Vitamin C for Cancer Treatment with Professor Margreet Vissers

The battle against cancer has been ongoing for hundreds of years now. But recently, interest in using vitamin C to improve outcomes for cancer patients has been growing. And the results of these various studies look promising.

Biochemist and medical researcher Professor Margreet Vissers joins us in this episode to explain her current research on vitamin C and how it helps the immune system fight cancer. She also talks about the other health benefits of vitamin C, as well as some of its limitations.

Is vitamin C the cancer treatment we’ve been looking for all along? Tune in to find out. 

 

Here are three reasons why you should listen to the full episode:

1. You will learn about vitamin C’s role in controlling tumours.
2. Discover how humans metabolise vitamin C differently from other animals.
3. Know how intravenous vitamin C turned around a leukaemia patient’s relapse.

 

Resources

• Watch Professor Margreet Vissers' lecture on her work on vitamin C.
• “The power of C” on University of Otago Magazine
• Das, A. B., Kakadia, P. M., Wojcik, D., Pemberton, L., Browett, P. J., Bohlander, S. K., & Vissers, M. C. M. (2019). Clinical remission following ascorbate treatment in a case of acute myeloid leukemia with mutations in TET2 and WT1. Blood Cancer Journal, 9, 82. doi: 10.1038/s41408-019-0242-4
• Vissers, M. C. M., & Das, A. B. (2018). Potential mechanisms of action for vitamin C in cancer: Reviewing the evidence. Frontiers in Physiology, 9, 809. doi: 10.3389/fphys.2018.00809
• Ang, A., Pullar, J. M., Currie, M. J., & Vissers, M. C. M. (2018). Vitamin C and immune cell function in inflammation and cancer. Biochemical Society Transactions, 46, 1147–1159. doi: 10.1042/bst20180169
• Carr, A. C., Vissers, M. C. M., & Cook, J. S. (2015). Parenteral vitamin C relieves chronic fatigue and pain in a patient with rheumatoid arthritis and mononeuritis multiplex secondary to CNS vasculitis. Case Reports in Clinical Pathology, 2(2), 57–61. doi: 10.5430/crcp.v2n2p57
• Dachs, G. U., Munn, D. G., Carr, A. C., Vissers, M. C. M., & Robinson, B. A. (2014). Consumption of vitamin C is below recommended daily intake in many cancer patients and healthy volunteers in Christchurch. New Zealand Medical Journal, 127(1390). Retrieved from https://www.nzma.org.nz/journal
• Carr, A. C., Vissers, M. C. M., & Cook, J. (2014). Parenteral vitamin C for palliative care of terminal cancer patients. New Zealand Medical Journal, 127(1396). Retrieved from http://www.nzma.org.nz/journal
• Carr, A. C., Vissers, M. C. M., & Cook, J. (2014). Relief from cancer chemotherapy side effects with pharmacologic vitamin C. New Zealand Medical Journal, 127(1388). Retrieved from http://www.nzma.org.nz/journal
• Pullar, J. M., Carr, A. C., & Vissers, M. C. M. (2013). Vitamin C supplementation and kidney stone risk. New Zealand Medical Journal, 126(1384). Retrieved from http://www.nzma.org.nz/journal
• Carr, A. C., Pullar, J. M., & Vissers, M. C. M. (2013). Beating the blues: The association between fruit and vegetable intake and improved mood. New Zealand Medical Journal, 126(1384). Retrieved from http://www.nzma.org.nz/journal
• Carr, A. C., Vissers, M. C. M., Lewis, J., & Elder, P. (2012). Multiple nutrient insufficiencies: Hypovitaminosis D and C in young adult New Zealand males. New Zealand Medical Journal, 125(1364). Retrieved from http://www.nzma.org.nz/journal
• Carr, A. C., & Vissers, M. C. M. (2012). Good nutrition matters: Hypovitaminosis C associated with depressed mood and poor wound healing. New Zealand Medical Journal, 125(1362). Retrieved from http://www.nzma.org.nz/journal

 

Episode Highlights [04:50] Vitamin C and White Blood Cells

• After killing bacteria, white blood cells destroy themselves so that the toxicity doesn’t spill into tissues.
• Vitamin C plays a role in regulating the cell death pathway.
• Margreet observed that white blood cells low in vitamin C did not go to resolve the end of the infection.

[07:15] How Neutrophil Extracellular Traps (NETs) Work

• NETs are a variation of vitamin C’s mechanism.
• Neutrophils are cells attracted to infection and eat hundreds of bacteria. They have oxidants that kill bacteria.
• Neutrophils eject ‘niche’ or the DNA package inside them. The niche has microbicidal proteins. The niche forms ‘traps’ that localise bacteria on the site of infection.

[13:18] Vitamin C Production in Animals

• All animals make their vitamin C mostly in the liver; some produce the vitamin in the kidney. Animals that can make vitamin C do it on demand. They can increase production a hundred times to keep blood levels saturated.
• Humans lost the gene to make vitamin C; thus, we are dependent on food for supply. When we are sick or infected, our body consumes vitamin C fast. If we do not replenish our vitamin C, our body levels will decline.

[16:35] Route of Vitamin C Administration

• Plasma vitamin C levels go up to a maximum level of 100 micromolars.
• Kidneys filter and regulate vitamin C. Saturated tissues will not absorb any more vitamin C; the excess will be released in the urine.
• Oral intake is suitable for day to day intake while people with severe illnesses will need infusion.
• Vitamin C infusion results in high plasma levels for a short period. Any excess will pass, and the plasma levels will be back to normal in 8 or 9 hours.

[22:01] Function of Vitamin C

• The enzyme needed to produce collagen needs vitamin C; thus, the vitamin is good for the skin.
• It plays various roles in inflammation, wound healing, controlling infection, and even brain function.
• Vitamin C regulates gene expression.
• Vitamin C supports the production of serotonin, as well as other hormones that regulate mood and reproduction.

