IV VITAMIN C 
EDMONTON IV THERAPY

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IV Vitamin C: background

Vitamin C is a well known anti-oxidant when taken orally.

Laboratory studies demonstrate that vitamin C in high concentrations has antitumor and chemosensitizing effects. Studies in humans have shown improvements in quality of life and cancer-related symptoms³³. 

At high doses, intravenously Vitamin C in a sense acts oxidatively¹, through hydrogen peroxide production outside of cancer cells; that is, it can damage susceptible cells.

The mechanisms of high-dose IVC are distinct from those of orally administered vitamin C. Oral dosing achieves a maximum serum concentration of less than 0.25 mM due to the limited absorptive capacity of the gastrointestinal tract. Intravenously administered vitamin C will increase serum levels more than 100-fold: up to 30 mM³³. 

In a study comparing a low dose of 1.25 g oral and IV vitamin C administration, there was a 6.6-fold greater plasma concentration achieved by the IV route over the oral route. Based on pharmacokinetic modeling, intravenous doses of 50 and 100 g were expected to yield plasma concentrations of approximately 13 to 15 mM, compared to 0.22 mM concentrations achieved by the maximum tolerated oral dose, 3 g 4 times daily³³.

After intravenous administration achieves a high concentration of ascorbate in the blood, ascorbate is distributed to extravascular spaces and identical concentrations are achieved both in the plasma and in extracellular fluid³⁴. 

In the extracellular fluid ascorbate is oxidized and releases an electron (and becomes the ascorbate radical.) Through electron transfer by a metal catalyst (eg. Fe) the electron it gives out is transferred to an O2 molecule to make superoxide and then through superoxide dismutation (two hydrogens combine with superoxide) and hydrogen peroxide is produced along with molecular oxygen³⁴. 

In normal cells, hydrogen peroxide is metabolized to water and oxygen according to the following reaction, by the enzyme catalase: 2H₂O₂ → 2H₂O + O2.

Tumor cells lack catalase, leaving them vulnerable to the cytotoxic effects of hydrogen peroxide and resulting in preferential cytotoxic activity associated with high concentrations of vitamin C. Tumor cells selectively take up more vitamin C compared to normal cells through upregulated transport by glucose transporters (GLUT) a process upregulated in tumor cells due to their increased metabolic need for glucose³³.

Because of the oxidative mechanism, synergy is expected between oxidative cancer therapies like high dose IV Vitamin C and Hyperbaric Oxygen which is a service we offer at our Edmonton office. 

IV Vitamin C “IV Vitamin C” can be used concurrently with many chemotherapies² (for a complete discussion reference to Anderson 2013) and has a reputation for reducing side effects of chemotherapy. Our Naturopathic doctors often use IV Vitamin C alongside or in-between chemotherapy treatments as an adjunctive therapy at our Edmonton office.

A 2007 study indicated that IV Vitamin C in 39 terminal cancer patients produced significantly lower scores for fatigue, nausea/vomiting, pain, and appetite loss after administration of vitamin C.⁴

At your initial consultation at our Edmonton office, your Naturopathic doctor will discuss compatibility of your standard oncologic protocol and IV Vitamin C. As evidenced below, in some situations data exists for safe co-administration of IV Vitamin C and a particular therapy. If the data does not exist or the interaction is not favorable, IV Vitamin C will be spaced away from a standard treatment based on the half life of the treatment in question.

It's important to note that: IV Vitamin C as cancer therapy was discarded several decades ago when 2 randomized trials of oral vitamin C therapy failed to demonstrate therapeutic benefit. However, more recent data indicates that IV administration of Vitamin C produces a 25-fold or greater plasma concentration than the same dose given orally and levels achieved via IV infusion are selectively cytotoxic in vitro to various cancer cell lines.²⁷

Pauling IVC data

IV Vitamin C can also be used for improving quality of life in advanced cancer patients. Our Naturopathic doctors frequently offer IV Vitamin C as one option to our Edmonton patients that have exhausted standard options.

The original evidence from Pauling (1976) demonstrated far greater outcomes in 100 advanced cancer patients suffering from a broad range of cancers (including Breast, Gastric, Lung, Esophageal, Colon, Ovarian, Gallbladder, Kidney, Lymphoma, Prostate, Uterine, Pancreatic and a few others). The survival times were drastically longer than expected as these patients were compared to 1000 similar controls³.

