Overview of High Dose Vitamin C
The Power of High-Dose Intravenous Vitamin C: Exploring Its Therapeutic Potential
High-dose intravenous vitamin C (IVC) has garnered significant attention in recent years for its potential therapeutic applications across various medical conditions. Unlike oral supplementation, IVC achieves plasma concentrations that may exert pharmacological effects, offering promising avenues in the management of infections, pain, and as an adjunct in cancer therapy. This blog post delves into the current scientific evidence supporting these applications.
Below is an overview of additional areas where IVC is being studied, along with relevant research findings.
1. Burn Injury Recovery
High-dose IVC has been investigated for its potential benefits in patients with severe burns. A study indicated that administering high-dose IVC may reduce fluid requirements, body weight gain, and wound edema, thereby improving gas exchange and renal function in the acute phase after burn injury. (PubMed)
Burn injuries precipitate a significant inflammatory response and oxidative stress, leading to increased capillary permeability, edema, and organ dysfunction. Vitamin C, a potent antioxidant, can scavenge reactive oxygen species, stabilize endothelial function, and reduce capillary leak, thereby potentially decreasing fluid requirements and improving outcomes in burn patients .PubMed
Clinical Evidence
Fluid Resuscitation Reduction : A landmark study by Tanaka et al. demonstrated that administering HDIVC at 66 mg/kg/hour for the first 24 hours post-injury significantly reduced the volume of fluid required for resuscitation in patients with extensive burns .JAMA Network
Improved Clinical Outcomes : A retrospective cohort study compared high-dose intravenous (1250 mg every 6 hours) versus low-dose oral (500 mg every 6 hours) vitamin C in patients with burns covering more than 20% of total body surface area. The high-dose group exhibited reduced fluid requirements, shorter hospital stays, and decreased time on mechanical ventilation, suggesting potential protective effects of HDIVC in burn resuscitation .ResearchGate
Ongoing Research: The VICToRY Trial : The VItamin C in Thermal injuRY (VICToRY) trial is a multicenter, randomized, double-blind, placebo-controlled phase III study aiming to evaluate the efficacy and safety of HDIVC (200 mg/kg/day for 96 hours) in critically ill burn patients. The primary outcome is a composite of persistent organ dysfunction and all-cause mortality at 28 days. Secondary outcomes include hospital length of stay, quality of life, and healthcare resource utilization .criticalcarenutrition.com+3CenterWatch+3criticalcarenutrition.com+3CDMRP+2criticalcarenutrition.com+2CenterWatch+2
2. Postoperative Atrial Fibrillation Prevention
Postoperative atrial fibrillation (AF) is a common complication after cardiac surgery. A meta-analysis suggested that vitamin C supplementation may reduce the incidence of postoperative AF and shorten the duration of hospital and ICU stays. (PMC, BioMed Central). The antioxidant properties of vitamin C may play a role in mitigating the oxidative stress associated with POAF.
Evidence Overview
Meta-Analysis Findings
A meta-analysis encompassing nine studies with a total of 1,037 patients undergoing cardiac surgery found that vitamin C prophylaxis significantly reduced the incidence of POAF. The pooled analysis demonstrated an odds ratio (OR) of 0.478 (95% CI: 0.340–0.673; P < 0.0001), indicating a substantial decrease in POAF occurrence among patients receiving vitamin C compared to controls. PMC
Geographic Variability in Outcomes
A systematic review and meta-analysis of 15 trials involving 2,050 high-risk patients revealed geographic differences in the efficacy of vitamin C. In nine trials conducted outside the USA, vitamin C supplementation was associated with a 44% reduction in POAF incidence (RR = 0.56; 95% CI: 0.47–0.67). Conversely, five trials conducted in the USA did not demonstrate a significant benefit (RR = 1.04; 95% CI: 0.86–1.27). ResearchGate+1BioMed Central+1BioMed Central+1ResearchGate+1
Additional Clinical Observations
A comprehensive review of 31 studies suggested that perioperative vitamin C administration may confer benefits beyond arrhythmia prevention, including reductions in ICU and hospital length of stay, ventilation time, inotropic support requirements, and postoperative fatigue. These effects are attributed to vitamin C's role in attenuating oxidative stress and inflammation during the perioperative period. PMC
Administration Protocols
While standardized protocols vary, some studies have employed the following regimen:HSForum Journal
Preoperative Phase: 2 grams of vitamin C administered intravenously 24 hours before surgery.HSForum Journal
Postoperative Phase (ICU): 500 mg of vitamin C administered intravenously every 12 hours for 48 hours.HSForum Journal+1PMC+1
Postoperative Phase (Ward): 500 mg of vitamin C administered orally every 12 hours for an additional 48 hours.
