Simple, science-based steps to boost your immunity can help prevent or moderate infection — including challenging the…

Lovins’ 16 March 2020 presentation, “Slowing Contagion,” highlighted the benefits of oral vitamin C in potentially reducing the risk of COVID-19 and similar respiratory RNA viruses. Should you contract such an infection, research indicates that sufficient oral l-ascorbate can lead to a milder and shorter illness, with a reduced likelihood of developing severe pneumonia. Moreover, intravenous vitamin C administered in high doses has shown effectiveness and safety in treating pneumonia cases in Intensive Care Units across the US and China, along with oral vitamin C for prevention or moderation (refer to the references on slide 12 of the PDF). Two recent studies suggest that around 2 grams daily can decrease ICU stays by 8.6%, and a range of 1–6 grams can cut ventilator duration by 25% for patients requiring over ten hours of ventilation. This represents a significant number of cost-effective “virtual ventilators” to address the shortage of actual ventilators as demand surges.

However, not all vitamin C is equivalent. This note aims to inform consumers on key factors when selecting this common supplement. Like all dietary supplements, vitamin C is not regulated by the US government and has not been assessed by the FDA for disease prevention, treatment, or cure. Lovins is not a medical professional and cannot provide medical guidance; however, Rasmussen, being a physician, can. This information should not replace the advice of your healthcare provider but can serve to enhance what they may have derived from older literature. The recommendations made in Lovins’ 16 March talk, grounded in comprehensive study and medical discussions, received strong support from Rasmussen during his talk and Q&A on 18 March. We are co-authors of this note without any financial interests or conflicts regarding mentioned products or firms; our goal is to share the most credible, science-based insights available. For any feedback, please reach out to [email protected].

What type of vitamin C should you consider?

There are primarily three forms of vitamin C, chemically referred to as “ascorbate” or “ascorbic acid,” along with various salt derivatives like “sodium ascorbate” or “calcium ascorbate.” There is a lack of published data indicating the type distribution of vitamin C available in the market. Only the third form is labeled clearly enough to identify its composition.

The first form of ascorbate is synthetically produced and consists of a 50/50 blend of two variants that, while having the same molecular structure, differ in their spatial arrangement. These two shapes have distinct functions in the body. The body can utilize “levulo-” or “levo-” or “l-” ascorbate, while “dextro-“ or d-ascorbate (which is only 5% effective in guinea pigs) is not needed and even detrimental, as it can irritate the gut. This irritation may limit the absorption of beneficial l-ascorbate. The synthetic mixture of d- and l-ascorbate may be what is sold as “vitamin C,” even under claims of purity, potentially rendering it half as effective due to the irritant nature of d-ascorbate. Unfortunately, determining whether a product is of this nature requires sophisticated independent chemical testing, which is generally not provided by manufacturers.

The second type of ascorbate is produced through fermentation of glucose by a specialized microorganism but is exposed to air throughout the process. Many benefits of vitamin C stem from its role as a potent antioxidant, which combats oxidative stress in the body by neutralizing harmful free radicals. A strong antioxidant seeks to bond with oxygen; however, if manufactured in an oxygen-rich environment, the vitamin C that reaches consumers may be partially oxidized, thus diminishing its efficacy. One analyzed sample revealed that it was one-fourth oxidized, half fully oxidized (to DKG, which is an irritant), and only one-fourth l-ascorbate. Without chemical analysis, it's impossible to ascertain how oxidized other brands are, and this second production method is widely adopted due to its cost-effectiveness, despite the risk of degradation from light and heat.

The third method mirrors the second but excludes air throughout the fermentation and processing stages, ensuring that the vitamin C reaching consumers is unoxidized (“fully reduced”) l-ascorbate. This is the preferred option, albeit more expensive to produce.

Such products should, and generally do, possess a crucial characteristic: since ascorbic acid is acidic (pH ~3.5), it can be harsh on cells. To be effectively absorbed into the gut and delivered where needed, it must be “buffered” by combining the ascorbate molecule with other essential atoms in the right proportions. Sodium is not an ideal choice, as most people consume too much sodium, which can elevate blood pressure. Some vitamin C products are buffered, while others are not, with varying degrees of thoughtfulness in formulation.

