The use of high-dose intravenous vitamin C (HDIVC) as a principal therapy in cancer care.
Mechanisms of Action
Vitamin C acts as a major water-soluble antioxidant at physiological concentrations but can generate hydrogen peroxide at higher concentrations. At high concentrations, vitamin C can act as a pro-oxidant, generating hydrogen peroxide, which is selectively toxic to cancer cells while sparing normal cells. This can lead to the induction of apoptosis (programmed cell death) in cancer cells. Vitamin C enhances collagen production, which may inhibit tumour invasiveness and metastasis, and supports proper immune cell functioning. High-dose vitamin C can inhibit the formation of new blood vessels (angiogenesis) that tumours need to grow, through its effects on collagen synthesis and gene expression related to angiogenesis. This is partly due to its ability to inhibit hypoxia-inducible factors and other angiogenesis-related genes
High Dose Intravenous Vitamin C (HDIVC) has been shown to reduce inflammation markers such as C-reactive protein (CRP) and pro-inflammatory cytokines, which are often elevated in cancer patients.
Clinical Efficacy and Safety
A great many case studies have reported prolonged survival and tumour regression in patients treated with HDIVC, often in combination with other natural therapies. Large-scale clinical trials have shown mixed results, with studies indicating stable disease but no significant tumour regression.
HDIVC has been strongly associated with improvements in quality of life, including reductions in fatigue, nausea, and depression, improvements in appetite, sleep and bodily functions. This is particularly so in palliative care settings. Patients receiving IVC often report better overall well-being and fewer symptoms of depression. stress and anxiety.
Clinical trials have demonstrated that HDIVC can be administered safely at high doses (up to 100 grams or more), with few adverse effects. Common side effects include minor issues such as nausea and dry mouth, while serious side effects are rare but can include extremely rarely kidney stones and haemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Pharmacokinetics
Oral administration of vitamin C results in limited plasma concentrations, whereas intravenous administration can achieve much higher levels, which are necessary for its proposed anti-cancer effects. Optimal dosing regimens are still under investigation, but higher doses and more frequent administration appear to be more effective for achieving therapeutic plasma concentrations and potential anti-cancer effects.
There is ongoing debate about whether high-dose vitamin C interferes with chemotherapy. Some studies suggest it enhances the efficacy of chemotherapeutic agents, while others raise concerns about potential antagonistic effects, the latter of which I doubt. In my opinion, HDIVC should be given to all cancer patients as it is rapidly depleted by the cancer itself, surgery, radiotherapy, medicines and other stressors. It is critical for the optimal functioning of the immune system. This has been supported by various studies and clinical trials.
More extensive clinical trials, particularly Phase II and III studies, are needed to better understand the efficacy of HDIVC in different cancer types and to establish standardised treatment guidelines (I dislike protocols).
High-dose intravenous vitamin C is an excellent first line therapy in cancer patient care, with potential benefits in improving quality of life, reducing inflammation, and exerting its anti-cancer effects through various mechanisms. Further research is needed to fully establish its clinical efficacy and optimal use in oncology, and this research should be performed by specialists in nutritional oncology and nutritional medicine.
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The most important step people can take in order to reduce their risk of developing cancer is to supplement vitamin D3 cholecalciferol sufficiently to attain at least the 50 ng/mL (125 nmol/L = 1 part in 20,000,000) level of 25-hydroxyvitamin D calcifediol (AKA "calcidiol") in the bloodstream which the immune system needs to function properly. The liver hydroxylates about 1/4 of ingested vitamin D3 into circulating 25-hydroxyvitamin D over a period of days to a week.
Without proper vitamin D3 supplementation, in quantities 5 to 10 (or more in obesity) times the very small amounts recommended by governments and many doctors (0.015 to 0.02 milligrams = 600 to 800 IU a day, on average) most people have only a fraction of the 25-hydroxyvitamin D their immune system needs to function properly.
Please see the research articles cited and discussed at: https://vitamindstopscovid.info/00-evi/ and https://nutritionmatters.substack.com.
It should be obvious that this is required for prevention and treatment of cancer, but many doctors have little interest in nutrition, and can't imagine that something so simple could be so important. If a drug or other substance approaching the effectiveness of vitamin D3 could be patented, the multinational pharmaceutical companies would sell it for 10 to 100 thousand dollars a gram.
Pharma-grade vitamin D3 is only made by a handful of companies, worldwide - none of them owned by the major pharmaceutical companies. It costs about USD$2.50 a gram, ex-factory. This is enough to supply an average weight adult with the supplemental vitamin D3 they need for their immune system to run properly for 22 years: 0.125 milligrams (5000 IU) a day on average.
The best recommendation for vitamin D3 supplemental intake quantities to attain at least 50 ng/mL 125 nmol/L circulating 25-hydroxyvitamin D, after several months, without risk of toxicity or the need for blood tests or medical monitoring, is from New Jersey based Professor of Medicine, Sunil Wimalawansa. These are ratios of body weight, with higher ratios for those suffering from obesity, since obesity reduces the ability of the liver to hydroxylate vitamin D3 and the excess adipose tissue absorbs both vitamin D3 and 25-hydroxyvitamin D.
