Articles

Alternative Microbiology

A man of science rises ever, in seeking truth; and if he never finds it in its wholeness, he discovers nevertheless very significant fragments; and these fragments of universal truth are precisely what constitutes science.

~ Claude Bernard.

I almost never have to search for material for this blog. The Secret always seems to provide topics. Subject matter appears unbidden out of the ether. But not this week. I enjoy deconstructing the nonsense of SCAM papers or blog entries more than any other type of blog entry. Perhaps the glee that last week’s entry provided had to be countered by some kind of cosmic balancing mechanism. Although the rational part of my mind objects to the personification of random existence, I suppose the Universe just does not want me to have that much fun two entries in a row. Probably explains why I have a viral URI and my brain has slowed almost to the point of functional inactivity. There is no shortage of SCAMs to write about, they are just not created equal in their ability to generate a passionate rant.

I am, as you know if you are regular reader, an infectious disease (ID) doctor. I find the field endlessly fascinating as ID reaches into all aspects of the human condition. I remember when I was driving from Minneapolis to LA in 1986 for my fellowship, Petersdorf wrote his (in)famous article that ID was a dying profession and soon, thanks to antibiotics, vaccines and other advances, infections would become a problem of the past. Fortunately for me, and unfortunately for thousands of people, that prediction has not come to pass although we are sliding slowly into the post-antibiotic era where soon I will be able to diagnose but not treat disease.

Infections have always been a major cause of human morbidity and mortality. Through most of human history, infections, trauma and starvation were the primary ways by which humans died. Tremendous amounts of work by thousands of people have elucidated many of the factors that increase the risk of infection. There are 1,213,762 citations on the PubMeds if you search for ‘infection’. Medicine has pushed infectious diseases to the edge of society. Compared to the past, most outpatient infections are trivial or easily treated. TB, malaria yellow fever, smallpox, measles, typhoid fever etc. etc. no longer commonly plague those in the developed world.

With the understanding of the life cycle of diseases, how they are spread, good nutrition, vaccination, flush toilets and a reasonably safe food supply we do not get infected at the rates that occurred in the bad old days. Infections do happen, sometimes for good reasons, sometimes for no reason at all, and with just enough frequency to keep me gainfully employed, although as I have whined about in the past, my consult volumes have declined about 50% this century as we have learned how to prevent many infections that once made up much of my practice.

We have an incredible understanding of the microbial pathogens that try to kill us and that will, someday unless we are cremated, consume us all. There is so much we understand about the microbial world and its interactions with us that it always flabbers my gaster to run across alternative microbiology: the many realty-free and somewhat incoherent frameworks that deny germs, our understanding of microbiology or have discovered their own unique understanding of the pathogenicity of various organisms. Rather than my usual detailed deconstruction of a single idea or topic, today will be a birds-eye overview, a compendium of microbiologic weirdness as seen through the fog of interferon.

I came across a peculiar book, The Genesis of Germs by Dr. Alan Gillen (the doctorate, ironically enough, in science education; like last week’s computer science degree, evidently the ‘science’ part was thought superfluous) a professor of biology at Liberty University. From my understanding, life on earth is old, billions of years old, and germs result from slow evolution over time. I never really had a sense of that time until I read John McPhee’s Annals of the Former World. Dr. Gillen has an alternative explanation for germs and infectious diseases.

I knew of intelligent design mostly in the context of the battles over the teaching of evolution in the schools several years ago, but I never paid it much mind professionally. ID is often understood as applied evolution. It may be the bacterial resistance or the human response to disease, but evolution has left its footprints all over my subspecialty. I suspect there are more variations in the human genome as a response to infections than any other process.

What is odd from Gillen’s textbook is that he starts from the premise that the world is about 6,000 years old, that evolution is not true and that intelligent design explains the world, then Gillen creatively interprets microbiology to fit these preconceived ideas. Why do we have germs and infection? Original sin.

It was not until after sin entered the world that some micro-organisms became pathogenic, or harmful, to man. One explanation is that the good bacteria began to deteriorate or degenerate into pathogenic bacteria. Genomic decay is one of the most likely theories for explaining the origin of bacterial pathogenicity….When a bacterium degenerates it loses valuable information and must find other sources to survive. Bacteria generally are made as one cell; as they lose information from their genetic hardware they consequently can no longer produce their own needed materials to synthesize their cell parts. And so, as they lack information they have to gain that information from some other creature (an animal or a person) and in doing so they cause disease symptoms.

Somehow I do not think that is a conceptual framework that will result in a deeper understanding of disease pathogenesis and treatment. Solutions to the next pandemic are unlikely to be forthcoming from the biology graduates of Liberty University. As we slowly slide into the post antibiotic era I am not sanguine that his approach of belief in scripture and Jesus leading to an end of germs and infectious disease, is likely to help me treat the next patient with a multi-drug resistant E. coli infection.

I know we have been writing on this topic for years but it remains remarkable how huge amounts of information can be ignored or creatively interpreted if they do not fit pre-existing beliefs. Does refining ones facts lead to opinion or does opinion lead to your understanding of the facts? My career, now in its 30th year, has been one of constant reassessment of my understanding of infectious diseases as new information appears with a change in my practice as a result. The old saying is half of what you learn in medical school will be eventually proven wrong, but the problem is you don’t know which half. It must be nice not having to worry about pesky facts or having to change your mind.

