How To Avoid Kidney Stones From IV Vitamin C (Oxalate Kidney Stones)

Are you curious about IV vitamin C, but have concerns about oxalate levels and complications that can come from there? Keep listening. Welcome to my YouTube channel. I'm Dr. A, and I get into all things integrative, holistic, naturopathic, intervening in chronic complex illnesses. So, let's dive into this topic, which has a huge number of replies on the various social media platforms. So, we wanted to do a video just about this one topic. And that is, what do we do when we give vitamin C intravenously to reduce the impact of the oxalates going up in the blood and then the kidneys? Now, oxalates are a metabolic breakdown product/toxin, depending on how much is there, and the most common time we hear about them is with the number one kind of kidney stone, which is a calcium oxalate kidney stone, most common type. But also, there are people who have oxalosis, where they may or may not get kidney stones, but their body will hold on to excess oxalate, and you can see it on organic acid tests, etc. And so the body holds on to oxalate, and it can create muscle pain, and joint pain, and a whole number of other problems. So oxalates can be a big deal. Now, it's known that vitamin C metabolism has an interaction with oxalate metabolism, and so in some instances, but not Others increasing vitamin C can increase oxalates, and if I already have oxalosis, is that going to be a problem? I'm an oxalate kidney stone former. Is that going to be a problem? And one of the biggest questions that would come in is, okay, you do you know all of this IV vitamin C at low dose and high dose. How do you keep people from getting kidney stones and all of that? Totally legitimate question. So let's get into that. So the most common concerns that we have with vitamin C are raising the level of oxalates and. either going towards systemic oxalosis or oxalate kidney stone, and that is a very common concern because it's known, because they're, they're not directly related, but the metabolism of vitamin C can interact with the metabolism of oxalate. But as I said in the beginning, why doesn't it happen to everybody? Now, I just want to, I'll start at the end of the story just to tell you, compare notes with a few colleagues who have done vitamin C IV like myself for decades, meaning 25, 35, 50 years in some cases. So we're talking about a sample size of managing somewhere around, you know, 180,000 to 200,000 IV vitamin Cs. So quite a lot of experience, right, amongst the group. In that group, the number of people, for example, who got an oxalate kidney stone was out of all those years. So how did we work around this oxalate problem? Well, to go back to the how, the way you work around the problem is to, number one, as I said in some of the other vitamin C videos, do appropriate screening. Got to make sure the kidneys are working. If the kidneys aren't working, then you may not tolerate a lot of IV vitamin C. So kidney function, we do the safety testing for G6PD, we do testing for other blood chemistries. So that's the start, is appropriate testing. Make sure the body can deal with the fluid and the electrolytes and all the other stuff. But then why would vitamin C and oral vitamin C can do it, but also IV vitamin C obviously could do it as well. Why would vitamin C increase oxalate? Because I said it's sort of two pathways that that have a common cousin that may or may not be activated. So here's the important thing: it doesn't have to be activated, but in some people what will happen is the vitamin C will metabolize down to. its oxidized form, which is dehydroascorbic acid or DHA, and then it has a breakdown product that's an intermediate that will become oxalic acid or oxalate. So the first way to avoid that is to not have the vitamin C get stuck in the oxidized state, but to let it— because in a redox reaction, you got a reduced state and an oxidized state. You can keep the vitamin C cycling so that it doesn't get stuck in the oxidized state, so it never goes to oxalate. So that is one way that it can do it, okay? The next thing is that there are nutrients that can help to— and we use this with our oxalosis patients all the time, which is very important— there are nutrients that help the enzymes inside of your liver to slow down oxalate production and export. So that's another terribly important thing to do to help the process so that we, number one, we don't contribute to oxalates, and then we slow down the liver pumping more oxalates out. Now, those nutrients are simple. It's vitamin B6. We normally use P5P, the active form, and magnesium. And they go to an aminotransferase enzyme, which is called AGT. You might have heard of liver enzymes called ALT and AST. Well, they have a cousin called AGT. AGT has an incredibly long name with a lot of chemistry in it, but what it does is it keeps a precursor to oxalate called glyoxylate moving away from oxalate into the formation of glycine, which is very good for your brain and other parts of your body. So if I have enough magnesium and B6 to run the AGT enzyme, I never make excess oxalate. So in people who have normal kidney function, they pass all the other Yes. The next thing that we look at is how biochemically do we keep vitamin C from creating oxalate, because we can shut that off, and then how do we keep the liver from creating excess oxalate? So on the liver side, we have the support, this aminotransferase enzyme AGT, which is B6 magnesium, and then on the vitamin C side, not going to the— down to the evil degradation products that become oxalate, we have cycling the vitamin C. Think of it this way. Reduced vitamin C is on top, and then there's a Fenton reaction and it oxidizes. We want that, but in a redox reaction it doesn't have to go down, it can go back up to reduced vitamin C. As long as the dehydroascorbate, the oxidized form, goes back up to ascorbate, or the reduced form, it can't go down to oxalate. This is why in reality we don't see, you know, and after a few hundred