Vitamin C and the common cold

0:01Why is immunity interesting to you? It's a really wonderful frontier of science because it's so deeply complicated. The average undergraduate textbook, so students that would come into a classroom at Imperial College London where I am to study immunology, they would have a textbook that is a thousand pages long. And that doesn't even get them to the frontier. That just gets you the kind of basics. After writing several books about it and teaching scores of students, Daniel M. Davis is still fascinated by the immune system. I think that the more depth you go into studying the immune system, the more you learn about this cell, that cell, this molecule, that molecule, this gene, that gene.

0:51It goes on and on, layer upon layer, regulating this bit with that bit, feedback loops here and there. And then how that system interacts with the body, your brain, your nervous system, your gut, your intestine, the way muscles affect the immune responsiveness. all sorts of nuances and complexities. What emerges for me is that the depth that there is to go into, the contemplation itself, becomes its own reward. And it feels like you're doing something profound and soulful by digging into the detail of what is happening in your body. Davis often gives lectures to all kinds of people. Sometimes those lectures are in front of other researchers, sometimes to students.

1:48And he's fascinated by the questions that he gets after these talks, when a shy hand shoots up in the back of a room. These questions that his students ask seem pretty simple. But the immune system is so complicated that even the simple questions are actually really difficult to get your head around. Should I take more of this supplement, that supplement? How does exercise affect me? Davis often replies, so this is everything we know about that question you just asked me. And this is everything we don't know about that question you just asked me. It's how science works. How we learn to learn. There's one question that Davis gets a lot.

2:32It's the perfect example, a simple, common question that sounds easy, but is actually really hard. So hard that one of the greatest scientists of all time spent decades trying to get to the bottom of this question. He staked his entire career, his good name, and his reputation trying to figure it out. Should I drink orange juice to get over a cold? I'm Amy Padula. This is Unexplainable.

3:20Linus Pauling is often said to be one of the greatest scientists of the 20th century. Linus Pauling grew up in Oregon in the early 1900s. He had an early aptitude for chemistry. A close friend introduced him to it. One day when I was 13 years old, he said to me, would you like to see some chemical experiments? And I said, yes, I would. We went into his house up to the second floor where he had his little bedroom, and he carried out about three experiments, which really astounded me. They pleased me immensely. Pauling enrolled at Oregon State University. He studied chemical engineering and then went on to graduate school at Caltech where he researched the structure of crystals.

4:09By the mid-1920s, he received a PhD in chemistry and mathematical physics. After that, he went to Europe to study with leading experts in quantum mechanics. He befriended Robert Oppenheimer and studied with other prominent scientists. Polling was a real wunderkind. He was even awarded a prestigious prize for work in pure science by young chemists. And then, in 1931, Polling got some real attention. He published a paper. It was called The Nature of the Chemical Bond. He did some very important work on understanding how atoms interact with each other and create chemical bonds. and it's fundamentally shaped how we understand chemical reactions and chemistry.

4:56Pauling's discoveries in that paper were so groundbreaking, they became an essential key to our later understanding of the shape of DNA. Pauling became the chairman of Caltech's chemistry department at age 36, and he later wrote a textbook that revolutionized the teaching of the discipline for decades. By the 1940s, Pauling joined the war effort. He worked on explosives and the patent for an armor-piercing shell. And he was one of a few scientists awarded a Presidential Medal of Merit by Harry Truman. But as his public profile began to rise in the science community, his politics changed. He'd been apolitical before, actively helping the armed forces in the war effort.

5:43And then something changed. A short time ago, an American airplane dropped one bomb on Hiroshima. Pauling was shocked. He began giving speeches about it to general audiences, explaining the science of the bomb and the grave moral implications of such a weapon. He felt that scientists should make their voices known about the risk. With this bomb, we have now added a new and revolutionary increase in destruction. It is an atomic bomb. It is a harnessing of the basic power of the universe. Pauling became a member of the Emergency Committee of Atomic Scientists, a small group that worked to encourage the peaceful use of atomic energy.

6:32Even for someone as respected as Linus Pauling, this was risky. There was a sense that science had a sort of purity to it, and most scientists were relatively apolitical in the public arena. Even the idea that scientists should have opinions was perhaps somewhat frowned upon. It was a dangerous message to the government. Pauling was suspected of being a communist, and Senator McCarthy saw him as a major threat. One communist on the faculty of one university is one communist too many. The State Department even denied Pauling a passport. There seemed to be suspicion that he might join the Soviet Union.