We have pro-SCAM commenters who come and go at the blog, but they all have a common characteristic: they do not change their mind because of facts. The pattern is consistent: they make errors of fact and those errors are corrected, but the pro-SCAM commenter never admits they were in error, nor do they have a change of opinion as a result of new information; they move on to other errors in fact. I suspect all the information about germs that contradict Dr. Gillen’s understanding of infection as a fall from grace 6,000 years ago cannot and will not be incorporated into a better understanding of infectious diseases. And I am glad the Dr. Gillen’s of the world, who advocate for a “biblical or creation perspective on disease”, are not in charge of the CDC.

The first cases of AIDS were reported when I was in medical school. AIDS has gone from a curiosity of unknown cause to a plague that filled my hospitals with sick and dying young men to an often-manageable chronic illness. It has been rare to see a death due to HIV this century; so much better compared to the 6 months from diagnosis to dead we used to see. It is amazing what has been learned about HIV and its complications and I would point out that none of the increase in survival we have seen has been due in any way to alternative medicines of any kind, for HIV or any disease. Science-based medicine delivers.

Germs don’t cause disease: if they did, we’d all be dead.

Yet there are those that still deny that HIV leads to AIDS. Last year I heard Peter H. Duesberg deliver a Gish Gallop on this opinion, contrary to a positively enormous scientific literature, that HIV does not cause AIDS but instead is due to drugs and sexual promiscuity. He may be the most prominent of the AIDS deniers. As I mentioned in the past, reality is a honey badger, it don’t care what your opinion is. You can deny the importance of HIV and convene a panel, as did the President of South Africa with Dr. Duesberg a member and support policies that HIV is not responsible for AIDS and promote alternative therapies. The result? Death.

Once that battle was lost in the courts and in the political arena, the Health Minister, Tshabalala-Msimang, continued to portray ARVs as ‘poison’ and to support alternative untested therapies. Demographic modelling suggests that if the national government had used ARVs for prevention and treatment at the same rate as the Western Cape (which defied national policy on ARVs), then about 171,000 HIV infections and 343,000 deaths could have been prevented between 1999 and 2007.

That is a remarkable record and a depressing result of denying reality. Not just HIV, there is still a contingent of people who deny germs cause disease, which to my mind is akin to denying that water is wet.

We do not catch diseases. We build them. We have to eat, drink, think, and feel them into existence. We work hard at developing our diseases. We must work just as hard at restoring health. The presence of germs does not constitute the presence of a disease. Bacteria are scavengers of nature…they reduce dead tissue to its smallest element. Germs or bacteria have no influence, whatsoever, on live cells. Germs or microbes flourish as scavengers at the site of disease. They are just living on the unprocessed metabolic waste and diseased, malnourished, nonresistant tissue in the first place. They are not the cause of the disease, any more than flies and maggots cause garbage.

You can always tell a germ denier as they spread the lie that Pasteur recanted on his death bed that bacteria cause disease. He actual final words were “I cannot” in response to being offer a glass of milk, although I suspect he spoke in French. He was right when he said “Messieurs, c’est les microbes qui auront le dernier mot (Gentlemen, it is the microbes who will have the last word)”. I hope my last words will be directed at my brother: “touched you last”. Like he will let me even on my death bed.

The real mystery—one that deeply intrigued me 25 years ago—is that so many therapies that totally disagree with one another manage to bring results. Ayurveda isn’t qigong; yoga isn’t Reiki; none of them is a placebo. Yet somehow healing exists, and the channel it takes can be quite unexpected and inexplicable.

~ D. Chopra

It is no mystery to me; they are all nonsense. But for every SCAM there is an equal and opposite SCAM. For every homeopathic nostrum there is a megadose therapy. And for every germ denier there is a proponent that all diseases or symptoms are due to infections. It is true of all interesting diseases, however.

Hulda Clark was of the opinion that all cancers and other diseases were due to Fasciolopsis buski, the liver fluke, and that HIV was due to the same pathogen.

If (Fasciolopsis) establishes itself in the thymus, it causes HIV/AIDS!

There is Candida and Lyme, both allegedly causing the same list of symptoms. How to tell the difference between the two? I have Lyme, given that only Lyme has the symptom of “Decreased ability to spell correctly.” Or the imaginary infection of Morgellons. Or the Marshall Protocol, which hypothesizes, among other things, that autoimmune illnesses are perpetuated by bacterial colonies in biofilms and that promoting vitamin D deficiency is the treatment. You know there is something wrong with an alternative treatment if even Dr. Mercola finds fault with it.

So many different ways to ignore the real, complex, and interesting fields of microbiology and infectious diseases. New microbiology, ignoring microbiology, new diseases and life cycles for existing organisms. A rich fantasy world.

Despisers of their fellows: They make poor observations, because they choose among the results of their experiments only what suits their object, neglecting whatever is unrelated to it and carefully setting aside everything which might tend toward the idea they wish to combat.

~Claude Bernard.

Posted in: Epidemiology, Evolution, Science and Medicine

Leave a Comment (60) ↓

60 thoughts on “Alternative Microbiology

  1. windriven says:

    “What is odd from this textbook is he starts from the premise that the world is about 6000 years old, that evolution is not true and intelligent design explains the world”

    The god that these people believe in is really a jerk. He – it is always a he – creates the world 6,000 years ago but seeds the landscape with faux fossils and rocks so diabolically constructed that sinning scientists believe them to be much older, gave his magnum opus ‘man’ brains, but commands him to ignore the tantalizing clues and believe instead the 2500 year old scribblings of Tusken Raiders translated and retranslated from a language roughly 11 living people still understand. Perfectly logical.

    He is a loving god who visits horrific diseases and deformities on tiny babies – and if they die before they’re baptized, well, tough tooties for them. He is a god of ‘an eye for an eye’ but his son is a ‘turn the other cheek’ girly-man. What a disappointment he must be. Kids these days…

    To misquote Chicolini Marx: “Who are you going to believe, god or your lying eyes?