thousand of these You would see more if they were going to happen, right? So what's in the middle of all this chemistry and all this other business, right? Well, we already talked about appropriate screening. So the first thing is, if you don't have good kidney function, we generally don't give you high-dose vitamin C because your kidneys can't handle it. And except in very rare instances, if the kidney function is low, it's too much stress on the kidneys to give high-dose vitamin C. And those are the people who will get more oxalosis. from it and can form crystals and other stuff. So first off, good kidney function, safety, G6PD, as we've talked about, and then all the other chemistry stuff that we look at. So that's a big deal. The next thing is hydration, and people are more dehydrated than they think. And also, high-dose vitamin C dehydrates you even more. So you can go from a low amount of oxalate in the blood to a higher amount of oxalate in the urine if you keep yourself Dehydrated. So in addition to all that other chemistry business, dehydration is the enemy. So in people who tend to form oxalate stones, people with oxalosis, etc., what we do is we give them a hydration IV, which is just usually something like half-normal saline right before they get their high-dose vitamin C. Then we give them a very specific formula of vitamin C with balanced electrolytes in it, which is something that came out of some NIH, National Institutes of Health-funded human research that I was involved in, and we found a better chemistry balance which helps out quite a bit, and all of those are available online, they're not proprietary or anything like that. Then the next thing is, we got good kidney function, we prehydrate the person, they drink a lot of water during, they drink a lot of water after, and then in most people taking oral, there's magnesium in the formula. They can take oral P5P, the active form of B6, which does not give you B6 toxicity. It's the other form that gives you B6 toxicity. P5P and magnesium orally in between your IVs, and generally that is enough to take care of the problem. Now, what about— because the B6 and the magnesium, remember, help with the liver production of oxalates, which we give the oxalate oxalosis patients even without vitamin C problems. So that's a big thing there, it's that aminotransferase enzyme system that's supported by B6 and MAG. But remember I said if we keep the vitamin C cycling between ascorbate and dehydroascorbate and back to ascorbate, it can't go to oxalate, it's blocked, okay. That's why this works so well generally when we do it appropriately. And so what keeps it cycling? Well, inside of your body when you And when you oxidize vitamin C to DHA, it can be reduced back up to ascorbate, so going away from oxalate formation, by 2 primary things. One is glutathione and the other is vitamin E. And vitamin E hangs out in your cell membranes and other fatty spaces, so it bumps into the ascorbate, so that's an easy way to do it, it's in your liver. And glutathione is created in your liver and is stored in your liver and other tissues. And again, you have certain amounts of glutathione to keep up. Now, if you've been very toxic, if you've been very inflamed, sometimes we have to raise the levels of the vitamin E family and glutathione to some degree so that then you will keep the vitamin C cycling. And again, it can't go to oxalate formation. So we have appropriate screening with the labs and the history. We have Good hydration during, before, and after the IV event. We have the support of the aminotransferase enzymes with magnesium and B6 orally. Then there's a bit of magnesium in the IV vitamin C formula for that purpose as well. And then we have the cycling support for vitamin C to keep it from ever having to go down and become oxalate. So this is probably why in those. few hundred thousand events of high-dose vitamin C, we just don't really see this as a problem. I know on paper it looks bad. Now, people often say, well, I went and I got a vitamin IV that had vitamin C, or I got a high-dose vitamin C IV, and all of my oxalate symptoms got way worse. The reason for that is one or a number of these other areas were not attended to, and It's you know that happens sometimes. Okay, and what I'm proposing is that when we have the safety and laboratory monitoring up front, we've got a good history. Might do organic acids, see where your oxalates are, and then we're attending to the cycling of vitamin C so it can't ever go in the oxalate direction. We're attending to the aminotransferase enzymes. system to— so you stop making oxalates in the liver. We just don't see that happen. And also, the formula is balanced in a particular way. So if none of those preventive measures are done, you can get other problems that go on. But this is why those of us who've done this for a very long time with thousands of patients and hundreds of thousands of administrations rarely see anything related to oxalate increase that is of a pathogenic or an aggravating nature. You got to take care of all of those things. Also, I'm going to link a paper, basically did a study with over 85,000 women, no history of kidney stones, and they showed that vitamin B6, the higher the B6 intake of the person in their diet and supplements together, the lower the number of stones that they had, and again, that backs up the biochemical explanation for B6. And also, there wasn't relationship between vitamin C and oxalate kidney stones, which is odd because that's what everybody has always said, but they didn't find that. So I'll put that down in the description box below too. Well, I hope you've enjoyed this video. If you have, take a look at one of these other ones. We're going to give you multiple options to look at as far as links to other videos. Go over the main YouTube page, we got a bunch a playlist, and we're building more and more and more playlists on integrative medicine topics to help you out and to educate you. And I'm Dr. A, and I'll see you on the next video.