They Had to Stop This Vitamin C Trial Early — Transcript

Full transcript

1. 0:00Earlier this month, one of the most
2. 0:01rigorous trials ever run on a vitamin
3. 0:03was stopped early because the people
4. 0:04getting the vitamin were dying faster
5. 0:06than the people getting nothing. It was
6. 0:08vitamin C at high dose directly into the
7. 0:10vein in patients with severe burns. Now,
8. 0:13the idea sounded right. Burns flood the
9. 0:15body with damage and vitamin C can mop
10. 0:17up that damage, so give plenty of it.
11. 0:19But, it proved the opposite. The deaths
12. 0:21roughly doubled and the safety board of
13. 0:23the trial had to stop it. This is why it
14. 0:25matters even if you've never touched an
15. 0:27IV infusion because it's the same trap
16. 0:29of assuming more of a good antioxidant
17. 0:32is automatically better because this has
18. 0:33backfired over and over again with pills
19. 0:36on the shelf. Here's why the burn trial
20. 0:38sounded so right when they first came up
21. 0:39with the concept. A severe burn sets off
22. 0:42a storm of what scientists call
23. 0:43oxidative stress. Think of it as
24. 0:45cellular rust, free radicals just
25. 0:47tearing at tissue. Vitamin C is an
26. 0:50antioxidant, so it neutralizes that kind
27. 0:52of damage. So, the logic seems simple.
28. 0:54More rust, so add more rust remover. The
29. 0:57doses tell you how far past normal that
30. 0:59they went. 50 mg per kilogram every 6
31. 1:01hours for 4 days. For a typical adult,
32. 1:04that works out to be roughly 14 to 16 g
33. 1:07of vitamin C a day delivered straight
34. 1:09into the bloodstream. So, compare that
35. 1:11with the 75 to 90 mg most adults need in
36. 1:14an entire day. So, this was not a
37. 1:16nutritional supplementation, it was a
38. 1:18pharmacologic flood and that flood
39. 1:20backfired. The main result, deaths or
40. 1:22lasting organ failure went the wrong
41. 1:24way. Now, I do want to be careful with
42. 1:26that death number because the trial was
43. 1:28stopped early with relatively few
44. 1:30deaths. So, the exact size is uncertain,
45. 1:32but every way that they looked at the
46. 1:33data, it pointed in the same way,
47. 1:36roughly a doubling. And that's why the
48. 1:37oversight board pulled the plug. And
49. 1:40this trial is not a one-off. The exact
50. 1:42same dose of intravenous vitamin C had
51. 1:44been tested 4 years earlier in a
52. 1:46completely different group of critically
53. 1:47ill patients, so people with sepsis, and
54. 1:50it did the same thing, a higher rate of
55. 1:52death or organ failure, 44.5%
56. 1:55compared to 38.5%.
57. 1:57So, two trials the same vitamin C flood
58. 2:00two different sets of very sick people
59. 2:02but the wrong direction. So how does an
60. 2:05antioxidant end up doing harm? And
61. 2:07remember the mechanism here is important
62. 2:09for what you decide to do for your own
63. 2:11supplement routine. The researchers
64. 2:12point to two things. First your kidneys
65. 2:15turn excess vitamin C into oxalate and a
66. 2:17flood of it can crystallize and damage
67. 2:19the kidneys. Exactly the wrong thing and
68. 2:21someone already fighting for their
69. 2:23organs and the second reason sounds a
70. 2:25like a paradox. So vitamin C is normally
71. 2:27a free radical mop but a badly burned
72. 2:29body is flooded with loose iron from
73. 2:31damaged tissue and when you add a
74. 2:33massive dose of vitamin C to that iron
75. 2:35the chemistry can run backwards. So
76. 2:37instead of soaking up free radicals the
77. 2:39vitamin starts making them producing
78. 2:40hydrogen peroxide that harms the very
79. 2:43cells that it was supposed to protect.