7:16But when he was awarded the Nobel Prize in Chemistry, they had to give it back so he could go to Stockholm for the ceremony. Well, I was pretty pleased. Back at Caltech, the faculty threw a huge banquet, more than 300 guests, to celebrate this big award.

7:43They performed an original musical in his name.

7:55The show was called The Road to Stockholm.

8:02ever wrong and his double bonds are strong they are strong they're the strongest longest double bonds around the strongest we have ever found 1958 he published a really important book blatantly titled no more war because he had taken up an important political stance against nuclear arms and would, you know, do wonderful speeches about how we need to be careful about nuclear weapons. Every activity that any one of us engages in has two effects. It brings to the participants the knowledge that he is taking a great action, that he is doing something that will affect the future of the world. And then it has its effect on other people.

8:53And so I say to you do away with your apathy. With his wife, Ava Helen, he presented in front of the UN to end nuclear bomb testing with thousands of signatures from scientists all over the world. He was subpoenaed by the Senate. How had he gathered these signatures? Did he have a communist organization behind him? My conscience does not allow me to protect myself by sacrificing these idealistic and fruitful people, and I am not going to do it. Pauling appeared before the committee in 1960, but refused to give the names of the people who circulated the petition. As a matter of conscience, as a matter of principle, as a matter of morality, I have decided that I shall not conform to the request of this subcommittee.

9:43After he published No More War, Pauling was graced once again with a prestigious honor, this time for activism. In 1962, he won a second Nobel Prize, this time for peace. On behalf of the Nobel Committee, to hand over to you this medal and a diploma. Thank you, sir.

10:16He is still, to this day, the only person to win two unshared Nobel Prizes. So he is someone that we certainly should be listening to. He was on the media, lots on TV, on the radio, in newspapers. When Pauling came home with this second award, there was no big party. No song and dance. Not even a personal congratulations from the president of Caltech. It wasn't a very happy time. There had been the period of McCarthyism when there were repressions of freedom of expression of opinion. It had been unpleasant for us when we didn't know what our friends were thinking or when it was pretty clear that some of them were no longer very friendly.

11:07He soon resigned from his position, a job he had held for over 40 years. And he took a job at the Center for the Study of Democratic Institutions, a liberal California think tank. His priorities were shifting, away from science and towards political work. After a lifetime of making unprecedented discoveries that labeled him a genius and taking up causes that branded him a traitor, he was about to take on the biggest crusade of his life. That's after the break.

11:47For the last 10 years, everything in American politics has basically revolved around one man. And as a political journalist who came of age during Donald Trump's rise in 2016, I've had a front row seat. I am officially running for president of the United States. It's going to be only America first. America first. Thousands of supporters of President Trump stormed the U.S. Capitol building. But is it possible to talk about politics without talking about Donald Trump? That's the question I'm going to ask in our new show from Vox. The idea of like a post-Trump or not exactly Trump-focused show can exist because he's not really driving any agenda items.

12:30It really does feel like so reactive. You know, I think this Iran thing is also going to cause a big split in the GOP. So far, it doesn't among like people who say they're MAGA voters are still with Trump. But like for the first time, you see on a major issue, open opposition from the start of this war. I'm Estet Herndon and welcome to America Actually.

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13:22They will teach you all the facts you need to know, and maybe some that are not so. Linus Pauling was nothing if not industrious. Like, he was the youngest member ever elected to the National Academy of Sciences. In 1949, he was made president of the American Chemical Society, two-time Nobel Prize winner. So what does a person do who's become an international hero twice over for the discoveries he's made and the stances he's taken, only to be knocked off his pedestal both by the government and a university afraid of his voice? What does someone like that do for redemption? Well, if your line is Pauling, you get really, really into vitamin C.

14:13You include this quote of his, I like to take a very complicated subject where there is no order and think about it for a long enough period that I can find some way of introducing order to it. Exactly. How does that strike you? He had a knack for thinking deeply about problems and working out solutions, but was very much grounded in chemistry. And I think even in that starts to lie one of the problems, because when he turned his attention to humans and human biology and nutrition and the idea of vitamins being important for helping us fight off diseases, everything is much, much more complicated.

15:00In 1965, he came across something bold in his research. Large doses of the B vitamin niacin could have some beneficial effects. for people suffering with schizophrenia. To be clear, though, this is an idea not supported today. But Pauling fixated on this B vitamin tidbit. Because with most drugs, there are limits on how much of them can be taken safely. But were vitamins different? He somehow thought that maybe there's something special about vitamins, that if you take them at a really high dose, they're still not harmful to the body. Pauling got in touch with a scientist, a man named Erwin Stone.