  2. Neil J says:

    I recently had the misfortune of being subjected to a keynote speech at my girlfriend’s med school formal, delivered by a doctor who seemed to be flirting with germ theory denial. She had become convinced, after spending time at the University of Arizona’s integrative medicine program, that the main cause of disease is “inflammation”, and was so enamoured of the notion that she wasn’t at all ashamed to announce it in front of an auditorium full of her students and peers. She received a standing ovation from a few of the students, but I was heartened to see that the rest of the faculty table remained seated.

    Hell, I’m a physicist and even I knew she was spouting nonsense. Maybe there’s a microbe responsible for such fantastical thinking, and it’s slowly but surely forging its way North of the border. Now might be the right time to think about quarantining Arizona.

    1. goodnightirene says:

      Love your post. The scary thing is that more and more of this sort of thing is being reported here and elsewhere.

    2. James says:

      Maybe there’s a microbe responsible for such fantastical thinking

      Maybe there is
      http://www.theatlantic.com/magazine/archive/2012/03/how-your-cat-is-making-you-crazy/308873/

  3. Calli Arcale says:

    Wait . . . so his book is based in *both* Young Earth Creationism and Intelligent Design? That’s hilarious to me, since normally Intelligent Design* is an attempt to synchretize evolution and millions of years of paleontological evidence with the premise of “God made us exactly as we are and there was no chance involved”. Intelligent Design should be anathema to him, if he’s a Young Earth Creationist, since if the account in Genesis is literally true, then there is no need for Intelligent Design to explain anything — it was all made out of clay in the beginning, not guided into existence over time.

    Once again I find myself wondering whether we’ll see Alternative Engineering offered or taken anywhere near as seriously as Alternative Medicine. (Watch the amazing Mystico and his assistant Janice put up a block of flats entirely by hypnosis!)

    * Not to be confused with Infectious Disease, of course, which I did confuse a couple of times while reading this; you might want to avoid the “ID” acronym in a discussion of creationism to avoid confusion.

    1. WilliamLawrenceUtridge says:

      Intelligent design is just big-tent creationism, like most creationism (and CAM) – who cares if your ideas are mutually contradictory when the plan is to shoehorn in your preferred nonsense through politics and courts?

    2. mousethatroared says:

      Calli Arcale “Once again I find myself wondering whether we’ll see Alternative Engineering offered or taken anywhere near as seriously as Alternative Medicine. (Watch the amazing Mystico and his assistant Janice put up a block of flats entirely by hypnosis!)”

      Well, there’s that building in London that melts cars….does that count? I guess not…more an unfortunate balance of engineering and esthetics.

      1. Lytrigian says:

        Or rather, aesthetics entirely uninformed by engineering. I remain astonished that anyone would construct what amounts to a gargantuan parabolic mirror just because it looks pretty, and then claim to be surprised by what happens when the Sun hits it.

        In the Robert Heinlein novella, “Magic, Inc.”, a contractor can build a set of bleachers for a parade by first building one section conventionally. He then cut it into bits, and hired a magician who used them to temporarily construct multiple sections using the magical laws of similarity and contagion. (The latter being entirely discrete from contagion in the infectious disease sense.) On one occasion a plank from a demolished house got mixed up with those for bleachers and he found he’d inadvertently built, if memory serves, a two-story townhouse…

        1. mousethatroared says:

          I’m working from memory, but I thought I heard on NPR that the architect claimed he had modeled the reflective heat potential of the building and it’s was only problematic a few days of the year, since London is typically cloudy and rainy…so it was okay, then. ;)

          1. Nashira says:

            Oh mercy me. According to the Guardian, the architect had already designed a building with this same heat reflection issue. But of course it’s not his fault that it happened again, right? It’s not like the sun exists in both Las Vegas *and* London.

            1. Renate says:

              Yes, without global warming, the sun never shines in London. I once spend a vacation in England, partly in London and we had nice weather for most of the 3 weeks and this was more than 35 years ago.

            2. Calli Arcale says:

              Wait — he built one in Vegas too? That’s in the freakin’ desert! You’d think that one would be a death ray.

              *yeesh* I clicked through and read the article. So the one in Vegas was actually setting people’s hair on fire. Wow.

              “I knew this was going to happen,” said Viñoly, speaking to the Guardian on Friday. “But there was a lack of tools or software that could be used to analyse the problem accurately.”

              Akin’s 9th Law: “Not having all the information you need is never a satisfactory excuse for not starting the analysis.”

            3. Lytrigian says:

              A clue, he should have gotten one.

  4. Keating Willcox says:

    The young earth theory is the worst enemy of ID. It is still possible to ask, given that everything that science knows is true, what is the evidence of intelligent design. This is pure science, even if the result has religious implications.

    As far as antibiotics and the germ theory, do these folks take into account the billions of organisms that make up each person?Surely if there are that many good germs, there must also be the possibility of bad germs as well.

    Last, if scientists spent their energy, not fighting young earth educators, and instead took on big Agro and the insidious use of antibiotics and hormones simply to increase crop yield, that would be a good thing.

    1. WilliamLawrenceUtridge says:

      ID is its own worst enemy, it can only convince the already convinced, systematically misrepresents actual science, and lies, constantly and endlessly, to anyone who bothers to listen. “Oh, no, the intelligent designer, it totally isn’t YHWH, it could be aliens! Or…aliens!” Meanwhile they present to Christian revival groups, get funded by Christian organizations, and when talking to actual Christians, talk unambiguously about one particular god, the one that plays best to their base. Such fundamental dishonesty is distasteful. There’s no science involved, it’s merely Paley’s watchmaker analogy writ tiny, and the usual “evolution doesn’t explain everything”, leaving out the “yet”.