This protocol aims to maintain adequate plasma vitamin C levels during the critical perioperative period.
3. Exercise-Induced Bronchoconstriction (EIB)
Exercise-induced bronchoconstriction (EIB) is a transient narrowing of the airways that occurs during or after exercise, leading to symptoms such as coughing, wheezing, and shortness of breath. Recent studies have explored the potential role of vitamin C in mitigating EIB symptoms.ScienceDaily+1ResearchGate+1
Clinical Evidence Supporting Vitamin C for EIB
A meta-analysis published in BMJ Open analyzed three placebo-controlled trials involving a total of 40 participants. The pooled results indicated that vitamin C administration before exercise reduced the post-exercise decline in forced expiratory volume in 1 second (FEV₁) by 8.4 percentage points (95% CI: 4.6 to 12), equating to a 48% relative reduction in FEV₁ decline. Additionally, one study reported that vitamin C decreased the proportion of participants experiencing EIB by 50 percentage points (95% CI: 23 to 68) .Wikipedia+1ResearchGate+1ScienceDaily+4PubMed+4ResearchGate+4
Further research suggests that both short-term and longer-term vitamin C supplementation may be beneficial. For instance, a study by Tecklenburg et al. found that a two-week regimen of 1.5 g/day vitamin C reduced post-exercise FEV₁ decline by 50% in patients with asthma .PMC+3BioMed Central+3ATS Journals+3
Proposed Mechanisms of Action
The exact mechanisms by which vitamin C may alleviate EIB are not fully understood, but several hypotheses have been proposed:ResearchGate
Antioxidant Properties: Vitamin C is a potent antioxidant that can neutralize reactive oxygen species generated during exercise, potentially reducing oxidative stress in the airways.ResearchGate+1ScienceDaily+1
Modulation of Inflammatory Mediators: Vitamin C may influence the metabolism of prostaglandins and leukotrienes, inflammatory mediators involved in bronchoconstriction.Wikipedia+1ResearchGate+1
Enhancement of Nitric Oxide Production: By supporting endothelial function, vitamin C might enhance nitric oxide availability, leading to bronchodilation.
Recommended Supplementation Protocols
Based on current evidence, the following vitamin C supplementation strategies have been explored:
Acute Supplementation: A single dose of 500 mg to 2 g of vitamin C taken 1 to 2 hours before exercise has been used in studies to assess immediate effects on EIB symptoms.
Chronic Supplementation: Daily intake of 1 to 1.5 g of vitamin C over a period of two weeks has been studied for its potential to reduce EIB severity in individuals with asthma.
It's important to note that while these protocols have shown promise in clinical studies, individual responses may vary. Consultation with a healthcare provider is recommended before initiating any supplementation regimen.
4. Sepsis Management
In sepsis, a condition marked by systemic inflammation and oxidative stress, patients often exhibit depleted vitamin C levels. High-dose IVC has been studied as part of combination therapies, such as the "Marik protocol," which includes hydrocortisone and thiamine. While early studies suggested potential benefits, subsequent large-scale trials have yielded mixed results. Below is a comprehensive overview of the current evidence, protocols, and considerations regarding HDIVC in sepsis management.
Mechanisms of Action
Vitamin C plays several roles that may be beneficial in sepsis:
Antioxidant Properties: Vitamin C scavenges reactive oxygen species, potentially mitigating oxidative stress-induced cellular damage.
Endothelial Function: It may help preserve endothelial integrity, reducing capillary leak and edema.