80. 2:44So the antioxidant becomes a
81. 2:46pro-oxidant. It's actually the same
82. 2:48reaction that scientists have tried to
83. 2:50use to kill cancer cells in previous
84. 2:52experiments and the authors are careful
85. 2:53to call this a likely explanation but
86. 2:55not a proven one. And it's not just in
87. 2:57the ICU setting where the more is better
88. 2:59approach has backfired. So in the
89. 3:01supplement space more is better has
90. 3:03backfired for decades. So the pattern is
91. 3:05almost the same. An antioxidant looks
92. 3:07great on paper so people take a massive
93. 3:09dose of it and the careful trial finds
94. 3:11the opposite. So start with beta
95. 3:13carotene for instance which is a
96. 3:15building block your body turns into
97. 3:16vitamin A. So on paper it's a beautiful
98. 3:19cancer fighter. So researchers gave it
99. 3:21to more than 18,000 people at high risk
100. 3:23of lung cancer. So these people were
101. 3:25smokers former smokers or asbestos
102. 3:28workers. The beta carotene group got and
103. 3:30get this 28% higher rates of lung
104. 3:33cancer. That trial was stopped early too
105. 3:35and it wasn't the only one. A separate
106. 3:37large trial in male smokers found the
107. 3:39same kind of signal about 18% more lung
108. 3:41cancer in the beta carotene group than
109. 3:44vitamin A on its own. A huge review
110. 3:46pulling together 67 trials and more than
111. 3:49230,000 people found that in the most
112. 3:52careful studies, antioxidant supplements
113. 3:54as a group, they slightly raised the
114. 3:56risk of dying and vitamin A was one of
115. 3:58the worst, raising it by 16%. Now for
116. 4:01vitamin E, and this one should stop
117. 4:03people in their tracks because it wasn't
118. 4:05sick patients and it wasn't smokers. It
119. 4:07was one of the largest prevention trials
120. 4:09ever run, about 35,000 healthy men given
121. 4:12a common mega dose of vitamin E, so
122. 4:15about 400 international units. Now to
123. 4:17put that into perspective, the
124. 4:18recommended daily allowance is about 22
125. 4:21units. So the men in the vitamin E
126. 4:23group, they ended up with significantly
127. 4:24more prostate cancer. In 2022, an
128. 4:27independent government panel called the
129. 4:29US Preventive Services Task Force, they
130. 4:31looked at all of this data and they put
131. 4:33it plainly, for beta-carotene, the harms
132. 4:36outweigh the benefits. For vitamin E,
133. 4:38there is no net benefit. And right about
134. 4:40now, a lot of people are going to raise
135. 4:42a common objection. So let me address it
136. 4:44head-on. The argument goes like this,
137. 4:46those vitamin E trials, they all used a
138. 4:48synthetic form called alpha-tocopherol.
139. 4:51The full-spectrum form, so tocotrienols,
140. 4:54they are supposed to be safer. The
141. 4:55problem is that at the moment, we just
142. 4:57aren't sure. Researchers have gathered
143. 4:59every randomized tocotrienol trial in
144. 5:01humans, so about 30 of them involving
145. 5:042,600 people and in every single one,
146. 5:07they measured short-term blood markers.
147. 5:09Not one of them tracked whether people
148. 5:10lived longer or got less cancer or had
149. 5:12fewer heart attacks. Most only ran for a
150. 5:15few weeks to a few months. So the harm
151. 5:17seen from the high-dose alpha-tocopherol
152. 5:19is real and it's measured. And the idea
153. 5:21that a different form must therefore be
154. 5:23safe is just an assumption with no
155. 5:25long-term trial data behind it. And that
156. 5:28is exactly the sounds good on paper
157. 5:29reasoning that keeps getting people into
158. 5:31trouble. So it's plausible, yes, but
159. 5:33it's not proven, not even close. So used
160. 5:36in the wrong way, so the wrong form,
161. 5:38wrong population, wrong assumptions
162. 5:39about the form, these things can
163. 5:41backfire. But if used in the right way,
164. 5:43antioxidants can genuinely be helpful.