      As far as antibiotics and the germ theory, do these folks take into account the billions of organisms that make up each person?Surely if there are that many good germs, there must also be the possibility of bad germs as well

      1) Yes, science takes into account the billions of organisms that live upon (and occasionally in) the body’s surfaces.

      2) What are you talking about? Probiotics? They are a rather hot research topic these days.

      Last, if scientists spent their energy, not fighting young earth educators, and instead took on big Agro and the insidious use of antibiotics and hormones simply to increase crop yield, that would be a good thing.

      Big Agro is quite science-based, and does a lot of good that the antiscientific left ignores or is blatantly ignorant of. For instance, they could, and have, successfully reduced the number of pesticides and herbicides used through genetic modification. I’m hoping they solve the antibiotics to cows problem through vat meat!

      However, Young Earth Creationists are a far, far more insidious problem as they attempt to errode the knowledge of and faith in science itself, attempt to discredit its methodology and prevent an entire generation of students from understanding how science really works. They are politically motivated, well-funded and nearly ubiquitous – and spreading outside of the United States. If I had to pick a topic for popular science educators to work on, I”m a bit torn – Creationism’s long-term pernicious effects are probably worse, but the challenges to GMO often go unaddressed and it’s taken as given that “Monsanto” is an argument rather than an ignorant cop-out. Ultimately both are not about science anyways, they are in large part about politics.

      1. mousethatroared says:

        WLU Big Auto is quite science based…yet they have to be forced to comply with some safety and environmental controls. Why is that?

        1. WilliamLawrenceUtridge says:

          I’m going with consumer protection for safety and economics (externalities) for environmental. I’m not saying Big Agro shouldn’t be governed by laws, I’m saying the unscientific Left is ideologically motivated to ignore the good that Monsanto does, to the world’s detriment. Not that Monsanto’s a saint, but from my reading, a lot of the alleged harm they do is misrepresented, and a lot of it is fueled by scientific ignorance and the same misfiring ritual purity centers that make people fear fluoridation.

          1. mousethatroared says:

            The commentor was a bit unclear. Concern over crops might be a concern about Monsanto – more of a antitrust concern in my mind.

            Concern over antibiotics and hormone is more livestock management…The concerns over antibiotics misuse are not-unscientific. Regulation seem inadequate at this point. Attempt to regulate have been predictably undermined by the livestock industry.

            To lump all these concerns together into “unscientific left” does the legitimate concerns injustice.

          2. WilliamLawrenceUtridge says:

            Monsanto isn’t really a monopoly though, there are other companies that do similar research. Plus, the main reason why GMO is so expensive is the (scientifically unnecessary) safety burden imposed upon the results. In economic terms, it’s a matter of high entry barriers, which means small start-ups can’t enter the market and drive down costs through competition.

            I’m talking basically solely about Monsanto and GMO, not livestock, and GMO is mainly a concern of the left.

    2. windriven says:

      @Keating Wilcox

      “[I]f scientists spent their energy, not fighting young earth educators, and instead took on big Agro and the insidious use of antibiotics and hormones simply to increase crop yield, that would be a good thing.”

      I’m not sure if your comment is intended to be satirical. I want to give you the benefit of the doubt and and credit you with a bone dry sense of humor. Surely you know that some scientists do oppose the use of antibiotics and hormones – but those are used to increase livestock yield, not crop yield. Human populations can live comfortably with less consumption of animal protein. I’d rather not, thank you, but I’ll do my part.

      Crop yield, GMOs, nitrogen fertilizers, pesticides and herbicides are another issue entirely. And sharply limiting these would likely trigger a Malthusian debacle that I’d rather not be around for. Let’s be sure we can more or less feed the world population before we go all organic.

    3. Marion says:

      And maybe if the antibiotic-obsessed antiscience right would stop wasting time & energy with attacks on “Big Agro”, which manages to feed billions of people, and instead advocated veganism, supported cultured meat (lab grown meat) to feed cats & dogs, supported outlawing breeding animals for meat, put people in prison for being part of the meat industry, and attacked Big Meat for needlessly breeding & torturing 10 billion animals a year – there would be more decent jobs to go around. Instead, they divert resources & efforts with exaggerated health damage to humans.

      1. WilliamLawrenceUtridge says:

        I can’t wait for vat meat to be commercial viable. Within years, I bet they’ll be infusing the vat-grown meat directly with different flavours, omega fatty acids and various other healthful substances. Perhaps even fiber! Yum!

  5. Craig Lilley says:

    “Through most of human history, infections, trauma and starvation were the primary ways by which humans died.”

    Forgive me cause I’ve had a few beers – aren’t these the ONLY reasons for human deaths. I can’t think of another way of dying that doesn’t fit these categories, therefore,you are wrong and alternative medicine wins. Sorry.

    1. windriven says:

      @Craig Lilley

      Cancer. Genetic defects. Cystic fibrosis. Muscular dystrophy. But all of those can be successfully treated with a combination of homeopathy, acupuncture and, most importantly antisubluxation maneuvers. When it works they live forever.

      1. WilliamLawrenceUtridge says:

        Aging, hayflick limits, poisoning, suffocation, radiation poisoning, and depending on whether it’s a subset of trauma or not, being burnt to death. Stake optional.

