Boost Your Immunity this New Year with IV Vitamin C

Vitamin C, also known as ascorbic acid, is a water-soluble vitamin that is involved in several essential processes in the body. Humans are not able to make their own vitamin C, relying on natural sources such as fruits and vegetables for our daily requirements. We have come a long way with research on the health benefits of vitamin C, including targeted work focusing on the benefits of Intravenous (IV) vitamin C. In IV form, vitamin C can saturate blood and tissues at higher levels than oral ascorbic acid ever could, as oral doses can only achieve a maximum blood concentration of 220 micromoles per liter. It has been hypothesized that when IV vitamin C is used in conjunction with other treatment modalities, it can have synergistic effects on the overall treatment regimen, therefore improving patient outcomes. Additionally, IV vitamin C is cheap and safe, with minimal side effects - - this is significant, as many therapies are quite the opposite.

It is known that vitamin C is depleted from factors, such as viral infections, fever, stress, smoking, and alcoholism. This is particularly of relevance to health issues that our modern-day society is faced with during the ongoing pandemic with COVID-19.

 A small case series was performed in 2020 on patients with moderate to severe COVID with low to moderate doses of IV vitamin C, finding a significant decrease in inflammatory markers, including ferritin and D-dimer. Although this was small case study, it still holds relevance and can further support implementing IV vitamin C to optimize treatment protocols and therefore patient outcomes. Additional studies conducted by Dr. Mao out of China concluded that all patients with moderate to severe COVID treated with IV vitamin C not only improved, but had hospital stays about 3-5 days shorter than the average 30-day hospital stay for COVID patients at the time. 

The CITRIS-ALI trial is the largest randomized placebo-controlled clinical trial studying the role of IV Vitamin C as an adjunct therapy in patients with sepsis and ARDS. This was a randomized, double-blind, placebo-controlled, multicenter trial conducted in 7 intensive care units in the United States from September 2014 to November 2017. Of note, sepsis is a broad term, however by brief definition is a life-threatening organ dysfunction that is caused by a dysregulated host response to an infectious pathogen - whether bacterial or viral. Vitamin C deficiency has been found to be common in patients with sepsis, as documented in prior observational studies. Fowler et al concluded “96-hour infusion of vitamin C compared with placebo did not significantly improve organ dysfunction scores or alter markers of inflammation and vascular injury”. However, the clinically significant take-away from this study is that it fails to highlight the secondary outcome stating that there was a significant reduction in 28-day all-cause mortality and significantly increased ICU free days to day 28 and hospital free days to day 60 in the vitamin C group. 

Although these trials have there flaws, it is important to note that they pave the way for future larger trials exploring the exact mechanism to study, timing and dosing effects of IV vitamin C. 

 As we know, vitamin C functions in several pathways in the body. To name a few, it acts as an antioxidant ridding the body of damaging free radicals, facilitates the production of infection-fighting lymphocytes, and functions in the biosynthesis of collagen - a protein that makes up ⅓ of our body protein, therefore having a vital role in healing. When host immune responses are dysregulated from infections or chronic disease, often vitamin C is depleted. Clinically, we have been utilizing IV vitamin C for about 16 years, for its antiviral, immunological, and collagen repairing properties, to name a few. Most recently, we have been implementing IV vitamin C as an adjunct in our COVID long hauler protocol.

 It is important to note that we have been discussing lower IV vitamin C doses - at high doses, we utilize IV Vitamin C for cancer, as it acts as a prooxidant rather than antioxidant - this warrants its own section. 

For additional information on IV vitamin C, please refer to the sections on “benefits of IV vitamin C for wellness and immunity” and “high dose vitamin C for cancer”. https://stramcenter.com/services/iv-vitamin-C-therapy/

Sources : 

Raul Hiedra, Kevin Bryan Lo, Mohammad Elbashabsheh, Fahad Gul, Robert Matthew Wright, Jeri Albano, Zurab Azmaiparashvili & Gabriel Patarroyo Aponte (2020) The use of IV vitamin C for patients with COVID-19: a case series, Expert Review of Anti-infective Therapy, 18:12, 1259-1261, DOI: 10.1080/14787210.2020.1794819

Fowler AA, Truwit JD, Hite RD, et al. Effect of Vitamin C Infusion on Organ Failure and Biomarkers of Inflammation and Vascular Injury in Patients With Sepsis and Severe Acute Respiratory Failure: The CITRIS-ALI Randomized Clinical Trial. JAMA. 2019;322(13):1261–1270. doi:10.1001/jama.2019.11825

https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-2-7

https://rebelem.com/the-marik-protocol-have-we-found-a-cure-for-severe-sepsis-and-septic-shock/

https://www.aima.net.au/wp-content/uploads/2020/06/Successful-High-Dose-Vitamin-C-Treatment-of-Patients-with-Serious-and-Critical-COVID-19-Infection.pd

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