Catecholamine Synthesis: As a cofactor in catecholamine biosynthesis, vitamin C might support vasopressor responsiveness.
Immune Modulation: Vitamin C can modulate immune responses, potentially attenuating the dysregulated inflammation seen in sepsis.
Clinical Evidence
In 2017, Dr. Paul Marik proposed the "HAT" protocol, combining hydrocortisone, ascorbic acid (vitamin C), and thiamine. An initial retrospective study reported a significant reduction in mortality among septic patients treated with this combination. However, the study's design limitations necessitated further investigation .Wikipedia+2Wikipedia+2Wikipedia+2
Randomized Controlled Trials
CITRIS-ALI Trial: This multicenter RCT evaluated HDIVC (50 mg/kg every 6 hours for 96 hours) in patients with sepsis-induced acute respiratory distress syndrome (ARDS). While the primary outcome (change in SOFA score) was not significantly different, a secondary analysis showed reduced 28-day mortality in the vitamin C group .
LOVIT Trial: A large RCT assessing HDIVC in septic patients found no significant benefit and raised concerns about potential harm, including increased risk of death or persistent organ dysfunction .
VICTAS Trial: This study investigated the HAT protocol's efficacy. Results indicated no significant improvement in ventilator- and vasopressor-free days or mortality .MDPI+3Wikipedia+3Wikipedia+3BioMed Central
Ongoing Research
The High-Dose Vitamin C on Sepsis (HDVCOS) trial is a multicenter, double-blind RCT in China, enrolling 620 patients to receive HDIVC (200 mg/kg/day) or placebo for 4 days. The primary outcome is 28-day mortality, with secondary outcomes including organ failure incidence and SOFA score changes .Frontiers+1PMC+1
Administration Protocols
Dosage: Common regimens include 1.5 g every 6 hours or continuous infusion at 200 mg/kg/day for 4 days.
Route: Intravenous administration is necessary to achieve therapeutic plasma concentrations.
Combination Therapy: Often administered alongside hydrocortisone and thiamine (HAT protocol).
5. COVID-19 Supportive Care
High-dose intravenous vitamin C (HDIVC) has been explored as a potential adjunctive therapy for COVID-19 due to its antioxidant and immunomodulatory properties. While early studies suggested possible benefits, more recent large-scale trials have yielded mixed results. Below is a comprehensive overview of the current evidence, protocols, and considerations regarding HDIVC in COVID-19 management.
Mechanisms of Action
Vitamin C is known for its antioxidant properties, which can neutralize reactive oxygen species and reduce oxidative stress. In the context of COVID-19, it is hypothesized that HDIVC may:
Modulate immune responses by enhancing the function of various immune cells.
Reduce inflammation by inhibiting pro-inflammatory cytokines.
Improve endothelial function, potentially mitigating vascular complications associated with severe COVID-19.
Clinical Evidence
Early Observational Studies
Initial studies, including a clinical trial in Wuhan, China, investigated the use of HDIVC in patients with severe COVID-19 pneumonia. These studies suggested potential benefits, such as improved oxygenation and reduced inflammatory markers. However, these findings were preliminary and necessitated further investigation.
Randomized Controlled Trials
Subsequent randomized controlled trials (RCTs) have provided more robust data:
A double-blind RCT analyzed the efficacy and safety of HDIVC in patients with moderate to severe COVID-19. The study found that vitamin C could reduce inflammatory markers and improve oxygenation but did not significantly impact mortality rates. PMC
A meta-analysis of multiple studies indicated that vitamin C supplementation reduced hospital mortality (23.9% vs. 35.8%) but was associated with a longer ICU stay. The analysis also noted a reduction in acute kidney injury among patients treated with vitamin C. PMC
The REMAP-CAP and LOVIT-COVID trials, encompassing over 2,500 patients across 20 countries, concluded that HDIVC did not improve outcomes for hospitalized COVID-19 patients. In fact, the findings suggested that the use of vitamin C in this context should be reconsidered. remapcap.eu+1Imperial College Healthcare NHS Trust+1Canadian Critical Care Trials Group
Administration Protocols
Various dosing regimens have been employed in clinical studies:
Dosage: Common protocols include 1.5 g every 6 hours or continuous infusion at 200 mg/kg/day for 4 days.