[27:48] What Vitamin C Dosages Do We Need?

• The Ministry of Health recommends 200 milligrammes a day for wellness.
• Foods high in vitamin C, such as kiwi fruit, capsicum, and broccoli, are recommended. But only a few people eat a good range of fresh fruit and vegetables.
• Margreet says if the aim of vitamin C intake is to alleviate illness, it is usually not achievable through our daily diet.
• Each condition requires a different recommended intake.

[34:17] The Role of HIF Protein in Cancer

• Hypoxia-inducible factor (HIF) is a transcription factor protein that switches genes on and off.
• HIF is present in all cells at all times and responds to low levels of oxygen.
• Under low oxygen levels, areas with poor blood vessels are provided with oxygen by generating new blood vessels.
• Cancer cells hijack this mechanism to have their supply of blood vessels, making the cells grow more.
• Hijacking the HIF protein also results in switching the cancer’s energy source to sugar.

[39:06] The Role of Vitamin C in Cancer

• The HIF proteins need to be shut off to prevent cancer from worsening.
• Enzymes that need vitamin C can switch off HIF proteins that need to be shut down, slowing down the tumour’s growth rate.
• Though it is tough to prove preventive action, many cancer rates have significantly decreased to half when vitamin C status is good.
• To maintain your well-being, keep vitamin C levels at optimum levels.

[45:07] Does Vitamin C Pose Any Risk?

• Vitamin C’s oxidation products need to be cleared out of the body.
• No toxic dose has been identified, provided you have good kidney function.
• There is no actual risk of kidney stone formation and kidney injury.
• People getting an infusion must be tested for kidney function.

[49:10] IV vs Oral Vitamin C Administration for Cancer

• Any amount of oral vitamin C has not shown potential to benefit solid tumours.
• Infusion is more advantageous than oral administration because it gets vitamin C to the core of the cancer to switch HIF protein off.
• Margreet shares the story of Anton Kuria, a previous leukaemia patient on IV vitamin C who experienced remission for two years.
• Vitamin C restored the normal functioning of the cells and wiped out most of the cancer cells.
• He relapsed not because he stopped vitamin C but because the cancer cells acquired new mutations.

[59:30] How Vitamin C Contributes to Quality of Life

• Vitamin C regulates adrenaline and boosts energy because it is key to making molecules that help energy production.
• It also alleviates the side effects of chemotherapy.
• Vitamin C also improves brain fog, concentration, mood, pain, nausea and fatigue.
• It does not interfere with other cancer treatments.

[1:06:02] Applications in the Clinical Setting

• Vitamin C is probably not going to kill cancer, but it can control it.
• Vitamin C gives an insight on how to manage the disease in the clinic.
• The excellent response to vitamin C is an opportunity to make it work better with other treatments.
• There will almost certainly be a quality of life benefit. It can alleviate the side effects of cancer and the disease itself.
• The beneficial effects manifest, so it is worth doing.

[1:16:56] What Needs to Be Done?

• We need to figure out how to apply vitamin C clinically and under specific circumstances.
• Give people the best information so that they can make the right choices.
• With better information, clinicians can also make informed choices for the benefit of their patients.

 

7 Powerful Quotes from This Episode

‘All of these things that cancers do to promote their survival is mediated by this response, and right at the center of this is the vitamin C off switch’.

‘Vitamin C is a very labile molecule, so very easily lost. And if you're not putting in more supply, then your body level is going to drop’.

‘If there's any wealthy people sitting out there, if you want to support this sort of research — it is absolutely essential because we're losing people left, right and center to these horrible diseases like cancer, like sepsis’.

‘I'm excited about this research, I really am, because it's going to save lives’.

‘That's why we try to do the research — because doctors have the patient's best interests at heart’.

‘Our clinical people, they’re at the coalface, and they're having to make life and choice decisions for their patients all the time’.

‘Many cancer rates significantly decreased by up to half for a number of cancers if your vitamin C status is good rather than bad’.

 

About Professor Vissers

Professor Margreet Vissers is a biochemistry academic from Waikato University and is currently the Principal Investigator and Associate Dean (Research) at the University of Otago in Christchurch, New Zealand. She has written and published journals and books about how vitamin C can help cure and prevent cancer.

If you want to learn more about oxidative medicine from Professor Vissers, you may contact her at margreet.vissers@otago.ac.nz.

 

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To pushing the limits,

Lisa

 

Welcome to Pushing the Limits, the show that helps you reach your full potential with your host Lisa Tamati, brought to you by lisatamati.com.

 

Lisa Tamati: Welcome everybody back to Pushing The Limits. This week I have Professor Margreet Vissers with me who is sitting in Christchurch. Now Professor Vissers, I'm just super excited. I'm a little bit nervous and excited to be talking to you today. Margreet, so can you tell us firstly, what your background is? Give us a little bit of context. You have a PhD done, free radical research and oxidant research from what I understand, and now you are very much deep into vitamin C research. Can you give us a bit of your background first?

Professor Margreet Vissers: Okay, yeah, yeah. Morena, Lisa. it's lovely to chat with you. I've trained originally as a biochemist. So when I was at Waikato University, I had this lecturer who kind of got me excited about biochemistry, it was a new thing at that time. And so I continued, that's become my passion, just understanding how things work in our bodies. So, I became interested in white blood cells. When I was doing my PhD, my PhD was on white blood cells that fight infections. 

And something we know about white blood cells is that they need a lot of vitamin C. They have a lot of vitamin C and we never knew why. So, all our white blood cells have a lot of vitamin C. So, there was always this question as to why do they need that. And that kind of percolated away in the background while we were researching other things. And then one day, these experiments where you added vitamin C and to kind of knock out any oxidant fixed because it's a well-known antioxidant. And it has this remarkable effects on the cells that I was working with which was the complete opposite of what I had expected. And when this happens in the lab, you usually think, ‘Are my samples in the wrong way’? I've got the best hunches. 

