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VITAMIN C IN THE TREATMENT OF

ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)

Robert F. Cathcart III, MD

 

Medical Hypotheses,

14(4):423-433, Aug 1984. 

Copyright ©, 1994 and prior years,

Dr. Robert F. Cathcart. Permission granted to distribute via the

internet  as long as material is distributed in its entirity and not

modified.

ABSTRACT

My previous experience with the

utilization of ascorbic acid in the treatment of viral diseases led me

to hypothesize that ascorbate would be of value in the treatment of

AIDS (acquired immune deficiency syndrome). Preliminary clinical

evidence is that massive doses of ascorbate (50-200 grams per 24 hours)

can suppress the symptoms of the disease and can markedly reduce the

tendency for secondary infections. In combination with usual treatments

for the secondary infections, large doses of ascorbate will often

produce a clinical remission which shows every evidence of being

prolonged if treatment is continued. This clinical remission is

achieved despite continuing laboratory evidence of helper T-cell

suppression. There may be a complete or partial destruction of the

helper T-cells during an initial infection that does not necessitate a

continuing toxicity from some source to maintain a permanent or

prolonged helper T-cell suppression. However, it is possible ascorbate

may prevent that destruction if used adequately during that prodrome

period. Emphasis is put upon the recognition and treatment of the

frequent intestinal parasites. Food and chemical sensitivities occur

frequently in the AID syndrome and may aggravate symptoms considered to

be part of the AID syndrome. A topical C-paste has been found very

effective in the treatment of herpes simplex and, to a lesser extent,

in the treatment of some Kaposi's lesions. Increasingly, clinical

research on other methods of treating AIDS is being "contaminated" by

patients taking ascorbate. 

INTRODUCTION

I had previously described that the

amount of ascorbic acid which can be tolerated orally by a patient

without producing diarrhea, increases somewhat proportionately to the

toxicity of his disease (1,2,3,4). Among the roughly 80% of persons who

tolerate ascorbic acid very well, -bowel tolerance- will be reached

when in excess of 10 to 15 grams of ascorbic acid dissolved in water is

taken in 4 to 6 divided doses per 24 hours. The astonishing finding was

that when that same person is acutely ill with a mild cold, that

tolerance may increase to approximately 50 grams per 24 hours. A severe

cold can increase tolerance to 100 grams; an influenza, even up to 150

grams; and mononucleosis or viral pneumonias, to as much as 200 grams

per 24 hours. These higher doses may have to be divided as frequently

as hourly. 

These large amounts of ascorbate are

being drawn off the GI tract at a rate sufficient to prevent

significant amounts from reaching the rectum and producing diarrhea.

Measurements of ascorbate in urine, saliva, or serum indicate that if

sufficient doses of ascorbate are not given when a patient is ill, the

body level of vitamin C drops rapidly. In such a case, there is not

enough vitamin C left in the body, particularly in the cells directly

involved by the disease, to guarantee all the known housekeeping

functions of the vitamin. Those functions known to be dependent on

vitamin C, including several metabolic reactions necessary for proper

functioning of the immune system, are put at risk of malfunctioning. I

call this condition -acute induced scurvy.- 

PREMIERE FREE RADICAL SCAVENGER

 

The reason ascorbate ameliorates so many

conditions is that it functions as the -premiere free radical

scavenger- (5). This function is not because it is the most powerful

free radical scavenger, but because it is possible to saturate every

cell of the body with more molecules of ascorbate than any other free

radical scavenger. The reason that it takes such massive doses for

optimal effect is because high concentrations of ascorbate must be

driven into the cells directly affected by the disease process

sufficient to neutralize all of the free radicals produced by that

process, and have some left over for vitamin C housekeeping functions.

When a disease process involves free radicals, that disease process is

capable of being ameliorated by massive doses of ascorbate. In the case

of many infectious diseases, the relief from free radical suppression

of the immune system, allows for more effective attack on the pathogen

by that immune system. 

