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High-Dose Vitamin C (PDQ®)

Health Professional Version

History

The earliest experience of using high-dose vitamin C (intravenous [IV] and oral) for cancer treatment was by a Scottish surgeon, Ewan Cameron, and his colleague, Allan Campbell, in the 1970s.[1] This work led to a collaboration between Cameron and the Nobel Prize–winning chemist Linus Pauling, further promoting the potential of vitamin C therapy in cancer management.[2,3] As a result, two clinical trials of oral vitamin C were conducted in the late 1970s and early 1980s.[4,5]

(Refer to the Human Studies section of this summary for more information about these early studies.)

Pharmacokinetic studies later revealed substantial differences in the maximum achieved blood concentrations of vitamin C based on the route of administration. When vitamin C is taken orally, plasma concentrations of the vitamin are tightly controlled, with a peak achievable concentration less than 300 µM. However, this tight control is bypassed with IV administration of the vitamin, resulting in very high levels of vitamin C plasma concentration (i.e., levels up to 20 mM).[6,7] Further research suggests that pharmacologic concentrations of ascorbate, such as those achieved with IV administration, may result in cell death in many cancer cell lines.[8]

Health care practitioners attending complementary and alternative medicine conferences in 2006 and 2008 were surveyed about usage of high-dose IV vitamin C in patients. Of the 199 total respondents, 172 had administered vitamin C to patients. In general, IV vitamin C was commonly used to treat infections, cancer, and fatigue.[9]

References

  1. Cameron E, Campbell A: The orthomolecular treatment of cancer. II. Clinical trial of high-dose ascorbic acid supplements in advanced human cancer. Chem Biol Interact 9 (4): 285-315, 1974. [PUBMED Abstract]
  2. Cameron E, Pauling L: Supplemental ascorbate in the supportive treatment of cancer: Prolongation of survival times in terminal human cancer. Proc Natl Acad Sci U S A 73 (10): 3685-9, 1976. [PUBMED Abstract]
  3. Cameron E, Pauling L: Supplemental ascorbate in the supportive treatment of cancer: reevaluation of prolongation of survival times in terminal human cancer. Proc Natl Acad Sci U S A 75 (9): 4538-42, 1978. [PUBMED Abstract]
  4. Creagan ET, Moertel CG, O'Fallon JR, et al.: Failure of high-dose vitamin C (ascorbic acid) therapy to benefit patients with advanced cancer. A controlled trial. N Engl J Med 301 (13): 687-90, 1979. [PUBMED Abstract]
  5. Moertel CG, Fleming TR, Creagan ET, et al.: High-dose vitamin C versus placebo in the treatment of patients with advanced cancer who have had no prior chemotherapy. A randomized double-blind comparison. N Engl J Med 312 (3): 137-41, 1985. [PUBMED Abstract]
  6. Padayatty SJ, Sun H, Wang Y, et al.: Vitamin C pharmacokinetics: implications for oral and intravenous use. Ann Intern Med 140 (7): 533-7, 2004. [PUBMED Abstract]
  7. Hoffer LJ, Levine M, Assouline S, et al.: Phase I clinical trial of i.v. ascorbic acid in advanced malignancy. Ann Oncol 19 (11): 1969-74, 2008. [PUBMED Abstract]
  8. Verrax J, Calderon PB: Pharmacologic concentrations of ascorbate are achieved by parenteral administration and exhibit antitumoral effects. Free Radic Biol Med 47 (1): 32-40, 2009. [PUBMED Abstract]
  9. Padayatty SJ, Sun AY, Chen Q, et al.: Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PLoS One 5 (7): e11414, 2010. [PUBMED Abstract]
  • Updated: October 7, 2014