Issue No. 6
July, 2003
Pulsed Intravenous Vitamin C (PIVC) Therapy
Vitamin C has already been extensively and unequivocally documented to readily
cure a wide range of infectious diseases, including many viral syndromes considered
incurable even today (Stone, 1972; Smith, 1988, Levy, 2002). In reviewing a
great amount of this information, it becomes apparent that for most infectious
diseases, especially viral ones, the only clinical failures of vitamin C appear
to occur when a large enough amount of vitamin C cannot be effectively delivered
to the invading microorganisms.
With this in mind, then, a more effective dosing and/or delivery system of
vitamin C to the various tissues of the body should further improve the clinical
efficacy of this agent. In cancer, Riordan et al. (1995) demonstrated the likelihood
that vitamin C was an effective anti-tumor therapy as long as high enough concentrations
of it could be achieved inside the tumor(s). These researchers also concluded
that oral vitamin C supplementation was unlikely to produce blood levels of
vitamin C high enough to have a direct killing effect on a given tumor. Later,
in studying a certain line of cancer cells and the ability of vitamin C to kill
those cancer cells, Casciari et al. (2001) elegantly demonstrated this point.
They showed that the rapid intravenous infusion of vitamin C as sodium ascorbate
in combination with alpha lipoic acid was effective in reaching vitamin C levels
that were toxic to the cancer cells. They also showed that a fat soluble analogue
of vitamin C, phenyl-ascorbate, was able to kill cancer cells effectively at
a dose roughly three times lower than seen with unaltered vitamin C.
All of the conclusions reached by Casciari et al. noted above support the proposed
concept that most clinical failures of vitamin C for infections or other medical
conditions relate to inadequate delivery. They administered as much as 60,000
mg of vitamin C over an 80-minute period, a very sizable dose and a fairly rapid
administration by most standards of current usage. Yet such a large and rapidly
administered infusion of vitamin C will not always be clinically effective.
This still does not mean that the vitamin C might not be the optimal treatment
for a given condition.
At the Colorado Integrative Medical Center (www.coloradomedicalcenter.com)
in Denver, CO, we are starting to use a unique form of vitamin C therapy known
as pulsed intravenous vitamin C (PIVC) therapy. First and foremost, this therapy
utilizes the principle that the more rapidly a given dose of any nutrient or
medication is given, the higher the peak blood level of that substance will
be. This very rapid delivery of vitamin C was first reported to be both safe
and highly effective by Klenner (1971). In acute barbiturate overdose Klenner
gave as much as 42,000 mg of vitamin C "by vein as fast as a 20 gauge needle
could carry the flow." This dose awoke the patient and began the reversal
of the barbiturate toxicity without causing any side effects of note. Klenner
safely administered IV push vitamin C on multiple occasions, often on very critically
ill patients, with great clinical success and no reported toxicity.
The concept of PIVC is to get acute blood levels of vitamin C as high as possible.
By simple diffusion physiology, an acute doubling or tripling of the blood vitamin
C levels will temporarily allow an acute doubling or tripling of the amount
of vitamin C that normally diffuses into perfused tissues via the gradient that
is present at the baseline concentration. The temporary blood levels achieved
can be substantial. If Casciari et al. can get a certain high blood level from
infusing 60,000 mg of vitamin C over 80 minutes, then an IV push of 20,000 mg
of vitamin C over 2 minutes can be expected to temporarily increase the peak
blood concentration by 10-fold or more over the rapid intravenous infusion.
This amount has already been administered safely on multiple occasions.
A physiological effect of such a rapid administration of vitamin C appears
to occasionally induce an acute hypoglycemia. Sylvest (1942) found that a majority
of people given intravenous vitamin C showed a clear lowering of blood sugar.
This effect is possibly due to a significant reflex release of insulin from
the pancreas. Such a conclusion is directly supported by the work of Cheng et
al. (1989), who found that vitamin C injected into rats "produced a dose-dependent
and marked hypoglycaemic effect after intravenous injection." They also
found that the hypoglycemic effect was maximal at five minutes after injection,
coinciding with an increase in the plasma insulin concentration. Vitamin C is
a very similar molecule to glucose, and a rapid spike of vitamin C released
into the blood likely can induce the same reflex insulin spike that is seen
in a glucose tolerance test, where a large dose of glucose is given to evaluate
how quickly and effectively one can restore glucose levels to normal by inducing
insulin release. Clinically, this hypoglycemic effect has been the most notable
in patients who are ingesting little food and drink, and in those patients who
are generally sickest, as in advanced neurological conditions. In such patients
just an infusion of vitamin C can cause hypoglycemia as well, not requiring
the rapid IV push. Such patients may need a bolus of 50% glucose to rapidly
reverse the low blood sugar, as it has been noted to occur even when the carrier
IV fluid is 5% dextrose (sugar) in water. However, the IV push does seem to
more reliably cause the hypoglycemic symptoms, which fits with the animal literature
cited above.