Please see https://vitamindstopscovid.info/00-evi/#00-how-much or https://nutritionmatters.substack.com/p/how-much-vitamin-d3-to-take for Prof. Wimalawansa's recently somewhat simplified recommendations, based on those in his 2022 article in Nutrients: "Rapidly Increasing Serum 25(OH)D Boosts the Immune System, against Infections - Sepsis and COVID-19" https://www.mdpi.com/2072-6643/14/14/2997.
There is very little vitamin D3 in food, fortified or not, or multivitamins. It can be produced by ultraviolet B exposure of ideally white skin, but this is not available all year round and always damages DNA and so raises the risk of skin cancer.
In clinical emergencies, such as COVID-19, sepsis, Kawasaki disease, MISC-C etc. the most important treatment, for the great majority of people who have half to one tenth of the circulating 25-hydroxyvitamin D their immune systems need, is to rapidly boost this level to at least 50 ng/mL 125 nmol/L.
For average weight adults, one approach is a single oral dose of 10 milligrams (400,000 IU) vitamin D3. This takes several days to raise the circulating 25-hydroxyvitamin D due to the time it takes to be hydroxylated in the liver. This might be acceptable in cancer cases, which typically develop over weeks and months.
The best approach is to raise the level in 4 hours or less with a single oral dose of 0.014 mg (14 micrograms) of calcifediol per kilogram body weight. For average weight adults, this is 1 milligram. Calcifediol *is* 25-hydroxyvitamin D. This is easily absorbed and goes straight into circulation. Daily vitamin D3 after that will maintain the healthy 25-hydroxyvitamin D level.
This is recommended by Prof. Wimalawansa in his article, and is the basis of FLCCC recommendations for COVID-19. Their Cancer Care monograph correctly gives high prominence to the need for 50 ng/mL 125 nmol/L 25-hydroxyvitamin D. https://covid19criticalcare.com/reviews-and-monographs/cancer-care/ However, it has a number of shortcomings.
1 - Fig 8 is misleading in several ways. The "vitamin D" receptor molecule (really the calcitriol receptor) is inside cells, not on the cell membrane. Most importantly, this diagram and the text in general does nothing to explain how immune cells require a good level of 25-hydroxyvitamin D to properly supply their intracrine (inside each cell) 25-hydroxyvitamin D --> calcitriol signaling system. This has nothing to do with endocrine (hormonal) signaling. These systems are crucial to the ability of many types of immune cell to respond to their changing circumstances. Most doctors and immunologists have never heard of this and they may wrongly assume that increased levels of circulating calcitriol will somehow "boost" the immune system. Please see: https://vitamindstopscovid.info/02-intracrine/ for a full tutorial explanation.
2 - They do not mention the 0.014 mg / kg BW calcifediol protocol (https://vitamindstopscovid.info/00-evi/#4.7). This may be because 10 mg of vitamin D3 is more easily obtainable than 1 mg of calcifediol.
3 - They do not mention a problem with some types of cancer in which the macrophages close to the malignant cells continually hydroxylate 25-hydroxyvitamin D to calcitriol (1,25-dihydroxyvitamin D) which goes into circulation and interferes with the kidneys' use of calcitriol to hormonally control multiple types of cell around the body which are involved in calcium-phosphate-bone metabolism. (Martin Hewison et al 2009 https://onlinelibrary.wiley.com/doi/full/10.1359/jbmr.2003.18.3.579.)
I believe that this action depletes 25-hydroxyvitamin D in the area of the tumor, so reducing the ability of the immune system to destroy the cancerous cells. This resembles granulomatous disorders, in which macrophages and other immune cells malfunction and form multiple deposits of such cells, which also continually hydroxylate 25-hydroxyvitamin D to circulating calcitriol.
The conventional approach to granulomatous disorders (of which sarcoidosis is one) is to limit the 25-hydroxyvitamin D level, even though this is typically low in most people. The trouble with this excessive level of circulating calcitriol is that it raises the level of calcium ions in the blood, which is normally very tightly controlled to be close to saturation level. This causes hypercalcemia which can be deadly, such as due to to calcification of the arteries or heart valves.
However, Kamphuis et al. 2014 https://sci-hub.tw/https://doi.org/10.1002/jbmr.2262 report that sarcoidosis patients do better with vitamin D3 supplementation. If this does no cause significant harm due to hypercalcemia, then it is easy to understand why: their 25-hydroxyvitamin D level increases so their immune cells have a better chance of functioning properly.
There are complex protocols for how to handle hypercalcemia in cancer. I have only glanced at three of these: https://doi.org/10.2147%2FTCRM.S83681, https://academic.oup.com/edrv/article/37/5/521/2567097 and https://academic.oup.com/jcem/article/108/3/507/6916871. The FLCCC cancer monograph does not mention hypercalcemia in cancer.
I am an electronic technician and computer programmer, not a doctor - and I have not deeply researched cancer. Based on my limited understanding to date, I would get the 25-hydroxyvitamin D level over 50 ng/mL 125 nmol/L ASAP - probably with supplemental vitamin K2 which tends to limit excessive calcium levels - on the basis that the person is not going to beat the cancer rapidly as long as the level is far below this. Hopefully this would happen before there was any serious trouble from hypercalcemia. I mention this because I think the FLCCC document should at least discuss this, in the context of most oncologists being wary of hypercalcemia and not fully appreciating how important it is to attain at least 50 ng/mL circulating 25-hydroxyvitamin D.
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