High Dose IVC
High Dose IV Vitamin C is a safe and effective complementary cancer treatment, which utilizes high doses of Vitamin C between 50 grams (50,000 mg) and 100 grams (100,000 mg), administered via IV, to improve Quality of Life and may reduce side effects of chemotherapy and/ or radiation; improve survival times; and be cytotoxic to cancer cells, while preserving normal cells.
Insurance typically doesn’t cover this treatment, let’s change that.
The Science
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High-dose IVC combined with cytotoxic chemotherapy in patients with advanced cancer: a phase I-II clinical trial
“We carried out a phase I-II safety, tolerability, pharmacokinetic and efficacy trial of IVC combined with chemotherapy in patients whose treating oncologist judged that standard-of-care or off-label chemotherapy offered less than a 33% likelihood of a meaningful response.
Fourteen patients were enrolled. IVC was safe and generally well tolerated, although some patients experienced transient adverse events during or after IVC infusions. Three (21% of) patients with different types of cancer experienced unexpected transient stable disease, increased energy and functional improvement.”
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High-dose IVC, a promising multi-targeting agent in treatment of cancer
Mounting evidence indicates that vitamin C has the potential to be a potent anti-cancer agent when administered intravenously and in high doses (high-dose IVC). Early phase clinical trials have confirmed safety and efficacy of IVC in eradicating tumor cells of various cancer types. [Its role has been theorized] as cancer-specific, pro-oxidative cytotoxic agent, anti-cancer epigenetic regulator and immune modulator, inhibiting hypoxia and oncogenic kinase signalling and boosting immune response. Moreover, high-dose IVC is powerful as an adjuvant treatment for cancer, acting synergistically with many standard (chemo-) therapies, as well as a method for mitigating the toxic side-effects of chemotherapy.
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Efficacy of High Dose IVC as complementary cancer therapy
“In preclinical studies, higher pharmacologic concentrations [of Vitamin C] could be achieved via intravenous injection and had selective cytotoxic effects on cancer cell lines. Ascorbic acid is postulated to act as a carrier of hydrogen peroxide to the extracelluar fluid (32) where it generates free radicals against tumor cells (33). High-dose IV ascorbic acid up to 1.5 g/kg/day (34), or used with chemotherapy (74) appears to be well-tolerated. It may improve the quality of life of terminal cancer patients.”
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Effect of high-dose intravenous vitamin C on inflammation in cancer patients
“In our study, we found that modulation of inflammation by IVC correlated with decreases in tumor marker levels. In summary, our data support the hypothesis that high dose intravenous ascorbate treatments may reduce inflammation in cancer patients.”
Methods: 45 patients with prostate cancer, breast cancer, bladder cancer, pancreatic cancer, lung cancer, thyroid cancer, skin cancer and B-cell lymphoma were treated at the Riordan Clinic by high doses of vitamin C (7.5 g -50 g) after standard treatments by conventional methods.
History of IVC
In the 1970s, Linus Pauling and Ewan Cameron reported increased survival of patients with advanced cancer treated with high-dose intravenous (IV) vitamin C (L-ascorbate, ascorbic acid). Thus, kicking off the IVC revolution. They found:
Vitamin C patients had a mean survival time ~300 days greater than that of the controls.
Survival times greater than 1 yr after the date of “untreatability” were observed for 22% of Vit C patients and for 0.4% of the controls.
The mean survival time of these 22 ascorbate-treated patients is 2.4 yr after reaching the apparently terminal stage;
8 of the ascorbate-treated patients remained alive 3.5 years after the “untreatability” stage.
Present Day Use
Integrative Oncologists have been using High Dose IV Vitamin C for years, but it has failed to break through mainstream oncology due to a lack of Phase III randomized clinical trials. The Pauling / Cameron studies were criticized for their retrospective nature and lack of standardization of key prognostic factors. Several well-designed randomized controlled trials failed to demonstrate a significant survival benefit, BUT these trials (through Mayo Clinic) used high-dose ORAL Vitamin C. So they failed to properly replicate the Pauling Studies and it’s well-known that pro-oxidant blood serum levels are NOT achievable through oral administration.
Phase I and II clinical trials have shown safety, and case studies have demonstrated efficacy through Quality of Life and survival time. It’s time for insurance to cover these treatments for terminal patients, patients looking to prevent a recurrence, patients seeking less toxicity from chemotherapy, and patients who lack other treatment options.