Route: Intravenous administration is necessary to achieve therapeutic plasma concentrations.
Combination Therapy: Vitamin C has been administered alongside standard treatments, including antivirals and corticosteroids.
6. Autoimmune Disorders
High-dose intravenous vitamin C (IVC) is being explored as an adjunctive therapy for various autoimmune conditions due to its potential antioxidant, anti-inflammatory, and immunomodulatory effects. While research is ongoing, some studies and clinical observations suggest benefits in certain autoimmune diseases.
Mechanisms of Action
IVC may influence autoimmune conditions through several mechanisms:
Antioxidant Activity: Neutralizes reactive oxygen species, reducing oxidative stress implicated in autoimmune pathogenesis.
Anti-inflammatory Effects: Modulates cytokine production, potentially decreasing pro-inflammatory mediators.
Immune Regulation: May enhance regulatory T-cell function and modulate immune responses.
Clinical Applications and Evidence
Rheumatoid Arthritis (RA): Some studies suggest that vitamin C supplementation can reduce oxidative stress and inflammation in RA patients. However, high-quality clinical trials are limited, and more research is needed to establish definitive benefits.
Systemic Lupus Erythematosus (SLE): Vitamin C's antioxidant properties may help mitigate oxidative damage in SLE. Preliminary studies indicate potential benefits, but comprehensive clinical trials are lacking.
Multiple Sclerosis (MS): Research on vitamin C in MS is sparse. While antioxidant therapy is considered in MS management, specific evidence for high-dose IVC is minimal.BioMed Central
Administration Protocols
IVC dosing varies based on individual needs and clinical judgment. Protocols often start with lower doses, gradually increasing to assess tolerance. Typical regimens may include:Twin Cities IV
Initial Phase: 15–25 grams per infusion, 2–3 times per week.wycoffwellness.com+1Mobile IV Wellness+1
Maintenance Phase: 25–50 grams per infusion, weekly or biweekly.
7. Chronic Fatigue Syndrome (CFS)
High-dose intravenous vitamin C (IVC) has garnered attention as a potential adjunctive therapy for chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME). While the exact pathophysiology of CFS remains elusive, oxidative stress and inflammation are believed to play significant roles. IVC's antioxidant and immunomodulatory properties may offer therapeutic benefits in this context.
Clinical Evidence Supporting IVC in CFS
Reduction in Fatigue Levels: A study investigating the effects of IVC on fatigue in office workers found that a single infusion of 10 grams led to a significant reduction in fatigue scores two hours post-infusion, with effects persisting for one day. This suggests that IVC may have immediate benefits in alleviating fatigue symptoms. PMC
Post-Viral Fatigue Management: Research indicates that vitamin C administration could alleviate fatigue by addressing vitamin C deficiency symptoms, supporting immune function, and reducing oxidative stress. This is particularly relevant for post-viral fatigue syndromes, which share similarities with CFS. PMC
Oxidative Stress and Inflammation: A review highlighted that high-dose IVC can reduce fatigue, cognitive impairment, and pain in conditions associated with oxidative stress. Given that oxidative stress and inflammation are implicated in CFS, IVC's antioxidant properties may be beneficial. Frontiers
Administration Protocols
While standardized protocols for IVC in CFS are not established, clinical practices have adopted various dosing regimens:
Dosage: Typical doses range from 7.5 to 25 grams per infusion, administered 2–3 times per week.
Duration: Treatment courses often span several weeks, with adjustments based on patient response and tolerance.
Combination Therapies: IVC is sometimes combined with other nutrients, such as B vitamins, magnesium, and amino acids, to enhance therapeutic outcomes.
It's essential to tailor IVC therapy to individual patient needs, considering factors like baseline vitamin levels and symptom severity.
8. Heavy Metal Detoxification
High-dose intravenous vitamin C (IVC) is being explored as an adjunctive therapy in heavy metal detoxification protocols. While IVC is not a chelating agent itself, its antioxidant properties may support the body's detoxification processes when used alongside established chelation therapies.
