Intravenous Vitamin C in Cancer
A brief overview of its use and considerations
By Michael Traub, ND, DHANP, FABNO, and Paul Anderson, NMD
Abstract: New information has become available about the clinical use of intravenous vitamin C in recent years, particularly in its application in cancer. However, great variability in practice persists, reflecting a lack of knowledge of how this treatment should be most safely and effectively employed. This article reviews the forms of nutrients that best balance changes in blood chemistry inherent in this therapy and the appropriate use of B vitamins and glutathione. IntroductionIntravenous vitamin C (IVC) is quite different physiologically than the oral form of the vitamin. Plasma values of intravenous vitamin C can reach more than 25 mmol/L versus the plasma limit of 250 μmol/L for orally ingested vitamin C.1 Therefore, IVC infusions have unique clinical applications, including the use of high doses as a therapeutic tool in cancer care.2 Many clinical trials have been done or are currently being done assessing the use of IVC in cancer care.3-7Such research into the biochemistry and application of this clinical tool is leading to a better understanding of best practices in implementing IVC in cancer care.
IVC has at least 2 diverse therapeutic applications, one derived from high doses of vitamin C, the other from lower doses. Both uses may be clinically helpful over a wide range of applications. This apparent therapeutic dichotomy exists because at lower doses, IVC acts as a cell-support and antioxidant supplement, whereas at higher doses it acts as an oxidative pro-drug.8 While there is no concrete definition of high-dose versus low-dose vitamin C, the general consensus among practitioners is that high-dose intravenous vitamin C (HDIVC) is greater than 10 g/infusion and low-dose intravenous vitamin C (LDIVC) is less than 10 g/infusion. HDIVC is being researched as a possible adjunct in cancer care and anti-infective protocols.9 HDIVC protocols are purely oxidative and contain only minerals needed to specifically balance electrolytes. Because HDIVC is meant to be oxidative, glutathione and supplements that increase glutathione (eg, n-acetyl cysteine) should not be given on the same day, lest the oxidative capacity be lowered.10 There is also in vitro research suggesting that other antioxidants, such as quercetin, curcumin, and melatonin, may interfere with the oxidative capacity of vitamin C, although this has not been demonstrated in animal models or humans.11Low-dose Intravenous Vitamin CMany protocols exist for the use of LDIVC. This is commonly referred to as a Myers’ cocktail, and the ordering physician can create a combination of nutrients specific to the patient’s condition and needs. While it can be used in the context of complementing conventional cancer treatment, LDIVC is also used for other conditions such as headaches, muscle spasms, arrhythmia, and anxiety, to name a few. A thorough review of LDIVC is beyond the scope of this article, but it should be noted that the use of LDIVC is generally considered safe.
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