CIDPUSA.ORG Autoimmune

UNSICK

The phenomenon of symptoms returning repeatedly if the ascorbate is not continued in high doses is most convincing. It is possible to have symptoms come and go many times. In fact, there is often a feeling when titrating to bowel tolerance that symptoms are beginning to return just before taking the next dose.

Often a patient will sense that he is probably catching some viral disease , flu and that he is in need of large doses of ascorbic acid. If he is experienced in taking ascorbic acid he may be able to suppress more than 90% of the symptoms. He feels that he should take large amounts of ascorbate, does not feel quite right, and may have peculiar mild symptoms. I call this condition UNSICK. Recognition of this state is important because it can be mistaken for more serious conditions.

INTRAVENOUS AND INTRAMUSCULAR ASCORBATE

Symptoms from acute viral diseases can most frequently be more permanently eliminated with intravenous sodium ascorbate. While it is true that tolerance doses of oral ascorbate will usually eliminate complications of acute viral diseases; at times, such as with certain cases of influenza, the large amount of oral ascorbate necessary to suppress symptoms over a period of a week or more, sometimes makes intravenous ascorbate desirable. Clinically large amounts of ascorbate used intravenously are virucidal (2, 5, 7, 8).

The sodium ascorbate used intravenously and intramuscularly must contain no preservatives. Usually there is only a small amount of EDTA in the preparation to chelate trace amounts of copper and iron which might destroy the ascorbate. Solutions containing sodium ascorbate 250 or 500 mgm per cc can be obtained. The 250 mgm solutions may be used in young children intramuscularly in doses usually 350 mgm/kg body weight up to every 2 hours. When the volume of the material becomes too great for intramuscular injections, then the intravenous route should be used. Inadequate doses will be ineffective. Quite frequently a child initially refusing oral ascorbate will cooperate after injections if given the alternative. While this method of persuasion seems cruel, it is better than the complications which might otherwise occur. These intramuscular injections can be used in a crisis situation. Kalokerinos (22) describes cases where certain death in infants already in shock has been averted by emergency intramuscular ascorbate.

For intravenous solutions concentrations of 60 grams per liter are made with the 250 or 500 mgm/cc sodium ascorbate diluted with Ringer's lactate, 1/2N saline, 1N saline, D5W, or distilled water for injection. I prefer the latter, but one has to be absolutely sure that an error is not made and pure water given. Ascorbate is more efficient intravenously than orally probably because chemical processes in the gut destroy a percentage of that orally administered. Doses of 400 to 700 mgm/kg of body weight per 24 hours usually suffice. Rate of infusion and the total amount administered can be determined by making sure that symptoms are suppressed and that the patient not become dehydrated or receive sodium too rapidly. Local soreness in the vein caused by too rapid infusion is relieved by slowing the intravenous infusion. One gram of calcium gluconate should be added to the bottles each day to prevent tetany.

I have not yet seen a case of phlebitis develop as a result of ascorbate administration. This rarity of phlebitis possibly suggests that this condition sometimes has something to do with ascorbate depletion.

Frequently I have the patient take oral doses of ascorbic acid at the same time he is taking intravenous sodium ascorbate. Bowel tolerance is actually increased by concomitant use of intravenous ascorbate. Care and experience is necessary with concomitant use because tolerance drops precipitously when the intravenous infusion is discontinued.

BACTERIAL INFECTIONS

Ascorbic acid should be used with the appropriate antibiotic. The effect of ascorbic acid is synergistic with antibiotics and would appear to broaden the spectrum of antibiotics considerably. I found that penicillin-K orally or penicillin-G intramuscularly used in conjunction with bowel tolerance doses of ascorbic acid would usually treat infections caused by organisms ordinarily requiring ampicillin or other more modern synthetic penicillins. Cephalosporins were used in conjunction with ascorbic acid for staphylococcus infections. The combination of tetracycline and ascorbate was used for nonspecific urethritis; however, patients who had previously repeated recurrences of nonspecific urethritis found they were free of the disease with maintenance doses of ascorbate. I am not sure that the tetracycline was necessary even in the acute cases, but it was used for legal reasons. Some other cases of unknown etiology such as two cases of Reiter's disease and one case of acute anterior uveitis also responded dramatically to ascorbate.

A most important point is that patients with bacterial infections would usually respond rapidly to ascorbic acid plus a basic antibiotic determined by initial clinical impressions. If cultures subsequently proved the selection of antibiotic incorrect, usually the patient was well by that time.