The Nutrition in Medicine Research Group carries out translational nutrient-based clinical studies with the aim of having a positive impact on patient health outcomes and quality of life.
Critical illness and septic shock
We have shown that critically ill patients, particularly those with septic shock, have severely depleted vitamin C status, despite recommended intakes. This indicates enhanced requirement for the vitamin during inflammatory and infectious conditions.
We are currently administering intravenous vitamin C to patients with septic shock to assess the effects on patient health outcomes and quality of life as vitamin C has been shown to support the cardiovascular system and other organ systems.
Current research
Published research
- Hypovitaminosis C and vitamin C deficiency in critically ill patients despite recommended enteral and parenteral intakes
- Stability of intravenous vitamin C solutions: a technical report
- Circulating myeloperoxidase is elevated in septic shock and is associated with systemic organ failure and mortality in critically ill patients
- The effect of conservative oxygen therapy on systemic biomarkers of oxidative stress in critically ill patients
- Neutrophils isolated from septic patients exhibit elevated uptake of vitamin C and normal intracellular concentrations despite a low vitamin C milieu
- Circulating protein carbonyls are specifically elevated in critically ill patients with pneumonia relative to other sources of sepsis
- Intravenous vitamin C administration to patients with septic shock: a pilot randomised controlled trial
Review articles and commentaries
- Ascorbate-dependent vasopressor synthesis: a rationale for vitamin C administration in severe sepsis and septic shock?
- Harm of intravenous high dose vitamin C therapy in adult patients: A systematic scoping review
- Vitamin C in pneumonia and sepsis
- Can a simple chemical help to both prevent and treat sepsis?
- Duration of intravenous vitamin C therapy is a critical consideration
- Vitamin C administration in the critically ill: a summary of recent meta-analyses
- Is the VITAMINS RCT indicating potential redundancy between corticosteroids and vitamin C?
- Is "mega-dose" IV vitamin C required for septic and critical coronavirus disease 2019 patients?
Infection and immune function
Vitamin C supports the immune system and has important roles to play in immune cell function. We are carrying out observational and interventional studies in immune-compromised patients and patients with severe infections, such as pneumonia, which is one of the major causes of sepsis. If we are able to attenuate the symptoms of severe infection, this may decrease the likelihood of sepsis developing and improve patient outcomes and quality of life.
Pneumonia and sepsis are major complications of severe COVID-19. For more information about the role of vitamin C in COVID-19 see the Vitamin C and COVID-19 Research Resource.
Current research
Published research
- The role of physiological vitamin C concentrations on key functions of neutrophils isolated from healthy individuals
- Patients with community acquired pneumonia exhibit depleted vitamin C status and elevated oxidative stress
- Patients undergoing myeloablative chemotherapy and hematopoietic stem cell transplantation exhibit depleted vitamin C status in association with febrile neutropenia
Review articles and commentaries
- Vitamin C and immune function
- Vitamin C in pneumonia and sepsis
- Vitamin C in pneumonia and sepsis
- Vitamin C and neutrophil function: findings from randomized controlled trials
- Optimal nutritional status for a well-functioning immune system is an important factor to protect against viral infections
- A new clinical trial to test high-dose vitamin C patients with COVID-19
- Micronutrient status of COVID-19 patients: a critical consideration
- The Emerging Role of Vitamin C in the Prevention and Treatment of COVID-19
- Vitamin C-An Adjunctive Therapy for Respiratory Infection, Sepsis and COVID-19
- Micronutrients and respiratory infections: the biological rationale and current state of clinical evaluation
- Vitamin C and COVID-19: should clinical trials be prioritized for low-income settings and vitamin C deficient populations?
- Vitamin C intervention for critical COVID-19: A pragmatic review of the current level of evidence
Mood and cognitive health
The brain and neuroendocrine glands contain the highest levels of vitamin C in the body indicating an important role for the vitamin in the nervous system. We are currently carrying out observational studies investigating the vitamin C status and biomarkers of inflammation and oxidative stress in patients with mood disorders.
Current research
Published research
Metabolic health
Individuals with diabetes mellitus are under enhanced inflammatory and oxidative stress. Our research shows that they have lower vitamin C status. We are currently carrying out observational and interventional studies to determine vitamin C status in severe diabetes and effect of vitamin C and micronutrient supplementation on inflammation in people with obesity and metabolic dysregulation (metabolic syndrome).
Current research
Published research
- Inadequate vitamin C status in prediabetes and type 2 diabetes mellitus: associations with glycaemic control, obesity, and smoking
- SunGold kiwifruit supplementation of individuals with prediabetes alters gut microbiota and improves vitamin C status, anthropometric and clinical markers
- Vitamin C status in people with types 1 and 2 diabetes mellitus and varying degrees of renal dysfunction: relationship to body weight
Patient quality of life
Acute and chronic illnesses can dramatically impact on patients’ quality of life. Furthermore, various drugs, such as those used during cancer chemotherapy, can also impact negatively on quality of life.
We have carried out a number of case studies showing dramatic improvement in quality of life of oncology patients administered intravenous vitamin C. We are currently carrying out a randomised controlled trial to improve the vitamin C status and quality of life of myeloma patients undergoing conditioning chemotherapy and stem cell transplantation.
Current research
Published research
- Relief from cancer chemotherapy side effects with pharmacologic vitamin C
- Parenteral vitamin C for palliative care of terminal cancer patients
- Parenteral vitamin C relieves chronic fatigue and pain in a patient with rheumatoid arthritis and mononeuritis multiplex secondary to CNS vasculitis
Review articles
- The role of vitamin C in the treatment of pain: new insights
- Intravenous vitamin C for cancer therapy - identifying the current gaps in our knowledge
- The effect of intravenous vitamin C on cancer- and chemotherapy-related fatigue and quality of life
Global health and nutrition
People in low-middle income countries (LMIC) tend to have depleted nutrient status due to inadequate dietary intakes of essential nutrients and related comorbidities which increase requirements for specific nutrients, such as vitamin C. These factors may increase their risk and morbidity from COVID-19. Elderly are particularly at risk of severe COVID-19, therefore, we plan to assess the vitamin C requirements of elderly people. People with obesity (itself considered a global pandemic) are also at higher risk of severe COVID-19, and have higher requirements for vitamin C. This is currently not taken into account in the setting of global dietary intake recommendations for vitamin C (see our in-depth reviews below).
Current research
Published research
- Appropriate handling, processing and analysis of blood samples is essential to avoid oxidation of vitamin C to dehydroascorbic acid
- Erythrocyte ascorbate is a potential indicator of steady-state plasma ascorbate concentrations in healthy non-fasting individuals
