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FOR IMMEDIATE RELEASE Orthomolecular Medicine News Service, Feb 2, 2020 Hospital-based Intravenous Vitamin C Treatmentfor Coronavirus and Related Illnessesby Andrew W. Saul and Atsuo Yanagisawa, MD, PhD(OMNS February 2, 2020) No matter which hospital a coronavirus patient may seek help from, the question is, Will they be able to leave walking out the front door, or end up being wheeled out the basement backdoor? Prompt administration of intravenous vitamin C, in high doses, can make the difference. Abundant clinical evidence confirms vitamin C's effectiveness when used in sufficient quantity. HYPERLINK "" \l "Ref1" [1] Physicians have demonstrated the powerful antiviral action of vitamin C for decades. HYPERLINK "" \l "Ref2" [2] Specific instructions for intravenous vitamin CThe Japanese College of Intravenous Therapy (JCIT) recommends intravenous vitamin C (IVC) 12.5/25g (12,500 - 25,000 mg) for acute viral infections (influenza, herpes zoster, common cold, rubella, mumps, etc.) and virus mimetic infections (idiopathic sudden hearing loss, Bell's palsy). In adults, IVC 12.5g is given for early stage illness with mild symptoms, and IVC 25g for moderate to severe symptoms. IVC is usually administered once or twice a day for 2-5 continuous days, along with or without general treatments for viral infections. IVC 12.5g cocktailSterile water125 mL50% Vitamin C25 mL (12. 5g)0.5M Magnesium sulfate10 mLAdd Vitamin B complexDrip for 30-40 minIVC 25g cocktailSterile water250 mL50% Vitamin C50 mL (25g)0.5M Magnesium sulfate20 mLAdd Vitamin B complexDrip for 40-60 minPatients with acute viral infections show a depletion of vitamin C and increasing free radicals and cellular dysfunction. Such patients should be treated with vitamin C, oral or IV, for neutralizing free radicals throughout the body and inside cells, maintaining physiological functions, and enhancing natural healing. If patients progress to sepsis, vitamin C should be added intravenously as soon as possible along with conventional therapy for sepsis. Toronto Star, 30 May 2003: "Fred Hui, MD believes that administering vitamin C intravenously is a treatment worth trying. And he'd like to see people admitted to hospital for the pneumonia-like virus treated with the vitamin intravenously while also receiving the usual drugs for SARS. 'I appeal to hospitals to try this for people who already have SARS,' says Hui. Members of the public would also do well to build up their levels of vitamin C, he says, adding that there is nothing to lose in trying it. 'This is one of the most harmless substances there is,' Hui states. 'There used to be concern about kidney stones, but that was theoretical. It was never borne out in an actual case.' Hui says he has found intravenous vitamin C effective in his medical practice with patients who have viral illnesses." HYPERLINK "" \l "Ref3" [3] Additional administration details are readily obtained from a free download of the complete Riordan Clinic Intravenous Vitamin C Protocol. HYPERLINK "" \l "Ref4" [4] Although initially prepared for cancer patients, the protocol has found widespread application for many other diseases, particularly viral illnesses. "Research and experience has shown that a therapeutic goal of reaching a peak-plasma concentration of ~20 mM (350- 400 mg/dL) is most efficacious. (No increased toxicity for posoxidant IVC plasma vitamin C levels up to 780 mg/dL has been observed.) . . . [T]he administering physician begins with a series of three consecutive IVC infusions at the 15, 25, and 50 gram dosages followed by post IVC plasma vitamin C levels in order to determine the oxidative burden for that patient so that subsequent IVCs can be optimally dosed." Pages 16-18 of the Riordan protocol present IVC administration instructions. or There are four pages of supporting references. "Given the rapid rate of success of intravenous vitamin C in viral diseases, I strongly believe it would be my first recommendation in the management of corona virus infections." (Victor A. Marcial-Vega, MD) Puerto Rico "It is of great importance for all doctors to be informed about intravenous vitamin