So instead of acting as an antioxidant, it seemed to be enabling cell death. And which was like really paradoxical. And, and so we did it again. And you know, same thing happened again. And not only was it a really strong effect, which antioxidants usually are, they're usually more graded. It was also an on-off event. So, if there was no vitamin C, it didn't happen. And if there was just a bit, it happened really well. 

And so we're looking for another activity. This is not an antioxidant, actually. We're looking for a different kind of function. And so this was in about 2001. And at the same time—so that wasn't work with white blood cells, that I was doing that, and that was a cancer work. 

And so, around about the same time, there was a discovery made overseas about this new class of enzymes that regulates hypoxia, the hypoxic responses, survival response, and that those enzymes require vitamin C to function. And I realized that what I’d—because I've been gone on thinking, ‘If it causes cells to die. Maybe it does this in white blood cells because that's the one thing that we need our white blood cells to do’. Apart from kill bacteria, we then need them to die themselves off.

Lisa: Yes.

Prof. Margreet: And to die tidally. Without, we need them to devastate the tissues around. It's a very controlled process. And I thought, ‘Maybe that's what vitamin C is doing in the cell. That it’s regulating the cell death pathway’. And so I did these experiments with white blood cells that didn't have any vitamin C and essentially showed that exactly to be true. That if white blood cells were low in vitamin C, they did not go on to resolve this what would be the end of an infection. So…

Lisa: So they wouldn't end up...

Prof. Margreet: They would end up. So, normally you have your white blood cells that kill the bacteria. They then destroy themselves in that process, because it's an endpoint reaction, and we need to clear those white cells. And so you need to clear them. They're full of all kinds of toxic things. You need to clear them in a way that doesn't spill all that toxicity into the tissues. Other white blood cells come along and eat those white blood cells. So they—it's like wrapping your garbage. 

So that if they didn't have vitamin C, that didn't happen. So, the other white blood cells would come in, but they basically couldn't see those other cells around them. And so they get the cell death and cell leakage. And I thought, ‘Ah, so scary. There's all kinds of things that happen when you're low in vitamin C’. And so this, and then I realized also that actually, this factor that controls this process, is also the thing that allows cancer cells to grow. And, and so this is a normal response in ourselves, and we need it for survival. You know, I swear, every day survival is dependent on this process working well. 

Cancer cells hijack the system to enable them to survive. And so, that means that it allows them to grow outside of an oxygen supply to make new blood vessels, to create a different energy source, so they can live on sugar instead of a more complex energy. It enables them to evade chemotherapy and enables them to undergo metastasis. All of these things that cancers do to promote their survival is mediated by this response, and right at the center of this is vitamin C off switch.

Lisa: Code that. So can we just pick up just a tad there. So, I've listened to a lecture by Dr. Berry Fowler that we mentioned earlier, talking about NETs, Neutrophil Extracellular Traps. So, is that what we're talking about here? So the neutrophils are coming along, eating the bugs? 

Prof. Margreet: That's a variation on that thing. So yes, neutrophils are astounding cells. And so, their function is to kill bacteria. The primary way that they do that—so they are attracted to any place where there's an infection. The primary way that they act is to first of all, eat the bacterium so that one neutrophil can swallow hundreds of bacteria. And then inside that pocket inside themselves, they pour onto those bugs within minutes, toxic enzymes and oxidants, including chlorine bleach that kills the bug. 

So, what they also do is they can inject from themselves, from the cell, they can inject their DNA. They can kind of melt the nucleus inside the cell with the DNA package. They can unpackage that, and then they can inject that from the cells, and that's what we call a niche. And that niche is coated with some of those microbicidal proteins. DNA is, as you might have seen pictures of it, that's a really sticky line…

Lisa: Yes, like egg white.

Prof. Margreet: …molecule. And so that can basically go a long way, and it doesn't degrade very easily. So, your body doesn't have a lot of DNAs floating around that can chew up DNA. So, these traps can sit there and they trap the back. They literally physically trap the bacteria onto the site of the infection. So, that can basically help localize that infection so that it's not traveling to other parts of the body.

Lisa: Does it even cause things like, if this infection was, say in the lungs, you'd get whiteout and that's the whiteout. Actually, what you're saying…

Prof. Margreeet: The whiteout in the lungs is either lots of neutrophils, just a lot of neutrophils, or a lot of fluid. Where we're seeing new neutrophil NETs, or their traps, and in the lungs as in COVID patients. So, there are these peculiar things going on in the lungs of COVID patients, where they're seeing quite localized and didn't wash out. So, not the kind of diffused whiteout that you see in a pneumonia, someone with respiratory distress, but very localized pockets. And we think that looking like, as all this information’s unfolding pretty much as we speak. It looks like neutrophil NETs central to that process that enhances that cytokine storm in COVID patients who end up with severe disease. So currently, the literature is jumping with…

Lisa: With vitamin C, and what would be helpful or not in the COVID scenario? No one's know it yet?

Prof. Margreet: No, it's not jumping with vitamin C and COVID. The Chinese, interestingly, published protocols for how to handle COVID patients. And they have they recommend, as soon as the patient comes into, into the hospital, should be giving them intravenous vitamin Cl to keep them out of ICU. And, or as soon as they get into ICU, to prevent them progressing. They've got very careful protocols about… Actually, their protocols say that helps. This is definitely a helpful step. We haven't taken that up, the rest of the world, despite some people advocating for it.

Lisa: So why would that be? Is it because… or we don't want to go into that? 

Prof. Margreet: That's a very good question. I've struggled with answering that question we come up against it all the time. That people will give vitamin D before they get vitamin C. Even though people have been—we've shown that patients who are really ill, have low vitamin C, unless you give them more. 

