Intravenous Vitamin C in the Intensive Care Setting
The fall season is here which means football games, leaves turning colors and brisk sunny afternoons. It also means inclement dark and rainy days, school children bringing home colds and public health messages to get a flu shot. Most people think about taking Vitamin C and Echinacea to build up the immune system. But Vitamin C can also be administered as an injection and in the injection form it is a very different treatment. In fact, Vitamin C as an intravenous treatment is very powerful medicine as the following story will attest. Yet, unlike most antibiotic and other intravenous medicines, intravenous Vitamin C has nearly no side effects.
We have had numerous articles in the Townsend Letter over the past two decades touting the benefits of Vitamin C. Linus Pauling, PhD, Nobel Prize winner for chemistry, devoted the majority of his research efforts in the latter part of his life studying how Vitamin C is critical for preventing degenerative disease and treating cancer. North Carolina physician Fred Klenner, MD was one of the earliest physicians to routinely administer intravenous Vitamin C to treat viral infections. The use of oral and intravenous Vitamin C has become well accepted in complementary alternative medicine and naturopathy for immune support, detoxification, treatment of infection and other applications. However, mainstream medicine has largely ignored Vitamin C use, orally or intravenously, for any clinical treatment. In clinical oncology settings patients are routinely advised to stop using Vitamin C while they are receiving chemotherapy and or radiation treatment. Furthermore, there is much experimental evidence that Vitamin C supports the treatment of infection. The current state of medicine sharply separates the alternative and mainstream medical community's use of Vitamin C.
A recent case of a farmer succumbing to swine flu in New Zealand may force the medical community to have to reevaluate its position on Vitamin C use. The farmer developed swine flu while on a fishing trip in nearby Toga. After developing a severe fever and upper respiratory infection he required emergency attention. His condition rapidly deteriorated and he became comatose. His pulmonary function required advanced intensive care intervention because even a ventilator was insufficient to carry out his respiratory functioning. A CT scan of his lungs demonstrated pulmonary "white-out" with no visualization of lung tissue due to overwhelming compromise by pulmonary edema. His condition demonstrated no improvement over the course of four weeks despite heroic intervention with conventional medicine. The medical treatment group advised that because of the progressive deterioration of his condition and ongoing coma that there would be no chance of survival and that the special intensive care pulmonary intervention should be discontinued.
The farmer's family disagreed with this decision and asked the hospital doctors if they would be willing to administer intravenous Vitamin C. While there was considerable disagreement with this request the administration eventually agreed to administer Vitamin C by i.v. The Vitamin C was given 25 grams every 6 hours over the ensuing two days. When the farmer's lungs were examined 48 hours later by CT scan the lungs "white-out" had disappeared and there was the first visualization of "normal" lung tissue in the course of four weeks. The patient still remained in coma but this had been the only improvement seen over the course of intensive care. The decision to pull the ventilatory equipment was reversed and a recommendation to continue intensive care was made. Unfortunately the hospital doctors recommended no further Vitamin C was to be administered. They had reasoned that the patient had improved because they had changed his bed positioning from a supine position to a prone position. Subsequently the pulmonary status deteriorated over the next week.
The family argued that it was the use of the Vitamin C not the change in bed position that accounted for his improvement. When they asked for a resumption of the Vitamin C a new intensive care specialist denied the request. Eventually the patient was moved to a different facility in New Zealand and intravenous Vitamin C was resumed albeit at a much lower dose of 2-3 grams daily intravenously. Even with this much lower dose the improvement in pulmonary function resumed. After four weeks of treatment the farmer came out of his comatose state. He began to receive Vitamin C orally and gradually improved sufficiently to be discharged from the hospital.
One year later the farmer is flying his plane surveying his farm holdings in New Zealand. He had been given all medication and intervention available in a critical care setting and his failure to improve led to a medical recommendation to terminate all care. Only with the use of intravenous vitamin C did he improve and eventually awaken from coma. Yet hospital medicine still has not acknowledged the role of Vitamin C in reversing his swine flu.
A video titled "Living Proof" by New Zealand's Sixty Minutes documenting his story is available for viewing:
Although intravenous Vitamin C is difficult to receive in the hospital setting it is easily arranged in an out-patient setting such as at Dr. Jonathan Collin's medical office. The Vitamin C is generally administered with other minerals and vitamins to increase its overall effectiveness in treating infection, inflammation, injury, burns, chronic fatigue, chemical and general hypersensitivity, and allergy. Degeneration and inflammation of the liver, for example, are supported by intravenous Vitamin C.
Fibromyalgia Treatment in the Conventional Setting
Over the past decade the pharmaceutical industry has begun to address the treatment of fibromyalgia. The primary concern has been the abatement of pain. Physicians are aware that fibromyalgia patients suffer chronic pain leading to insomnia, depression, inactivity, and work disability. The last thing most physicians want to face are patients seeking opiod pain medications to chronically control pain. Of course, fibromyalgia remains very difficulty to treat so effective pain management is necessary for recovery. Given the disinterest by most physicians in naturopathic treatment modalities there has been a great deal of interest for a magic bullet, a drug like Prozac for depression, that might be of use in treating fibromyalgia.
Two drugs have taken center stage over the past five years for reducing the pain of fibromyalgia—Pregabalin (Lyrica) and Duloxetine (Cymbalta). Like most drugs these agents have a pharmacologic mechanism which blocks normal physiologic activity in the brain to achieve reduction in pain. In the case of Pregabalin, a drug originally designed to control seizures, neuron activity is blocked preventing the release of neurochemicals that signal pain. The drug belongs to the same class of drugs (alpha-2-delta ligands) as Neurontin, another agent used extensively to control pain. Duloxetine, has a mechanism that more closely resembles Prozac, by blocking the reuptake of serotonin but unlike Prozac also blocks the reuptake of norepinephrine. Others drugs in this class (serotonin-norepinephrine reuptake inhibitors) include Effexor and Pristique.
Both Pregabalin and Duloxetine have had success in placebo-controlled studies in reducing pain. However, pain reduction of 50% was only achieved in about 30% of the patients. Like most neurologic medications side effects were experienced in a majority of patients. For Pregabalin sleepiness and dizziness were major adverse effects with many patients experiencing dry mouth, blurred vision and difficulty in concentration. Harsher adverse effects, such as angioedema, hypersensitivity, and peripheral edema were seen less often. For Duloxetine patients experienced sleepiness, fatigue and nausea as well as dry mouth, constipation, and weight gain. Like other anti-depressant medications there is now a labeled risk for suicidal thoughts and concern about triggering a manic episode.
It would appear that these medications pose a major tradeoff for reducing the pain of fibromyalgia versus experiencing significant side effects. For alternative and naturopathic practitioners the question arises whether it would be appropriate to use such a medication in the course of an integrative treatment protocol. There is the possibility that the use of these medications at a lower dose may provide some benefit in pain control not achieved by a nutritional approach. It would certainly be reasonable to consider such a medication in place of using or initiating opiod treatment. Nevertheless, it appears that conventional therapy for fibromyalgia remains problematic and insufficient. Supportive therapies including the use of herbals, vitamins and minerals, amino acids, i.v. drips, homeopathic protocols, detoxification strategies and food allergy elimination trials would appear to be a better approach to treating fibromyalgia pain.
Resource: Wood P. New FM Medications: Some Points to Ponder. Fibromyalgia Aware. Aug. 2009; 20: 32-35