C. When a patient is already in hospital severely ill, this would be the best solution to help save her or his life." (Karin Munsterhjelm, MD) Finland Winning the hospital gameWhen faced with hospitalization, the most powerful person in the most entire hospital system is the patient. However, in most cases, the system works on the assumption that the patient will not claim that power. If on your way in you signed the hospital's legal consent form, you can unsign it. You can revoke your permission. Just because somebody has permission to do one thing doesn't mean that they have the permission to do everything. There's no such thing as a situation that you cannot reverse. You can change your mind about your own personal healthcare. It concerns your very life. The rights of the patient override the rules of any institution. If the patient doesn't know that, or if they're not conscious, or if they just don't have the moxie to do it, the next most powerful person is the spouse. The spouse has enormous influence and can do almost as much as the patient. If the patient is incapacitated, the spouse can, and must, do all the more. If there is no spouse present, the next most powerful people in the system are the children of the patient. When you go to the hospital, bring along a big red pen, and cross out anything that you don't like in the hospital's permission form. And before you sign it, add anything you want. Write out "I want intravenous vitamin C, 25 grams per day, until I state otherwise." And should they say, "We're not going to admit you," you reply, "Please put it in writing that you refuse to admit me." What do you think their lawyers are going to do with that? They have to admit you. It's a game, and you can win it. But you can't win it if you don't know the rules. And basically, they don't tell you the rules. This is deadly serious. Medical mistakes are now the third leading cause of death in the US. Yes, medical errors kill over 400,000 Americans every year. That's 1,100 each day, every day. HYPERLINK "" \l "Ref5" [5] There are mistakes of commission and mistakes of omission. Failure to provide intravenous vitamin C is, literally, a grave omission. Do not allow yourself or your loved ones to be deprived of a simple, easy to prepare and administer IV of vitamin C. "If a family member of mine died due to coronavirus infection, after a doctor refused to use intravenous vitamin C, I would challenge his or her treatment in a court of law. I would win." (Kenneth Walker, MD, surgeon) It can be doneVitamin IVs can be arranged in virtually any hospital, anywhere in the world. Attorney and cardiologist Thomas E. Levy's very relevant presentation is free access. HYPERLINK "" \l "Ref6" [6,7] and . Both the letter and the intent of new USA legislation now make this easier for you. "The new federal Right to Try Act provides patients suffering from life-threatening diseases or conditions the right to use investigational drugs... It amends the Food, Drug, and Cosmetic Act to exempt investigational drugs provided to patients who have exhausted approved treatment options and are unable to participate in a clinical trial involving the drug. Advocates of right to try laws have sought to accelerate access to new drugs for terminally ill patients who are running out of options. Arguably, the law does not represent a radical change in this and several other states, however, because in 2016, California had already joined the majority of other states in adopting a law enabling physicians to help terminally ill patients pursue investigational therapies, without fear of Medical Board or state civil or criminal liability. . . The new Right to Try law should give physicians, as well as drug manufacturers, some added comfort about FDA enforcement in these cases." HYPERLINK "" \l "Ref8" [8] Therefore, in regards to intravenous vitamin C, do not accept stories that "the hospital can't" or "the doctor can't" or that "the state won't allow it." If you hear any of this malarkey, please send the Orthomolecular Medicine News Service the text of the policy or the law that says so. In the meantime, take the reins and get vitamin C in the veins. References:1. Saul AW (2020) Nutritional Treatment of Coronavirus. HYPERLINK "" \t "_blank" 2. Saul AW (2020) Vitamin C Protects Against Coronavirus. HYPERLINK "" \t "_blank" 3. Mawhinney J (2003) Vitamin C touted to fight virus. Toronto Star, 30 May 2003. HYPERLINK "" \t "_blank" . 