Clinical benefits and risks of high-dose intravenous vitamin C: a systematic review.
Level 1 - systematic review of randomized trials
Systematic review synthesizing randomized controlled trials and other clinical studies.
PubMed 41815850 · doi:10.25122/jml-2025-0176
What was done
A PRISMA-informed systematic review searched PubMed/PMC, Scopus, and Web of Science (2010–2025) to synthesize evidence on the clinical benefits, risks, and infusion settings of high-dose intravenous vitamin C (IVC) in sepsis, oncology, and symptom management, prioritizing randomized controlled trials, systematic reviews, and high-quality observational studies.
What was found
The abstract reports no numerical outcome statistics or pooled effect estimates. Mechanistic studies showed downregulation of pro-inflammatory STAT1/PD-L1 pathways in experimental sepsis. Phase I/II oncology trials demonstrated safety and quality-of-life improvements, alongside a reported survival benefit in one randomized phase II pancreatic cancer trial combining IVC with chemotherapy. Major risks identified include oxalate nephropathy and hemolysis in patients with glucose-6-phosphate dehydrogenase deficiency. The review concluded evidence does not support routine IVC use in sepsis, and oncologic use remains exploratory.
Why it matters
It reinforces that routine high-dose IVC is not recommended in sepsis despite mechanistic rationale, and that oncologic applications remain investigational with mandatory pre-screening required to avoid renal and hemolytic complications.
Limits
The abstract reports no study counts, participant sample sizes, or quantitative meta-analytic metrics. Oncologic evidence is limited to early-phase trials, and data regarding home-based infusion outcomes remain scarce.
Cited by
- supports Patients with glucose-6-phosphate dehydrogenase deficiency are at risk of hemolysis when given intravenous vitamin C doses of 40 g or higher.