The original Pauling protocol gave 10g of Vitamin C for 10 consecutive days. Our Naturopathic doctors frequently give doses that are dramatically higher at our Edmonton office, often ranging between 15 and 75 grams for many cancer cases.  

A 2015 study demonstrated tolerability of high dose IV Vitamin C (60g) ten patients with metastatic prostate cancer over 4 weeks¹⁴. Our observations using IV Vitamin C in our Edmonton patients mirror what's been seen in numerous trials: IV Vitamin C has a high level of tolerability even in later stage cancer patients. 

Case Reports

Breast, Ovarian and others: A 2015 journal article outlined 9 cases of IV Vitamin C use. Four Breast Cancer Cases, Two Nasopharynx Cancer, Ovarian Cancer and Liver Cancer Cases suggested survival beyond prognosis, improvement in quality of life, and even complete remission⁹. One case of Lung cancer in this article demonstrated a poor response to IV Vitamin C.

A few case reports indicate excellent efficacy of IV Vitamin C in Lymphoma⁵, Kidney Cancer⁵ and Bladder cancer⁵ causing long term remissions.  Our Naturopaths' preference is to consider using IV Vitamin C as a standalone therapy is in these cancers. It is worth noting that data exists for Lymphoma and Kidney cancer using LDN and IV ALA respectively (See ALA Section).

Prior to this, data from Riordan demonstrated cases in which IV Vitamin C was helpful in Lymphoma, Kidney, Colon, and Breast Cancer also confirming possible efficacy in Kidney Cancer and Lymphoma again 

Kidney Cancer: A 70-year-old white male diagnosed with Kidney Cancer where shortly after nephrectomy, he developed metastatic lesions in the liver and lung. He began intravenous vitamin C treatment,starting at 30 grams twice per week. Six weeks after initiation of therapy, reports indicated that the patient was feeling well, and his metastases were shrinking²².

Fifteen months after initial therapy, the patient’s oncologist reported the patient was feeling well with absolutely no signs of progressive cancer. The patient remained cancer-free for 14 years and he died of congestive heart failure at the age of 84.

Lymphoma: In the other case of Lymphoma that responded well to IV Vitamin C, a patient that initially did well on chemotherapy, but had to discontinue due to side effects had started IV vitamin C which was escalated until he was receiving 50 grams two times per week.

He continued on that dose for 11 months. Three months after beginning vitamin therapy a CT-scan showed no evidence to malignancy and he was declared to be in complete remission by his oncologist.²²

Colon Cancer: With regards to Colon Cancer, a 51-year-old white male with colon cancer with liver metastases that underwent surgery and 5-FU and leucovorin for twelve cycles initial had a decrease in his CEA from 90.2 to 67.7, after subsequent liver resection his CEA was 9.8 post surgery. He began receiving weekly 5-FU and Leucovorin again. His first vitamin C infusion was 15 grams over one hour. Between June 1997 and February 1998 his doses were escalated to 100grams twice weekly which seemed to eliminate almost all of his chemotherapy side effects. IV Vitamin C was slowly tapered to 50 grams once monthly. The patient's CEA was kept in range and as of March 1999 (the time of writing) there was no evidence of metastatic disease²².

Breast Cancer: In 1995 a hospitalized 68 year old women with widely metastatic end-stage Breast Cancer was seen. She was placed on intravenous vitamin C, 30 grams per day initially, increasing to 100 grams per day. Within one week, the once bedbound patient began walking the halls of the hospital and was eventually discharged from the hospital. At home she received 100 grams of intravenous vitamin C three times per week. Three months after starting the vitamin C therapy a bone scan revealed resolution of several skull metastases. Unfortunately, six months after starting the vitamin C, she fell while shopping at a mall, and subsequently died of complications from pathological fractures.²²

Pancreatic Cancer: In October 1997, a 70-year-old male with widely metastatic Pancreatic cancer affecting all abdominal organs was started on Gemcitabine and 5-FU and his CA-19-9 continued to elevate until it was 7400U/mL (normal <33). He was started on IV Vitamin C and the dose was escalated to 75 gram infusions bi-weekly. His CA-19-9 serum concentration declined dramatically during this treatment. In April 1998 when he received the results of a CT-Scan of the abdomen/pelvis which showed no change compared to a CT in January (suggests that the intravenous vitamin C was acting as a cytostatic and not a cytotoxic agent in this case)²².

