COMMON QUESTIONS ON BENEFITS OF INTRAVENOUS VITAMIN C

Why high dose intravenous Vitamin C (IVC )?

 

It is found that Intravenous Vitamin C can bypassing normal gut metabolism and excretion pathways — creates blood levels that are 100 — 500 times higher than levels seen with oral ingestion. With such high blood levels (350 to 400 mg/dl of vitamin c), it selectively kills cancer cells while leave the normal cells intact. (Ref: Riordan Clinic).

High-dose IVC (> 0.5 g per kg body weight) is claimed to have several effects

  • a) cytotoxicity for cancer cells, but not for normal tissue,
  • b) improved quality of life for cancer patients,
  • c) protection of normal tissues from toxicity caused by chemotherapy, and
  • d) reinforcement of the action of radiation and some types of chemotherapy.

Reference : Luc Geeraert and the CAM-Cancer Consortium. Updated July 9, 2014


Does high dose intravenous Vitamin C cause kidney stones or kidney failures?

 

It has been documented that oral ingestion of oral vitamin c was associated with a dose dependent 2 fold increased risk of kidney stones formation among men .(1)

The anecdote of vitamin C and kidney stones is mentioned in a major textbook of pharmacology: “…risks of megadose treatment … include formation of kidney stones” (Marcus & Coulston 2001). The statement that vitamin C may cause kidney stones has been reiterated, e.g., in the Nordic Nutritional Recommendations without any references (NNR 2004 p 310).”

Vitamin C does increase the production of oxalate in the body, there is no evidence that it increases stone formation. It could even have the reverse effect, for several reasons.

Firstly, vitamin C tends to bind calcium, which could decrease its availability for formation of calcium oxalate.

Secondly, vitamin C has a diuretic action: it increases urine flow, providing an environment that is less suitable for formation of kidney stones.

Finally, stone formation appears to occur around a nucleus of infection. High concentrations of vitamin C are bactericidal and might prevent stone formation by removing the bacteria around which stones form.

Vitamin C could also prevent other types of kidney stones. Less common forms of stone include uric acid stones (8%), that form in gout, and cystine stones (1%), which can occasionally be formed in children with a hereditary condition; these stones are not side effects of vitamin C. Other stones include those made from calcium phosphate (5%), which dissolve in a vitamin C solution. Acid urine, produced by ascorbate, will also dissolve the struvite stones (magnesium ammonium phosphate) that often occur in infected urine.

  • Ascorbate in low or high doses generally does not cause significant increase in urinary oxalate.[6-10]
  • Ascorbate tends to prevent formation of calcium oxalate kidney stones.[7,8]
  • Risk factors for kidney stones include a history of hypertension, obesity, chronic dehydration, poor diet, and a low dietary intake of magnesium.

References:

  1. Ascorbic Acid Supplements and Kidney Stone Incidence Among Men: A Prospective Study. Thomas LDK, Elinder CG, Tiselius HG, Wolk A, Akesson A. (2013). JAMA Intern Med. 2013;173(5):386-388. doi:10.1001/jamainternmed.2013.2296.
  2. What Really Causes Kidney Stones (And Why Vitamin C Does Not) Orthomolecular Medicine News Service, February 11, 2013. http://orthomolecular.org/resources/omns/v09n05.shtml
  3. Hickey S, Roberts H. (2005) Vitamin C does not cause kidney stones. http://orthomolecular.org/resources/omns/v01n07.shtml
  4. Hickey S, Saul AW. (2008) Vitamin C: The Real Story, the Remarkable and Controversial Healing Factor. Basic Health Publications ISBN-13:9781591202233 http://orthomolecular.org/resources/omns/v09n05.shtml
  5. KIDNEY STONES (Renal Calculi) AND THEIR RELATION TO DIET. DoctorYourself.com – Kidney Stones , Andrew W. Saul 200
  6. Wandzilak TR, D’Andre SD, Davis PA, Williams HE (1994) Effect of high dose vitamin C on urinary oxalate levels.  J Urology151:834-837.
  7. Hickey S, Saul AW. (2008) Vitamin C: The Real Story, the Remarkable and Controversial Healing Factor. Basic Health Publications ISBN-13: 9781591202233
  8. Hickey S, Roberts H. (2005) Vitamin C does not cause kidney stones. http://orthomolecular.org/resources/omns/v01n07.shtml
  9. Robitaille L, Mamer OA, Miller WH Jr, Levine M, Assouline S, Melnychuk D, Rousseau C, Hoffer LJ. Oxalic acid excretion after intravenous ascorbic acid administration. Metabolism. 2009 Feb;58(2):263-9. doi:10.1016/j.metabol.2008.09.023.
  10. Padayatty SJ, Sun AY, Chen Q, Espey MG, Drisko J, Levine M. (2010) Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PLoS One. 5(7):e11414. doi: 10.1371/journal.pone.0011414.