This vitamin C-induced hypoglycemia should prove to be a very desirable effect
clinically, however. Severe hypoglycemia has already been safely and deliberately
induced in a protocol that has been in existence for over 70 years now. Known
as insulin potentiation therapy (www.iptq.org), intravenous insulin (roughly
20 to 40 units) is given rapidly to induce hypoglycemia. As hypoglycemia becomes
manifest, minidoses of cancer chemotherapeutic agents are administered. Such
small doses, in the presence of insulin-induced hypoglycemia, appear to be facilitated
in their transport across the cell membrane pathways such that the drugs reach
killing concentrations inside cancer cells at much lower dosage levels. Traditional
chemotherapy can often be given without causing the otherwise inevitable loss
of hair seen with the much larger doses.
Vitamin C and glucose actually directly compete with each other for insulin-mediated
transport into the various cells of the body (Washko et al., 1991; Cunningham,
1998). Increased intracellular access should prove to be a major leap forward
in the effective treatment of most diseases already known to be responsive to
vitamin C, and in likely quite a few more diseases that just need more effective
dosing of vitamin C to show a positive response. Proprietary protocols being
developed at the Colorado Integrative Medical Center are using such "Vitamin
C-Enabled Intracellular Nutrition" (VEIN) methodologies.
A side effect associated with high doses of vitamin C, along with other nutrients
given intravenously, and sometimes associated with concomitant hyperbaric oxygen
therapy, has been noted at our facility. On three occasions patients have complained
of bilateral mid-back discomfort. When this has been reported, further intravenous
nutrients are discontinued, oral hydration and intravenous hydration are initiated,
and oral or intravenous furosemide is given. This has resolved the discomfort
in all circumstances. No associated abnormal laboratory findings have been seen
to result. It is hypothesized that when the solute load gets high enough in
the blood perfusing the kidney, a dehydrating effect is acutely inflicted on
the kidney cells, causing the pain/discomfort reflex. Neglected, more serious
complications could occur. However, the regimen just outlined takes care of
such situations fairly promptly. Furthermore, such a side effect can actually
give the health care practitioner a practical point beyond which further intravenous
nutrition should not be pushed acutely.
Anecdotally, I have had the occasion to clinically cure a case of acute Lyme disease with three days of intravenous vitamin C therapy. Whether this is readily repeatable, or whether a chronic case of Lyme disease would respond as well remains to be seen. At the Colorado Integrative Medical Center we are now initiating a combination of therapies including those mentioned in this newsletter to see precisely how much success we can have on a regular basis with this particular disease. We are presently accepting new patients at this time who have this condition and are looking for another treatment option.
Contact Information:
Colorado Integrative Medical Center
1260 South Parker Road
Denver, CO 80231
Toll-free: 866-750-2121
FAX: 303-750-4992
Ask for Darren Green, office manager
Bibliography
Casciari, J., N. Riordan, T. Schmidt, X. Meng, J. Jackson, and H. Riordan.
(2001) Cytotoxicity of ascorbate, lipoic acid, and other antioxidants in
hollow fibre in vitro tumours. British Journal of Cancer 84(11):1544-1550.
Cheng, J., S. Hsieh-Chen, and C. Tsai. (1989) L-Ascorbic acid produces
hypoglycaemia and hyperinsulinaemia in anaesthetized rats. The Journal of
Pharmacy and Pharmacology 41(5):345-346.
Cunningham, J. (1998) The glucose/insulin system and vitamin C: implications
in insulin-dependent diabetes mellitus. Journal of the American College of
Nutrition 17(2):105-108.
Klenner, F. (1971) Observations on the dose and administration of ascorbic
acid when employed beyond the range of a vitamin in human pathology. Journal
of Applied Nutrition 23(3&4):61-88.
Levy, T. (2002) Vitamin C, Infectious Diseases, and Toxins: Curing
the Incurable.
Philadelphia, PA: Xlibris Corporation. (www.xlibris.com)
Riordan, N., H. Riordan, X. Meng, Y. Li, and J. Jackson. (1995) Intravenous
ascorbate as a tumor cytotoxic chemotherapeutic agent. Medical Hypotheses
44(3):207-213.
Smith, L. (1988) The Clinical Experiences of Frederick R. Klenner,
M.D.: Clinical Guide to the Use of Vitamin C. Portland, OR: Life Sciences
Press.
Stone, I. (1972) The Healing Factor: "Vitamin C" Against
Disease. New York, NY: Grosset & Dunlap.
Sylvest, O. (1942) The effect of ascorbic acid on the carbohydrate metabolism.
Acta Medica Scandinavica 110:183-196.
Washko, P., D. Rotrosen, and M. Levine. (1991) Ascorbic acid in human
neutrophils. The American Journal of Clinical Nutrition 54(6 Suppl):1221S-1227S.
Copyright 2003 by Thomas E. Levy, M.D., J.D.
All Rights Reserved; Reproduction Permitted only with Acknowledgement
and of the Entire Document
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