Lisa: So, the sicker we get, the more vitamin C—and I've seen some of your lectures where you've shown graphs of people coming into hospital, and then the levels of plasma vitamin C are very low compared to the generally well, population. And I know from other research that I've done too, in this case, like my father's with sepsis. He would have been probably at the level of scurvy. I can't show that because they couldn't explore it, and would have been needing massive dosages of vitamin C. So the sicker we are… so, this is what's funny people is that animals produce their own vitamin C. The goat is the king of vitamin C making. I believe from Linus Pauling’s work. And the goat can produce up to 70 grams a day of vitamin C. We don't

Prof. Margreet: So yes. All animals bear a few, make their own vitamin C in the liver, and some animals in the kidneys. There's a few miscellaneous animals, including all primates, of which we have one—so, chimpanzees and gorillas and monkeys in us, who way back, lost the gene to make it. And so we're dependent on eating it. Guinea pigs similar, and fruit bats are the other most common species. 

So, we're dependent on eating it for our supply. Now, all animals that make their own, make it according to demand. So, they keep their blood level saturated, no matter what. So if they get sick, and their body starting to consume more, their liver makes more. And so they just keep themselves saturated. And they can increase production up to 100 times, in order to maintain that level. So we can't do that. So we're totally dependent on what we put in our mouth. 

And so, once we get sick, and our bodies consuming more, if we're not compensating for that, then our body levels will decline. So it's totally about supply and demand. So, when you're normally well, your body's just ticking over a little bit. A good diet is good to keep you optimal under those circumstances. You get a cold, you're consuming a little bit more. Now most people, when they get a cold, they run off and get some citrus or something because that's what that feels like eating them naturally. If you get a flu, that demand goes out even more. If you get pneumonia, it goes up even more. And so the sicker you are, the more vitamin C your body's consuming. Not all. Some illnesses are more oxidative than others. 

But any infection, like the minute you ramp that up, and that can be like a local infection. It can be burn infection. So it doesn't have to be like a whole body infection. We just recently did this—have been doing a study with people with chronic wounds like leg ulcers, and most of those people have low vitamin C status. And that won't be helping the wound. So as soon as your body has a demand to put on it, vitamin C is a very labile molecule, so very easily lost. And if you're not putting in more supply, then your body level is going to drop.

Lisa: And then we're also limited out with the oral administration of vitamin C. Our bowels can only tolerate, before we get diarrhea, or something like that. So if our power intake to the levels that we might need if we were severely ill, we wouldn't get up—because our plasma levels only go to 100 micromolar from what I understand. We can't actually get higher than that from all dosing.

Prof. Margreet: Oh well, only a little bit transiently. So, if you wouldn't take a one gram tablet, your plasma level would go up to above 100 for a little while. So maybe that might get up to 150. But your kidneys will clear that. And so I always kind of give the analogy of a dry sponge. So if you imagine that you're pouring water on a dry sponge, that your body is... Your blood is only the delivery mechanism, so vitamin C is going to get from your blood into the cells. If your blood levels are low, your tissue levels will be low. So that's a dry sponge. 

So if you pour more vitamin C onto there, it will go into circulation. But as soon as it's in the blood supply, it will be sucked out into those tissues. So your kidneys will never see that above 100 micromolar. Once your tissues are saturated, so the whole sponges which you might, if you pour more on and then you touch, and then your blood supply goes up over 100, stays over 100 because your tissues are not taking up any more than they need. Then there's a filter in the kidneys that regulates that all vitamin C passes out, and then it's like, ‘How much is in the bloodstream’? ‘Do I need any more’? ‘And then I'll take it back up’. So it gets taken back up or not. And if the body's got enough, then no more be taken up and end up down the toilet which is fine.

Lisa: Yes, it's not going to hurt you. But if so, then intravenous vitamin C has a different mechanism though, isn't it? We can get the micromotors up quite high.

Prof. Margreet: Intravenous delivery is such fast, express delivery. And so it's to be what—it can do two things. What we think, it can be useful in under two circumstances. So normally for your day to day health, oral intake, this is ample. If you are really—a lot people in ICU, or who are people with severe pneumonia who are turning over vitamin C at a great rate, it's really hard to get like you might need to give those people seven or eight grams of vitamin C a day, in order to restore, get their plasma level sit close to normal. So it's hard to give that amount of oral intake to people who are that sick. 

And so under those circumstances, the easiest thing to do is just to inject that, and that's what we call infusion. So then you bypass the gut, you can just infuse it straight into the circulation. And the rate of infusion determines that that plasma level will be very high for a very short time, then it will go out into the body where it needs to be. And any excess will pass out. And then urine. So after about eight or nine hours, you're back to normal. But your tissues, your sponges.

Lisa: Yes, so that they are in what they need. The vitamin C that's actually in the cell will stay around longer than, won't it? And do its actual job, if it's in the mix.

Prof. Margreet: It's doing its job, that’s right. So those cells that had become depleted and now have a function restored. And what we've discovered is, it's not just one function anymore. So in the last 10 years, vitamin C has been shown to be involved in supporting... So initially there—everyone will know about... Walk into any chemist and you'll see vitamin C creams for sale, cosmetics. Rub it on your face, or whatever. But because we all believe that vitamin C is good for our skin. And it is good for your skin, actually. It's really good for your skin. But getting a few rubber done, it doesn't actually get into your skin when you rub it on.

 

Lisa: Right. Don't waste your money on expensive cream.

Prof. Margreets: We know that... That's right. We know that it makes collagen juicy. So the enzyme that makes collagen, that needs vitamin C to work, was the first member of a family. Of about at the moment, there's about 60 members of this family. So, and apart from making collagen, they do all kinds of other things. So including regulate all about gene expression. So what we've discovered is that, it's really important to support enzymes that determine how your cell function changes. So…

Lisa: It reads the DNA so to speak. So this enzyme, one of these enzymes..

Prof. Margreet: These enzymes apply or remove marks from the DNA that say, ‘Read this gene, or don't read this gene’. And that's changing all the time. As cells respond to different stresses in different scenarios, and go through different growth phases. And vitamin C turns out, is absolutely critical for that process to be working well. And so you know, sort of…

Lisa: This kind of fit everything in the body. Pretty much like every single cell in your body.

