The IP address used for your Internet connection is part of a subnet that has been blocked from access to PubMed Central. Addresses across the entire subnet were used to download content in bulk, in violation of the terms of the PMC Copyright Notice. Use of PMC is free, but must comply with the terms of the Copyright Notice on the PMC site. For additional information, or to request that your IP address be unblocked, For requests to be unblocked, you must include all of the information in the box above in your message.Last week we posted about IVC and Sepsis and a phase 1 safety trial on the use of IVC in patients with severe sepsis that has been published in the Journal of Translational Medicine. We would be remiss if we didn’t follow-up that post with information from our 2011 article that asked if intravenous ascorbic acid (vitamin C) could be used to prevent and treat cancer-associated sepsis. To break down the topic, let’s first look at what sepsis is. Defined on the Mayo’s Clinic’s website, “Sepsis is a potentially life-threatening complication of an infection.
Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammation throughout the body.” This complication can set off a chain of events that can cause multiple organ failure, and can lead to septic shock. Its symptoms, like fever, chills, increased heart rate, disorientation, etc. are often mistaken for other conditions and not correctly diagnosed until quite serious, making the risk of death very real. Some 28-50% of those who get sepsis die. But how common is it? 1-2% of all hospitalizations doesn’t seem like much, but when broken down: 750,000 cases of sepsis each year in the US1 and 30,000 cases of severe sepsis in the UK every year2. Sepsis is the most common in those with weakened immune systems, elderly persons, infants and children. This puts those with chronic illnesses, like cancer, (the subject of our study) at the top of the list in susceptibility. Our article proposes the use of ascorbic acid (AA) as an aid to existing forms of treatment and prevention of cancer-associated sepsis.
It states, “Patients with advanced cancer are generally deficient in AA. Once these patients develop septic symptoms, a further decrease in ascorbic acid levels occurs. Given the known role of ascorbate in: a) maintaining endothelial and suppression of inflammatory markers; b) protection from sepsis in animal models; and c) direct antineoplastic effects, we propose the use of ascorbate as an adjuvant to existing modalities in the treatment and prevention of cancer-associated sepsis.” Our article acknowledges from a personal perspective that one of the author’s interest in the topic comes from direct experience, having a mother who passed away with leukemia. He realized that the quality of life at end stages can be devastatingly poor and there was a need for supportive steps that increase the quality of life and attempt to restore some level of relief to patients who face the same challenges as his mother. As he sought more information, it became clear to him that the use of vitamin C to treat cancer was controversial.
This controversy, the author theorizes, stems from some reports that orally administered vitamin C failed to demonstrate benefit, and the fact that vitamin C is mostly used by “alternative medicine” practitioners. Armed with a personal interest in the subject and the belief that the opinions shouldn’t be more important than evidence, the authors of the study sought an unexplored area of vitamin C research: the suppression of inflammation in the cancer patient. (Most studies focus on reducing tumor size.) To read the study in its entirety, you can download it from the NIH website, or you can go to the Riordan Clinic website and check out that journal article, as well as a wealth of other published research. To bring the article to its conclusion, it states: AA administered intravenously has a long and controversial history in relation to reducing tumors in patients. This has impeded research into other potential benefits of this therapy in cancer patients such as reduction of inflammation, improvement of quality of life, and reduction of SIRS [ systemic inflammatory response syndrome] initiation and progression to MOF [multi-organ failure].
While ongoing clinical trials of i.v. AA for cancer may or may not meet the bar to grant this modality a place amongst the recognized chemotherapeutic agents, it is critical that we collect as much biological data as possible, given the possibility of this agent to be a wonderful adjuvant therapy.This conclusion – coupled with the more recent conclusion that IVC is safe, well tolerated and may positively impact the extent of organ failure and inflammation – is not to be considered a victory in the fight to bring IVC to mainstream medicine, but rather, a step in the right direction. If IVC can be used to treat inflammation on a scale that includes life-threatening conditions like sepsis, won’t the mainstream medical community soon see its benefits for less severe conditions?How Intravenous Vitamin C May Be Lifesaving in Acute Sepsis! Kirk’s video overview of his interview with Dr. Natarajan (2:49) Sepsis is a massive acute “autoimmune response” from an infection in which the immune system attacks one’s internal organs, resulting in their failure and death from vascular collapse.
Low plasma vitamin C levels increase the risk to sepsis. 41% percent of hospitalized patients are deficient in vitamin C and 19% have scurvy (classic vitamin C deficiency). Sepsis costs 20 billion dollars a year in the U.S. to treat. A day treatment in the hospital can cost $18,000-20,000. A single dose of intravenous vitamin C may cost $50.00. Vitamin C may work in reducing sepsis incidence and prevent death by: SUMMARY: In septic patients intravenous vitamin C at 50 mg/kg/day or 200 mg/kg/day or placebo in 4 divided doses administered over 30 minutes every 6 hours for 96 hours in 50 ml of 5% dextrose and water achieved plasma levels of 300µM and 3mM of vitamin C respectively and exhibited rapid reductions in multiple organ injury (SOFA) scores while no such reduction was seen in placebo patients. Ascorbic acid significantly reduced the pro-inflammatory biomarkers C-reactive protein and procalcitonin indicating a reduction in systemic inflammation. Unlike placebo patients, thrombomodulin in ascorbic acid infused patients exhibited no significant rise.
Thrombomodulin is a protein normally bound to the surface of endothelial cells and not found free in the circulation. If the blood level of thrombomodulin rises, it is indicative of vascular injury. These results suggest attenuation of vascular endothelial injury with intravenous vitamin C. There were no side effects noted from the intravenous vitamin C. Accurate methods of accessing vitamin C in the critical care setting are with HPLC analysis and the fluorescent end-point assay. “Ascorbate-dependent vasopressor synthesis: a rationale for vitamin C administration in severe sepsis and septic shock?” Expert Interview by Kirk Hamilton PA-C with Alpha A. Fowler, III, MD Phase I safety trial of intravenous ascorbic acid in patients with severe sepsis “Intravenous Vitamin C – Integrative Therapies” a first-time conference sponsored by the University of Kansas Medical Center, September 30 – October 1, 2016. (See Dr. Drisko interview). Dr. Ramesh Natarajan will be speaking at this conference.