“Study overview of pre-clinical, clinical and omics studies using high-dose VitC as anti-cancer agent. Estimated bar graphs of most represented cancer types VitC doses are shown in orange and include high dose (≥ 1 mM in vitro or 1 g/kg in vivo and clinical), medium dose (≤ 0.5 mM in vitro), and low dose (≤ 0.1 mM in vitro,< 1 g/kg in vivo, ≤ 10 g whole-body dose clinical). Described effect in pre-clinical studies is expressed by percentage of the total number of studies. Reported results in completed clinical trials are expressed by number of studies. Number of studies per global molecular profiling type are also indicated. Omic results include n = 20 in vitro and n = 4 in vivo studies.” Source: High-dose intravenous vitamin C, a promising multi-targeting agent in the treatment of cancer; Journal of Experimental & Clinical Cancer Research 2021
High Dose IVC Resources
Review: High-dose intravenous vitamin C, a promising multi-targeting agent in the treatment of cancer; J Exp Clin Cancer Research 2021
Review: The Role of Vitamin C in Cancer Prevention and Therapy: A Literature Review; Antioxidants 2021
Review: Intravenous Vitamin C and Cancer: A Systematic Review; Integrative Cancer Therapy 2014
Clinical Trials & Case Studies Riordan Clinic: Data from Riordan Clinic’s Ongoing Use of High-Dose IVC in Cancer; Riordan Clinic, Kansas
24 subjects with advanced cancer or hematologic malignancy not amenable to standard therapy were given IVC at doses of 0.4 g/kg to 1.5 g/kg (equivalent to a range of 28 to 125 grams in a 70 kg adult) three times weekly. Phase I studies indicate that IVC can be safely administered to terminal cancer patients at high doses.
Case Studies: Effects of High Doses of Vitamin C on Cancer Patients in Singapore: Nine Cases; Integrative Cancer Therapies 2015
“Results. Cases suggesting survival beyond prognosis, improvement in quality of life, safe coadministration with and improved tolerance of conventional therapy, and deterioration in clinical condition following withdrawal of vitamin C therapy are documented clinically.”
Clinical Trial: High Dose Parenteral Ascorbate Inhibited Pancreatic Cancer Growth and Metastasis: Mechanisms and a Phase I/IIa study; Scientific Reports 2017
“IVC was safe in patients and showed the possibility to prolong patient survival.”
Clinical Trial: High-dose intravenous vitamin C combined with cytotoxic chemotherapy in patients with advanced cancer: a phase I-II clinical trial; PLoS One 2015
Despite a nearly hopeless prognosis this patient experienced a temporary but important symptomatic and functional improvement with temporary stable disease during treatment with IVC and chemotherapy.
Clinical Trial Pancreatic Cancer: Pharmacologic Ascorbate Reduces Radiation-Induced Normal Tissue Toxicity and Enhances Tumor Radiosensitization in Pancreatic Cancer; Cancer Research 2018
“Specifically, treatment with [IVC] increased median overall survival compared with our institutional average (21.7 vs. 12.7 months) … These findings demonstrate that pharmacologic ascorbate enhances pancreatic tumor cell radiation cytotoxicity in addition to offering potential protection from radiation damage in normal surrounding tissue, making it an optimal agent for improving treatment of locally advanced pancreatic adenocarcinoma.”
Clinical Trial Brain Cancer: First-in-Human Phase I Clinical Trial of Pharmacologic Ascorbate Combined with Radiation and Temozolomide for Newly Diagnosed Glioblastoma; Clinical Cancer Research 2019
Median progression-free survival (PFS) was 9.4 months and median OS was 18 months. Conclusions: P-AscH-/RT/TMZ is safe with promising clinical outcomes warranting further investigation.
Clinical Trial Colon Cancer: Phase I study of high-dose ascorbic acid with mFOLFOX6 or FOLFIRI in patients with metastatic colorectal cancer or gastric cancer; BMC Cancer 2019
Clinical Trial NSCLC: The safety and pharmacokinetics of high dose intravenous ascorbic acid synergy with modulated electrohyperthermia in Chinese patients with stage III-IV non-small cell lung cancer; Eur J Pharm Sci 2017
Clinical Trial Pancreatic Cancer: Phase I evaluation of intravenous ascorbic acid in combination with gemcitabine and erlotinib in patients with metastatic pancreatic cancer; PLoS One 2012, Thomas Jefferson University, Philadelphia, Pennsylvania
Clinical Trial, Pancreatic Cancer: Pharmacological Ascorbate with Gemcitabine for the Control of Metastatic and Node-Positive Pancreatic Cancer (PACMAN): Results from a Phase I Clinical Trial; Iowa, Cancer Chemother Pharmacol 2014
“Data suggest pharmacologic ascorbate administered concurrently with gemcitabine is well-tolerated.”