165. 5:45And the clearest proof of that starts
166. 5:47with the exact question that we've
167. 5:48raised, does the form matter? Yes, it
168. 5:51does. And the best example in all of
169. 5:53medicine starts with the same villain
170. 5:55from a minute ago, beta-carotene.
171. 5:57There's a common eye disease called
172. 5:58age-related macular degeneration. So, it
173. 6:01slowly destroys the center of your
174. 6:02vision. And for a long time, the only
175. 6:04thing that seemed to genuinely slow it
176. 6:05down was a specific supplement formula
177. 6:08involving vitamins C and E, and then
178. 6:10also involving zinc and beta-carotene.
179. 6:12And it did work. It cut the risk of the
180. 6:14disease getting worse by about a
181. 6:16quarter. But, there was a problem
182. 6:17sitting inside that formula, the
183. 6:19beta-carotene. That same building block
184. 6:21that in those big trials raised lung
185. 6:23cancer in people who'd smoked. So, you'd
186. 6:25have the strange situation where the
187. 6:27treatment saved people's vision, but it
188. 6:29contained an ingredient that for the
189. 6:31wrong population raised cancer risks.
190. 6:33So, researchers started to look for an
191. 6:35alternative. So, lutein and zeaxanthin
192. 6:37are pigments that give corn and egg
193. 6:39yolks their yellow color. And the body
194. 6:41deliberately stockpiles them in one tiny
195. 6:43spot at the very center of the retina,
196. 6:45the part that does your sharpest vision.
197. 6:47They sit there as a built-in filter,
198. 6:49soaking up most of the damaging light
199. 6:51before it hits the cells behind them.
200. 6:53So, supplementing with these supplies
201. 6:55the eye with what it already uses
202. 6:57instead of trying to feed it a foreign
203. 6:59antioxidant. So, the researchers built a
204. 7:01second trial called AREDS2,
205. 7:04and they asked a direct question. Take
206. 7:06beta-carotene out and swap it in for
207. 7:08lutein and zeaxanthin and see what
208. 7:10happens. This is this whole video in one
209. 7:13experiment. It's the real version of the
210. 7:15tocotrienol question. Not we assume that
211. 7:17a different form is safer, but we
212. 7:19actually tested head-to-head with hard
213. 7:21outcomes. And here's what they found.
214. 7:23First, on safety. Lung cancer was about
215. 7:252% in the people getting the formula
216. 7:27with beta-carotene compared to 0.9% in
217. 7:31the people getting it without. But, if
218. 7:32you take the beta-carotene out, that
219. 7:34signal goes away. And the second
220. 7:36question is whether this new formula
221. 7:38still worked. So, in the direct
222. 7:39comparison, the lutein and zeaxanthin
223. 7:41formula came out at least as good as the
224. 7:44old beta-carotene one in terms of
225. 7:45slowing the disease down. Slightly
226. 7:47better, in fact. So, safer and at least
227. 7:50as effective. So, the whole field
228. 7:52switched. Beta-carotene was dropped in
229. 7:54favor for lutein and zeaxanthin. And
230. 7:56speaking of changes, there's been
231. 7:57another one related to antioxidants and
232. 7:59exercise, and that's just come in the
233. 8:01past year due to new evidence. So, if
234. 8:03you're young and healthy and you train,
235. 8:05taking a big dose of antioxidant
236. 8:06vitamins around your workout is a
237. 8:08mistake. Regular viewers have heard me
238. 8:10cover this in detail. So, the short
239. 8:12version is that exercise produces brief
240. 8:15bursts of free radicals, and that burst
241. 8:17is a signal that your body needs to
242. 8:19adapt. And if you interfere with that
243. 8:21signal by giving high-dose vitamins C
244. 8:23and E, you blunt the cellular machinery
245. 8:25that exercise is trying to build. And
246. 8:27it's not just antioxidant supplements
247. 8:29that can get in the way of exercise
248. 8:30benefits. So, metformin, for instance,
249. 8:33in people without diabetes can blunt