In a different case report,  IV Vitamin C was used as the exclusive treatment and a stage IV Pancreatic ductal adenocarcinoma patient survived nearly 4 years after diagnosis, with IV Vitamin C as his sole treatment, and he achieved objective regression of his disease¹⁸. 

Ovarian Cancer: Case reports in two Ovarian Cancer patients with IV Vitamin C alongside chemotherapy demonstrated long term remissions from combining IV vitamin C with two chemotherapies (carboplatin and paclitaxel); which is typically a malignancy with a poor prognosis⁶. 

Each patient received 60g of vitamin C twice weekly intravenously. Oral anti-oxidant were a part of both patients protocols once they transitioned to IV Vitamin C which is similar to how our Naturopathic doctors administer IV Vitamin C as well at our Edmonton office (dose and frequency). This has been replicated in an animal trial as well¹⁵.

In 2013, five cohorts of three patients received IV Vitamin C for 4 consecutive days per week for 4 weeks, unfortunately, the majority of the patients experienced declination. It is unclear which tumor types were being studied in this trial so it’s hard to comment on the lack of efficacy¹⁶.

Liver Cancer: A case report published in 2015 described a patient having a robust response in Liver cancer to IV Vitamin C which mirrors the case report series discussed above.¹¹

GBM: A case of a woman with glioblastoma who lived for over four years from diagnosis experiencing good quality of life for most of that time. She underwent initial debulking craniotomy, radiotherapy and chemotherapy, as well as having intravenous vitamin C infusions 2–3 times weekly over the four years from diagnosis.

Multiple Cancers with Chemotherapy: A 2015 clinical trial used IV Vitamin C in conjunction with chemotherapy in patients that had a low probability of responding to chemotherapy alone. The best responses were found in a Cervical cancer case in conjunction with Paclitaxel, a Biliary cancer case with oxaliplatin and capecetabine, and a Tonsillary cancer case with Carboplatin and Docetaxel¹²; this mirrors our Naturopathic Doctors' policies regarding combining chemotherapy and IV Vitamin C in our Edmonton patients: Taxanes, Platins and 5-FU derivatives are deemed to be compatible with IV Vitamin C. Lung cancer and Colon cancer showed partial responses when IV Vitamin C was combined with chemotherapy.¹²

Clinical Trials

Lung Cancer: Our Naturopathic Doctors now strongly consider IV Vitamin C therapy combined with Platinum based chemotherapy in Lung Cancer with extremely positive effects from a small 2017 trial: Disease control rate and objective response rate were greatly superior to historical controls¹⁹.

Our Naturopaths also now suggest IV Vitamin C in conjunction with Artemesinin as the latter alone has shown appreciable benefit in a Lung Cancer clinical trial;¹⁰ IV Vitamin C action is potentiated by Artesunate which suggests it may work better in concert with Artesunate. At our Edmonton clinic our Naturopaths work with Artemesinin which is the parent compound of Artesunate. Artemesinin and other Wormwood derivatives are usually dosed away from anti-oxidants and with an oil to improve absorption.

A 2017 trial combined IV Vitamin C and electrohyperthermia in Stage III and IV hyperthermia. The authors did not comment on efficacy but simply mentioned that plasma levels of vitamin C were greatest when the two therapies were applied simultaneously²⁰. Quality of life improved over the four week study period. We do not currently offer Hyperthermia at our Edmonton office. Data does exist for combining Hyperthermia, Ketogenic Diets, Hyperbaric Oxygen and Chemotherapy for various malignancies (see Hyperbaric Oxygen Section).

GBM: A 2017 clinical trial assessing IV Vitamin C in combination with radiation and temozolomide chemotherapy in Glioblastoma multiforme ("GBM" - an aggressive brain cancer). Average overall survival was 21.5 months (median was 18.2 months) versus the historical median of 14 months¹⁹. This study is important as it combines IV-C with radiation with no apparent reduction in efficacy. Furthermore, this demonstrates that IV Vitamin C apparently crosses the blood brain barrier and therefore is a reasonable option for brain metastases. Our Naturopathic Doctors always integrate metabolic approaches (eg. Ketogenic diets and IV Alpha Lipoic Acid) with regards to brain cancers like GBM in our Edmonton patients along with Oxidative treatments like IV Vitamin C. 