4. The Riordan IVC Protocol is a free-access download at 5. James JT (2013) A new, evidence-based estimate of patient harms associated with hospital care. J Patient Safety 9:122-128. HYPERLINK "" \t "_blank" . 6. Levy TE. Vitamin C: the facts, the fiction, and the law. HYPERLINK "" \t "_blank" 7. Levy TE. Vitamin C And The Law. OMNS. HYPERLINK "" \t "_blank" . 8. Nelson H, Zimmitti S (2018) New Federal Right to Try Act. NH Healthcare Law Perspectives. HYPERLINK "" \t "_blank" To learn more about intravenous vitamin C:There are many articles posted for free reading at Mikirova N, Hunninghake R. (2014) Effect of high dose vitamin C on Epstein-Barr viral infection. Med Sci Monit. 20:725-732. HYPERLINK "" \t "_blank" . "The clinical study of ascorbic acid and EBV infection showed the reduction in EBV EA IgG and EBV VCA IgM antibody levels over time during IVC therapy that is consistent with observations from the literature that millimolar levels of ascorbate hinder viral infection and replication in vitro." Gonzalez MJ, Berdiel MJ, Duconge J, Levy TE, Alfaro IM, Morales-Borges R, Marcial-Vega, V, Olalde J. (2018) High Dose Vitamin C and Influenza: A Case Report. J Orthomol Med. 33(3) "Based on the positive outcome in this case, we propose that Intravenous Vitamin C should be studied as a vital component of the treatment protocol for acute viral infections." Dr. W. Gifford-Jones: People are dying needlessly of coronavirus. HYPERLINK "" \t "_blank" Murata A. (1975) Virucidal activity of vitamin C: Vitamin C for the prevention and treatment of viral diseases. Proceedings of the First Intersectional Congress of Microbiological societies, Science Council of Japan, 3:432-42. Saul AW. Vitamins in Hospitals Saul AW. (2020) Vitamin C Protects Against Coronavirus. Orthomolecular Medicine News Service. HYPERLINK "" \t "_blank" Saul AW. How to Get Intravenous Vitamin C Given to a Hospitalized Patient: A Checklist Cathcart RF. Preparation of Sodium Ascorbate for Intravenous and Intramuscular Administration Note: The Japanese College of Intravenous Therapy (JCIT) was founded in 2007. JCIT has organized educational seminar on intravenous nutrient therapy and integrative medicine for 13 years. JCIT now consists of 850 active members of physician and dentists. Every year, the College organizes 10 or more educational seminars with protocols for intravenous vitamin C therapy, mainly along with the Riordan Protocol, for patients with acute and chronic diseases. More than 2500 physicians in Japan have learned these protocols, and patients can easily find member's clinics all over Japan. In addition, JCIT recommends that physicians stock extra vitamin C vials in case of a pandemic. The JCIT website (Japanese language only): Nutritional Medicine is Orthomolecular MedicineOrthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: Find a DoctorTo locate an orthomolecular physician near you: Editorial ARTICLE Front. Physiol., 18 June 2019 | Editorial: Vitamin C in Cancer and Infectious Diseases: Physiological, Biochemical and Therapeutic InterventionsJin Wang1*, Fan Wu1 and Christopher Corpe21Scientific Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China2Nutritional Science Department, King's College London, London, United KingdomEditorial on the Research TopicVitamin C in Cancer and Infectious Diseases: Physiological, Biochemical and Therapeutic InterventionsVitamin C, also known as ascorbic acid, is an essential micronutrient in the human body. Vitamin C is a co-factor for at least 15 enzymes involved in the biosynthesis of collagen and L-carnitine, Hypoxia-Inducible Factor (HIF) degradation, peptide amidation, tyrosine metabolism, and the conversion of dopamine to norepinephrine (Institute of Medicine (US) Panel on Dietary Antioxidants Related Compounds, 2000; Pei et al., 2019). It is also a detoxifier and powerful anti-oxidant, eliminating free radicals. Vitamin C is also