Prof. Margreet: To greater and lesser extent.  And so that said, that's at the most fundamental level. It seems that that process is actually quite extraordinarily sensitive to changes in Vitamin C. So, I kind of make the analogy, about a car running, when running on three cylinders, or two cylinders, instead of four cylinders. Yeah, you can still get it to go along the road. But, you know you're not getting the best ride…

Lisa: Not the best of your motor.

Prof. Margreet: ...that you might get. And so you know, it is we're discovering so many things, so many fundamental processes that require vitamin C to work optimally. And also that they are responsive to small changes— relatively small changes in vitamin C status. So there are mood enhancing enzymes that do the same thing. We've just published a study with students from Otago, who are all extremely well. Probably one of the wealthiest populations we've ever studied but they don't eat well. When we gave them kiwi fruit today, it just brought their vitamin C levels up. They felt well, then they’re already well. 

Lisa: They're already healthy. They don't have...

Prof. Margreet: They are surely well. So, they were—and even not at the extremes of deficiency. So it's like you can… we should be where animals are—optimal all the time.

The dialogue around vitamin C for decades and decades was about avoiding deficiency. The only thing that became a problem was when you had scurvy, and were dying, and anything else was fine. And so what we're discovering now is that—it’s not fine. You need to be the best you can be in order to avoid all kinds of scenarios. So it's…

Lisa: It's about optimizing…

Prof. Margreet: Probably the most, of all the vitamins that we've—well actually, vitamin B6 has a very fundamental… But probably the most diverse in that section of all the vitamins. So it's doing many things, in many places that affects an awful lot of functions.

Lisa: So we're talking like inflammation, wound healing, infectious states, and controlling infection. We're talking about skin collagen production...

Prof. Margreet: Absolutely, our brain is loaded with vitamin C.

Lisa: Well, it is one of the biggest users of the vitamin C.

Prof. Margreet: Yes, yes. So it's… Our brain is very hungry for vitamin C. So it's near for many reasons, including the support of molecule size serotonin, which is like your feel good moods. The production of other hormones that regulate mood reproduction. 

Lisa: Yes. Yes. Yes. 

Prof. Margreet: The list goes on and on.

Lisa: My mind just goes wow. This could help with things like brain injuries, which I'm heavily into helping...

Prof. Margreet: Yes, absolutely. Absolutely.

Lisa: And RDA is one of the lowest in the world, isn't it? It is 45, I think milligrams or something ridiculous. That is not okay. Why can't we get this changed? You know we need 200 to 500 at least, don't we?

Prof. Margreet: Yeah, there is a recommendation from the Ministry of Health that 200 milligrams a day as the recommended target for wellness. But RDAs are a confusing measure because they're actually the number at which 90% of people will avoid deficiency. So which is, right at the bottom, what do we need, in order to not die, basically? And so that message gets a little bit confused with, ‘This is how much we need, total’. And so 45 milligrams a day is, most countries around the world have up to the limit to at least double federal muster around 100, which is still in the minimum. But we just want bet our aims to get the New Zealand RDA… 

Lisa: So maybe say one of your cats in a… I think it was work by Dr. Levine or [29:00] Maggie’s showing the rates from the 45 milligrams type thing up to 2.5 grams a day. It was a steep curve. Well, 50 milligrams in 500, where you get a huge benefit and then, even if you wanted to optimize, you could go even up to two and a half. 

And of course then if you have one, oh no some horrible disease, or you have a lot of stress, or you have cognitive issues, or you have sepsis, or you have pneumonia, and then you may need like up to I don't know how many times. And that's one of the questions, isn't it? That you are trying to elucidate is that, ‘What are the dosages that we need’? 

Prof. Margreet: That’s right, and I think we were hoping to hit, as instead of seating a whole new RDA for everything, is to have a recommended intake for different conditions. 

Lisa: Absolutely.

Prof. Margreet: So that you'd know if you hit a few, or if you do have a medical challenge of some sort. They use vitamin C infusions for burns patients.

Lisa: Yes.

Prof. Margreet: Because we know that burns patients chew through vitamin C. So that kind of massive inflammatory response does require your body who needs to be given a lot more vitamin C. So there is your, I can recommend it to intake for burns patients. 

Well, if we knew that, when you have the flu, ‘Here's your recommended intake’. But when you have, if you have issues with this or that, you should be taking this amount. So which I think might be easier for people to get their head around than just one level, because we think that if we sit a daily intake aimed at alleviating illness, then that's normally not that achievable through our daily diet. And so you can't see it as an unachievable target for people to take vitamin C that they can't get from their diet because... So we always recommend food first and that is, so, 200 milligrams a day is what you would get if you did as you were told, an eight five plus. One of those five of the high vitamin C food, then you'll be fine. 

Lisa: You're in the range.

Prof. Margreet: So easily. So one kiwifruit, or some capsicum or a good amount of broccoli, or just if you can mix it up. But if you are eating a good range of fresh fruit and vegetables, you would be there.

Lisa: But if you're eating just bananas or something that is on the five a day, but isn’t  high on the vitamin C level, you won't be meeting those recommendations. So we need to get a little bit more specific. 

I want to go now into the cancer story, because I know like in the 1970s, Linus Pauling, who was a brilliant man, double Nobel Prize-winning scientist, sort of jumped in two feet first—if you like—with cancer. His studies that he did with cancer and vitamin C have extended the lives of these cancer patients that he was dealing with, four times as long. 

But he sort of started a storm—if you like—of controversy, because back then there was no mechanism of action that was understood as, ‘How could this be happening’? And from there, it was sort of, plucked out of the year. Where is this vitamin C thing’? 

You and your colleagues around the world have now sort of elucidated some of the mechanisms of action, and actually given some validity to what Linus Pauling was saying and later researchers.

