Intravenous Therapies: High Dose Vitamin C

Background:

In 1986 Linus Pauling first raised the possibility that high dose Vitamin C (Vit-C) can be used to treat cancer. This hypothesis was met with intense skepticism by the scientific community and prompted Mayo Clinic to conduct two randomized controlled trials. The trials showed that Vit-C was totally ineffective. These findings account for the residual resistance and doubts in medical community regarding the use of Vit-C as a cancer treatment. It  was not recognized, though,  that Dr. Pauling administered Vit-C intravenously while the Mayo Clinic study included only orally administered Vit-C. There is a profound difference between the two routes of administration.

Research:

Mark Levine, MD, and his team of researchers at the NIH-NIDDK, established two primary concepts in the mechanism of action of Vit-C. First, Vit-C is so rapidly removed from the body that the absorption rate and the secretion rate reach an equilibrium in the bloodstream at a relatively low oral dose of approximately 350 mg. When given intravenously at a dose of 50 to 100 grams (more than 100 times higher than the oral dose), the blood concentrations can reach much higher levels. It is at these levels that Vit-C can kill cancer cells. Second, at high blood concentration Vit-C is a pro-drug for hydrogen peroxide, which is a powerful free radical and is toxic to cells. Normally, healthy cells possess a natural antioxidant that neutralizes hydrogen peroxide and thus the cells  are not harmed. However, cancer cells are deficient in this antioxidant and therefore are killed by hydrogen peroxide. Dr. Levine also demonstrated in an in-vitro model the effectiveness of Vit-C against a panel of cancer cell lines.

There are several case reports published in peer-reviewed medical journals that meet quality standards set by the National Cancer Institute. The reports  demonstrate that a small number of patients have responded to a high dose IV Vit-C infusion treatment after all other treatments have failed.

However, experimental data demonstrating the effectiveness of Vit-C against cancer in animal models, and most importantly, data from randomized clinical controlled trials (the gold standard) are still needed.

Practice:

Based on a vast pool of clinical experience, IV administration of high dose Vit-C has been shown to essentially have no side effects, unlike chemotherapy drugs and radiation therapy. Since IV Vit-C works just like chemotherapy and radiation therapy by releasing free radicals, there are no contraindications for their simultaneous use. In fact, Vit-C may work synergistically with chemotherapy and potentiate its effect.

However, there are some disadvantages. The course of therapy is long and intense, two to three times per week (2 hours each) and for the duration of about a year. It can cost over $20,000 for a year-long course of treatment if it is not covered by an insurance.

When evaluating new innovative cancer treatments we need to ensure that three basic requirements are met:

One: There is a clinical plausibility, i.e., credible case reports exist.

Two: There is a biological plausibility, i.e., the mechanism of action is clear.

Three: Proven clinical effectiveness, i.e., a randomized controlled trial has been conducted.

High dose IV Vit-C therapy has met the first two requirements. It is unfortunate that it would take many years before the last step can be accomplished.

We feel compelled to offer this treatment to patients when there are no other choices even though the definitive clinical evidence of its effectiveness is not yet available.

Other Uses:

In addition to treatment for cancer, we use high dose intravenous Vitamin C to treat a variety of infections as an adjunctive modality.  Please inquire about the specifics.