Mechanisms of Action
IVC is believed to aid in heavy metal detoxification through several mechanisms:
Antioxidant Activity: Vitamin C can neutralize reactive oxygen species generated by heavy metal exposure, potentially reducing oxidative stress.
Support for Glutathione Recycling: Vitamin C may help regenerate glutathione, a critical antioxidant involved in detoxification pathways.
Immune System Support: By bolstering immune function, vitamin C might assist in the removal of toxins.
These supportive roles suggest that IVC could enhance the efficacy of chelation therapies by mitigating oxidative damage and supporting overall detoxification processes.
Clinical Evidence
While direct clinical studies on IVC as a standalone therapy for heavy metal detoxification are limited, some integrative medicine practitioners incorporate IVC into comprehensive detox protocols. For instance, combining IVC with chelating agents like DMSA (dimercaptosuccinic acid) and glutathione is a practice observed in certain clinics. This combination aims to prevent the redistribution of heavy metals during the detoxification process, although more research is needed to validate these approaches. Health and Vitality Center+1Wikipedia+1Wikipedia
It's important to note that the primary treatment for heavy metal toxicity remains chelation therapy using agents such as EDTA, DMSA, or DMPS, which have established efficacy in binding and facilitating the excretion of heavy metals.
Administration Protocols
In clinical settings where IVC is used adjunctively for detoxification, the following protocols are commonly observed:
Dosage: IVC doses may range from 25 to 50 grams per infusion, depending on individual patient needs and tolerance.
Frequency: Infusions are typically administered 1–3 times per week over several weeks.
Combination Therapy: IVC is often combined with chelating agents and other supportive nutrients, such as glutathione, to enhance detoxification pathways.
These protocols are tailored to individual patients and should be supervised by healthcare professionals experienced in integrative detoxification therapies.
9. Skin Health and Anti-Aging
High-dose intravenous vitamin C (IVC) is increasingly recognized for its potential benefits in skin health, particularly in enhancing hydration, promoting collagen synthesis, and providing antioxidant protection. While topical vitamin C applications are well-established in dermatology, IVC offers an alternative route to deliver higher concentrations of ascorbic acid directly into the bloodstream, potentially leading to more pronounced systemic effects.
Mechanisms of Action
Vitamin C plays a pivotal role in skin physiology through several mechanisms:
Collagen Synthesis: Vitamin C is essential for the hydroxylation of proline and lysine residues during collagen formation, contributing to skin firmness and elasticity.
Antioxidant Protection: As a potent antioxidant, vitamin C neutralizes reactive oxygen species, mitigating oxidative stress induced by ultraviolet (UV) radiation and environmental pollutants.
Melanin Regulation: Vitamin C inhibits tyrosinase activity, an enzyme involved in melanin production, thereby aiding in the reduction of hyperpigmentation and promoting a more even skin tone.
Anti-inflammatory Effects: Vitamin C modulates inflammatory pathways, potentially reducing redness and inflammation associated with various skin conditions.
Clinical Evidence
While direct studies on IVC for skin health are limited, several investigations provide insights into its potential benefits:
Skin Hydration and Brightness: IVC therapy has been associated with enhanced skin hydration and brightness. By delivering vitamin C directly into the bloodstream, higher plasma concentrations are achieved compared to oral administration, potentially leading to improved skin appearance. azivmedics.com
Reduction of Inflammatory Markers: Acute administration of vitamin C via IV has been shown to reduce inflammatory markers by up to 30% within hours, which may contribute to improved skin conditions characterized by inflammation. azivmedics.com
Collagen Production and Anti-aging Effects: Vitamin C's role in collagen synthesis suggests that IVC could support skin structure and reduce signs of aging. While most studies focus on topical applications, the systemic availability of vitamin C through IV administration may offer complementary benefits.
Administration Protocols
IVC therapy protocols for skin health vary, but common practices include:
Dosage: Doses typically range from 10 to 25 grams per infusion, depending on individual needs and clinical judgment.