Overall, these issues surrounding mainstream vitamin C products can render them at least two to potentially four times less effective than pure l-ascorbate that is both fully reduced and buffered. Cheap vitamin C on the shelf may not translate to effective results in your body. Personally, Lovins consumes 13–20 grams daily (1 gram = 1,000 milligrams) of high-quality vitamin C—triple-crystallized under nitrogen to ensure unoxidized pure l-ascorbate (free from d-ascorbate). This product is also buffered with potassium, magnesium, calcium, and a small amount of zinc in an appropriate physiological ratio. It’s marketed as PERQUE PotentC Guard, available in 1-gram capsules or as a powder that can be mixed with water, juice, applesauce, cereal, etc. Lovins sources his from www.vitamins-today.com or 800–806–8671; many other vendors can be found online with a product name search. Searching for “l-ascorbate AND fully reduced AND buffered” will yield competing brands (listed alphabetically and not researched) such as www.alkalineforlife.com, www.beyondhealth.com, www.pure-essentials.com, www.tnawc.com, and www.vitaminc.healthrangerstore.com.

Some brands include additional components like stabilizers, binders, fillers, colorings, flow agents, etc., which may be undesirable, necessitating careful label scrutiny. One bulk vitamin C brand was even found to contain toxic methanol. Therefore, it’s important to choose reputable companies with stringent quality control and a strong scientific foundation.

Next, once you've selected a source you trust…

How much vitamin C should you consume?

Practitioners of “orthomolecular medicine,” which focuses on supplying the body with essential substances it cannot produce (like vitamin C), have recommended oral vitamin C for over seven decades to mitigate the severity and likelihood of various illnesses. Since the 1970s, the standard recommendation against viral infections like colds and flu has been to aim for 3–5 grams of vitamin C daily. Individual needs for vitamin C can vary widely based on numerous factors, including health status. A rough guideline is to consume two grams less than the amount that leads to diarrhea. This “titration to bowel tolerance” involves gradually increasing the daily intake until experiencing diarrhea (or loose stool) and then reducing the dose by two grams daily. However, the most precise method of determining individual vitamin C requirements is known as C-Cleanse, which involves using the powdered form of PERQUE PotentC Guard, along with water, a teaspoon (approximately 3 grams), and a timer. This should be done on an empty stomach first thing in the morning, and you may need to use the restroom several times over the course of hours. The evolution of this test is summarized here. As your health improves, your vitamin C needs will decrease.

Why consider taking more than 3–5 grams daily? Because that amount is the minimum suggested to significantly reduce the risk of viral infection. However, higher doses will provide better protection, up to your individual requirement level (or to bowel tolerance if you don't perform a C-Cleanse calibration). As outlined in the C-Cleanse instructions, the ideal dose is approximately three-fourths of the amount that triggers a “whoosh” bowel evacuation.

Additionally, the physical, chemical, and mental stressors that our bodies face today are substantially higher than those encountered in the 1970s, suggesting that the necessary dosage to counteract oxidative stress may be several times greater than previously recommended. This aligns with C-Cleanse results reported to its creator and developer of PERQUE supplements, Russell Jaffe MD PhD (biochemistry). (Full disclosure: he is Lovins’ long-time personal medical advisor and a friend to both authors.)

It's also crucial to note that when ill or battling an infection, your body often requires much more vitamin C—sometimes tens of grams daily. If you become sick, don’t limit yourself to your calibrated dosage; you may need to consume multiple grams per hour to meet your heightened cellular demands for this essential nutrient. One expert suggests an initial 10-gram loading dose (if you’re not already close) followed by at least 2 grams each hour. Your bowel tolerance will increase in response to your needs. Those who believe that high doses are unnecessary because it will merely result in expensive urine should reconsider; this notion is outdated and should be informed by the insights on ascorbate saturation provided below.

In summary, orthomolecular practitioners advocate that a minimum of 3–5 grams per day of a high-quality oral vitamin C product, such as PotentC Guard, can offer significant protection (though with individual variability) against viral infections. If you do contract an infection, it should contribute to a milder, shorter illness with a reduced chance of severe complications. (As demonstrated in Lovins’ 16 March 2020 presentation, a standard meta-analysis of clinical trials supports the last three benefits but not the first preventive one—because those trials utilized doses that were inadequately small and infrequent, potentially compromising the quality of the chemical tested, thus failing to validate the orthomolecular claims, as acknowledged by the authors of that meta-analysis.)

