Many claims have been made about the role of vitamin C (ascorbic acid) in enhancing the immune system, especially with regard to the prevention and treatment of the common cold. Twenty years have passed since Linus Pauling wrote Vitamin C and the Common Cold.3S Pauling based his opinion on several studies that showed vitamin C was very effective m reducing both the severity of symptoms and the duration of Vitamin C the common cold. Since 1970, 20 double-blind studies have tested Pauling's assertion.39 However, despite the fact that every study demonstrated that the group receiving the vitamin C had either a decrease in duration or symptom severity, for some reason the medical community still debates the clinical effect. A recent article that appeared in the Journal of the American College of Nutrition sheds some light on the controversy.

In 1975 Thomas Chalmers analyzed the possible effect of vitamin C on the common cold by calculating the average difference in the duration of cold episodes in vitamin C and control groups in seven placebo-controlled studies. He found that episodes were 0.11 days shorter in the vitamin C groups and concluded that there was no valid evidence to indicate that vitamin C is beneficial in the treatment of the common cold. Scientific articles and monographs extensively cite Chalmers' review. However, other reviewers have concluded that vitamin C significantly alleviates the symptoms of the common cold. A careful analysis of Chalmers' review reveals serious shortcomings. For example, Chalmers did not consider the amount of vitamin C used in the studies and included in his meta-analysis a study in which only 25 to 50 milligrams per day of vitamin C was administered to the test subjects. For some studies Chalmers used values that are inconsistent with the original published results. Using data from the same studies, the authors of the new study calculated that vitamin C at a dosage of 1 to 6 grams per day decreased the duration of the cold episodes by 0.93 days; the relative decrease in the episode duration was 21 percent. The argument in the medical literature that vitamin C has no effect on the common cold is based in large part on a faulty review written two decades ago.

The best recommendation is to supplement with vitamin C in any sort of infection, particularly in elderly patients. A recent double-blind study of 57 elderly patients admitted to St. Luke's Hospital in Huddersfield, England, for severe acute bronchitis and pneumonia demonstrates the value of this recommendation. The patients were given either 200 milligrams of vitamin C per day or a placebo. Patients were assessed by clinical and laboratory methods (vitamin C levels in the plasma, white blood cells, and platelets; sedimentation rates; and white blood cell counts and differential). Patients receiving the modest dosage of vitamin C demonstrated increased vitamin C levels substantially in all tissues, even in the presence of an acute respiratory infection.

Using a clinical scoring system based on major symptoms of respiratory infections, results indicated the patients receiving the vitamin C fared significantly better than those on placebo. The benefit of vitamin C was most obvious in patients with the most severe illness, many of whom had low plasma and white blood cell vitamin C levels on admission.
These results indicate that even relatively small doses of vitamin C in a hospital setting can produce significant clinical improvement. Vitamin C supplementation is warranted in all elderly patients with acute respiratory infection, especially those who are severely ill. Pneumonia is still a major killer of the elderly.

In acute infections, intravenous administration may be appropriate. This recommendation is especially true for viral hepatitis, whether acute or chronic. According to Robert Cathcart, M.D., hepatitis is one of the easiest diseases for ascorbic acid to cure. He recommends intravenous doses of vitamin C of 40 to 100 grams for hepatitis and AIDS. Dr. Cathcart demonstrated that vitamin C in these high doses can greatly improve acute viral hepatitis in 2 to 4 days. He showed clearing of jaundice within 6 days. Other studies demonstrated similar benefits. If you cannot find a physician to administer the vitamin C intravenously, call the American College of Advancement in Medicine (1-800-532-3688) or take enough vitamin C to bowel tolerance (see below under Dosage Ranges).