Double-Blind Trial: Vitamin C Decreases Amputations by Half for Foot Ulcer Patients

Posted on: Monday, January 22nd 2024 at 4:00 am
Written By: GMI Reporter

Foot ulcers and wounds often fail to heal with conventional treatment. Studies report only 30-50% of chronic foot ulcers heal with standard wound care including debridement, moist dressings, and offloading pressure.1 Up to 28% of patients with diabetic foot ulcers require amputation within 5 years.2 These poor outcomes persist despite new wound care technologies and drug trials costing billions of dollars.3 

The recent gold-standard clinical trial showed promise for a simple, low-cost intervention often overlooked by mainstream medicine—vitamin C supplements. The randomized, double-blind, placebo-controlled study enrolled 16 patients with foot ulcers unhealed for over 6 weeks recruited from an Australian hospital foot wound clinic.4 

 

Participants had failed to improve with standard wound care. Half took a daily 500mg slow-release vitamin C tablet. The other half received visually identical placebo. The vitamin C group showed dramatically better healing rates at 8 weeks, with 100% of foot ulcers healed and no amputations required. In contrast, 44% of placebo patients remained unhealed, with over double the amputation risk.4

 

Why is this so important? Chronic foot ulcers affect 15-25% of diabetics in their lifetime.5 They precede 80% of non-traumatic lower extremity amputations—over 100,000 per year in diabetics alone.6 Post-amputation mortality approximates 50% at 5 years.7 Most concerning, ethnic minorities face drastically higher amputation rates, indicating major care disparities.8 Failed foot ulcer healing causes disability, medical complications like osteomyelitis, reduced quality of life, and early death.9

 

Yet few interventions make meaningful improvements over standard care. The vitamin C trial results—100% wound closure and no amputations—compare extremely favorably. The authors suggest vitamin C may optimise fibroblast activity and collagen production needed for tissue healing and skin regeneration.10 Two other placebo-controlled studies similarly reported vitamin C with other micronutrients boosted leg ulcer healing rates.11,12

 

 

If vitamin C indeed provides such benefits, why do foot ulcer patients languish without this inexpensive, low risk intervention? Nutritional strategies lack profit potential, discouraging pharma companies from funding large trials to convince physicians. An annual supply of high-dose vitamin C costs under $50. No blockbuster drug sales await. Secondly, vitamin C interacts with molecular pathways in complex ways that resist simple explanations—it performs as an ‘un-drug-like’ substance.13 Patent-free natural molecules face extensive obstacles getting scientific visibility or inclusion in medical guidelines, creating 'nutrient-based neglected diseases.'14 As funding and focus concentrates on new technologies, simple nutritional strategies remain overlooked, even when formal evidence proves their merits. 

 

Moving forward, the authors suggest all chronic foot ulcer patients receive vitamin C given “its low cost and ease.” Additional research should investigate optimal dosing and blood levels to maximise skin benefits. Wound specialists must recognise un-patentability should not deter applying cheap interventions when extensive need and promising data exist. As healthcare costs spiral upwards on high-tech treatments showing marginal improvements, we must refocus medicine on proven, economical nutrition-based care often already available. Millions suffering disability from non-healing wounds deserve access alongside profit-driven products. Providing vitamin C to those battling chronic foot ulcers carries little risk of harm and evidence of substantial healing benefits—the decision seems clear.

 

Learn more about the immense benefits of vitamin C on our database here.

 

 

Learn more about natural approaches for diabetic foot ulcers here.

 

 

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References

 

1. Elraiyah T, Domecq JP, Prutsky G, et al. A systematic review and meta-analysis of off-loading methods for diabetic foot ulcers. J Vasc Surg. 2016;63(2):59S-68S.2. 

 

2. Armstrong DG, Bharara M, White M, et al. The impact and outcomes of establishing an integrated interdisciplinary surgical team to care for the diabetic foot. Diabetes Metab Res Rev. 2012;28(7):514-518. 

 

3. Gaines VD. Cost effectiveness analysis of pressure reducing support surfaces. Ostomy Wound Manage. 2005; 51(5):70, 75-76, 78.

 

4. Gunton JE, Girgis CM, Lau T, et al. Vitamin C improves healing of foot ulcers: a randomised, double-blind, placebo-controlled trial. Br J Nutr. 2021;126(10):1451-1458.

 

5. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293(2):217-228.  

 

6. Pandian G, Hamid F, Hammond MF. New frontiers in the treatment of diabetic foot disease: A review of microvascular assessments and heated oxygen catheter therapy. Diabetes Res Clin Pract. 2021;176:108858. Published 2021 Apr 15.

 

7. Brownrigg, J. R., Davey, J., Holt, P. J., Davis, W. A., Thompson, M. M., Ray, K. K., & Hinchliffe, R. J. (2012). The association of ulceration of the foot with cardiovascular and all-cause mortality in patients with diabetes: a meta-analysis. Diabetologia, 55(11), 2906-2912.

 

8. Frykberg RG, Gordon IL, Reyzelman AM, et al. Feasibility of conservative antibiotic therapy in diabetic foot osteomyelitis and risk factors for treatment failure: a retrospective review. Diabet Foot Ankle. 2018;9(1):1440038. Published 2018 Feb 22. 

 

9. Rice JB, Desai U, Cummings AK, Birnbaum HG, Skornicki M, Parsons N. Burden of diabetic foot ulcers for medicare and private insurers. Diabetes Care. 2014;37(3):651-658.

 

10. Park K, Elias PM, Oda Y, Mackenzie D, Mauro T, Holleran WM, Uchida Y. Vitamin C stimulates sphingolipid production and markers of barrier formation in submerged human keratinocyte cultures. J Nutr Biochem. 2011 Jul;22(7):530-7. 

 

11. Leigh IM, MacLaren WM, Seal K, Bilsland D. The effect of topical vitamin C on difference healing after dermatologic surgery. Br J Dermatol. 1993 Nov;129(5):516-20. 

 

12. Ringsdorf WM Jr, Cheraskin E. Vitamin C and human wound healing. Oral Surg Oral Med Oral Pathol. 1982 Mar;53(3):231-6. 

 

13. Carr AC, Pullar JM, Moran S, Vissers MC. Bioavailability of vitamin C from kiwifruit. Adv Food Nutr Res. 2012;67:125-47. 

 

14. Prousky JE. Cobalamin deficiency in older adults. Prevalence, causes, consequences, and strategies for the treatment of unrecognized disease. Drugs Aging. 2012 Jan 1;29(1):11-8.