250. 8:35some of the positive effects of
251. 8:36exercise. So, in a resistance training
252. 8:38study, the people on the placebo built
253. 8:40more muscle compared to the people on
254. 8:42metformin. And resveratrol does the same
255. 8:44thing. If you exercise, adding any of
256. 8:47these is likely the more isn't better
257. 8:49mistake. And for years, that made
258. 8:50antioxidants look like a blanket bad
259. 8:52idea for anyone exercising. But here is
260. 8:55where it changed. In older adults, the
261. 8:57picture flips. So, as we age, the
262. 8:59balance tips the other way, where the
263. 9:00system tips too much towards oxidative
264. 9:02stress rather than too little. And in
265. 9:05that group, antioxidant supplements
266. 9:07paired with exercise actually beat
267. 9:09exercise alone. Now, I do want to be
268. 9:11clear here. This is not that older
269. 9:12adults should mega-dose with
270. 9:14antioxidants. Instead, it's a clean
271. 9:16illustration of this thesis that the
272. 9:18same intervention can have opposite
273. 9:20answers depending on who you are. If
274. 9:22you're young and exercising, then taking
275. 9:24doses of antioxidant above the
276. 9:25recommended daily intake is probably not
277. 9:27a good idea. But if you're slightly
278. 9:29older, that balance has already tipped,
279. 9:31and a little bit of antioxidant support
280. 9:33can probably help. And just for clarity,
281. 9:35this flip is only true for antioxidants.
282. 9:37So, metformin and resveratrol, they
283. 9:39still blunt the positive effects of
284. 9:41exercise. And to get the antioxidant
285. 9:43balance right, there's a really
286. 9:44interesting avenue that's worth
287. 9:45exploring. And viewers of this channel
288. 9:47would have heard me talking about glynac
289. 9:49supplements before. So, rather than
290. 9:50flooding the body with a finished
291. 9:52antioxidant, you give it the raw
292. 9:54materials instead to make its own, and
293. 9:56then let it self-regulate how much it
294. 9:58needs. So, in older adults, that
295. 9:59improved a range of aging markers in a
296. 10:01recent clinical trial. And one last
297. 10:03thing, and this is a frontier where the
298. 10:04evidence bit thinner, but genuinely
299. 10:06quite interesting. So, those same eye
300. 10:08antioxidants, lutein and zeaxanthin,
301. 10:10they don't just collect in the eyes,
302. 10:12they also build up in the brain. And in
303. 10:14a 2026 trial in teenagers who used a lot
304. 10:16of screens, attention and processing
305. 10:18speed improved as well. And to summarize
306. 10:21this video, the lesson is simple. It
307. 10:22isn't that antioxidants are bad, rather
308. 10:25we have to get the right form at the
309. 10:26right dose for the right person, and
310. 10:28that beats megadosing every single time.
311. 10:31And this is not just a small point, it's
312. 10:32the whole reason why a carefully worked
313. 10:34out formula matters more than the
314. 10:35instinct just to throw more at the
315. 10:37problem. More is better is the thing
316. 10:39that keeps backfiring. And here's the
317. 10:41practical takeaway. Don't megadose by
318. 10:44default. When you see a label boasting
319. 10:46hundreds or thousands of percent of the
320. 10:48recommended daily intakes of different
321. 10:49vitamins and minerals, just be very,
322. 10:51very cautious. Treat that as a warning
323. 10:53sign, not a selling point, and make sure
324. 10:55to check out third-party testing
325. 10:57resources such as consumerlab.com or
326. 10:59labdoor.com. And if you want to go into
327. 11:02a bit more detail about how the same
328. 11:03antioxidant dose can blunt the positive
329. 11:05effects of exercise in a young person,
330. 11:07but can actually help in an older
331. 11:08person, make sure to check out this next
332. 11:10video here, where I go through that
333. 11:12latest study.