Treating sepsis with vitamin C, thiamine, and hydrocortisone: Exploring the quest for the magic elixir

J. Obi, S. M. Pastores, L. V. Ramanathan, J. Yang, N. A. Halpern

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


The administration of ascorbic acid (vitamin C) alone or in combination with thiamine (vitamin B1) and corticosteroids (VCTS) has recently been hypothesized to improve hemodynamics, end-organ function, and may even increase survival in critically ill patients. There are several clinical studies that have investigated the use of vitamin C alone or VCTS in patients with sepsis and septic shock or are ongoing. Some of these studies have demonstrated its safety and potential benefit in septic patients. However, many questions remain regarding the optimal dosing regimens and plasma concentrations, timing of administration, and adverse effects of vitamin C and thiamine. These questions exist because the bulk of research regarding the efficacy of vitamin C alone or in combination with thiamine and corticosteroids in sepsis is limited to a few randomized controlled trials, retrospective before-and-after studies, and case reports. Thus, although the underlying rationale and mechanistic pathways of vitamin C and thiamine in sepsis have been well described, the clinical impact of the VCTS regimen is complex and remains to be determined. This review aims to explore the current evidence and potential benefits and adverse effects of the VCTS regimen for the treatment of sepsis.

Original languageEnglish
Pages (from-to)231-239
Number of pages9
JournalJournal of Critical Care
StatePublished - Jun 2020
Externally publishedYes


  • Critical illness
  • Laboratory testing
  • Levels
  • Sepsis
  • Septic shock
  • Thiamine
  • Vitamin C


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