compelling if it was an RCT. I imagine there could be many confounders here.

Analysing these data further, we broke down patients into two groups: patients who did not receive IVC treatment and patients who received five or more treatments. Figure 2 shows how EBV EA IgG levels changed with time of treatment for patients in these two groups.

According to the data, the percent decrease in antibodies (percent improvement, as far as reducing infection is concerned) is much higher in the ≥5 IVC group, than in the untreated group. The average values (±SD) for percentage of improvement are 17±13% for untreated subjects and 46±39% for subjects treated more than five times. Compared to untreated controls, the rate of decrease in the EBV antibodies for treated subjects are significantly different (p<0.002) from those of the untreated subjects.

The methods above say "Among people in our database who were treated at the clinic with intravenous vitamin C (7.5 g to 50 g infusions) for various illness, we found 178 patients" but this chart includes people who did not receive vitamin C, so I don't know where they came from.

Also, did the people who did not receive IVC already have low antibody levels, so a smaller/no decrease would be expected?

The effect of number of treatments is confirmed in Figure 3, which shows how the percent improvement (decrease in EBV EA IgG) increased as the number of treatments increased. The change in the percentage of improvement with number of treatments (slope of the line in Figure 3) is 2.7±0.7% per treatment (p<0.001).

Same question about starting antibody levels being related to number of treatments here too.

EBV also correlated to vitamin D levels. They followed these patients for some time, but I don't see anything saying what time point these readings are from. Also, no p-value provided here.

Finally, we analysed the other values of clinical tests for these patients (vitamins and minerals) to find other variables that correlate with EBV antibodies. Thus far, we have found that vitamin D concentration correlates with EBV EA IgG antibody levels (Figure 6).

Effect of vitamin D levels on EBV EA IgG levels. Curve fit is exponential: y=79 exp(−0.041x) (r=0.44)

The data is from patients at the Riordan Clinic, which provides high dose IV vitamin C to patients. The lead author has worked there since 1997, and the other author since 1989, so I don't understand why the paper says they have no competing interests.

The author have no direct financial interest in the subject matter discussed in the submitted manuscript.

They have also received a warning letter from the FTC (Federal Trade Commission) to stop saying vitamin C is beneficial/preventive for COVID:

This is to advise you that FTC staff has reviewed your website at https://riordanclinic.org on April 21, 2020. We also reviewed your social media website at https://www.facebook.com/riordanclinic, where you direct consumers to visit your website to schedule IV treatments of high dose vitamin C and other supplements. We have determined that you are unlawfully advertising that certain products or services prevent or treat Coronavirus Disease 2019 (COVID-19).

 

[forestglip]

I emailed the lead author to ask about the competing interests section. If she doesn't respond, I might make a comment on PubPeer, unless someone here can point out why that might legitimately say no COI.