By Patrick Holford, author and founder of www.vitaminCforcovid.com
A government survey of people over-65-year-olds found that 4% – that’s almost half a million – have overt vitamin C deficiency (defined as below 11 mcmol/l).
However, in residential care homes an estimated 40% have vitamin C levels below 11 µmol/l, the same as seen in those diagnosed with scurvy, according to a study from the MRC Human Nutrition Research unit in Cambridge.[1]
Scurvy, caused by a chronic lack of vitamin C, killed two million sailors in the 17th and 18th century.
With almost half (47%) of all COVID deaths being in care homes[2] could a lack of vitamin C, which is essential for fighting any viral infection, be to blame?
Vitamin C and ageing
Not only is vitamin C critical for fighting any viral infection, many older people with health conditions need more vitamin C. The precipitous decline in vitamin C seen in COVID is the last straw.
There is growing evidence from animal studies that the efficiency of vitamin C absorption from the gut to the bloodstream declines with age.[3] Consequently, so too do blood vitamin C levels.[4] For this reason some experts recommend a minimum intake of 400 mg of vitamin C for older persons just to keep the immune system and body in good health. An orange provides 50 mg so this kind of required intake calls for daily supplements.
Vitamin C and Covid
Blood vitamin C levels not only predict who is most likely to suffer from severe COVID, but a study in an Intensive Care Unit (ICU) in the US, vitamin C levels accurately predicted who would or wouldn’t survive.[5] This is because vitamin C levels drop dramatically when a person becomes infected. A survey of elderly Scottish patients hospitalized with respiratory infections also found that a third had scurvy levels of vitamin C.[6]
Vitamin C is not only profoundly anti-viral, both boosting the immune system’s response but also helping to make interferon which stops the virus replicating, it is also a powerful antioxidant. Antioxidants protect the body from the ‘oxidising’ damage that occurs during viral infection, which damages the lungs and other vital organs.
ICUs are reporting the alarming vitamin C depletion in COVID patients.
All bar one of eighteen critically ill patients in a Barcelona Intensive Care Unit had undetectable levels of vitamin C, below the scurvy level[7].
In an ICU in Colorado most were low in vitamin C but those who did not survive had the lowest level, with half overtly deficient.[8]
While increasing age is a risk factor for COVID mortality, when a patients’ vitamin C levels are taken into account, age was no longer a predictor, but their vitamin C status was.
Why are older people low in vitamin C?
According to expert Anitra Carr, Associate Professor and director of Nutrition in Medicine Research at Otago University in New Zealand: “Older people tend to have more chronic health conditions which are often associated with increased inflammation and generation of harmful oxidants. Vitamin C is an excellent antioxidant that can help mop up excess oxidants. During severe viral infections, the body is put under much more oxidative stress and the levels of antioxidants such as vitamin C drop rapidly. In older people cognitive decline can also result in them not eating as well as they should. While a dietary intake of 100 mg/day, which is equivalent to one large orange or a kiwifruit, can maintain adequate blood levels, when under severe viral attack the body needs way more vitamin C than this.”
The anti-viral effect of vitamin C was the life’s work of twice Nobel Prize winner Linus Pauling, who took 6 grams a day in his eighties. The Linus Pauling Research Institute at Oregon State University says that older people need at least 400 mg, four times the basic recommended level, to be healthy.
The Swiss Nutrition Society which advises their government calls for all to supplement 200 mg a day, plus extra vitamin D, ‘especially for the adults age 65 and older to strengthen the immune system.’
While this would help to prevent scurvy it’s not enough if someone becomes infected. Dr Marcela Vizcachipi, head of COVID critical care research at the Chelsea and Westminster Hospital has increased the vitamin C dose she gives to her critically ill patients intravenously, to 6 grams since testing her patient’s vitamin C levels.
The importance of testing
I personally want to see routine vitamin C testing when visiting aged care homes. Vitamin C deficiency is easy to test with a urine strip. It’s cheap and takes 20 seconds. If it doesn’t change colour that’s a really good indication that the person is deficient. If it changes colour from green to yellow you know they have enough. When you’re younger you might get away with it if you eat lots of fruit and vegetables but older people have to supplement.
The average 85-year-old has 9 good years ahead of them. We shouldn’t write them off. Them must be tested for vitamin C deficiency and given what they need to support their immune system.
For more information see: www.vitaminC4covid.com
ABOUT THE AUTHOR: 
Patrick Holford, BSc, DipION, FBANT, NTCRP, is a leading spokesman on nutrition and mental health and founder of both the Food for the Brain Foundation and the Institute for Optimum Nutrition, an educational charity that offers degree accredited training in nutritional therapy.
He was a student of the twice Nobel Prize winner Dr Linus Pauling, who put vitamin C on the map in the 70’s. Originally trained in psychology, Patrick was involved in ground-breaking research showing that multivitamins can increase children’s IQ scores – the subject of a Horizon television documentary. He was one of the first promoters of the importance of zinc, essential fats, low-GL diets and homocysteine-lowering B vitamins and their importance in mental health and Alzheimer’s prevention, working closely with David Smith, Emeritus Professor of Pharmacology at the University of Oxford.
He is author of 45 books translated into over 30 languages, including Flu Fighters, now translated into French, Italian and Chinese. He is a retired visiting professor at the University of Teesside and is in the Orthomolecular Medicine Hall of Fame with his mentors, Drs Linus Pauling and Abram Hoffer.
He is founder of www.vitaminCforcovid.com
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[1] CJ bates et al, ‘Micronutrients: highlights and research challenges from the 1994–5 National Diet and Nutrition Survey of people aged 65 years and over’British Journal of Nutrition (1999), 82, 7–15
[2] BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2334
[3] Michels AJ, Joisher N, Hagen TM. Age-related decline of sodium-dependent ascorbic acid transport in isolated rat hepatocytes. Arch Biochem Biophys. 2003 Feb 1;410(1):112-20. doi: 10.1016/s0003-9861(02)00678-1. PMID: 12559983.
[4] Faure
et al. 2006; Birlouez-Aragon et al. 2001; Ravindran et al. 2011; Nyyssonen et al. 1997; Wrieden et al. 2000). Schleicher, R.L.; Carroll, M.D.; Ford, E.S.; Lacher, D.A. Serum vitamin C and the prevalence of vitamin C
deficiency in the United States: 2003–2004 National Health and Nutrition Examination Survey (NHANES).
Am. J. Clin. Nutr. 2009, 90, 1252–1263.
[5] Arvinte C, Singh M, and Marik PE, Serum levels of Vitamin
C and Vitamin D in a cohort of critically ill COVID-19 patients of a North American
Community Hospital Intensive Care Unit in May 2020. A Pilot Study, Medicine in Drug Discovery (2020), DOI:10.1016/j.medidd.2020.100064
[6] Hunt, C.; Chakravorty, N.K.; Annan, G.; Habibzadeh, N.; Schorah, C.J. The clinical effects of vitamin C supplementation in elderly hospitalised patients with acute respiratory infections. Int. J. Vitam. Nutr. Res. 1994, 64, 212–219. Available online: http://www.mv.helsinki.fi/home/hemila/CP/Hunt_1994_ch.pdf
[7] Chiscano-Camón L, Ruiz-Rodriguez J, Ruiz-Sanmartin A, Roca O, Ferrer R. Vitamin C levels in patients with SARS-CoV-
2-associated acute respiratory distress syndrome Critical Care (2020) 24:522
DOI:10.1186/s13054-020-03249-y
[8] See ref (6 above)