Study Colon Cancer: Pharmacologic doses of ascorbic acid repress specificity protein (Sp) transcription factors and Sp-regulated genes in colon cancer cells; Nutrition and Cancer, 2011
Study Prostate Cancer: Pharmacological ascorbate induces cytotoxicity in prostate cancer cells through ATP depletion and induction of autophagy; Anti-Cancer Drugs. Apr 2012
Study Breast Cancer Cells: SVCT-2 in breast cancer acts as an indicator for L-ascorbate treatment; Oncogene 2013
Study Ovarian Cancer (mouse models): High-dose parenteral ascorbate enhanced chemosensitivity of ovarian cancer and reduced toxicity of chemotherapy; Science Translational Medicine 2014
Clinical Trial Oral Vitamin C: A pilot study of the impact of Vitamin C supplementation with neoadjuvant chemoradiation on regulators of inflammation and carcinogenesis in esophageal cancer patients; J Cancer Res Ther Jan-Mar 2019
Research Against IVC as a complementary therapy
(it’s important to look at ALL the research, not just pick & choose)
Phase II Clinical Trial, Prostate Cancer, Denmark: Weekly ascorbic acid infusion in castration-resistant prostate cancer patients: a single-arm phase II trial; Transl Androl Urol 2017
“Patients received [once] weekly infusions of AA (week 1, 5 g; week 2, 30 g; and weeks 3-12, 60 g) followed by efficacy evaluation at 12 weeks.”
“Infusion with 60 g of AA [for 9 weeks] did not result in disease remission.”
Issues: The dosage was not enough (the authors of the study admit, their starting point, originally 20g — unpublished data — was too low for blood serum levels. Secondly, 1x per week is not sufficient. Research has shown IVC should be administered 2x to 3x weekly. The researchers also gave patients 500mg AA orally, which should not be given during IVC. Also, IVC was seemingly used as monotherapy, as some participants chose to not do the trial so they could participate in chemotherapy. We advocate for IVC as complementary therapy, not monotherapy. And IVC often needs to be administered for longer periods of time than 9 weeks.
Clinical Trial: Phase I clinical trial of i.v. ascorbic acid in advanced malignancy; Annals of Oncology 2008
“High-dose i.v. ascorbic acid was well tolerated but failed to demonstrate anticancer activity when administered to patients with previously treated advanced malignancies.”
Please note: This trial only looked at advanced untreatable malignancies (i.e. that did NOT respond to other treatment such as chemo and radiation), and 33% of patients had been treated with 3 or more therapies at the time of trial. Dosing was administered at 0.4, 0.6, 0.9, and 1.5 g/kg assigned at registration — for a 154lb (70kg) person this would be 28g, 42g, 63g, and 105g respectively (med weight was 68kg). Again, most successful doses are seen at 50g to 100g (but this was 2008 so the information was being established). For example, the researchers found: “patients in the 0.4-g/kg cohort experienced a significant deterioration in physical function over the course of the study (5.4 ± 4.2 versus 13.4 ± 1.1, mean ± SD, P < 0.01 by Mann–Whitney test), but there was no deterioration in physical function among patients in the higher dose cohorts.”
They did find that “Intravenous ascorbic acid, administered in a dose of 1.5 g/kg three times weekly, appears to be safe and free of important toxicity in appropriately screened patients with advanced untreatable malignancies” and “Patients whose ascorbic acid dose was ≥0.6 g/kg maintained their physical quality of life throughout the trial, whereas those at the lowest dose did not.”
Issues: Only 6 patients in the study received the “now” recommended dose and 2 of those patients (30%) achieved stable disease (on an “untreatable” cancer). While this study’s authors concluded that High Dose IVC showed no anticancer effects, stable disease or Quality of Life for an untreatable cancer may be seen as a win for a patient.
High-Dose IVC must be prescribed by a doctor. Contraindications of High Dose IVC:
Patients with renal insufficiency, high dose IVC may lead to kidney stone formation or acute oxalate nephropathy
G6PD deficiency (red cell glucose-6-phosphate dehydrogenase deficiency) has been linked to cases of hemolytic anemia, following high dose IVC
Both conditions should be screened prior to high-dose IVC administration.
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