IV ALA & ALA/LDN/HCA Treatment
Metabolic treatment of cancer.
Naturopathic medicine offers numerous metabolic cancer approaches often combining: Alpha Lipoic Acid, Hydroxycitrate, Low Dose Naltrexone, and Hyperbaric Oxygen.
LDN - Naltrexone is approved for the treatment of alcohol addiction as a 50mg per day tablet. The mechanism of action is complete opiate receptor blockade (endorphin receptors) which removes the pleasure sensation derived from drinking alcohol. Low Dose Naltrexone ("LDN") in the range of 3-4.5 mg per day has been shown to have the opposite effect. Low Dose Naltrexone causes brief opiate receptor blockade which upregulates endogenous enkephalins (endorphins) which subsequently bind to OGFr (opioid growth factor receptor)and inhibit cancer cell proliferation (increased methionine-enkephalin)1. Met-enkephalin is involved in regulating cell proliferation and can inhibit cancer cell growth in multiple cell lines. LDN is also said to up-regulate NK-Cell and Cytotoxic T Cell (CD8) and their activity.
Our clinic works with local prescribers to enable access to our patients to LDN.
ALA - Alpha Lipoic Acid is a vigorous free radical scavenger made naturally in the body and it inhibits NF-κB activation that can produce proliferation, angiogenesis, mutagenesis, metastasis. However, it appears to stimulate prooxidant-driven apoptosis (programmed cell death)4. This process is activated by an increased uptake of oxidizable substrates into the mitochondria of cancer cells.
ALA is the necessary cofactor for the pyruvate dehydrogenase enzyme complex (PDHC) converts cytoplasm-generated pyruvate into acetyl CoA, which then enters the Krebs cycle (without ALA there is no energy produced in the mitochondria).
ALA inhibits PDK (pyruvate dehydrogenase kinase) which inhibits PDHC, and by doing so it further increases PDHC activity. Also, ALA is a natural inhibitor of aerobic glycolysis, a common mechanism for energy production in cancer cells. The mechanism is said to mirror the action of DCA (dichloroacetate). This action is thought to be strongly synergistic with Hyperbaric Oxygen therapy.
IV ALA can reach much higher plasma levels than the oral form, with the oral capsules maintaining levels in between IV infusions.
Our clinic uses both oral and IV Alpha Lipoic Acid
HCA – Hydroxycitrate or Hydroxycitric acid, an extract from Garcinia cambogia purported to be of use in weightloss which exhibits complimentary activity to ALA in cancer cells3. Hydroxycitrate can inhibit ATP citrate lyase which produced inhibition of tumor proliferation in vitro and reduced in vivo10
|LDN is made available through referral relationships with prescribing professionals.|
Metabolic treatment of cancer
Questions about ALA and LDN Treatment?
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Case Reports for LDN
2007 Case report, aptly named Reversal of signs and symptoms of a B-cell lymphoma in a patient using only low-dose naltrexone.
Our Naturopaths have followed a long term case of follicular lymphoma at our Edmonton office that did exceedingly well with intravenous Alpha Lipoic Acid and a Ketogenic diet. Hyperbaric treatment was not offered at our office at this time.
Medicor Case Reports1:
A presentation in February 2016 by Akbar Khan MD discussed specific case reports where the results were clearly attributable to LDN:
Small intestine cancer
Bladder cancer X 2
Dr. Bihari case reports6:
In the clinic of Dr Bernard Bihari, in 2002 fourteen cases were chosen by an oncologist from the National Cancer Institute with a clear cut response to LDN:
Lung Cancer x 2
Lymphoma x 3 Cases (2 Non-Hodgkin, and 1 Hodgkin)
Our Naturopathic Doctors consider referral for LDN especially in all these listed cancers. Referral is to local prescribing professionals in Edmonton.
Our clinic offers Edmonton state of the art Hyperbaric chambers. There is reported synergy between Hyperbaric oxygen and other metabolic supports in the context of Alternative Cancer Care.
In part based on "Metabolic Updated Protocol – 2020 Anderson11" an article published by Paul Anderson ND discussing "Metabolic Therapies in Advanced “Salvage” Cancer Cases."
Dr. Anderson discusses the synergy between *DCA, Retinoids, PolyMVA, Alpha Lipoic Acid and Hyperbaric Oxygen Therapy (*note our office does not offer DCA).