a key regulator of immune function, cellular growth and differentiation (Ang et al., 2018). Most animals are able to synthesize vitamin C; however, 30–50 million ago humans lost the ability to synthesize the vitamin due to the development of mutations in the gulonolactone oxidase gene (Drouin et al., 2011). High concentrations of vitamin C act as a pro-oxidant, eliciting hydrogen peroxide–dependent cytotoxicity in cancer cells without adversely affecting normal cells (Chen et al., 2008). High-dose vitamin C has also been investigated in people and shown to improve the health-related quality of life of terminal cancer and infectious diseases patients ( HYPERLINK "" \l "B7" Mikirova and Hunninghake, 2014). In this research topic, we have gathered together 7 articles; 2 original research contributions and 5 review articles which are focused on the physiological role of vitamin C in health, the biochemical and molecular mechanisms of vitamin C in cancer, and the importance of vitamin C in infectious diseases.Whether vitamin C has anti-cancer properties or not has been debated for decades (Cameron and Pauling, 1978; Moertel et al., 1985; Nauman et al., 2018). The review by Vissers and Das highlights the fact that vitamin C has been used for many years by cancer patients in an unregulated environment, either as a dietary supplement or in pharmacological doses administered by infusion. Daily vitamin C supplementation can likely reduce the incidence of gastric, esophageal, oral, pharyngeal and cervical cancer, and vitamin C-rich fruits may help prevent colon cancer and lung cancer (Pal et al., 2012). In addition, numerous reports have shown when high-doses of vitamin C are combined with conventional chemotherapy drugs the vitamin enhances the inhibition of cancer cell growth. Interestingly, the review by Vissers and Das shows pharmacologic doses of vitamin C result in oxidative stress, which preferentially targets cancer cells. Other mechanisms of action include vitamin C induced release of mitochondrial cytochrome C, leading to H2O2-mediated activation of the caspase cascade and apoptosis, and a significant decrease in tumor growth rates (Pei et al., 2016). Significant quantities of hydrogen peroxide are also generated by the autoxidation of pharmacologic levels of vitamin C and stimulation of the 2-oxoglutarate dependent dioxygenase family of enzymes (2-OGDDs) that require vitamin C as a cofactor. Support for these proposed mechanisms has come from many in vitro studies and xenograft animal models. With a number of early phase clinical trials currently underway, evidence for potential mechanisms of action is required to inform the most appropriate study design and choice of cancer model. Park et al. also reviewed the molecular mechanisms underlying the regulation of oxidation/reduction systems, focusing on the altered metabolomic profile in cancer cells. They suggested vitamin C alters de novo synthesis of GSH, resulting in alterations in the ratio of glutathione (GSH/GSSG). Alterations in GSH metabolism is further associated with increased glutathionylation of GAPDH, altered glucose metabolism, and high ROS levels and GSH oxidation. We believe the scope of this research topic provides the reader with insights into the multiple molecular mechanisms responsible for the anti-cancer properties of vitamin C.In the present research topic, Carr and Cook investigated the use of high dose IVC in cancer patients. High-dose intravenous vitamin C (IVC) has been used for decades as a complementary, alternative, and adjuvant medicine in clinic, and has been shown to significantly prolong the survival of patients (Hoffer et al., 2015). Although IVC has been clinically accepted and used for many years, there are still many questions regarding the clinical use of IVC in cancer therapy, such as the frequency and duration of IVC treatment, the optimal route of medication, safety, interaction with chemotherapy, quality of life, and the potential mechanisms of action. Parent et al. examined the relationship between dietary intake of vitamin C, in foods, supplements and multivitamins, and the incidence of prostate cancer in a large population-based