    2. mousethatroared says:

      Craig Lilley “Forgive me cause I’ve had a few beers – aren’t these the ONLY reasons for human deaths. ”

      There are other ways to die, think.

      V – Vascular
      I – Inflammatory
      N – Neoplastic
      D – Degenerative / Deficiency
      I – Idiopathic, Intoxication
      C – Congenital
      A – Autoimmune / Allergic
      T – Traumatic
      E – Endocrine

      1. Craig Lilley says:

        This led to some widespread googling and I can confirm that all the things you mention are, in fact, different ways to die. But wouldn’t things be simpler if we just had three? Three is much less than nine. Maybe you just need to change your belief system.

        Anyway, at least I have your mnemonic. Thanks!

        1. windriven says:

          You’ve traded beer goggles for google goggles?

        2. WilliamLawrenceUtridge says:

          I hope you’re not serious. If you’re kidding, that made me laugh :)

          If not, it makes me sad :(

        3. mousethatroared says:

          Craig Lilley – Yes, three would be simpler, especially if I mistook my hypothetical severe shellfish allergy for an infection or starvation and continued eating shellfish. Then I’d be dead and being dead is very simple.

          You are poeing us, aren’t you? :)

      2. Marion says:

        That’s an excellent mnemonic, mousethatroared.
        I often have to remind myself of the variety of ways humans and nonhumans can die.

        But you left out: “Darwin Award Style Hilarity”

  6. RobRN says:

    “…the world is about 6,000 years old…” HA!!!

    Somewhere I heard that the Chinese have written history from before that – I wish I had a solid reference for that to use as ammunition when I encounter fundies!

  7. Vicki says:

    For actual writing, it seems to be a bit under 6,000 years ago, But there’s cave art quite a bit older than that. The same people who deny the carbon dating of the paintings at places like Lascaux would deny the dating of any writing that old: they can’t accept the methods that date things like the oldest writings at Harappa without their entire house of cards collapsing.

    There are individual living organisms that are much more than 6,000 years old.

    1. WilliamLawrenceUtridge says:

      Generally the issue is more the ambiguity of the alleged writing itself, not a “house of cards” or ideological motivation. Such is the nature of all archaeology, the further back you go, the more speculation and the less evidence.

  8. Andrés says:

    Perhaps I have been too pesimistic. Perhaps vitamin C megadose vindication is coming (no homeopathic nemesis needed). Not that I have found anything new about vitamin C and rabies (gross estimation of the probability of 17 or less of the 48 guinea pigs in the treatment group dying and 35 or more of the 50 controls dying supposing it being completely by chance —supposing probability of a death being 52/98— is 0.01%). I have found some new research on vitamin C and sepsis by a research group from the Virginia Commonwealth University. In Ascorbic acid attenuates lipopolysaccharide-induced acute lung injury they found that 4 of 7 ascorbic acid (200mg/kg) treated mice and 5 of 7 dehydroascorbic acid (200mg/kg) treated mice survived intraperitoneally lipopolysaccharide letal dose (0 of 7) for the control group. Gross estimation of the probability for this or a more extreme result (higher survival in the treatment group) is 0.17%. They have further explored the mechanism in a couple of papers (here and here) inducing sepsis.

    I have already pointed out that very ill patients have low concentrations of ascorbic acid even when receiving total parenteral nutrition with something like 200mg/day of vitamin C (this paper). I have already pointed out that the only recent intervention study I am aware of is a retrospective cohort one with 3g/day and several other substances for seven days pointing toward a positive effect commented here and here (via Dr. Dach). It seems that nobody cares to use ascorbic acid increasing the dose yet.

    1. windriven says:

      Hey Andres-

      Nothing you have said seems to be worth the huge task of tracking recursively through your cited posts to get to the source citations. When I started I got as far as the Jungeblut 1941 paper on in vitro ascorbic acid.

      You follow that in vitro means, in effect, in the test tube. You also understand that lots of things happen in test tubes that don’t happen in the far more complex body of a living organism, right?

      Do us a favor and quit with the enigmatic comments. If you have something to say, lay it out along with citations to source docs.

      1. Andrés says:

        Well, I think you can skip any SBM-comment link on my later comment and just click on any other of the links. No one of those links points toward an in vitro only study.

        I always try to point to sources, mind you. Sorry, I am not going to stop referencing previous comments because I don’t want to repeat myself every time I comment around here. Feel free to skip over my comments if you wish. It seems to be common practice anyway.

        We are still learning new action mechanisms of vitamin C in the immune system, backed up the plausibility of their existence previously to be known by vitamin C natural history in vertebrates. There already is a lot of supporting evidence to the hypothesis “intravenous/intramuscular vitamin C in high doses (let’s say 400mg/kg per day) is an effective viricidal (as a matter of fact, an effective antitoxin too) intervention” from in vitro and in vivo animal experiments to human clinical experience documenting a case series.

        My point? That hypothesis should be refuted à la Popper, not ignored. It doesn’t cut it despising the supporting evidence with sentences like:

        For every homeopathic nostrum there is a megadose therapy.

        I wouldn’t bother to comment around here if this blog were called “SCAM Bashing”. I agree that as stated by Dr. Hall (point 36) they are free to choose any subject to write about. But this blog is called Science Based Medicine. I think that the Science part obliges to higher standards of refutation than guilt by association.

        PS: Is there any way left to subscribe to comments of a single post?

        1. WilliamLawrenceUtridge says:

          There already is a lot of supporting evidence to the hypothesis “intravenous/intramuscular vitamin C in high doses (let’s say 400mg/kg per day) is an effective viricidal (as a matter of fact, an effective antitoxin too) intervention” from in vitro and in vivo animal experiments to human clinical experience documenting a case series.