-Note: this premiere free radical

scavenger function has little to do with nutrition but is a

pharmacologic effect of ascorbate when utilized in unnatural amounts

for humans.- 

Actually, the complete neutralization

of free radicals requires several steps involving other substances,

e.g. glutathione. However clinically, the most frequent limiting factor

in the reduction of free radicals is ascorbate. In certain conditions

such as chemical allergies, certain other limiting factors may become

critically important, e.g. selenium and glutathione. Some have worried

that a buildup of dehydroascorbate would be toxic in certain of these

conditions. Clinically, this consideration has not created a problem

when very large doses of ascorbate are used. Perhaps it is the high

ratio of ascorbate to dehydroascorbate, I am careful to maintain in

these patients, that protects against any temporarily accumulating

dehydroascorbate. Further, I should like to point out that the

dehydroascorbate formed should not be as toxic as that free radical the

ascorbate reduces as it itself is oxidized into dehydroascorbate. 

 

In a way, it is unfortunate that this

free radical scavenger and vitamin C are the same substance. When

ascorbate is destroyed in the process of destroying free radicals, the

vitamin C stores, particularly in the cells directly involved in the

disease process, are so depleted as to cause disorders of known

housekeeping functions of vitamin C. 

It is certain that AIDS causes this

depletion. The sicker the patient is, the more ascorbate will be

destroyed by the disease process. This depletion certainly contributes

to the terminal events and probably plays a key role in the increased

susceptibility of AIDS patients to various pathogens. 

ASCORBATE VS. AN AIDS SUPPRESSOR

FACTOR

A recent article describes the discovery

of a -suppressor factor- in AIDS patients. This suppressor factor was

found to be neutralized in the test tube by concentrations of ascorbate

equivalent to that which would be achieved in a man who ingested 10 to

20 grams of ascorbate a day. It was thought that this amount was -"far

too toxic"- to use in humans and that a less toxic antioxidant should

be found (6). 

-Actually, 10 to 20 grams/24 hours of

ascorbate is easily tolerated and is not toxic-

(1,2,3,4,7,8,9,10,11,12,13,14). Unfortunately, clinically I have shown

that the AIDS disease process destroys even larger amounts of ascorbate

than the 10 to 20 grams because bowel tolerance is regularly increased

to the range of from 40 to 185 grams of C per 24 hours in the patient

who has moderate Kaposi's lesions and/or moderate lymphadenopathy.

-Therefore, the 10 to 20 gram equivalent of ascorbate in the test tube

will not be adequate in vivo-. 

PRELIMINARY STUDY

Because of the hypothesis that AIDS

patients would benefit from large doses of ascorbate, I began the

actual treatment of AIDS patients and have found that ascorbate is

indeed very valuable when used in conjunction with certain conventional

treatments. 

The following preliminary

recommendations are based partly upon an anecdotal group of

approximately 90 AIDS patients who sought medical care from physicians

but who also took high doses of ascorbate on their own. Additionally,

it is based upon 12 of my AIDS patients, 6 of whom were given

intravenous ascorbate for a short period of time. Most of these

patients have had considerable improvement in their condition. This

improvement seems somewhat proportional to the amount of ascorbate

taken by the patient relative to the severity of his disease. If the

patient tolerates enough ascorbate to "neutralize the toxicity" of his

disease and if the secondary infections are treated; his condition will

go into remission. Subjectively, symptoms decrease and increase

inversely with how closely the patient titrates to bowel tolerance. 

 

The only death has been in a patient

who had previously chemotherapy, interferon, and total body Xray

therapy. Additionally, his veins were so destroyed by previous

treatments that intravenous vitamin C therapy could not be continued

under the existing circumstances. 

Such a preliminary report of

recommendations is justified only because of the urgency of the problem

addressed and because in San Francisco and now New York, news of the

ascorbate treatment is spreading rapidly. Ascorbate is being used by an

increasing percentage of the AIDS patient population but without much

guidance. There have been many requests by physicians for the treatment

protocol. 

ASCORBATE TREATMENT PROTOCOL FOR AIDS

PATIENTS

The following protocol is recommended

for AIDS and AIDS related conditions including lymphadenopathy,

idiopathic thrombo- cytopenia purpura, and Pneumocystis carinii

pneumonia. 