Is it safe to use such high dose of vitamin C for vulnerable cancer patients?

Clinical trials found that it is safe to regularly infuse brain and lung cancer patients with 800 — 1000 times the daily recommended amount of vitamin C as a potential strategy to improve outcomes of standard cancer treatments. In a work presented March 30, 2017 in Cancer Cell, University of Iowa researchers also show pathways by which altered iron metabolism in cancer cells, and not normal cells, lead to increased sensitivity to cancer cell death caused by high dose vitamin C.

High-dose vitamin C is essentially non-toxic. Reported side-effects are minor if patients are adequately screened for renal disease and glucose 6-phosphate dehydrogenase deficiency, and when doses are gradually increased with careful monitoring of the patient.

According to FDA’s Adverse Events Database. Of 199 survey respondents (out of 550), 172 practitioners administered IV vitamin C to 11,233 patients in 2006 and 8876 patients in 2008. Average dose was 28 grams every 4 days, with 22 total treatments per patient. Estimated yearly doses used (as 25 g/50 ml vials) were 318,539 in 2006 and 354,647 in 2008. Manufacturers’ yearly sales were 750,000 and 855,000 vials, respectively. Common reasons for treatment included infection, cancer, and fatigue. Of 9,328 patients for whom data is available, 101 had side effects, mostly minor, including lethargy/fatigue in 59 patients, change in mental status in 21 patients and vein irritation/phlebitis in 6 patients. Publications documented serious adverse events, including 2 deaths in patients known to be at risk for IV vitamin C.

References:

1. High doses of vitamin C to improve cancer treatment passes human safety trial — Science Daily.  https://www.sciencedaily.com/releases/2017/03/170330142341.htm

2. Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. Padayatty SJ1Sun AYChen QEspey MGDrisko JLevine MPLoS One. 2010 Jul 7;5(7):e11414. doi: 10.1371/journal.pone.0011414


Any Associated Adverse Events?

 

Vitamin C itself is essentially non-toxic. In general, adverse events after high-dose intravenous vitamin C were mild, and consistent with side effects occurring due to rapid infusion of any high-osmolarity solution, and were preventable by drinking fluids before and during the infusion.

Reference:

Intravenous high-dose vitamin C, Luc Geeraert and the CAM-Cancer Consortium. Updated July 9, 2014.


Why high-dose vitamin C kills cancer cells?

Low levels of catalase enzyme make cancer cells vulnerable to high-dose vitamin C .

Study show vitamin C breaks down easily, generating hydrogen peroxide, a so-called reactive oxygen species that can damage tissue and DNA. The study also shows that tumor cells are much less capable of removing the damaging hydrogen peroxide than normal cells. Cancer cells are much more prone to damage and death from a high amount of hydrogen peroxide.

Normal cells have several ways to remove hydrogen peroxide, keeping it at very low levels so it does not cause damage. The new study shows that an enzyme called catalase is the central route for removing hydrogen peroxide generated by decomposing vitamin C. The researchers discovered that cells with lower amounts of catalase activity were more susceptible to damage and death when they were exposed to high amounts of vitamin C.

The study suggests that cancers with low levels of catalase are likely to be the most responsive to high-dose vitamin C therapy, whereas cancers with relatively high levels of catalase may be the least responsive,”

Dr. Hunninghake also notes that his team has documented seven ways by which IVC helps fight cancer. These seven areas are:

  1. Self-sufficiency of growth signals
  2. Insensitivity to antigrowth signals
  3. Evasion of apoptosis (cell death)
  4. Unlimited proliferation potential
  5. Enhanced angiogenesis (blood-vessel supply to the tumor)
  6. Tissue invasion and metastasis
  7. Inflammatory microenvironment

References:

