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Decades ago, when Linus Pauling and Abram Hoffer first proposed mega-dose vitamin therapy as a serious treatment, mainstream medicine and the press promptly discredited this as quackery. To this day, the media faithfully bombards us with the message that vitamins and minerals are useless, harmful or even killing us.(1-6) When one considers the lowly vitamin pill as an economic rival to drugs, and the dependence of the media on drug company advertising, the motivation to discredit mega-dose vitamins becomes all too obvious. Seemingly oblivious to this negative message, physicians quietly go about their business using megadose vitamin therapy in the intensive care unit with considerable success. Recent reports of this have been appearing in medical journals, finally vindicating Linus Pauling and Abram Hoffer as yes, of course, they were right all along.(7-9)
Left above image:US Military Project Hope Intensive Care Unit courtesy of wikimedia commons.
Septic Shock - a PreTerminal Event
Forty years ago, during my training days working in the intensive care unit, the onset of septic shock was a grave sign, and usually a preterminal event. In spite of the best treatment with high powered antibiotics and high dose hydrocortisone, these severely ill patients invariably succumbed. Survival was so rare, it was declared a miracle. While treatments have improved since the old days,septic shock still carries a fifty percent mortality rate.
IV Selenium For Septic Shock in the ICU
In 1999, Dr Angstwurm showed that many critically ill patients have low selenium levels. Selenium is the key component of glutathione peroxidase, a selenoprotein anti-oxidant. In 2007, Dr Angstwurm recruited 249 septic shock patients from eleven intensive care units in Germany, and gave them IV selenium over a 14 day protocol. Results showed mortality reduced to 39% for the selenium treated group, compared to a fifty percent mortality, otherwise. An impressive result, considering the high mortality rate and futility of most other treatments.(10-11) In 2008, Dr Carlos studied septic shock patients and found that selenium levels could be used to predict clinical course. Those with the highest selenium levels had the best outcome, and the lowest selenium levels had the worst outcome.(12)
A Basket of Mega-Dose Vitamins
If one antioxidant, selenium, was beneficial in the ICU setting, then perhaps a basket of antioxidants would be even more so. In 2008, Dr Giladi of Vanderbilt tested this hypothesis with a shopping cart of antioxidants. Intravenous Vitamin C, E and Selenium was given over a 7 day protocol to 2,200 ICU trauma patients, and compared to placebo. Dr Giladi reported a 28% mortality reduction for the mega-dose vitamin group.(13) A second report on the same patient study group Febuary 2010 showed that the mega-dose vitamin group also benefited from a 53% reduction in abdominal wall infections, and 38% reduction in respiratory failure.(14)
Reducing Infection Rates, and Time on Ventilators
In 2006, Dr Berger reported that a trace mineral infusion with zinc, copper and selenium reduced by half the infection rates for burn patients in the ICU. These infections were nosocomial pneumonia and ventilator associated pneumonia. (15) In 2009, Dr Alison Avenell from Edinburgh Scotland reported a 10-15% reduction in infection with pneumonia and clostridia difficile enterocolitis in ICU patients treated with a 5 day protocol of IV selenium. (16) In November 2009, Dr El-Attar reported that trace mineral infusions with selenium, zinc and managanese given to patients with chronic lung disease resulted in reducing by half the time on mechanical ventilation.(17)
Animal Model of Inflammatory Hepatic Vasculitis
A 2000 report from China evaluated the effect of selenium and vitamin E on an animal model of experimental hepatic vasculitis. They found the two agents, Selenium and Vitamin E dramatically reduced hepatic inflammation in the experimental animals down from 100% to 20%. (18)
Why Do We Need Selenium?
To understand the importance of selenium, consider the toxic fumes produced by your automobile. You might be surprised to know that your body makes the same foul stuff, similar to your car's toxic exhaust. Instead of an exhaust pipe to get rid of the fumes, our bodies have the selenoprotein anti-oxidant system. The main selenoprotein is glutathione peroxidase which works together with other antioxidants, such as Vitamin C and E, to remove the oxidative by-products of cellular energy production. Severe illness leads to depletion of selenoproteins and build up of oxidative by products which may overwhelm the body's defenses leading to catastrophic outcomes. Replenishing selenium and other anti-oxidants in this setting makes sense, and is in fact extremely beneficial.
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