Standard pharmacological guidelines would suggest adjusting children's doses proportionally based on their weight compared to a 70-kg (150-pound) adult. The scientific community has not reached a consensus regarding the administration of vitamin C to infants (or the appropriate dosage if recommended), but your pediatrician may find this information helpful for guidance. The same applies if you are pregnant or breastfeeding. It is crucial to consult knowledgeable, experienced medical professionals in these cases.

How often should you take vitamin C?

This essential aspect is often overlooked. Vitamin C is rapidly utilized and eliminated by the body, frequently losing half of its presence within half an hour to a few hours. Consequently, if taken only once or twice daily, your tissues may remain deficient, resulting in diminished benefits. Orthomolecular physicians, grounded in evidence and clinical experience, typically recommend splitting vitamin C doses into intervals every few waking hours (many suggest every three hours or less) — and hourly if you are unwell. For those in good health, consider taking a gram (or two or three, based on your calibration and health status) at breakfast, mid-morning, lunch, mid-afternoon, dinner, and before bed. If you feel particularly vulnerable, an additional gram or two during the night can be beneficial. Vitamin C taken within bowel tolerance is generally regarded as very safe — except for a few specific groups of individuals.

Who should *NOT* take high doses of vitamin C?

Individuals with diabetic ketoacidosis or glucose-6-phosphate dehydrogenase deficiency (G6PD), or possibly those who are pregnant/breastfeeding (as mentioned earlier), should consult their healthcare professional before considering high doses of vitamin C. Many physicians also express caution regarding large doses for two additional conditions: hemochromatosis (though Dr. Jaffe argues that the feared Fenton reaction with excess iron occurs in vitro but not in vivo, particularly with buffered l-ascorbate) and active oxalate kidney stones (which Dr. Jaffe claims are dissolved by buffered l-ascorbate, provided proper hydration is maintained; thus, his recommended vitamin C does not exacerbate but aids in treating these stones). It’s essential to discuss all potential contraindications with your doctor.

Even if your medical situation renders high doses of vitamin C inadvisable, you should consider (with your physician's guidance) taking as much as you safely can. Why? Because our bodies require vitamin C, far exceeding the minimal amounts needed to prevent scurvy (the basis of official dietary recommendations), and obtaining sufficient vitamin C solely from the recommended daily servings of fruits and vegetables can be challenging. Everyone should aim to consume ample fresh fruits and vegetables, but a typical medium-sized orange contains only about 65–70 mg of vitamin C, meaning the minimally protective 3–5 grams daily equates to approximately 40–70 oranges. Some foods (research online) contain higher concentrations — Dr. Szent-Györgyi, who won the 1937 Nobel Prize for isolating vitamin C, explored what keeps paprika vibrant — yet achieving an optimal health level of vitamin C through diet alone is challenging unless one consumes a great-ape-like diet, constantly nibbling on tropical fruits and leafy greens.

Are multivitamins or supermarket packets of “energizing” powdered vitamins adequate sources of vitamin C?

They may be better than nothing, but they typically provide only about a gram or less of vitamin C, and it’s unlikely that it is unoxidized, well-buffered, or even l-ascorbate. Opting for a specific vitamin C product like PotentC Guard can be more cost-effective, without the risk of excessive intake of other ingredients while trying to secure adequate vitamin C levels. Well-structured multivitamins with proper formulations can also benefit your health, though excessive amounts can be counterproductive.

Could other supplements be beneficial during this pandemic?

Some research indicates that additional nutrients can indeed provide support. Notably, PERQUE Repair Guard contains safer polyphenolics (refer to slide 13 from Lovins’ 16 March 2020 presentation) that serve as antiviral complements to vitamin C, enhance immune defense and repair, and function as a potent anti-inflammatory and moderate analgesic. Their synergistic effect suggests a ratio of four Repair Guards to one PotentC Guard — each capsule is 1 gram — based on bowel tolerance for both products. Other supplements can also be valuable; for instance, Lovins’ slide 14 discusses vitamin D (Dr. Jaffe recommends titration not just to 30 but to 50–80 ng/mL) and the effective use of zinc lozenges at the onset of a sore throat.

What additional measures should I take?