Prostate Cancer: A 2017 clinical trial 20 castration resistant prostate cancer patients were evaluated for efficacy of IV Vitamin C after 12 weeks of treatment. The mean baseline PSA level was 43 µg/L. A median increase in PSA was found amongst these patients²¹. For this reason our Naturopaths often start with a metabolic approach versus an oxidative approach (i.e. IV Vitamin C) to prostate cancer as this has demonstrated rapid psa decreases in responders at our Edmonton clinic.

5-FU compatibility with IV Vitamin C

Platin compatibility with IV Vitamin C

Lymphoma: A 2014 Phase I study suggested that IV Vitamin C at doses of 75g can be combined with CHASER chemotherapy regimen (Rituximab, Cyclophosphamide, Cytarabine, Etoposide, Dexamethasone) for Non-Hodgkin Lymphoma.¹³ Our Naturopaths' experience in NHL at our Edmonton office suggests efficacy of high dose IV Vitamin C in conjunction with Low Dose Naltrexone. We've also seen responses in our Edmonton patients using IV Alpha Lipoic Acid in NHL and our experience mirror that of Anderson (2020) which implies a metabolic approach is favorable in Lymphoma²¹. 

Ovarian Cancer: A 2011 clinical trial evaluated the safety of IV Vitamin C combination therapy in patients with stage III or IV ovarian cancer. Twelve patients received standard carboplatin–paclitaxel combination therapy for 6 months, and 13 patients additionally received IV Vitamin C infusions for 12 months. The patients receiving IV Vitamin C experienced a lower incidence of toxicities in most categories compared with those who did not receive ascorbate. Although this study was not powered to test efficacy, the addition of IV VItamin C to chemotherapy showed a trend toward improved survival and delayed disease progression. Based on this trial, as well as the above mentioned case reports, our Naturopaths will often suggest combining IV Vitamin C with carboplatin–paclitaxel in our Edmonton ovarian cancer patients¹⁵. 

Breast Cancer: Another study looked at data from 125 breast cancer (stages IIa to IIIb). A total of 53 of these patients were treated with a modest 7.5g IV Vitamin C in addition to standard therapy for at least 4 weeks and 72 without this additional therapy (control group).

IV Vitamin C administration resulted in a significant reduction of complaints induced by the disease and chemo-/radiotherapy, in particular of nausea, loss of appetite, fatigue, depression, sleep disorders, dizziness and bleeding tendency.

During chemotherapy and radiotherapy, as well as during the aftercare period, the overall intensity of symptoms was reduced by one-third and one-half, respectively. 

The authors concluded "i.v. vitamin C was shown to be a well tolerated optimization of standard tumour-destructive therapies, reducing quality of life-related side-effects." This is interesting as antagonism was not suggested by combining anti-oxidant doses of IVC with radiation²⁹. 

Pancreatic Cancer: A 2012 study combined IV Vitamin C with chemotherapy (Gemcitabine and Erlotinib) in Pancreatic cancer patients which resulted in positive results that are not typically seen due to the chemotherapy alone. This was again confirmed in 2013 where 9 patients received twice weekly IV Vitamin C alongside weekly gemcitabine: 6 of 9 patients maintained or improved their status during the trial¹⁷. IV Vitamin C is a common recommendation we make to our Edmonton Pancreatic cancer patients to be safely done alongside Gemcitabine. However, based on the work of Berkson, there is a strong case to be made for utilizing IV Alpha Lipoic Acid with Pancreatic Cancer. 

Breast Cancer: A 2013 study by Anderson⁸ demonstrated improved survival rates when vitamin C was administered to Stage IV breast cancer patients alongside a wormwood derivative called Artesunate (see Artemesinin page for more detail). For this reason, our Naturopaths frequently consider IV Vitamin C along with Wormwood derivatives in stage IV breast cancer at our Edmonton office. However, since even Anderson's data is not curative, we will add metabolic supports to our breast cancer patients alongside oxidative treatments. 

Gemcitabine and Erlotinib and IV Vitamin C

Artesunate and IV Vitamin C in Stage IV breast cancer

IV Vitamin C update

Bazzan (2018)²⁷: A retrospective chart review of all patients receiving IV Vitamin C for cancer at the Thomas Jefferson University Hospital over a 7-year period was conducted

86 patients who received a total of 3034 doses of IV Vitamin C ranging from 50 to 150g.