Frequency: Sessions may be administered once or twice weekly over several weeks to observe noticeable improvements in skin quality.
Combination Therapies: IVC is often combined with other nutrients, such as glutathione and B-complex vitamins, to enhance overall skin rejuvenation effects.
It's essential to consult with a healthcare professional experienced in IV therapies to determine the most appropriate protocol based on individual health status and goals. Our Beauty Bag IV includes vitamin C, biotin, and B complex for the benefits of vitamin C and skin health.
10. Mood Disorders
High-dose intravenous vitamin C (IVC) is being explored as a potential adjunctive therapy for mood disorders, including depression and anxiety. While research is ongoing, several studies have investigated the relationship between vitamin C levels and mood regulation.
Potential Mechanisms of Action
Vitamin C may influence mood through several biological pathways:
Neurotransmitter Synthesis: Vitamin C is involved in the synthesis of neurotransmitters like dopamine, norepinephrine, and serotonin, which play crucial roles in mood regulation.
Antioxidant Properties: As a potent antioxidant, vitamin C can mitigate oxidative stress, which has been linked to the pathophysiology of depression.
Anti-inflammatory Effects: Vitamin C may reduce inflammation by lowering pro-inflammatory cytokines, potentially alleviating depressive symptoms.
Clinical Evidence
Association Between Vitamin C Levels and Depression: A study analyzing data from the National Health and Nutrition Examination Survey (NHANES) found that higher serum ascorbic acid levels were associated with a lower prevalence of depression. Participants in the highest quartile of vitamin C levels had a significantly reduced risk of depression compared to those in the lowest quartile. Frontiers+1ScienceDirect+1
Vitamin C Supplementation and Mood Improvement: A meta-analysis suggested that vitamin C supplementation might have mood-elevating effects in individuals with subclinical depression. However, the authors emphasized the need for more rigorous studies to confirm these findings. ScienceDirect
Vitamin C in Hospitalized Patients: In a randomized controlled trial, acutely hospitalized patients with low vitamin C levels who received vitamin C supplementation experienced a 34% reduction in mood disturbance scores compared to those who did not receive supplementation. PubMed
Preclinical Studies: Animal studies have demonstrated that vitamin C administration can produce rapid antidepressant effects, including the regrowth of neuronal dendritic spines, similar to the effects observed with ketamine treatment.
Administration Protocols
While standardized protocols for IVC in mood disorders are not established, clinical practices have adopted various dosing regimens:
Dosage: Doses typically range from 10 to 25 grams per infusion, depending on individual needs and clinical judgment.
Frequency: Infusions are often administered 1–2 times per week over several weeks, with adjustments based on patient response and tolerance.
Combination Therapies: IVC may be combined with other nutrients, such as B vitamins and magnesium, to enhance therapeutic outcomes.
It's essential to tailor IVC therapy to individual patient needs, considering factors like baseline vitamin levels and symptom severity.
11. MRSA & Infections
High-dose vitamin C (ascorbic acid) has garnered attention for its potential antimicrobial properties, particularly against methicillin-resistant Staphylococcus aureus (MRSA). While research is ongoing, several studies have explored the efficacy of vitamin C in combating MRSA infections.
Mechanisms of Action
Antibacterial and Anti-Biofilm Effects: Vitamin C has demonstrated antibacterial activity against various pathogens, including MRSA. Its mechanisms include:
Inhibition of Bacterial Growth: Vitamin C can directly inhibit the growth of MRSA strains. PMC
Disruption of Biofilm Formation: Biofilms protect bacteria from antibiotics. Vitamin C has been shown to disrupt MRSA biofilm formation, enhancing the effectiveness of antimicrobial agents. Frontiers
Synergistic Effects with Antibiotics: Combining vitamin C with antibiotics may enhance antimicrobial efficacy:
Enhanced Antibiotic Activity: Vitamin C, when combined with antibiotics like vancomycin, has shown increased antibacterial effects against MRSA in vitro. microbiologyresearch.org
Reduction in Antibiotic Resistance: The combination may reduce the development of antibiotic resistance by disrupting bacterial defense mechanisms.