          Yes, we call that “preliminary evidence”, the kind used to build a case to test in humans. They are suggestive, they are not proof. It’s easy to prove things in test tubes, petri dishes, animals and small case series. Also, what happens to the human body when roughly 0.04% by weight of it is made up of vitamin C, forced directly into the bloodstream? That’s a lot of vitamin C, what sorts of effects would that have on the rest of the body? Could it have a pro-oxidant effect? Could you get rebound scurvy? How about the effects of having to balance the pH of that much acid, or excretion? What are the long-term effects? Are you concerned about kidney failure? What about the amount of fluid you would need to infuse that much vitamin C, and the resulting concentration of solutes and ions in the blood?

          As for whether the hypothesis is tested or not – you would pretty much have to defer to the experts. Funding decisions are made by peer review, when discussing public money. Perhaps Big Pharma, or the multi-billion dollar supplement industry could chip in some money to run the trials if they are so promising. I have no doubt that both would love an excuse to sell vitamin C by the ton – but unfortunately, when using vitamins as a drug one must test them as a drug, to ensure safety and efficacy. Dr. Gorski once described vitamin C for cancer treatment as a long run for a short slide, perhaps its use as a viricidal agent will be more promising.

          I wouldn’t bother to comment around here if this blog were called “SCAM Bashing”. I agree that as stated by Dr. Hall (point 36) they are free to choose any subject to write about. But this blog is called Science Based Medicine. I think that the Science part obliges to higher standards of refutation than guilt by association.

          Meh, feel free to not read it. I will note however, that many posts are either on single papers that are analyzed by the editors (often for flaws) or general summaries of topics based on expert consensus statements and systematic reviews. What you are doing is cherry-picking. Perhaps in a good way, the same way a researcher writing the introductory section of an article might, to offer a brief but cogent summary of the sub-sub-sub issue they are addressing. Perhaps the way a proponent of an unlikely idea might, providing all the positive evidence and willfully ignoring the negative evidence, to an audience that is uninterested in sifting the literature to find out if you are representing, or misrepresenting the topic.

          If you’re right, great! Once proven, high-dose vitamin C will become one of the standard treatments available to doctors. But prove it first, don’t proclaim it a win on the basis of glass and rat studies. Or apply for an NIH grant, or write directly to Pfizer and their ilk to suggest new studies. I’m not sure why you’re trying to convince people here though.

          1. Andrés says:

            We already have quite a good idea of the secondary effects of an intravenous vitamin C treatment from the phase I trial by Dr. Hoffer et alter. Another phase I trial of intravenous vitamin C has already taken place with higher doses. Of course when I say intravenous vitamin C it has to be sodium ascorbate and they have refined those electrolytes needed in this latter study. Perhaps a clinical trial in acute cases of influenza with pneumonia should exclude those patients with compromised kidney function.

            I cherry picked only in the sense of focusing in intramuscular/intravenous infusion of gram doses. I have already said that given the different blood concentrations attained regarding to oral ingestion it seems plausible that they are not going to have the same effect.

            I am trying to access a medicine doctor perhaps in a position to organize a clinical trial around here (Spain). No success at the moment.

            I keep trying to convince people around here because of my Quixote character I suppose.

            1. WilliamLawrenceUtridge says:

              1) Your phase I trial failed to show anything beyond “people with advanced cancer don’t appear to suffer from IV vitamin C infusion”

              2) It’s a trial of cancer. What relevance does it have to the treatment of viral infection?

              3) The process to lead up to a clinical trial is of bench and animal research, followed by human trials. We know a lot about vitamin C and how it is processed in the body. The fact that vitamins are necessary for human life does not mean they are magical, and we have no evidence that vitamin C is much better than any other compound given in huge doses at preventing or treating viral or bacterial infections. You are trying to skip over the basics of clinical research on the basis of a fallacy – that if a little vitamin C is necessary, a huge dose of it must be magic. It’s a common misconception found among CAM promoters, and in particular the orthmolecular lunatics. Rather than jumping into human studies, you need to reconcile your claims with existing knowledge about vitamin C found within the body.

              There is a reason why science has sub-sub-sub-specialized. We know a lot. It is naive to think that an outsider nonspecialist can just leap in and posit a novel, hitherto-unappreciated mechanism. Even brilliant, proven scientists like Pauling got it wrong. One must respect science.

              1. Andrés says:

                1) Your phase I trial failed to show anything beyond “people with advanced cancer don’t appear to suffer from IV vitamin C infusion”

                I have already commented on it: I don’t think probable that a short course of intravenous vitamin C is going to drive any long-term harm when they have not beeng observed in any of the patients of Dr. Hoffer’s study, some of them (two with stable disease) more than 6 cycles, each cycle 4 weeks, each week three treatments of 0.6g/kg.

                2) It’s a trial of cancer. What relevance does it have to the treatment of viral infection?

                Really? It was you who asked:

                Also, what happens to the human body when roughly 0.04% by weight of it is made up of vitamin C, forced directly into the bloodstream? That’s a lot of vitamin C, what sorts of effects would that have on the rest of the body? Could it have a pro-oxidant effect? Could you get rebound scurvy? How about the effects of having to balance the pH of that much acid, or excretion? What are the long-term effects? Are you concerned about kidney failure? What about the amount of fluid you would need to infuse that much vitamin C, and the resulting concentration of solutes and ions in the blood?

                So I think it is quite pertinent those two Phase I trials focused on identifying unexpected consequences of high doses of intravenous vitamin.