1. University of Iowa Health Care. “Why high-dose vitamin C kills cancer cells: Low levels of catalase enzyme make cancer cells vulnerable to high-dose vitamin C.” ScienceDaily. ScienceDaily, 9 January 2017.  https://www.sciencedaily.com/releases/2017/01/170109134014.htm

2. Claire M. Doskey, Visarut Buranasudja, Brett A. Wagner, Justin G. Wilkes, Juan Du, Joseph J. Cullen, Garry R. Buettner. Tumor cells have decreased ability to metabolize H2O2: Implications for pharmacological ascorbate in cancer therapy. Redox Biology, 2016; 10: 274 DOI: 10.1016/j.redox.2016.10.010


What are the Benefits of High Dose IVC for cancer patients?

Theoretical and Experimental Applications of Vitamin C in Cancer.

 

Proposed mechanisms of vitamin C activity in the prevention and treatment of cancer include:

  • enhancement of the immune system by increased lymphocyte production:
  • stimulation of collagen formation, necessary for ‘walling off’ tumours;
  • inhibition of hyaluronidase, keeping the ground substance around the tumour intact and preventing metastasis (1);
  • inhibition of oncogenic viruses;
  • correction of an ascorbate deficiency, often seen in cancer patients;
  • expedition of wound healing after cancer surgery (2);
  • enhancement of the effect of certain chemotherapy drugs, such as tamoxifen, cisplatin, DTIC and others (3);
  • reduction of the toxicity of other chemotherapeutic agents;
  • prevention of cellular free radical damage; and
  • neutralization of carcinogenic substances (4).

References:

1. Cameron E and Pauling L. Ascorbic acid and the glycosaminoglycans. Oncology. 27: 181-92. 1973.

2. Sukolinskii VN and Morozkina TS. Prevention of postoperative complication in patients with stomach cancer using an antioxidant complex. Vopr Onkol. 35: 1242-45. 1989.

3. Lee YS and Wurster RD. Potentiation of anti-proliferative effect of nitroprusside by ascorbate in human brain tumour cells. Cancer Lett. 78: 19-23. 1994.

4. Aidoo A, Lyn-Cook LE, Lensing S and Wamer W. Ascorbic acid (vitamin C) modulates the mutagenic effects produced by an alkylating agent in vivo. Environ Mol Mutagen. 24: 220-28. 1994.

5. Vitamin C and Cancer – Storm of Controversy , by Nicholas Calvino DC and Stephen Levine listed in cancer, originally published in issue 71 – December 2001 , PositiveHealth.com – United States of America

http://ivcinfusions.com/articles/Vitamin%20C%20and%20Cancer%20-%20Storm%20of%20Controversy%20-%20PositiveHealth.com%20-%20United%20States%20of%20America.pdf


Possible Concerns on High Dose Intravenous Vitamin C 

Dehydration – IVC can dehydrate, but this can easily be avoided if the patient makes sure to drink plenty of water before, during, and after treatment.

Lowered Blood Sugar Levels – the patient should eat a balanced meal before treatment to help avoid low blood sugar levels after IVC.

Reduced blood levels of calcium and potassium – the IVC solution includes these minerals to maintain blood electrolyte balance.

Vein irritation or pain – the IVC solution contains sodium bicarbonate to neutralize its acidity. Your doctor can also reduce the drip rate. Patients with ports (a surgically-placed medical appliance giving direct vein access) do not typically experience vein irritation.

Overall health – your doctor should analyze lab work, including both blood and urine testing, before and during treatments.

Existing kidney issues or liver disease – patients with either of these conditions should be monitored more closely, but negative side effects are still rare.

High-dose IVC intolerance – before beginning IVC treatment, your doctor should test for the Glucose 6 Phosphate Dehydrogenase – G6PD – especially if you are of African, Middle Eastern, Asian, or Mediterranean descent.

References:

1. The Benefits of Intravenous Vitamin C Treatment, Adapted from Dr. Stengler’s Health Revelations Newsletter. http://www.markstengler.com


Remarks

There is no clinical evidence that supplemental antioxidant vitamins, including vitamin C, harm cancer patients. Indeed, much of the recent cell culture and clinical research suggests that a combination of antioxidant vitamins and minerals as an adjunct to conventional therapy may have benefit. This is a complex issue, however, and there is clearly more to learn from controlled clinical trials about the use of these modalities in treating cancer before definitive conclusions can be drawn.

 

 

 

 

 

 

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