Positive effects:
- A 50 g vitamin C infusion has a pro-oxidative effect. Cytotoxic effect through the Fenton reaction. Vitamin C reduces iron(III) ions to iron(II) ions. The iron(II) ion reacts with oxygen and forms superoxide. The decomposition of superoxide leads to H2O2. Hydrogen peroxide reacts with iron(II) ions and forms hydroxyl radicals.
- Cytotoxic effects: from 15–25 mmol/l (1–3 g/kg body weight)
- High-dose vitamin C therapy has a therapeutically paradoxical effect. Healthy cells are protected by antioxidants. Malignant cells are attacked by the pro-oxidative effect (H2O2 formation) and driven into apoptosis, the activity of the hypoxia-induced factor HIF is reduced, tumor suppressor proteins are upregulated, an increase in TET2 activity is possible, and the fermentation metabolism can be reduced.
- Oncology patients often already have a reduced antioxidant capacity before chemotherapy. In advanced tumor disease, the vitamin C level is often drastically reduced. High-dose vitamin C therapy can reduce the risk of secondary tumors, can enhance the effect of antineoplastic therapy, and resistances can be prevented.
- Inflammatory processes can be significantly reduced.
- Improvement in quality of life: EORTC-QLQ 30, especially tissues that are sensitive to oxidative stress, such as the mucous membranes (nausea, vomiting, loss of appetite) and nerve tissue (fatigue, depression, sleep disorders), benefit from high-dose vitamin C.
Therapy recommendations: There is evidence that the properties of the substances contained in the product can have a positive effect on health disorders of the mentioned indications:
- adjunctively in tumor therapy
- pro-oxidative therapy
- stimulation of mitochondrial biogenesis
- in the early stages of bacterial and viral infections: The oxidative, immunomodulating effect of vitamin C can alleviate the course, reduce fever, and shorten the recovery time
- Detoxification: Toxins from food and the environment can be mobilized under high vitamin C doses; support detoxification organs, use binders or chelation
Contraindications: Do not use in children under 6 years. In case of impaired function of the kidneys, liver, heart, and in albumin deficiency, an adjustment of the individual dose is recommended. Patients who take beta-blockers have an increased risk of a decompensated cardiovascular reaction, as beta-blockers inhibit the effect of adrenaline (emergency medical treatment). Patients with a tendency to allergic reactions and/or with diseases based on histamine release (e.g., asthma) should be questioned about their known allergens according to the principles of therapeutic duty of care.
Contraindications: Hyperthyroidism, thalassemia, hemochromatosis. A high-dose vitamin C infusion can promote the release of iron from the body's stores. G6PDH deficiency can lead to acute hemolytic anemia, which is caused by the destruction of red blood cells. Laboratory parameters must be checked. There should be no history of asthma.
CAVE: Bronchoconstriction due to vitamin C is possible. In case of impaired kidney function, high-dose vitamin C can have a nephrotoxic effect.
Tip: To prevent vascular spasms, oral administration of calcium 500–1,000 mg with 1 liter of water 30 minutes before the infusion is recommended. In addition, Magnesium Injekt 200 mg or Magnesium Injekt 1,000 mg is recommended parenterally.
Application: i.v., to be diluted in 750 ml of body-temperature Ringer's lactate solution. To prevent vascular spasms, add Magnesium Injekt 200 mg 1–2 ampoules. Vitamin C 75 g to be diluted in 1,000 ml of body-temperature Ringer's lactate solution. To prevent vascular spasms, add Magnesium Injekt 1,000 mg. Over 75 g vitamin C: Magnesium Injekt 1,000 mg 2 ampoules. The vitamin C dose can be gradually increased up to a vitamin C plasma level of 300–500 mg/dl (measurement on the day of the infusion). With vitamin C 150 g, a vitamin C plasma level of over 500 mg/dl has been measured. The carrier solution should be reduced by the liquid content in which the vitamin C is dissolved. The infusion should always be freshly prepared. Dosage: 1–3 g vitamin C per kg body weight
Note for doctors and therapists: In principle, the doctor/therapist determines the indication in individual prescriptions. The suggestion is merely a recommendation for a therapy option, whereby the dosage and frequency of application are solely at the discretion of the doctor/therapist. The treating therapist is responsible for the treatment and must individually check and assess the respective application for each patient before the start of treatment.