                3) The process to lead up to a clinical trial is of bench and animal research, followed by human trials. We know a lot about vitamin C and how it is processed in the body.

                We don’t know as much as you are implying. Certainly we are still discovering new actions on the immune system and still trying to understand how does it works in another ones already known.

                The fact that vitamins are necessary for human life does not mean they are magical, and we have no evidence that vitamin C is much better than any other compound given in huge doses at preventing or treating viral or bacterial infections. You are trying to skip over the basics of clinical research on the basis of a fallacy – that if a little vitamin C is necessary, a huge dose of it must be magic.

                Are you kidding me? It is not a fallacy, it is an hypothesis. If mammals increased ascorbic acid production under stress perhaps humans may benefit of increasing/assuring ascorbic acid blood levels under stress. It will be a fallacy whenever it is falsified à la Popper, currently it hasn’t been as far as I can discern. I have already commented on its plausibility. I have already pointed to animal and human supporting evidence.

                It’s a common misconception found among CAM promoters, and in particular the orthmolecular lunatics. Rather than jumping into human studies, you need to reconcile your claims with existing knowledge about vitamin C found within the body.

                You are aware that this is simply an ad hominem attack, aren’t you? I am quite certain that existing knowledge points towards using vitamin C in high doses to treat viral and bacterial infections. All you bring up is your opinion on the matter and that of I don’t know which supposed experts.

                There is a reason why science has sub-sub-sub-specialized. We know a lot. It is naive to think that an outsider nonspecialist can just leap in and posit a novel, hitherto-unappreciated mechanism.

                You are aware that I am not positing any novel, hitherto-unappreciated mechanism but pointing toward those scientists that have posited them, aren’t you?

                Even brilliant, proven scientists like Pauling got it wrong. One must respect science.

                I already have stated my opinion about Pauling supposed messing up. I must be a little dumb today. Just tell it clearly to me: are you implying that I am stupid? Not that it matters at all in respect to the hypothesis being falsified or not.

              2. WilliamLawrenceUtridge says:

                I do think you have a particularly vivid assurance of your ability to parse the data, and an excessive trust in research, conducted by some extremely questionable “doctors”, merely because you want the hypothesis to be true. And I wonder what a genuine expert on vitamin C metabolism or infectious disease would have to say about this.

  9. windriven says:

    Andres,
    Can you sum up in a paragraph or two exactly what you think science should be doing with ascorbic acid? Pubmed is littered with studies of ascorbic acid in vitro, in vivo, in mouse models, even in sturgeon. A brief review of a number of these suggests that whatever signal might exist is buried in a lot of noise. Still, study is ongoing.

    This is, as you noted, Science Based Medicine. SBM does not jump on a bandwagon that is still on the drafting table. Further, nothing that I have read in the professional literature suggests that vitamin C is a silver bullet; only that there are some interesting results worth pursuing. And they are being pursued. Write your congressperson asking for more research money for NIH.

    So what exactly would you have science do that it isn’t already doing?

    1. Andrés says:

      Speeding up I supose.

      Nevertheless, I don’t know why it is not common practice measuring blood vitamin C levels in ICUs and any deficiency (they seem to be common) corrected since we already know its influence in the immune system. Replenishment to normal levels of a vitamin wouldn’t require any drug-like approach.

      1. windriven says:

        “Replenishment to normal levels of a vitamin wouldn’t require any drug-like approach.”

        I don’t catch your meaning here,Andres. How would ascorbic acid infusion not be a drug-like approach? Drugs are compounds that are introduced to the body to produce particular physiological effects. I guess drinking a glass of orange juice wouldn’t pass muster. But IV ascorbic acid, I think, easily meets the definition of a drug.

        1. WilliamLawrenceUtridge says:

          Vitamins given in high enough concentration acts as drugs. Vitamin K and coagulation. Vitamin D and death (polar bear liver!). Niacin and hypercholesterolemia (and “
          flushing of the skin, stomach upset, headache, dizziness, blurred vision, and liver damage
          ). Vitamins given at high enough doses to have acute effects beyond mere prevention of deficiency are just as likely to have side effects. Nearly anything does, the dose makes the poison for essentially everything – water, vitamins, food, oxygen, and certainly drugs. You simply can’t absorb enough vitamin C through food or pills to raise blood levels past a certain point, and your body did not evolve to have blood levels of vitamin C past this point – so the effects are unknown. Particularly any chronic effects. The constant shifting of the goalposts by proponents whenever the latest study shows no change in health parameters is ridiculous and irritating. Hey, maybe high-dose vitamins aren’t actually good for you! A bit is healthy does not mean more is better.

          1. windriven says:

            “Vitamins given in high enough concentration acts as drugs”

            Exactly my point, William. In fact I’m not sure that I would argue that concentration is a necessary modifier.

            “A bit is healthy does not mean more is better.”

            Proof positive that you aren’t from Texas.

        2. Andrés says:

          Replenishment to normal physiological level in those patients with measured low ones doesn’t need any clinical trial of any kind in my view. It is plausible that it will get a positive effect. Clinical trials are needed to check supraphysiological levels though.

          Vitamins given in high enough concentration acts as drugs. Vitamin K and coagulation. Vitamin D and death (polar bear liver!). Niacin and hypercholesterolemia

          I wouldn’t take vitamin K1 or gram doses of niacin without medical supervision. Polar bear liver is toxic due to vitamin A, not D.

          You simply can’t absorb enough vitamin C through food or pills to raise blood levels past a certain point, and your body did not evolve to have blood levels of vitamin C past this point – so the effects are unknown. Particularly any chronic effects.