32 patients received only ascorbic acid as part of their cancer management (1197 doses),

54 patients received ascorbic acid in conjunction with chemotherapy (1837 doses - which included drugs such as paclitaxel, carboplatin, sorafenib, irinotecan, and gemcitabine). 

Vitamin C Only: 1 - Bladder, 4 - Breast, 5 - Colon, 2 - Endometrial, 1 - CLL, 4- Hepatocellular, 2 - Lung, 2-Lymphoma, 1 - Mesothelioma, 1- Ovarian, 1 - Pancreatic, 1- Penile, 4 - Prostate, 

Vitamin C with Chemotherapy: 6 - Breast, 3 - Colon, 1 - Ewing's, 1 - CLL, 1 - Hepatocellular, 5 - Lung, 1-Lymphoma, 1- Mesothelioma, 3 - Ovarian, 29 - Pancreatic and 1 - Prostate. 

The most common adverse events related to IV Vitamin C were temporary nausea and discomfort at the injection site (reported in less than 3% of the total number of infusions). 

For all patients receiving IV Vitamin C, there was a significant improvement or stability in fatigue, bowel habits, and pain symptoms. A small number of patients with mood disturbances, such as depression, also generally reported improvements in their overall mood. Appetite and weight loss was improved in 15 patients and was not substantially altered in 70 patients. 

Takahashi (2012)³⁰: Data from 60 patients were used for the study. In 57 of the study patients (95.0%), the primary lesions were solid tumors (Lung 14, Breast 8, Stomach 8, Colon 6, Uterus 4, Liver 3, Prostate 3, Ovary 3, Pancreas 2, 2 Malignant lymphoma) 61.7% had advanced cancer with metastatic lesions, of which 12 had postoperative recurrence. Standard therapy was concomitantly administered in 34 patients (56.7% - mostly chemotherapy). 

In the quality of life assessment, the global health status scores showed significant improvement from 44.6 +/- 27.8 before IV Vitamin C therapy to 53.2 +/- 26.5 at 2 weeks and 61.4 +/- 24.3 at 4 weeks of IVC therapy. The functional scale scores also showed significant improvement in all 5 items, i.e., physical, role, emotional, cognitive, and social functioning with fatigue showing the largest improvement. 

At 4 weeks of IV Vitamin C therapy, the median single dose was 50 g and 36 patients (60.0%) received doses ranging from 50 to 65 g, and 21 (35.0%) received doses of 75 g or more. 

IV Vitamin C and hyperbaric oxygen

Our office provides Hyperbaric Oxygen Therapy in Edmonton.

High levels of ascorbate result in lower expression of HIF, which decreases tumor growth and increases sensitivity of cancer cells to the toxic effects of vitamin C²⁷

In "Pharmacological Ascorbic acid and Hyperbaric Oxygen Therapy Target Tumor Cell metabolism via an Oxidative Stress Mechanism" one group conducted experiments with regards to potential synergy between IV Vitamin C and Hyperbaric Oxygen Treatment. 

Using mouse VM-M3 Cells (highly metastatic brain tumor cells) which were treated with a less than cytotoxic concentration of Vitamin C(<0.5mM) and one session of HBOT (100% O2 for 60 minutes at 2.5 ATA). <0.5mM "sub-cytotoxic" doses were used as doses higher than this are already cytotoxic on their own. 

24 hour treatment with Hyperbaric Oxygen and 0.3mM Vitamin C had enhanced cytotoxicity compared to all other treatments. 

The group concluded the cytotoxic oxidative stress mechanism of IV Vitamin C is therapeutically exploited by Hyperbaric Oxygen Therapy.

In the article "Increasing the Effectiveness of Intravenous Vitamin C as an Anticancer Agent³¹" one group has published "We propose the utilization of hyperbaric oxygen immediate­ly after IV vitamin C therapy to increase its effectiveness as an anticancer agent, in order to increase the formation of hydrogen per­oxide, and therefore enhance the anticancer effect of IV vitamin C."

Paul Anderson ND HBOT IVC Protocols³²

The typical protocol is HBOT dive then HDIVC administration.

• Low dose Vitamin C (under 25 grams) pair with HBOT from 1.3 to 2.5 ATA 

• High dose strategies (over 25 grams) should be paired with 1.3 to 1.5 ATA.