The official recommendations for minimizing your exposure to the virus through isolation, social distancing, handwashing, etc., are correct and critically important. In addition to these measures, though not yet part of the official guidance, are standard practices for enhancing immune function so that if exposed, the chances of infection decrease, leading to a quicker recovery. Immune-boosting strategies mentioned in Lovins’ 16 March talk include adequate sleep, stress reduction, hydration, balanced nutrition, regular exercise, limited or no alcohol consumption, avoidance of toxins, and maintaining chemical balance. This balance can beneficially incorporate suitable amounts of high-quality dietary supplements; most key supplements are outlined on slide 6. Although vitamin C is often downplayed in official recommendations (slide 7), slides 8–11 illustrate that this perspective is based on misinterpretations of existing literature (which healthcare professionals currently lack the time to re-evaluate!). Slide 12 emphasizes the remarkable clinical value of high intravenous doses of vitamin C in severe pneumonia cases, such as those caused by COVID-19 in certain patients, indicating that vitamin C may indeed play a significant role in addressing this illness. Most importantly, the four points highlighted on slide 11 suggest that vitamin C is crucial for our defense against COVID-19, irrespective of its preventive effects via oral dosing.

It is our strong belief that healthcare professionals, frontline workers, and high-risk individuals (particularly the elderly, those with chronic illnesses, the impoverished, the homeless, refugees, and prisoners) should urgently initiate a regimen of at least 3–5 grams of quality vitamin C daily, divided throughout the day, and more if possible — as much as their bowel tolerance allows or as indicated by a C-Cleanse test. As our nation struggles to catch up on avoiding exposure amid rising infection rates that could overwhelm our healthcare system, properly administered vitamin C could be a crucial component of our national health strategy.

If the higher-quality but more expensive third type of vitamin C is unaffordable, aim for the best available option, preferably the second type (labeled as l-ascorbate, buffered if possible); it is better than nothing. Choosing the lowest-cost option may not yield the best results. We hope that governmental bodies will make type-3 vitamin C accessible to those in greatest need, potentially providing it for free at Social Security Offices, Post Offices, and within prisons, shelters, and detention facilities. If current suppliers cannot meet demand, we should utilize the Defense Production Act (brewers are capable of large-scale fermentation) but modify it to ensure anaerobic production of unoxidized ascorbate. We have a singular opportunity to flatten the steep curve of infection, necessitating the rapid distribution of highly effective vitamin C to as many individuals as possible.

Nerdy note on *l*-ascorbate saturation. Some claim that Levine et al.'s 1996 research indicating the body's saturation occurs at approximately 1 g/d of oral l-ascorbate (based on a small sample of healthy NIH staff) invalidates the orthomolecular assertion that oral doses around 10 g/d can provide significant antiviral protection. However, administering up to 36 g of oral sodium ascorbate, predominantly in phosphatidylcholine liposomes, has achieved ~400 µM/L C in plasma, while another subject accustomed to 10 g/d of oral C maintained levels of 300 and sustained 100–150 µM/L with divided doses of 12–18 g liposomal ascorbate:

• Pharmacokinetics of oral vitamin C

  • Purpose. To test whether plasma vitamin C levels, following oral doses in supplemented volunteers, are tightly…
  • www.tandfonline.com

This evidence raises significant doubts about the NIH's RDA assumption that plasma levels must and do saturate at ~70–80 µM/L. In contrast, intravenous administration can safely achieve impressive plasma concentrations of 25–30 mmol/L, or 25,000–30,000 µM/L:

• Vitamin C: A Concentration-Function Approach Yields Pharmacology and Therapeutic Discoveries

  • A concentration-function approach to vitamin C (ascorbate) has yielded new physiology and pharmacology discoveries. To…
  • academic.oup.com

The science surrounding ascorbate saturation is evolving, indicating that sustained levels sufficient for cellular saturation are vital for l-ascorbate to inhibit viruses and neutralize free radicals that cause disease symptoms. Thus, we should anticipate threshold effects rather than a linear dose/response starting at low doses. Regardless of whether one believes that ascorbate excretion half-life is 0.5 or ~2 hours, it is excreted quickly, necessitating multigram oral doses every few hours to maintain adequate saturation levels for achieving clinical benefits (additional information is available here). Excreted ascorbate cannot donate electrons. Thus, the strongest evidence concerning l-ascorbate saturation does not undermine the need for high oral doses and may indeed support their use.