As predicted, AIDS patients are

usually capable of ingesting large doses of ascorbate. It is desirable

that the amount of ascorbate taken orally be maximized. Patients are

-titrated to bowel tolerance- (the amount that almost, but not quite,

causes diarrhea). A -balanced ascorbate- mixture is utilized which is

made up of a mixture of approximately 25% buffered ascorbate salts

(calcium, magnesium, and potassium ascorbate) and 75% ascorbic acid.

This mixture is dissolved in a small amount of water and taken at least

every hour. The purpose of the frequent doses and this balanced mixture

is to maximize the amount of ascorbate tolerated without producing

diarrhea. Patients are permitted to vary the percentage of ascorbate

salts to straight ascorbic acid according to taste. The usual amount

tolerated initially is between 40 and 100 grams per 24 hours. -Doses in

excess of 100 grams per 24 hours may be necessary with secondary

bacterial and viral infections-. As the patient's condition improves,

bowel tolerance will decrease. 

When intravenous ascorbate is found

necessary because the toxicity of the condition exceeds the ability of

the patient to take adequate amounts of ascorbate to scavenge all of

the free radicals created by the primary AIDS infection and the various

secondary infections, the following intravenous solutions should be

utilized. Sodium ascorbate buffered to a pH 7.4 and without

preservatives is added to sterile water in a concentration of 60 grams

per 500 cc. This concentration is twice the concentration I have

recommended before because it is well tolerated in young males with

large veins. Patients with small veins may be best treated with

solutions of 60 grams per liter. The time of the infusions should be

over at least a 3 hour period, preferably longer. As much as daily

administration of 3 bottles, 180 grams per 24 hours, may be necessary

in acutely ill patients, e.g. Pneumocystis carinii pneumonia,

disseminated herpes, disseminated cytomegalovirus, and atypical

pneumonia. Enough ascorbate should be administered to detoxify the

patient regardless of the amount needed. Additionally, oral doses of

ascorbate should be taken simultaneously with the intravenous

ascorbate. -Do not let the patients become lazy and discontinue bowel

tolerance doses of ascorbate while the intravenous ascorbate is being

administered-. 

INTESTINAL PARASITES

If the AIDS patient has intestinal

parasites, he must be treated for them. There is a very high percentage

of male homo- sexuals infected with intestinal parasites. These

intestinal parasites are themselves very immunosuppressive. The

prognosis for an AIDS patient is greatly enhanced by proper treatment

of these parasites. -Entamoeba histolytica-, especially, and -Giardia

lamblia- must be treated. Intestinal parasites, ordinarily considered

-non-pathogens-, should be treated. If negative, repeated stool

examinations for ova and parasites should be taken if there is the

slightest clinical sign of intestinal parasite infection. Samples

should be fresh, not over 2 hours old. Laxatives may increase chances

of discovering the parasites. Additional samples may have to be taken

through a sigmoidoscope if other specimens are negative for ova and

parasites. With treatment, Herxheimer's reactions should be expected

frequently. Symptoms, including Kaposi's lesions, may be exacerbated,

despite the ascorbate, during treatment for intestinal parasites. 

 

CANDIDA ALBICANS

Candida should be sought and treated. It

should be emphasized to patients that they owe it to themselves and

society to treat the Candida consistently because of the possibility of

breeding resistant strains. The possibility of candida in the gut,

esophagus, mouth, sinuses, skin, etc. should be considered. In patients

who clinically appear to have Candida but in whom Candida cannot be

cultured, sensitivities to Candida should be suspected and treatment of

especially the bowel should be considered. Herxheimer's reactions, when

antibiotics against Candida are employed, should be considered one

indication that Candida is a problem. In these sensitive patients,

foods and vitamins containing yeasts should be avoided. Lactobacillus

in large amounts should be fed to these patients in an attempt to

normalize bowel flora. Sugar and refined carbohydrates should be

avoided because Candida thrives on them. 

There is a high incidence of food and

chemical sensitivities associated with Candida sensitivities (15,16,17)

and Candida must be suspected whenever such sensitivities are

discovered.