IV Vitamin C & HBOT

IV vitamin c dosing

Vitamin C has been administered intravenously in doses as high as 115g per treatment without adverse consequences,²³ and we occasionally administer doses this high at our Edmonton office as well (although this is almost a four hour treatment). However, most common doses we run at our Edmonton office are between 60-80 grams Vitamin C per intravenous treatment mostly commonly run at 0.5g/minute (well tolerated) and should not exceed 1g/minute²⁴. 

A phase I study at McGill University in 24 patients with terminal cancers reported no toxicity 1.5g/kg IV Vitamin C up to three times weekly. 1.5g/kg sustains plasma ascorbic acid concentrations >10 mmol/l for >4 h in patients with normal renal function. Because apoptotic cell death occurs in many cancer cell lines exposed to ascorbate concentrations >5 mmol/l for <1 h, 1.5 g/kg was adopted as the recommend dose for future studies from this study²⁴. Similarly administration of ascorbic acid is known to falsely elevate glucometer readings. 

As with any large volume IV treatment, worsening of baseline ascites or edema or pericardial effusion are considerations²⁷ as IV Vitamin C is often in volumes between 500 and 1000ml with a large sodium load as well as congestive heart failure or severe hypertension. Particular care is taken when patients have preexisting impairment in renal function, which would make them unable to clear a hypertonic fluid load. High-dose IV vitamin C is also contraindicated in patients with renal failure or anuria, chronic hemolysis, severe iron overload, or severe dehydration. 

Our clinic generally uses 1.5g/kg when dosing IV Vitamin C in advanced malignancy for our Edmonton patients. It is also possible to measure blood glucose levels with a glucometer to approximate 400mg/dL levels of Vitamin C as in-vitro data from Riordan suggested this is a cytotoxic plasma dose²². Pharmacokinetic studies have generally observed an elimination half-life of approximately 2 hours,with the implication that glucometer readings could remain abnormal for 6 to 8 hours postinfusion.²⁷

G6PD testing is done as a baseline and monitoring in for all oxidative IV Therapies, IV Vitamin C included but also for IV Hydrogen Peroxide as well which we also perform at our Edmonton office. A G6PD test is needed before we go beyond 20-25grams of IV Vitamin C in a given patient^24,26.

We also measure creatinine in patients prior to receiving IV Vitamin C and periodically monitor kidney function throughout however we have not seen adverse effects even in patients with single functioning Kidneys (no negative effects are mentioned in the literature either). Because ascorbic acid is broken down to oxalic acid, there has been concern that high-dose IV Vitamin C could potentially cause oxalate kidney stones so a history of Kidney stones is considered as part of our screening but this is thought to only be an issue if pre-existing Kidney dysfunction exists²⁷. Screening of electrolytes is also done periodically and our IV Vitamin C formulations have added potassium, magnesium and calcium chloride to account of negative shifts in these electrolytes²⁸. 

Blood tests taken during or shortly after IV administration of vitamin C may yield incorrect readings for glucose, creatinine, cholesterol, triglycerides, total iron-binding capacity, and uric acid³⁵. It has been recommended that patients not have blood tests within 4 hours after receiving IV vitamin C but we usually advise patients to wait until the next day before lab testing.

Glutathione may interfere with some of the anticancer effects of vitamin C.³⁵ Our Naturopaths generally do not administer Glutathione with someone with an active cancer as it is thought to reduce cancer cell susceptibility to oxidative stress. 

IV Vitamin C is titrated upwards (i.e. not starting at the 1.5g/kg dose) in the rare event the patient experiences rapid tumor necrosis or tumor lysis syndrome²⁴. 

In a presentation by Anderson (2019) derived from data from BIORC (Bastyr Integrative Oncology Research Centre) it was found that if a person was taking IV Vitamin C therapy, treatments less than 12-15 IVs was difficult to properly assess a clear outcome. After about 15 "Full Dose" IVs an assessment was able to be made with regards to Regression, Stable disease or Progression²⁶.

So in general, at our Edmonton clinic, we also suggest IV Vitamin C is usually done twice a week for 6-8 weeks and after about 15 - 20 IV treatments if a positive response is seen, it can be done once a week if desired (a slow withdrawal trial is attempted if desired). 

HDIVC oxidative effect sustains between 2 to 12 hours after treatment²⁶ so anti-oxidant treatments are generally not done intravenously on the same day at IV Vitamin C.