For those trying to understand why high dose Vitamin C appears to have *increased* mortality in #LOVITtrial, remember that anti-oxidants aren’t always good.
Interesting review about mechanisms by which ROS contributes to host defense against infection.
ncbi.nlm.nih.gov
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Interesting review about mechanisms by which ROS contributes to host defense against infection.
ncbi.nlm.nih.gov
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Teleologically, it’s conceivable that vitamin C levels drop in sepsis for a reason: such as to facilitate microbial killing.
We see something analogous with a drop in iron levels in sepsis. We sequester iron to inhibit pathogen growth during infection.
ncbi.nlm.nih.gov
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We see something analogous with a drop in iron levels in sepsis. We sequester iron to inhibit pathogen growth during infection.
ncbi.nlm.nih.gov
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Prior studies have shown that IV iron supplementation *increases* the risk of infection.
jamanetwork.com
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jamanetwork.com
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Similarly, many studies found that vitamin D levels are low in sepsis & that lower VitD levels are associated w/ worse outcomes.
And Yet, when the #PETALstudy was performed it found numerically HIGHER mortality (23.5% vs 20.6%) w/ VitD supplementation!
nejm.org
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And Yet, when the #PETALstudy was performed it found numerically HIGHER mortality (23.5% vs 20.6%) w/ VitD supplementation!
nejm.org
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These are examples of the normalization fallacy: if a lab value is abnormal in illness compared to health, then surely normalizing the lab value will restore the patient to health!
Not so fast! Great article by @phlegmfighter about this flawed logic.
medicalevidenceblog.com
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Not so fast! Great article by @phlegmfighter about this flawed logic.
medicalevidenceblog.com
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