So now if we go into the cancer story, there's still—I mean I've lost two friends this week to cancer. We desperately need this research to be completed or furthered fast. So if there's any wealthy people sitting out there, if you want to support this sort of research, and is absolutely essential, because we're losing people left and right to these horrible diseases like cancer, like sepsis. We know that they're going to be beneficial. But you've actually discovered, so the HIF. I wanted to talk about the HIF protein… the HIF-1.

Prof. Margreet: Yeah, that's the protein that I was mentioning…

Lisa: Yes, earlier when I'm…

Prof. Margreet: It’s also active in the white blood cells. 

Lisa: Yes. Can you explain what the HIF protein does in regards to tumor growth, and why vitamin C is so important in regards to that.

Prf. Margreet: Okay. So what is that, that's an acronym for Hypoxia-inducible Factor. Scientists are great at giving meaningless acronyms to meaningless terms. So, it’s a protein, it's what we call a transcription factor protein. So it's a protein that travels to the DNA, and switches genes on and off. These are master regulations proteins in these families of transcription factors. 

So HIF is a major transcription factor that is present in all our cells all the time. Its role is to respond to low levels of oxygen. And so, if for some reason our oxygen supply is cut off. For example, if you had a tourniquet applied to a part of the end, and you cut off your blood supply, those cells in that tissue would get hypoxic. We need that not to die off. We need that to survive, that tissues, that when you restore the blood supply, that everything's actually fine. That's the normal function of the HIF protein, under conditions of low oxygen, just switch on a survival response. 

It also does that, if you know has a lot of responses to basically regulate oxygen around your body. So it will, in areas where there are poor blood vessels, it will regenerate new blood vessel formation. You can't live without this protein. So we can't generate an animal that doesn't have it, doesn't survive beyond birth. 

So this process is hijacked by cancer cells. So if you imagine, you will have seen pictures of a growing tumor starts off as a few cells. When that tumor, when that little clump of cells gets to be two millimeters across, it's very small, that doesn't have its own blood supply. And no oxygen will get to them, will get to the center cells, and they'll die. And this two millimeter tumor will die off. So but what happens when those cells run out of oxygen, because they switch on this HIF protein. And so when that switched on, those cancer cells now say, ‘Aha, I can make new blood vessels’.

Lisa: They grow.

Prof. Margreet: And it does that, it makes new blood vessels, can grow bigger. And as it grows bigger, every time it starts to run out of oxygen in the center, it makes new blood vessels. And so the tumor can grow, and grow, and grow. As well as switching on that formation of new blood vessels, it also turns those cancer cells into, ‘If I'm not getting enough oxygen, I need to get my energy from sugar now. I can't use our oxidative mechanism of energy creation’. So they become glycolytic. So then they start to depend on sugar for energy. We know that this is a property of tumors, that they're totally switched on to that. And when they get switched on to that, they stay on that. And so then they're able to become acidic, and they get all of these properties that cancer cells have. And it's all switched on initially by this protein. 

And so the more HIF is expressed in your cancer cells, the worse off—the better off the cancer is, and the worse off patient is. So there's a huge effort being put on to trying to switch HIF off than cancer cells. Unfortunately, switching it off is not as easy as switching it on. And because it's switched off by a mechanism you have to turn on. And so the turning on of that mechanism requires either supplying of these enzymes. The switching off of HIF is done by these enzymes that need vitamin C. So when you supply vitamin C, you're then supplying energy to the off switch. And the off switch will dampen down that tough response. So that means doesn't come on as easily, you know, much how you keep it going... 

Lisa: Not grow as fast...

Prof. Margreet: And the HIF is ramped down and the cancer will grow more slowly. So that's one mechanism that we have now very good evidence for, indicating that giving vitamin C to cancer cells…

Lisa: Slow tumor growth treatment 

Prof. Margreet: … is a really good idea. 

Lisa: So this, I saw another one of the charts with the mouse model that you had on the tumor growth showing the ones who had the vitamin C, the tumor growth was much slower than the ones who didn't, so that was because the HIF was switched—in effect switched off by the vitamin C.

Well, I'm excited about this research, I really am. Because it's going to save lives. And this is the whole point of the call. And I don’t know if this conversation gets a little bit scientific, but hang in there with us people because this stuff's really important for life. 

So can this prevent cancer? So if I want to be prophylactic, I want to be like, I don't want I've got cancer, perhaps genetically in the family, and I've got a higher risk. Can I take higher dosages of vitamin C with the hope of keeping the HIF from ever been switched on? Would that mean...

Prof. Margreet: We know that having optimal vitamin C makes it harder to switch that HIF on. The other thing we know, it's very hard to prove any kind of preventative action, because you need to have huge studies to do that, with thousands of people. Those studies that… there's a lot of epidemiological work out there that has looked at people's vitamin C status, and their susceptibility to different cancers. And so, but there can be many factors can play a part in that, and we don't know whether that's just the HIF, or whether that's a boost in your immune surveillance, or whatever functions there may be. But many cancer rates significantly decreased by up to half for a number of cancers, if your vitamin C status is good rather than bad. 

Lisa: Wow. Being over the 50 micromolar level... 

Prof. Margreet: Yes. So if you’re—people who are that kick themselves to optimal level, have lower incidences of many diseases, actually. And they live longer, and just all measures of well-being are improved. But they also have much lower cancer rates.

Lisa: Wow, so there's a reason, even if we don't have the whole answer yet for dosages and so on, would be to keep your vitamin C levels at the optimum, not at the minimum, your entire life, if that’s possible. What you mentioned before that there is a technology that's perhaps underway, that will be able to just, with a fingerprint, a prick of blood, be able to tell us what is in our blood, that would be amazing. I want one of those exactly where we are.

Prof. Margreet: I think your doctor’s surgery once…

Lisa: Yes, they definitely don't, because that would be just gold. I mean, in a situation like with my dad at the hospital, I couldn't get a vitamin C test to prove that he had a nutrient deficiency and so therefore, didn't treat the nutrient deficiency because I couldn't do the test.

