Vitamin C Hole in the Head:

An Attempt to Cure an Oscar's Hole in the Head Disease with a Natural Source of Vitamin C

Health and Well-being of Ornamental Fish More Similar to Human Health than We Realize

by Josh Day
(updated July 11 2008)

Hole in the Head disease, or HLLE (head and lateral-line erosion) is a common disease that strikes many large cichlids. Cichlids are South American freshwater fish such as oscars, angelfish, discus, and severums. You'd know an oscar if you saw one.

Here's mine below, a red Oscar afflicted with a moderate case of hole in the head:

As you can see, hole in the head isn't pretty.

Grown red oscar afflicted with hole in the head (HLLE)

Fortunately, hole in the head is treatable and rarely fatal if you catch it on time and immediately begin treatment. And thankfully, my fish's case looks much worse when shot by a flash-equipped camera. Watching him swim and feed in my tank, the average eye wouldn't even notice anything wrong with him.

Here's a summary of what's believed to cause hole in the head:

  • Chronic bad water conditions (nitrates over 60 ppm)
  • Poor diet and nutrient deficiency
  • Protozoan and bacteria
  • Use of carbon filtration over a long period

It's tough to nail down the exact trigger. Nobody really understands this disease... we don't even know if it's a disease or a condition. The aquarium hobby is rife with heated discussions about hole in the head and what causes it and what cures it.

I do regular water changes on my Oscar tank, but nitrates had been over 80 for some time. This may have caused the hole in the head. I'd also been using a powerful carbon and resin filtration for at least three months, so that may have been the culprit too (though this theory is generally not accepted and many hobbyists believe it's been roundly debunked).

But I have a theory of my own.

Lack of vitamin c has been reported in many hole in the head outbreaks (though this in no way could definitively be the sole cause). I feed my Oscars a nutrient-packed pellet diet, as well as occasional bloodworms and beefheart. On paper his diet is ideal.

However, I happen to know something about vitamin c that many people, especially fish hobbyists, don't know.

The majority of vitamin c supplements, as well as vitamin c-added nutrients for non-human use, does not contain real vitamin c. What's used instead is a compound called ascorbic acid.

Here's what Dr. Ben Kim has to say about ascorbic acid:

If you take a look at a variety of vitamin C supplements, you will find that the majority of them contain only ascorbic acid or a compound called ascorbate, which is a less acidic form of ascorbic acid. Ascorbic acid is NOT vitamin C. It represents the outer ring that serves as a protective shell for the entire vitamin C complex, much like an orange peel that serves as a protective shell for an orange.

Real vitamin C found in whole foods like fruits and vegetables contains the following components:

* Rutin
* Bioflavonoids (vitamin P)
* Factor K
* Factor J
* Factor P
* Tyrosinase
* Ascorbinogen
* Ascorbic Acid

When you take only ascorbic acid found in your synthetic vitamin C tablet or powder, your body must gather all of the other components of the full vitamin C complex from your body's tissues in order to make use of it. In the event that your body does not have adequate reserves of the other components, ascorbic acid itself does not provide the same range of health benefits that the full vitamin C complex does. (Dr. Kim)

Real Vitamin CCould this be the case in non-humans as well? I don't know, but it's worth a shot to experiment.

I've begun soaking pellets in water sprinkled with Real Vitamin C. After time the pellets will soak up the vitamin c and provide the fish with the entire spectrum that is this important vitamin and not just one aspect.

I've also cut feedings back to every other day, turned up the temperature in the tank, and included live earthworms, frozen bloodworms, and canned peas in the oscar's diet. I have also changed out 50% of the water (too much too fast, my friendly bacteria in the tank has died off somewhat) and removed the carbon filtration.

I've cured two severe cases of hole in the head in the past with discus solely by feeding quality frozen bloodworms and implementing frequent water changes.

If I don't see any results in five days, I'll be forced to treat with the medicine metronidazole, which has been proven to fix hole in the head. Unfortunately, I've never had any luck with this in the past. Metronidazole did nothing for my discus and I lost several clown loaches with internal parasites while undergoing intense mentronidazole treatments.

Anyway, throw out your bottle of rock vitamins (ascorbic acid) and give the real deal a try. If you aren't interested in true vitamin c powder, you can get vitamin c through the foods below:

  • Sweet red pepper
  • Strawberries
  • Oranges
  • Broccoli
  • Grapefruit

Update (7-11-08)

Unfortunately, the vitamin c powder has not been as effective as I had hoped.

The holes remain.

Good news is they are not any bigger, so that's at least something.

I added minced garlic and a vitamin-rich food to the treatment. I also do frequent small water changes, and this seems to help the most as I think I can tell a difference after a water change.

The oscar had a head-on collision with a sharp piece of driftwood and tore his forehead wide open in two areas above the eyes, exposin deep white flesh. I upped the vitamin c and garlic (an anti-fungal and anti-bacterial herb). I also fed fresh live earthworms.

In two days the lesions healed and today you can barely see the battle damage.

Disclaimer: Throughout this entire website, statements are made pertaining to the properties and/or functions of food and/or nutritional products. These statements have not been evaluated by the Food and Drug Administration and these materials and products are not intended to diagnose, treat, cure or prevent any disease.