15:41And Stone made an alarming claim. High doses of vitamin C helped Stone and his wife heal rapidly after a car crash. Pauling glommed on to some of Stone's ideas. He was interested in vitamin C's benefits beyond the recommended amount needed to prevent scurvy. Like, were there any benefits of the vitamin in much higher doses? And he correctly said, well, the amount you need to not get that particular disease is not the same necessarily as the amount that is optimal for your health. Pauling wasn't wrong to question these things. And it is extremely hard to know how much of any supplement, of any vitamin, of any mineral, of anything, is actually ideal for our health.

16:33Pauling and his wife began taking very high doses of vitamin C to the tune of 3 ,000 milligrams a day per Stone's recommendation. They were taking something like 30 times the recommended amount in any country. And they came to feel that this huge intake stopped them from catching colds. Pauling then compiled research across scientific journals including findings from controlled trials that supported his own ideas. Getting these reinforcements of his idea as anecdotes. And then published a book in the spring of 1970. It was called Vitamin C and the Common Cold. Did the book do well? Oh, it was an instant bestseller.

17:20Unlike any of my books, I'm sad to say.

17:26Pauling's big theory was the more vitamin C you took, the lower your chances of getting sick and the less sick you got. And he recommended a mega dose of 2300 milligrams or more a day for optimum health. The grabby clickbait headline, vitamin C can stop you from catching a cold, caught wildfire. The timing was perfect. Counterculture of the late 1960s fueled a ravenous interest in whole foods, natural remedies. A whole business popped up around vitamin C. Factories were built. Manufacturers of the vitamin even dubbed the public consumption of it the Linus Pauling effect. And public consumption of the vitamin continued for decades.

18:16Where's my vitamin C? Harry, we can do better. Where is my vitamin C? George, we can do better. What can do better than your vitamin C? Introducing one-a-day core C500. Anything your C can do, we can do better. So the public may have been buying a lot of it, but the medical establishment was not buying it at all. The American Journal of Public Health accused Polling's book as little more than theoretical speculation, and the journal Science rejected Polling's paper on an evolutionary need for vitamin C. Pauling had failed to convince the science community of his ideas, in part because he sidestepped the scientific peer review process in favor of publishing his ideas for a general audience.

19:02But he wrote more books. This new book, just a couple of months ago, Vitamin C, The Common Cold and the Flu, has about twice as much material in it, including not only The Common Cold and the Flu, but hepatitis and many other diseases. His convictions about the vitamins' benefits became more controversial as he reached his 70s. After that first book came out, a physician in Scotland, this guy Ewan Cameron, started communicating with Pauling. He claimed the cancer patients he was treating were helped by vitamin C. Cameron appealed to Pauling, writing, I am unashamedly optimistic that with your help, we could conquer cancer.

19:48And of course, Linus Pauling seized on this as a whole other angle on the importance of vitamin C. Other scientists at the time immediately considered Cameron's data to be too anecdotal, not done with any rigorous way as a clinical trial, but rather just his own opinion about what was happening to his patients. Pauling encouraged Cameron to continue his studies of cancer and vitamin C. The two of them co-authored a paper and submitted it to the Proceedings of the National Academy of Sciences. It was rejected. Twice. But Pauling didn't back down. He remained enthusiastic about vitamin C. Even in his personal life.

20:33Ava Helen, Linus Powling's wife, had surgery for stomach cancer but did not take radiotherapy or chemotherapy and instead took a high dose of vitamin C and she claimed that it helped her feel better. I just want to, I just, I can't believe this. Like, just help me understand how a mind like this would be seduced by the anecdote. I've sort of interviewed lots of really brilliant scientists have done amazing things and one other thing that often comes out is it sounds so simple and so obvious and yet perhaps we forget they are still susceptible to getting things wrong even a person who's won two nobel prizes won't get everything right All of us are also sort of susceptible to, you know, somehow it feels like we're kind of hardwired to sort of enjoy very black and white thinking, whereas everything is much more gray scale.