Prof. Margreet: Yeah, it's very difficult. It's a very… it's not an easy test to do. And so a lot of standard labs don't do it regularly. So you got to be fussy with the blood sample. And it's often a challenge in a clinical setting.

Lisa: Okay, I hope that they do manage to do this because this would be very beneficial for everybody's health, because it's everything from heart disease to blood—we mentioned collagen to having good skin, to all of these sorts of things. But we would be well advised to make sure that we are getting our optimal vitamin C dose. 

Is there a danger, like I’ll be completely upfront, I have an intravenous vitamin C once a week at the moment and my mum's on it for once a week. I won’t keep that up forever. I'm also taking oral vitamin C as well. I usually take between two and four grams a day, and I'm not saying that I recommend that for anybody but that's just what I'm doing because I want to... There is no toxicity with vitamin C, is there? There's no risk, I mean on one hand an expensive way but that's...

Prof. Margreet: Yes well. No, no toxic dose has never been identified, provided you have good kidney function. So you do need to be on the clear. If you can't clear it, or if you're dehydrated, and you're not producing any urine, you'd need to be on the clear because it will oxidize in your body. And when it does, those oxidation products need to be cleared out. And so you know it is, that’s the waiver. 

So your body clears it to 100 micromolar for a reason because you don't actually want to have massive amounts running around all the time. And providing your tissues is saturated, any additional excess that you put on, it's not going anywhere, just going out.

Lisa: So I had down Dr. Ron Hunninghake on the podcast a couple of weeks ago there. He's a doctor from the Riordan Institute. I don't know if you know the Riordan Institute. And he said he's overseen personally as a doctor over 200,000 IV, vitamin C sessions, if you'd like. And I said to him, ‘Well, you know, one of the arguments that I face with doctors with my dad, was that it could damage his kidneys’. Apart from the fact that they did damage your kidneys too, which was my argument back. They said that kidney stones could be an issue. And that was one of the problems. 

Dr. Hunninghake, I posed that question to him. And he said in his 200,000 IVs, he's had three people with kidney stones, but they all had them previously. And he doesn't think there is—again, he hasn't done the clinical studies—but he doesn't think that there is a huge risk for kidney stone formation that is also dependent on the calcium being in the kidneys from what I understand. So that that is one of the arguments. That is…

Prof. Margreet: That's right. Yes. Because it’s the thing you will hear. It’s the first reason why you wouldn't want to take vitamin C. And I think we are trying to… it is important that you can clear it. So you do need, and I think for, rather than causing kidney injury, you don't—You need a functioning kidney. You need functioning kidneys to clear it. Otherwise, you will end up with problems. But anyone who's given an infusion is usually tested or checked for that. But...

Lisa: Or in a case, like with dad’s, there wasn't any option. So like, it was that or nothing. He wasn't going to survive.

Prof. Margreet: You only need to clear... as long as you're making urine. Unless your body is, as you know, completely deficient. It is something that you need to lift. So it's a little bit… do say to people… if our patients are dehydrated, we give them a drink, right? Because we give them fluids if they're dehydrated, we give them fluids. So if your body is missing something that it's supposed to have to function, should give them some.

Lisa: Yes, it would be a simple thing, especially if we can test it.

Prof. Margreet: It would not, it's not a big deal, really, to give them some. I think the cancer story is a little more complex than that. Because what we think with solid tumors is that,  because any amount of oral vitamin C has not been shown to benefit solid tumors paricularly. And what our hypothesis was, is that if you give intravenous vitamin C, you achieve a higher level in the plasma. So you're basically trying to get the vitamin C to the place where the vasculature is poor, which is that hypoxic center of the tumor. The oxygen can't get to because the blood vessels are poor, vitamin C can't get there either. And you need both to get there. So…

Lisa: To kill the chamber basically,

Prof. Margreet: ...to switch that HIF off in that place. So we think that if you give infusions, then that increased dose actually gets to that core of the tumor.

Lisa: And this is where?

Prof. Margreet: So this is where an infusion is an advantage than oral vitamin C. This is where Linus Pauling got into, where he got into strife bit, and he was giving intravenous doses. He maintained that they had an additional benefit. The conditions at the time, didn't believe that. And they repeated his experiments with oral dosing, and found it to have no effect. And so he didn't, that time we didn't know about half, and he didn't. So he was arguing back and forth. And so it just became a bun fight, actually. There was no resolution, and a lot of acrimony, and never did the cause any good for him, or the clinicians either, and certainly not the patients.

Lisa: This is such a shame, really, because it is also something.

Prof. Margreet: So, kind of tone was set at that time. And, and it's taking a long time to pick that conversation. I think now we have not only the health mechanism, but we have these epigenetic, or the genetic regulatory enzymes that are also involved in many cancers. And in fact in a number of cancers, those enzymes are the mutated enzyme. They're the mutation in those enzymes that will drive the cancer. It's very common in hematological cancers, common in some glioblastoma, so brain cancer, and bowel cancer. 

So there are two mechanisms whereby vitamin C might work. And so, we have just recently shown with myeloid leukemia that if you have a mutation in that enzyme, and you give additional vitamin C to those cancer cells, then… So if you have a mutation, you have two copies of every enzyme. If you take one out, 50% left. That 50% is trying to do the job at a hundred percent, and it isn't able to. So if that enzyme, that last 50% needs vitamin C given a vitamin C boost, within upping its level, you can upregulate it. And we think that it's now restoring normal function to those—they didn’t stop behaving like cancer cells... 

Lisa: And actually...

Prof. Margreet: ...and just behave like normal cells. And so this would be a great treatment adjunct for chemotherapy.  Famous illogical cancers, because you now have cells that would respond normally rather than be these aberrant, crazy cells. 

