Treating Sepsis & the Role of Vitamin C in Patient Outcomes

Vitamin C and its relationship to the immune system and infection have been the subject of studies for years. In the past I have written about the protective effects of Vitamin C exhibited in Scandinavian winter athletes and military troops who took a supplement daily. They developed fewer “colds” of a less severe nature than the control group who did not. Surprisingly, if Vitamin C was added once a participant showed symptoms of a cold or viral infection it did not have the same protective benefits.

The relationship between Vitamin C and severe infection came up again discussed in an abstract presented at the American Thoracic Society 2022 International Conference held this past May. Researchers looked at whether its addition to patients being treated for sepsis would be beneficial.

The researchers conducted a systemic review of PubMed, Embase and Central Cochran’s Registry and found 21 studies in which Vitamin C was introduced to patients with sepsis. They found that when Vitamin C was added to the treatment of sepsis, either orally or intravenously, there was a significant reduction in mortality and less need for interventions such as intubation and mechanical ventilation, use of vasopressors to support blood pressure. The theory is that Vitamin C may reduce pro-inflammatory bio markers in severe sepsis and normalize physiologic function which in other cases might have led to an exaggerated immune response and the destruction of multiple organ systems.

Vitamin C is plentiful in fruits and fairly inexpensive when purchasing as a supplement. Starting your day with an orange or a grapefruit just might be preventing infection down the road.

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Misleading News on Colonoscopy for Colon Cancer Screening

I rarely take issue with research which is peer reviewed and published in prestigious medical journals but a study published in the New England Journal of Medicine regarding screening for colon cancer created more havoc and uncertainty about the worthiness of screening with a colonoscopy than is appropriate.

Michael Bretthaur, MD, PhD of the University of Oslo in Norway invited almost 85,000 adults aged 55-64 in Europe to participate in a screening colonoscopy or serve in a control group with no screening. Only 42% of those invited took the colonoscopy. Based on the large numbers in the study, the conclusion was that the procedure did little to reduce death from colon cancer over a 10-year period. This conclusion was noted by the international media and played up with the idea that maybe screening colonoscopy isn’t such a great tool? NBC and CBS nightly news covered it that way. CNN actually led with a misleading headline about it.

If you actually looked at just the data of those who had the procedure, it appears that colonoscopy reduced the incidence of colon cancer by 31 % and the risk of colon cancer related death by 50%. The message should have been “If you were screened with colonoscopy your chances of dying from colon cancer were reduced by at least 50%.”

There were problems with the study. The health care providers doing the colonoscopy were not as accomplished at finding polyps as the physicians who perform the study in the USA. The 10-year follow-up period of who developed colorectal cancer is considered too short a window for this particular disease which probably requires a 15-year observation window. The research team conducting the study will now be following the participants for another five years to correct this flaw. The numbers and conclusions are expected to change with the additional five years of data.

No sane person wants to prep for a colonoscopy and have the procedure. However. it is one of life’s necessary prevention evaluations. The media’s presentation of this study added great doubt to its efficacy. People will undoubtedly skip colonoscopy screening due to the way newspapers and TV news shows covered this study.

Colonoscopies save lives and by removing precancerous polyps with malignant potential save suffering too. I just had my colonoscopy. I hated every minute of the prep. The bowel cleansing preparation continued to upset my system for twelve hours post procedure. That said, it was worth every second of feeling uncomfortable to prevent a miserable disease.

Artificial Sweeteners & Cardiovascular Risk Increase

Mathilde Touvier, MD, and colleagues of the Sorbonne Paris Nord University published an observational study in the British Medical Journal online edition showing a link between consumption of artificial sweeteners and cardiovascular disease. Their study looked at total daily consumption of artificially sweetened drinks and consumption from foods as well as sweetener added from packets to food or beverages.

The study included over 103,000 French adults who were followed for an average of nine years.  The participants consumed on average the equivalent of 100 ml of diet soda or one individual packet of tabletop sweetener (42.46 mg/day). These individuals had a 9% increased risk of a heart attack, stroke, need for a cardiac catheterization and angioplasty or transient ischemic attack compared to those who did not use artificial sweeteners.

The researchers could not find a “safe daily dosage” below which the sweeteners did not increase risk. They did note that the higher the consumption of artificial sweetener the higher the risk of a cardiovascular event.  Aspartame intake was associated with an increased risk of cerebrovascular events while acesulfame potassium and sucralose increased the risk of a coronary event. It is felt that these sweeteners influence insulin sensitivity ultimately resulting in increased risk for a disease event.

A synopsis of the study was published in the online journal MDedge Internal Medicine.  This article included an opinion by researchers who published studies supported by the artificial sweeteners industry which dispute the methods and conclusions of Dr Touvier’s study.

Until the answers are resolved, it appears avoiding artificial sweeteners is as good an idea as avoiding too much sugar. I prefer limiting sugars at 16 calories per teaspoon compared to risking the potential ill effects of artificial sweeteners.