case-control study, specifically addressing the issues of cancer aggressiveness and screening patterns. Their study included 1,916 histologically confirmed prostate cancer cases and 1,985 population controls, information on a wide range of socio-demographic, lifestyle, and medical factors, including PSA screening. Consumption of 63 food items 2 years prior to diagnosis/interview was also collected, along with the use of dietary supplements. Using the Prostate Cancer and Environment Study (PROtEuS) in Montreal, Canada, their work demonstrated that vitamin C did not seem to hold promise with regard to prostate cancer prevention.A combination of nutrition, nutraceuticals, and drugs is the preferred therapeutic approach to fight against cancer. Colorectal cancer (CRC) is classified a fatal type of cancer, and conventional first and second line chemotherapeutic regimens for CRC are based on a combination of drugs including fluoropyrimidine, oxaliplatin (Oxa), and irinotecan (Iri). Pires et al. analyzed the combination of high concentrations of vitamin C with reduced concentrations of drugs conventionally used in CRC patients and found that pharmacological vitamin C increased the efficacy of Iri and Oxa against CRC.Another important part of this research topic is to discuss vitamin C in the treatment of infectious diseases. It is well-known that Gram-negative bacteria Helicobacter pylori are closely related to stomach diseases and gastric cancer. A large number of clinical reports have shown that ascorbate deficiency is associated with gastritis. In patients with H. pylori-infected gastritis, H. pylori, first discovered by Robin Warren and Barry Marshall, is one of the most common bacterial infections in gastritis, with H. pylori infection exceeding 50%. Gastritis and peptic ulcers are also caused by infectious pathogens that eventually develop into chronic gastritis, mucosa-associated lymphoma, and even gastric adenocarcinoma. In this research topic, Mei and Tu summarizes the relationship between vitamin C and H. pylori infection, and outlines potential strategies to prevent H.pylori infection that are based on emerging advances in our understanding of ascorbic acid physiology and pharmacology.The final chapter in this research topic brings together a number of related dermatological studies which have shown that vitamin C can effectively promote the formation of the skin barrier via collagen synthesis, establishing a natural antioxidant barrier in the dermis, and regulating skin cell growth, differentiation, and signal transduction. Severe vitamin C deficiency leads to atopic dermatitis (AD) and porphyria (PCT). Vitamin C can be an effective drug for treating skin diseases, but the appropriate doses require further study. In this research topic, Wang et al. summarize the effects of vitamin C on five skin diseases (porphyria cutanea tarda, atopic dermatitis, malignant melanoma, and herpes zoster and postherpetic neuralgia) and emphasize the clinical application of vitamin C as an adjuvant for drugs or physical therapy for other skin diseases.Together, this research topic gives insight into the multiple and complex roles of vitamin C, and in particular its involvement in cancer and infectious diseases. It provides guidance for therapeutic approaches and future research on the clinical use of high-dose intravenous vitamin C. Through research we need to better understand the mechanisms of vitamin C action, the optimal administration route, the appropriate dose and administration frequency. From such work we will gain insights into the clinical value of vitamin C, its role at a physiological and biochemical level, and expand the value of vitamin C in the treatment of cancer and infectious diseases. We look forward to new applied and useful data in this growing area.Author ContributionsJW, FW, and CC planned and edited this special topic. JW and FW wrote this editorial. JW and CC revised this editorial.FundingThis work was supported by the National Special Research Program of China for Important Infectious Diseases (2018ZX10302103-003) and a grant from National Natural Science Foundation of China (81672383).Conflict of Interest StatementThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.ReferencesAng, A., Pullar, J. M., Currie, M. J., and Vissers, M. C. M. (2018). Vitamin C and immune cell function in inflammation and cancer. Biochem. Soc. Trans. 