Lisa: I know that you had a case, so I won't mention the name in case and that's not okay. But I know that you…

Prof. Margreet:  Oh, it is okay to mention the name.  Because Anton's family have actually asked me to mention his name.

Lisa: Okay. So yes, I heard about Anton Kuraia's journey with leukaemia and how he had intravenous vitamin C, and that put him into remission. And he unfortunately lapsed later on and if you pick up the story there, but you got a tissue analysis, or you managed to get some tissue when he relapsed later on. In the two enzymes, the TT2, is it? And the W . . . 

Prof. Margreet: That's one of these enzymes. So Anton is the case that we've learned a lot. And he, very generously when he read that… So he had this turn around, like a miracle response to vitamin C. And which really piqued our interest at the time we didn't know about the TT enzymes, and I almost lost my money on that. And thought, he wouldn't surprise me if he had one of these mutations, but he was in complete remission for two and a half years. And while he maintained a vitamin C regime, so he was taking it continued with intravenous vitamin C, each injectable, for couple of weeks, or something during that time. And when I spoke with him, I said, ‘You know what? I'd really like is I'd like to figure out just why this has happened and lapsed some of your cancer cells. But you haven’t got any sign’, which is great.

Lisa: Yes, which is great. 

Prof. Margreet: And we had no idea, quite what was going on, and how long that remission would hold for. And, unfortunately, two and a half years later, he relapsed. But at that point he said, ‘You know how you wanted some cancer cells? Well, I have some, and I don't want to know that’. But he pushed through and sent us a sample. And it was of his bone marrow, which, we had one sample, and I'm like, ‘Well, we need to think about what we do with this one’. We had a really good plan. And, and we managed to get a bit of funding from the local bone marrow cancer research trust for a project. And they're like, ‘If you got a good project’, and I’m like, ‘I do actually have a really good project’. 

So I put a young post-doc onto that, who has been absolutely marvelous, and together with the clinicians in Auckland, we tracked down the risks of Anton samples that were in the Auckland clinic, and ran the DNA analysis, the genetic analysis on his cancer, and discovered that he had not one but two mutations that involved a requirement for TET2 activity. And so both of the clients, so myeloid leukaemia is a clonal disease. One clone can have one mutation, another clone can have another mutation or both. They're two clones, each one with a mutation that required TET2 or a feature TET2 activity. Both of those clones were wiped out by the vitamin C. 

Lisa: Wow. So they kicked them alive?

Prof. Margreet: Yes, yes. But what we discovered was that, that didn't wipe out the cells completely because that one of the clones came back.

Lisa: Was it because he stopped the vitamin C, like if…

Prof. Margreet: What we discovered was that when it came back, that clone had acquired additional mutations, as they do often. And so cancers do that, they cause you to be more and more aberrant as it continues. So the original mutation was still there, but so were additional mutations. And so the second time around, the vitamin C treatment worked a little bit. It seemed like it was trying to work. He went and had more chemotherapy. And then that didn't work, got sent home again. With weeks to live anyway, back onto the vitamin C, and got better. But the blood cell count never came down to zero again, and…

Lisa: So basically the cancer was stronger the second time with more aberrant mutations.

Prof. Margreet: Yes. But he didn't, he didn't seem to know what's going on. But my gut has got really good.

Lisa: So something was, so that brings in the quality of life because that's proven, isn't it? If you're having to have chemotherapy, and having vitamin C can be very beneficial for quality of life. Least fatigue, least nausea, all of those sorts of horrible things that happened to poor chemo patients can be...

Prof. Margreet: That’s a story we believe, of just replenishing the depleted supply in your body. So basically, you're giving your body these toxic cocktails, you're expecting your body to function, and then respond. And at the same time that's running out of a vital nutrient. And so if you, if you can restore that, then your fatigue levels… so one of the things that vitamin C does is it supports the promotion of energy. So it regulates adrenaline. Absolutely key to making adrenaline, to making molecules that support energy production, energy metabolism. 

And so, if you're starting to run low on those things at the same time as you're undergoing the chemotherapy, what can be written off as a side effect of the chemotherapy can be alleviated. A few can restore some of those normal functions. So a lot of the kind of brain fog, things, ability to concentrate, mood things, pain, and nausea and fatigue, a lot of the measures improve.

Lisa: Wow. So that alone is a reason to be considering it.

Prof. Margreet: It's a very important consideration. 

Lisa: Absolutely, it’s quality of life. 

Prof. Margreet: Absolutely, as far as we can tell, it does not interfere with any other cancer treatments. Because that's the other worry that people have, doctors have, that, ‘I don't know, because it might interfere with the treatment I'm trying to give you for your cancer’.

Lisa: And this is a problem when people go to their oncologist, their local oncologist. They’d be saying, ‘Don't do vitamin C’. This is why this information is so key to be able to share it.

Prof. Margreet: Well, that's why we tried to do the research. Because doctors have the patient's best interests at heart. And they worry when patients come in and say, ‘You know, should I take this? Can I take that’?and they're throwing everything they can at the cancer. And they worry that something else that you’re doing might work against that. And so they are always very cautious and rightly so. Because we want our doctors to be working from evidence, from an evidence base. 

And currently, we don't have those answers here. That we can absolutely say… I mean, this is why we're working so hard to try and identify the causes, and how vitamin C is working. So that then we can give that information to the clinicians, who can then put that together with their patient information and say, ‘Well, for you on this drug, this will be fine. You do that, you know, and in fact, it will help with this and this and this’. So or, ‘Under these circumstances, now, I'd rather you didn't do that, until you've got this out of the way’, or whatever. So we can manage better advice and give patients an idea as to what they can expect. 

So like, with the haematological patients, we’re starting to identify what genetic subgroups of the cancer might respond. So then you might be able to say to you, to a cancer patient, ‘Looks like you've got this mutation. This is very likely to be helpful for you’, or ‘It looks like you don't have this mutation. It's unlikely that it's going to help you. You can try, but it's unlikely