          Vitamin D is not a vitamin. Vitamin C is quite different than the rest of vitamins. It is the only one which first some fresh water fish and hence later terrestrial vertebrates get to produce themselves. The immune system of all of the vertebrates use vitamin C. At least mammals produce it in higher amounts under stress. Perhaps humans may benefit of increasing/assuring ascorbic acid blood levels under stress such as viral or bacterial infection. That hypothesis is not stupid. That hypothesis should be falsified.

          1. WilliamLawrenceUtridge says:

            Polar bear liver is toxic due to vitamin A, not D.

            Yep, my mistake, though of course vitamin D is still toxic in high doses.

            Vitamin C and D are both vitamins, under the definition of “something essential for life not produced by the body”. You can argue vitamin D is an exception because of sunlight. Fair enough. But if you put someone in a dark room and don’t give them vitamin D in food or supplements, they will die of vitamin D deficiency and rickets is a real thing. So I’m calling vitamin D a vitamin and I think it’s reasonable to do so. As for the rest, sure, it’s a hypothesis. It could be tested. Whether it’s worth the money spent on it is another question, one best left up to peer review committees in my mind.

            1. Andrés says:

              Yep, my mistake, though of course vitamin D is still toxic in high doses.

              Of course. I completely avoid multivitamin mixtures including vitamin D. I hope vitamin D only formulations to be more reliable.

              As for the rest, sure, it’s a hypothesis. It could be tested. Whether it’s worth the money spent on it is another question, one best left up to peer review committees in my mind.

              As a matter of fact a clinical trial trying to falsify it should be relatively cheap if focused on critically ill patients in ICU (like the retrospective cohort one) and high doses of intravenous vitamin C of at least 0.4g/kg per day (this dose doesn’t bring up any side effect). As I have already commented, focusing on mild infections (like a cold) would be overkill for intravenous vitamin C and hardly plausible to show a clear effect or lack thereof.

          2. Sawyer says:

            But that hypothesis has been tested systematically for over 80 years! It seems to come out slightly positive in small trials, and (surprise surprise) the positive effects drop below statistical significance in larger studies.

            In a world of infinite funding and the ability to detect microscopic effect sizes, sure, I’d be all for scientists studying Vitamin C in more detail. In the real world there are thousands of other topics that take priority.

            1. Andrés says:

              But that hypothesis has been tested systematically for over 80 years! It seems to come out slightly positive in small trials, and (surprise surprise) the positive effects drop below statistical significance in larger studies.

              Really? I suppose you are talking about oral vitamin C and cold prevention/treatment. I have already conceded the poor results in prevention and treatment with oral doses up to 8g/day. I am talking about the hypothesis “intravenous/intramuscular vitamin C in high doses (let’s say 400mg/kg per day) is an effective viricidal (as a matter of fact, an effective antitoxin too) intervention”. Feel free to point toward any falsifying evidence.

  10. Skeptiquette says:

    I guess I will try again to post it in the correct thread…

    I think there are some legitimate avenues to explore in “alternative microbiology” , which in my mind means microbiological ideas that are nascent (like Dr. Crislip pointed out in his first quote, unifying theories or understandings are built from fragments through arduous scientific research) and only a piece of the greater puzzle.

    I will just point out one idea that I think holds some water and could alter the way we do “business” in the medical world. That is the idea of microbial endocrinology. Here is a link to a quick primer:

    http://www.asm.org/ccLibraryFiles/FILENAME/000000004816/znw00409000169.pdf

    This idea is prefaced on the fact that bacteria have coevolved with various organisms that secrete hormones and have developed receptors for these exogenous macro molecules, and so, have the ability to alter their patterns of genetic expression depending the state of the host.

    In a sense, this bridges that gap of the oft touted quote that: “it is the terrain that matters” meaning it is the state of the host that makes one sick, not the bacteria.
    The interplay between host and pathogen is very important and could unlock clues to potentially therapeutic avenues of treatment for infectious disease that are more effective than current approaches.

    Some of the seminal work done in the field in the last decade has explored how stress hormones can alter the expression of genes in bacteria, eliciting the expression of virulence factors. It is certainly an interesting notion to think that the state of the host may be provoking the virulence of a normally symbiotic bacteria or even an invading pathogen. It also makes sense that this would be the case. To what extent we can alter this provocation and prevent infection is up in the air.

    Some other ideas that come to mind when contemplating this are:

    How does the state of the immune system regulate bacterial genetic expression? Is the inflammatory state a provocateur of virulence in normal flora (strep pneumoniae, B. Pertussis, which are etc.) think secondary bacterial infections post viral infection. (this idea in contrast to the concept of secondary infection due to compromised immune system from primary viral infection)

    How does the normal flora regulate the tone of the innate immune system? i.e. circulating cytokines (regulatory, anti-inflammatory, and pro-inflammatory).
    How does diet affect the milieu of normal flora? Which may ultimately impact the above questions?

    Do, and if so, How do vaccines affect the trajectory of bacterial colonization of the neonate? Via alteration of the cytokine milieu? Via alteration of normal pathogen exposure?

    Just some thoughts to spark discussion…

    Skeptiquette

  11. Roman says:

    “…the world is about 6,000 years old…” HA!!!

    How Hubble Killed God…

    March 9, 2004: NASA releases a single image taken by the Hubble Space telescope that proves a fatal blow to the concept of God, but despite the compelling evidence, many simply don’t comprehend the significance of the image.

    http://paralleldivergence.com/2006/11/11/how-hubble-killed-god/

    This evidence yet again stamps “expired” on creationist and ID asseverations. Funny that no one in the wide world out there gives any sign of ever having noticed.

Comments are closed.