If you watched the 60 Minutes item Living Proof on Wednesday night, you’ll no doubt agree that King Country farmer Alan Smith is lucky to be alive.
Acutely affected by the H1N1 virus, Smith lay in intensive care close to death, an ECMO machine battling to keep his fluid-filled lungs functioning. As Mike McRoberts says in the introduction to the 60 Minutes piece by veteran reporter Melanie Reid, Smith came back from the dead.
But what saved his life?
Well, if the 60 Minutes piece is to be believed, large doses of vitamin C administered to Smith intravenously at the behest of his desperate family pulled him back from the brink of death. The family had to battle doctors to allow the treatment to proceed and even had to enlist top-flight constitutional lawyer Mai Chen to apply the legal blowtorch to the hospital treating Smith to allow the treatment to continue.
Smith’s lungs began to clear as the vitamin C was administered though his family admits this may have had something to do with the fact that at the same time, Smith was put in the prone position – that is, he was rolled onto his stomach in the hope that this would help clear his lungs.
Where did the family come across the idea of administering vitamin C intravenously? What does the peer-reviewed literature say about this sort of treatment for pneumonia-like symptoms? Could Smith’s family have actually risked harming him by giving him large doses of vitamin C? None of that is clear from the piece, because 60 Minutes didn’t interview anyone with a medical or scientific background equipped to answer these questions. No one from the two hospitals that treated Smith would comment on how he was treated but it is clear from the case notes flashed across the screen that the doctors treating his thought intravenous shots of vitamin C was a wacky idea and would do him no good.
The upshot is that we have an apparent “miracle” on our hands – that’s definitely how 60 Minutes promoted the piece:
So was it a one-off miracle? Or has the family stumbled on a miracle cure?
Or how about option three – no one knows what led to Smith’s recovery and there’s certainly no evidence it was vitamin C. Not that you’d get that sort of equivocation from 60 Minutes, who obviously didn’t want to let pesky experts get in the way of a powerful story about a good kiwi family standing up to a cold medical bureaucracy. At the Science Media Centre, we asked experts to watch the piece and provide feedback on it.
Professor John Fraser, Head of School of Medical Sciences, University of Auckland told the SMC:
It is disappointing that the journalist did not attempt to seek expert advice on the reasons why the consultants were unwilling to administer high dose vitamin C. There is certainly no evidence from the medical literature that this treatment works particularly in severe cases of pneumonia. The consultants were quite right to resist the use of an unproven treatment, and to their credit they did acquiesce to accommodate the family’s wishes because they felt it would do no harm. In this remarkable case the patient did survive but there is no evidence that this was due to the vitamin C. This is a wonderful story of personal survival and it is sad that it has been used to discredit those professionals who were just trying to provide their best for a very sick patient. If the vitamin C had killed him, then the story would have been different. That is the risk of using an unproven treatment.
None of this point of view was reflected in the 60 Minutes piece, though any number of independent experts like Professor Fraser would have happily provided it if asked.
The evidence on intravenous vitamin C
At the very least, 60 Minutes could have added a bit of background about intravenous vitamin C treatments and the lack of empirical research suggesting such treatment is effective. I haven’t been able to find a single study looking at intravenous use of vitamin C to treat people in Smith’s condition. There are instead assorted case studies of patients treated in this way – but almost always for types of cancer and there have been some studies looking at vitamin C administered to mice and rats. This paper published in the Journal of Orthomolecular Medicine ten years ago suggests: “Some cancer patients have had complete remissions after highdose intravenous vitamin C infusions”.
A study by the US National Institutes of Health (NIH) published in the Proceedings of the National Academy of Sciences in 2008 showed “high-dose injections of vitamin C reduced tumour weight and growth rate by about 50 percent in mouse models of brain, ovarian, and pancreatic cancers”. The paper caused some heated debate among scientists as this letter from molecular biologist Professor Piet Borst to PNAS illustrates:
It is possible that ’the promise of ascorbic acid in the treatment of advanced cancer may lie in combination with cytotoxic agents’. As long as this has not been tested, we should try to avoid a new hype of vitamin C as cancer treatment by pointing out, especially in PNAS, the limitations of the available data.
There simply isn’t enough peer-reviewed literature to see this treatment endorsed by the medical profession other than those offering alternative therapies yet isolated cases of cancer sufferers going into remission following treatment with intravenous vitamin C keep the media spotlight on this supposed miracle cure. Check out another such story that screened in the US on ABC:
The reality is that Smith’s being placed in the prone position is just as likely to have been responsible for his recovery than the administering of large doses of vitamin C or anything else for that matter. We simply don’t know and the 60 Minutes piece suggests you should be willing to defy the advice of medical experts and demand alternative therapies for yourself or loved-ones who are seriously ill. How irresponsible is that?
Alison, while I think you are doing a great job, there is evidence that caterpillar ovary cells, hard to find as they may be, are used in the parmaceutical industry:
” Protein Sciences extracts genes from the dead flu virus and inserts it in a virus that feeds on a tropical caterpillar known as an armyworm. The virus is then exposed to ovary cells harvested from a single caterpillar and reproduced in large quantities. Ovary cells are used because they remain stable as they are cultured in a laboratory. ” source http://www.bloomberg.com/apps/news?pid=newsarchive&sid=ahgs1cipLGGY
Frankly, what if these therapeutic organic chemicals are being growth in such cells. What’s wrong with that? Diabetics used to be kept alive with insulin harvested from dead animals, before the wonders of genetic engineering came along.
Erwin, with respect to your LD50 figures for ethylene glycol, so what? Have you drunk any Italian wine recently? You’re still alive aren’t you? LD50 is only a part of the story – you have to look at the dose and at how the body deals with the chemical in question. For example, the LD50 for rats of pure ethanol (drinking alcohol) is about 7000 mg per kg of body weight. For a 60-70kg teenager that LD50 level equates to about one 750ml bottle of 80 proof (40% pure) alcohol – such as gin or bourbon or vodka. Drink it in a short period of time and you will be very sick and may not wake up. Drink the same amount of alcohol with a mixer at the rate of a glass an evening and it will do you no harm at all because the human body is well able to break down alcohol in small doses. The LD50 is not very relevant – what is relevant is the actual amount of the dose, as Alison notes above, and how the body deals with the chemical in question.