46, 1147–1159. doi: 10.1042/BST20180169PubMed Abstract | CrossRef Full Text | Google ScholarCameron, E., and Pauling, L. (1978). 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, 4538–4542.PubMed Abstract | Google ScholarChen, Q., Espey, M. G., Sun, A. Y., Pooput, C., Kirk, K. L., Krishna, M. C., et al. (2008). Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice. Proc. Natl. Acad. Sci. U.S.A. 105, 11105–11109. doi: 10.1073/pnas.0804226105PubMed Abstract | CrossRef Full Text | Google ScholarDrouin, G., Godin, J. R., and Page, B. (2011). The genetics of vitamin C loss in vertebrates. Curr. Genomics 12, 371–378. doi: 10.2174/138920211796429736PubMed Abstract | CrossRef Full Text | Google ScholarHoffer, L. J., Robitaille, L., Zakarian, R., Melnychuk, D., Kavan, P., Agulnik, J., et al. (2015). High-dose intravenous vitamin C combined with cytotoxic chemotherapy in patients with advanced cancer: a phase I-II clinical trial. PLoS ONE 10:e0120228. doi: 10.1371/journal.pone.0120228PubMed Abstract | CrossRef Full Text | Google ScholarInstitute of Medicine (US) Panel on Dietary Antioxidants and Related Compounds (2000). Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC.Google ScholarMikirova, N., and Hunninghake, R. (2014). Effect of high dose vitamin C on Epstein-Barr viral infection. Med. Sci. Monit. 20, 725–732. doi: 10.12659/msm.890423PubMed Abstract | CrossRef Full Text | Google ScholarMoertel, C. G., Fleming, T. R., Creagan, E. T., Rubin, J., O'Connell, M. J., and Ames, M. M. (1985). 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, 137–141. doi: 10.1056/nejm198501173120301PubMed Abstract | CrossRef Full Text | Google ScholarNauman, G., Gray, J. C., Parkinson, R., Levine, M., and Paller, C. J. (2018). Systematic review of intravenous ascorbate in cancer clinical trials. Antioxidants 7:E89. doi: 10.3390/antiox7070089PubMed Abstract | CrossRef Full Text | Google ScholarPal, D., Banerjee, S., and Ghosh, A. K. (2012). Dietary-induced cancer prevention: an expanding research arena of emerging diet related to healthcare system. J. Adv. Pharm. Technol. Res. 3, 16–24. doi: 10.4103/2231-4040.93561PubMed Abstract | CrossRef Full Text | Google ScholarPei, Z., Wu, K., Li, Z., Li, C., Zeng, L., Li, F., et al. (2019). Pharmacologic ascorbate as a pro-drug for hydrogen peroxide release to kill mycobacteria. Biomed. Pharmacother. 109, 2119–2127. doi: 10.1016/j.biopha.2018.11.078PubMed Abstract | CrossRef Full Text | Google ScholarPei, Z., Zhang, X., Ji, C., Liu, S. M., and Wang, J. (2016). Transcriptomic and functional pathways analysis of ascorbate-induced cytotoxicity and resistance of Burkitt lymphoma. Oncotarget 7, 63950–63959. doi: 10.18632/oncotarget.11740PubMed Abstract | CrossRef Full Text | Google ScholarKeywords: vitamin C, cancer, infectious diseases, physiology, therapeutic interventionCitation: Wang J, Wu F and Corpe C (2019) Editorial: Vitamin C in Cancer and Infectious Diseases: Physiological, Biochemical and Therapeutic Interventions. Front. Physiol. 10:734. doi: 10.3389/fphys.2019.00734Received: 20 February 2019; Accepted: 27 May 2019;Published: 18 June 2019.Edited by:Gareth Davison, Ulster University, United KingdomReviewed by:Marcos Lopez, University of Chicago, United StatesPreparation of Sodium Ascorbate for IV and IM Use(For physicians only) by ROBERT F. CATHCART III, M.D. The following are excerpts from letters Dr. Cathcart sent out to physicians on the subject of IVC. If the physician does not want to make their sodium ascorbate stock solutions from scratch like I recommend (and I can well understand why you might not), you can order from? Merit Pharmaceuticals, 2611 San Fernando, Los Angeles, CA 90065. For CA 800-696-3748; Out-of State 800-421-9657. To order the Sodium Ascorbate Fine Crystals, specify Roche. Wholesale Nutrition, 915 S. San Tomas Equino Road, Campbell, CA 95008.?800-325-2664 or FAX 408-867-6236 ( editor's note: Ascorbate (vitamin C) for intravenous use is also available elsewhere. An internet search is recommended. We have no financial connection whatsoever with any health products company. Intravenous or injectable use of a vitamin absolutely requires your physician's participation. DO NOT ATTEMPT TO SELF-INJECT.)