PolyMVA is palladium bonded to alpha-lipoic acid (they are irreversibly bound together resulting in a molecule that is both fat and water soluble) with Vitamins B1, B2 and B12, formyl-methionine, N-acetyl cysteine,and trace amounts of molybdenum, rhodium, and ruthenium. It's thought to be a "supercharged" Alpha Lipoic Acid. We've used PolyMVA in our Edmonton office orally, intramuscularly as well as intravenously. It's costly which has primarily limited our use of it in place of Alpha Lipoic Acid and the published data for ALA for cancer care is far more established.
Metabolically speaking, PolyMVA is thought to support the electron transport chain specifically (accept and donate charge) resulting in improve mitochondrial energetics.
Anderson agrees with other Hyperbaric literature we've referenced that "HBOT alone offers limited curative effect and is typically not used as monotherapy," that is, he views it as a synergist with other metabolic therapies.
Benefits were seen in this combined metabolic approach in Lymphoma, Leukemia, Multiple Myeloma and GBM and CLL possibly as well from just oral metabolic therapies and "later additions such as HBOT, Exogenous Ketones etc. have only IMPROVED outcomes." Interestingly, "The ONE main discriminator of success above all others was ability to make the diet changes." Our Naturopaths are strong proponents of Ketogenic diets alongside metabolic therapies as well.
Anderson notes "while nothing certainly works universally in advanced cancer a combined metabolic protocol should be considered as a potential therapy in all cases."
Anderson's Combined Metabolic Oncology Therapy – Protocol:
1. Dietary Intervention
3. Use of intravenous Poly-MVA and DCA
4. Addition of hyperbaric oxygen therapy (HBOT)
Use of concurrent Hyperbaric chamber:
Dive may be increased to 1.5 ATA X 60 minutes.
• With the full protocol above TWO HBOT dives per week are optimal.
The reality of Anderson's Combined Metabolic Oncology Therapy, is that there is strong mechanistic synergy between metabolic treatments like ALA (or PolyMVA) and other metabolic treatments like Hyperbaric Oxygen and Ketogenic diets and substances like DCA.
Hyperbaric Oxygen is a strong driver of oxidative phosphorylation and as noted above, Alpha Lipoic Acid also works to this end as it is a cofactor for the pyruvate dehydrogenase which converts pyruvate into acetyl CoA, which then drives the Krebs cycle.
Other synergistic therapies to Hyperbaric Oxygen and Alpha Lipoic Acid include: B1, Acetyl-L-Carnitine, Niacinamide and Metformin, and possibly CoQ10, PQQ, Solomon's Seal and Quercetin (The Mitochondrial Rescue protocol popularized by Dr. Neil Mckinney).
As discussed in the Hyperbaric Oxygen Section, metabolically supported chemotherapy (MSCT) combines different chemotherapy regimens alongside ketogenic diets and hyperbaric oxygen therapy. It would be expected that other metabolic treatments such as IV ALA would further improve efficacy of MSCT. This is also expected based on the in vivo data presented by Poff and D’Agostino (2013) where Ketogenic diets were strongly synergistic with Hyperbaric Oxygen Treatment and Ketogenic diets.
LDN is extremely well tolerated with some patients reporting vivid dreams which is usually dealt with titrating the dose down. It is also extremely cost effective. There is an incompatibility with opiate pain medications such as morphine and codeine most commonly seen as Dilaudid and Tylenol 2,3 and 4 however combining LDN and opiates can sometimes be achieved if the medications are immediate release preparations and LDN is spaced away.
NSAIDs, Muscle relaxants and topical analgesics are encouraged as well. LDN has a wide range of use and has been studied in Autoimmune Disorders (Crohn’s & MS), Fibromyalgia and Autism.
Metabolic cancer protocols, as with any cancer protocol, do not always work in every case. However, in our 10+ years of Alternative Cancer care we've seen responses more often and more robust with metabolic therapies than with other approaches (oxidative, anti-oxidant). Therefore, our Naturopathic doctors always consider integration of metabolic cancer therapies as part of our protocols for our Edmonton patients.
Based on the available evidence, Alpha Lipoic Acid when given intravenously appears to have a strong effect in particular cases. Based off the experience of Anderson, it appears that IV ALA (and PolyMVA) do in fact synergize with Ketogenic diets and Hyperbaric Oxygen.