Clinical Evidence
While in vitro studies are promising, clinical evidence is limited:
Case Reports: Some case reports suggest that high-dose intravenous vitamin C, in combination with antibiotics, may improve outcomes in severe bacterial infections, including those caused by MRSA.
Need for Clinical Trials: Robust clinical trials are necessary to establish the efficacy and safety of high-dose vitamin C in MRSA treatment protocols.
Administration Protocols
In clinical settings, vitamin C has been administered as follows:
Dosage: High-dose intravenous vitamin C protocols have used doses up to 1.5 g/kg body weight per day, divided into multiple infusions. icjournal.org
Combination Therapy: Vitamin C is often administered alongside standard antibiotic regimens to potentially enhance antimicrobial effects.
Our Recommendations: Our recommendations for infections is IV Ozone Therapy with High Dose Vitamin C (starting at 15 grams). We recommend AT LEAST a series of 4 treatments within a week.
Safety Considerations
IVC is generally well-tolerated; however, certain precautions are necessary:
G6PD Deficiency: Patients with glucose-6-phosphate dehydrogenase deficiency may be at risk for hemolytic anemia when receiving high-dose vitamin C and should be screened prior to therapy.
Renal Function: High doses of vitamin C can increase oxalate levels, potentially leading to kidney stone formation, especially in patients with pre-existing renal conditions.
Iron Overload Disorders: Vitamin C enhances iron absorption; caution is advised in individuals with conditions like hemochromatosis.
Monitoring and appropriate patient selection are crucial to minimize potential risks associated with IVC therapy. As a result, we start IVC at a generally safe dose of 10-15 grams and titrate up (start with a small amount of something and gradually increase it to find the right dose or effect). This is a safe starting point and can be helpful no matter what you’re hoping to tackle.
For doses over 15 grams we require recent labs, the CBC and CMP, prior to any increase in vitamin C. These can easily be ordered through your primary care provider or we can order them through the IV Lounge.
Additionally, all patients who desire a dose over 15 grams will need recent lab work and need to be approved by our medical director prior to administration.
Prior to Surgery:
Interference with Bleeding Risk & Coagulation
High-dose vitamin C may affect platelet function and the coagulation cascade.
While not a blood thinner per se, it can alter the delicate hemostatic balance, especially in very high doses or in combination with other nutrients or medications.
This could theoretically increase bleeding risk during surgery.
Masking Inflammatory Markers
Vitamin C is a potent antioxidant that reduces markers like C-reactive protein (CRP) and interleukins.
Surgeons and anesthesiologists monitor inflammation closely—blunting those markers may delay diagnosis of infection or surgical complications.
Renal Load During Anesthesia
High-dose vitamin C metabolizes into oxalate, which is cleared by the kidneys.
Surgery (especially under general anesthesia) can temporarily stress renal function, and combining that with high oxalate load may increase the risk of kidney strain or stones.
Interactions with Medications
Vitamin C may interact with certain medications used during surgery or anesthesia, including:
Steroids
Opioids
Blood pressure agents
This could alter the intended effects or dosages of these drugs.
Lack of Established Safety in Perioperative Protocols
Most surgical guidelines have not formally studied or validated high-dose IVC use perioperatively.
In the absence of standardized protocols, most clinicians err on the side of caution and pause it before surgery.
When to Use Instead
Before surgery: Low-dose oral vitamin C (up to ~1,000 mg/day) may be fine and beneficial for collagen production and healing—with provider approval. We recommend or Pre-Surgery IV (Just a Flesh Wound Pre) as an IV to prepare your body for surgery.
After surgery: High-dose IVC is sometimes used post-operatively (once bleeding risk is low and renal function is stable) to support recovery, immunity, and tissue repair.
While high-dose intravenous vitamin C shows promise in various therapeutic areas, it's essential to approach these treatments with caution. Many applications lack robust clinical evidence, and potential risks, such as kidney stones or interactions with other medications, should be considered. Consultation with healthcare professionals is crucial before initiating high-dose IVC therapy.
Note: This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any new treatment.