? The Stock Bottle of Sodium Ascorbate Sterilize a 500 cc IV bottle along with a funnel, the rubber stopper, and a spoon. Then fill the bottle to the 300 cc line with sodium ascorbate fine crystals. (I weighed the sodium ascorbate out one time and 250 gm came up to the 300 cc line.) Then add 1/3 of the 20 ml bottle (6.6 cc) of edetate disodium injection, USP 150 mg/ml. Then add water for injection q.s. 500 cc. Shake up the bottle and if there is 1 mm of crystals left on the bottom, add 1 mm of water to the top. It turns out that sodium ascorbate is soluble to almost exactly a 50% concentration at room temperature. I do not worry about the sterility of this because this is very bacteriocidal. Perhaps it should be filtered to get out particulate matter but I have never seen this to be a problem. The pH of this has always turned out to be 7.4. My nurse discovered recently that if you do not shake the mixture to make it go into solution until after you refrigerate it and are ready to use it that the solution is less yellow. I presume that this is good because sodium ascorbate is clear and dehydroascorbate is yellow. The made up solutions are always a little yellow but refrigeration before mixing results in a far less yellow mixture.? Preparation of the IV Bottle I recommend that the above stock bottle solution be added to lactated Ringer's such that 30 Gms (60 cc) to 60 Gms (120 cc) this be added to a quantity of lactated Ringer's sufficient to make 500 cc of the final solution to be injected IV. I had been using water for injection some time ago because this solution is several times hypertonic already and I did not want to add more tonicity. However, recently I have found that lactated Ringer's feels better to patients so I use that for the final dilution (not the stock solution described above.)? IM Injections IM injection material for infants is made from the stock solution diluted 50% in water giving a 25% solution. Generally, the size of the injection can be 2 cc in each buttocks. Ice may be applied if it hurts to much. This may be given every hour or so, frequently enough to bring the fever or other symptoms of excessive free radicals down rapidly. General Comments I have not had any trouble with these solutions. I hear all sorts of weird stories from patients who have gotten ascorbate elsewhere. I do not know if it is an acid problem (because ascorbic acid was used rather than sodium ascorbate) or whether some colleges get carried away with what other things they add to the intravenous solutions.? I think that there may be, at times minor troubles with commercially prepared solutions because of the following. I understand that the U. S. Pharmacopeia specifies that the solutions be made from ascorbic acid and then buffered with sodium hydroxide or sodium bicarbonate to a pH between 3.5 and 7.0. I worry that 60 grams of ascorbate at a pH of 3.5 is too acid. I know that Klenner (the first physician who used high dose intravenous ascorbate by vein) also made his solutions from sodium ascorbate powder.? I watch patients for hypocalcemia (although I have not seen it), hypoglycemia (I encourage patients to eat while taking the IV), and dehydration (I encourage water and slow the IV down.) I also see headaches afterward but not so much since I have been emphasizing the continuing high doses of oral ascorbic acid as soon as the IV is over. Actually I give oral ascorbic acid while the IV is going to get a double effect. Bowel tolerance goes up while the IV is running but one has to be careful to stop giving oral C about an hour before the IV stops or else you may get diarrhea as soon as the IV stops. The oral ascorbic acid is then started again 1/2 to 1 hour after the IVC stops.? ? Copyright (C) 1996 Robert F. Cathcart, M.D.. Permission granted to distribute as long as distributed intact and with this attribution.? ................
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