Can we take Vit C while we're on Folfox?

small experience base here

There were 1-2 prior members here on Folfox who seemed to do ok but weren't big commenters.   

I don't think "standard" doctors have much correct information about IV vitamin C.  I typically see and hear laughably ignorant errors from them on IV vitamin C.  I would talk to the Riodan Clinic several times. They have an 800 number, with a free call in for an hour group discussion with a Q&A format about IV vitamin C experience, several times a week.  Dr Ron Hunihake is probably their most experienced IV viamin C doctor. They use several MD and ND doctors to cover the phone discussions; listening to several different conversations might be very useful.  It's FREE !

Also Riordan Clinic has a website with papers too.

We've never subscribed oxaliplatin, rather my wife uses an oral 5FU chemo plus a lot of off label stuff and IV vitamin C for stage 4b.  This has been success for some years now with a high quality of life.  If you want to compare notes, give them a call and see what their Folfox IV vitamin C experience base is.  And let us know in between - extra discussion here might yield better insights on your phone calls.

Supplements and Vitamins

My doctor didn't want me taking any supplements during chemo beccause it can interfer with treatment.  Ask your doctor, better they make that decision than on this board. 

Kim

My doctor didn't want me

My doctor didn't want me taking any supplements during chemo because it can interfere with treatment.  

The crucial question is which supplements are (less commonly) incompatible with which chemo.  The problem with conventional oncologists is that they almost totally ignore getting accurate information about anything not "standard".  Frank vitamin C, D3 and other deficiencies remain common in CRC, and need something.  A few supplements are problematic, like (common in low quality multivitamins) folic acid with 5FU is toxic (natural folate is good).   Many supplements and supplemental treatments are important in their own right - enough so that we have been able to skip oxi- itself.  It turns out that steady oral 5FU (asia) can be an excellent chemo to mix and match targeted supplements with.

According to my Onc, the Vitamin C is a strong antioxidant, and at least some parts of the FOLFOX are a strong oxidant, so she told me that I should definitely avoid taking vitamin C while I was on the FOLFOX because it would inhibit the effectiveness of that treatment.

Curiously, a lack of evidence based medicine to well cover that very, very broad statement. It is  overly simplistic and inaccurate, whether Folfox works or not with any given vitamin C plan. IV vitamin C has an oxidant mode and some forms of vitamin C actually block sugar transport in the cancer cell.  There are papers that show IV vitamin C aids other platinum based cancer treatments, but I haven't seen much good research on oxaliplatin, ca 2010-2012.   One serious problem is a lack of incisive, unbiased research in the mainstream oncology world about what works and what doesn't work with various vitamin C modes and doses.  

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I would look for less conventional MDs and NDs with substantial cancer experience, those who watch and participate in  the supplement -chemo area.  If I relied on conventional oncologists for advice about vitamins, supplements, cimetidine and celecoxib... I simply would not still have a  wife - chemo wouldn't work well enough, long enough or be tolerable enough.  

getting fortified...

It's like finding hens' teeth.

I had to do a lot of research to find pieces of information.  Basically there was a paper that showed folic acid is truely poisonous as a substitute for oral leucovorin tablets (calcium folinate) in about half of 5FU patients.  Then the initial recommended capacitabine MTD loading between Europe (2500 mg/m2) and the US (2000 mg/m2) may be considered attributable to the dietary folic acid content, due to folic acid fortified foodstuffs and grains in the US.  There is no cancer benefit to 5FU-folic acid toxicity.  Then, according to an original capacitabine filing, no net benefit to adding even high dose leucovorin to capecitabine but leucovorin is a lot less toxic.  A Merck patent showed that the bindings make reasonable amounts of natural type folate (L-5MTHF) protective of non cancer cells with relatively small effect to cancer cell treatments with 5FU-LV.

In my wife's case, she suffered clear toxic reactions (stomatitis and cytopenias) to folic acid content at ca 1000 - 1500 mcg of dietary folic acid content including a folic fortified brewers yeast.  We then chose total dietary elimination of folic acid specifically, no folic fortified foods period (e.g. FDA approved flour/grain contamination, obsolete B or multivitamin formulations). Then she could tolerate 33% more 5FU drug plus LV tablet then added, with noticeably less toxicity by using liver or liver product (e.g. pate or liverwurst) that contains natural folates and other nutrients instead, with a big boost to Hgb.  Her IV vitamin C and supplement program also suppresses 5FU toxicity while improving 5FU activity.  The IV vitamin C also helps reject copper content from the liver foods, a consideration for cancer treatment.  Because some B vitamers are considered particularly helpful, we hand loaded B vitamins for a few years.

Clearly there is a range of detrimental reactions for 5FU-folic acid toxicity but no net benefit.  So why take any folic acid content (vs natural folate)?  She now takes leucovorin as a tegafur (oral 5FU) adjunct, but dosage is a critical item there.

"Natural folate is B9".  ahem.

It is crucial to distinguish

It is crucial to distinguish (natural) folates from folic acid, an inferior source with toxicity issues.  For my wife, the liver - source of natural folate, natural cobalamins, Q10 etc means a much better CBC.  She was thus able to drop the conventionally prescribed (yuk) iron caps for her aggravated anemia too which may account for some of the recur risk.