A cocktail of steroids and vitamin C, often found in citrus and leafy green produce, might hold the key to treating sepsis. Or, clinical trials might prove it overhyped. liv friis-larsen / Alamy
After 28 years teaching and practicing critical care medicine, Dr. Paul Marik knows when a patient is at death’s door. So in January 2016, when 53-year-old Valerie Hobbs came into his intensive care unit with a severe case of sepsis, he expected it would be for the last time.
Hobbs had been admitted to Virginia’s Sentara Norfolk General Hospital for an infected gall-bladder that had led to septic shock. Now, the confounding infection was causing her blood pressure to bottom out and her organs to fail. Marik’s best guess was that she would be dead by morning.
“Faced with a young patient who is dying, you have to say to yourself, what else can I do?” he recalls. There was one thing he could do: order intravenous vitamin C.
Yes, vitamin C, the ubiquitous nutrient that children are encouraged to consume by eating dark leafy greens as well as citrus, peppers and other orange-hued produce. It’s well-known to prevent scurvy and help with heart function. But Marik, who is chief of the pulmonary and critical care medicine unit at Eastern Virginia Medical School, had been reading research papers that also showed some success treating sepsis patients with intravenous vitamin C—along with a steroid to reduce inflammation and thiamine to help with absorption.
More than a million Americans fall ill from severe sepsis annually, and between 28 and 50 percent of them die, according to the National Institute of General Medical Studies. Because it often requires a long hospital stay, sepsis costs U.S. hospitals about $23 billion annually. The Global Sepsis Alliance reports that sepsis kills between 6 and 8 million people each year. That’s more deaths than those caused by prostate cancer, breast cancer and AIDS combined.
Given the stakes, the vitamin C treatment didn’t seem so crazy. After all, Marik knew that sepsis patients often have undetectable levels of the nutrient, compared to healthy patients. Animals produce increased levels when they are stressed, but humans, thanks to a fatal mutation, are unable to make it on their own. The studies Marik read reported that replenishing vitamin C in sepsis patients could help them deal with shock and prevent organ damage. Why not give it a try?
“Most times you don’t have intravenous vitamin C, but fortunately our pharmacy had a small amount,” he says. “It was like the stars were aligning.” He gave Hobbs a cocktail of intravenous vitamin C, hydrocortisone and thiamine, and waited.
The next morning, Marik came in to discover Hobbs alive and already off the medication supporting her blood pressure. Her kidney function had improved. Two hours later, she was taken off a ventilator. Three days later, she went home. “You say, wow, what just happened?” Marik recalls. If the vitamin C protocol really did cure her, the consequences would be profound. Still, he thought, it might have been a fluke.
Not long after, Marik he had another patient come in seriously ill with sepsis. He tried the same protocol and had the same success. The X-rays of a third patient who came in with pneumonia and severe sepsis revealed that, one day after the protocol, his lungs were 50 percent clearer. The second day, they were 100 percent better, Marik says.
“At that point, I knew there was something here,” he says. “This was not just a fluke.”
Marik is no loose cannon. Even skeptics of his results acknowledge his expertise. He has authored more than 400 medical journal articles and four books, including a critical care textbook—together “an extraordinary contribution to the literature in critical care,” says Dr. Craig Coopersmith, a leading sepsis researcher at the Emory University School of Medicine.
Still, his colleagues at the hospital told him he was talking nonsense until they saw the results.