21:40The bottom line answer, I think, to that question is just very simply Linus Palin was a human. With Cameron, Palin doubled down on the cancer benefits. He asserted that vitamin C in high doses was of value in almost every disease state. He was repeatedly rejected for funding for his research from the National Cancer Institute. By the early 1970s, Pauling was nearly completely ostracized from the medical profession. He contacted the head of the National Cancer Institute about his work. The head of the Institute decided to set the record straight. There would be a clinical trial. to decide once and for all whether vitamin C will help cancer patients.

22:24They chose a heavy hitter to run the experiment, a man named Charles Myrtle, professor of oncology at Mayo Medical School. The trial would test whether or not the vitamin shrank the size of a person's tumor. It would be double-blind, include late-stage cancer patients, and it would include high doses of the vitamin. The results, when they came back, said absolutely not. Charles Myrtle concluded, vitamin C does not help patients with cancer. The final report slammed Polling's point of view. Vitamin C performed no better than a dummy medication. But that wasn't the end of the matter. Polling fought back.

23:09He argued that the Myrtle experiment had flaws. The patients have been given aggressive chemotherapy treatments ahead of the vitamin C trial, weakening their immunity. This is important because it is true that clinical trials are vital to how we find out new medical information. But it is also equally true that clinical trials can be still debated. It depends a lot on what is being measured and the particular situation for the patients. But despite Pauling's retort, the Myrtle study was taken as proof that Pauling's ideas were, for lack of a better word, quackery. Pauling wrote another book. It was called Cancer and Vitamin C.

23:55He put more pressure on the Institute to do another study. So, Charles Myrtle did another clinical trial. And this time he made sure to use patients who had not had any prior treatment. So in 1985, the second Myrtle study was published. Again, he concluded, seemingly once and for all, vitamin C had no effect on helping people with their cancer. And then again, Linus Pauling found ways to think about it deeply, look at the data, and could still argue the point. He said that you just looked at the outcomes, you know, how long they lived for. But Charles Myrtle did not look at how were the patients feeling.

24:47And Ewan Cameron said that, yes, his patients were feeling much better on high dose of vitamin C, and that wasn't taken into account. Secondly, Linus Paulding said the trial ended too early. You need to give patients high-dose deficiency for a long time to allow the drug to have an effect. The bottom line is that there was then and there is now no evidence that vitamin C cures cancer. Even though the matter was closed, Pauling still called for a retraction of the Myrtle study. In December 1991, Pauling had contracted prostate and rectal cancer. He got surgery for it, but also treated it with vitamin C, raw fruits, and vegetables.

25:32In a lecture at Stanford Medical School in 1992, he espoused the vitamins benefits for people with heart disease, even suggesting it could help people with AIDS. He died two years later. Two-time Nobel Prize-winning chemist Linus Pauling is dead at age 93. I'll probably be remembered as having discovered vitamin C. Of course, I didn't discover vitamin C. Will vitamin C cure the common cold? No. Back in 2013, a review of nearly 30 studies of people with colds taking a normal amount of vitamin C found little to no evidence that it reduced the symptoms. People who supplement themselves with vitamin C get over a cold about 8 % quicker.

26:20So that means on average, if you suffer for a few days, you might get a little better. a few hours earlier than if you hadn't taken the supplement. But that is still quite hard to interpret because people taking high dose of vitamin C are probably doing lots of other things in their lives that help them be healthier. So overall, vitamin C has not really much of an impact in how quickly you get over a cold, and it definitely has no impact on whether you catch a cold in the first place. Today, revenue for vitamin C has surpassed over$2 billion, and it's growing. Davis says it's not going to help, but it's also not going to hurt you.

26:56But what he is weary of is the idea that any one simple supplement like vitamin C be held up as a kind of cure-all. We are wired to listen to other people. We naturally warm to a scientist telling us something as declarative as that when they've won two Nobel Prizes and are charismatic. Linus probably did something brilliant and yet did something utterly not brilliant. From history of science, there's a moral to be learned. The faculty that performed the musical for Linus Pauling at Caltech, right after he won the Nobel Prize in Chemistry, issued a sort of cautionary tale. Every chemist needs his patrons.

27:42Filthy lucre can't be spurned. But don't forget that Galileo very nearly burned. So make those associates smile. Galileo once almost burned at the stake for claiming the planet revolved around the sun. It was a statement so shocking that the Catholic Church moved to persecute him. He eventually recanted his defense of heliocentrism, and he lived under house arrest for the rest of his life. It wasn't until 1992 that the Vatican finally acknowledged that Galileo was right. Linus Pauling believed so deeply in the power of vitamin C, even when presented with evidence countering his conviction for decades.