Vitamin C dosage for every session? In other words for non-regular Desferal use

Hi,
   Andy did a great post on Vitamin C that it helps increasing the efficiency of Desferal, but the daily dose of Vit. C should not exceed 500mg as it can cause too much iron to be released in the blood stream that can cause heart problems.

O.K That was for those who do their Desferal regularly every night and the leftover Vitamin C and iron gets chelated in the next session.

But what about the dose of Vit. C for those who don't do it regularly (like me , hey I'm improving on this since I started doing it myself and have been doing it twice as before!).

My mom recommends 2 glasses of Orange juice every time I put on my Desferal while I think that I should go for the 250mg pill (at each Desferal session) which should contain more Vitamin C than 2 glasses of orange juice.

What's your advice on this?

The maximum amount of vitamin C a thal should take per day is 250 mg. The recommended dose is between 100-250 mg. Vitamin C helps to release more iron into the blood where desferal can remove it. Too much C can release too much iron to the point where it can cause clumping in the heart and adversely affect heart function. No studies have been done on the affect of vitamin C with other chelators, so it is not known what effect, if any, there is.

I think orange juice is an excellent source of C and two glasses at the start of your desferal is a good idea, but you are right in saying that the 250 mg pill is more than you will get from orange juice. It might be best to take a lower dose pill along with the orange juice.  A question I have is, does it make sense to take more C or orange juice or source of C while doing the desferal, in addition to what is taken at the start? Also, would it make sense to take a vitamin C pill that is time released? Is it more effective if the C is released over the whole period of time desferal is taken?

I think that when we take Vitamin C, it reduces iron into ions that easily bind to Desferal. These ions should stay in the blood stream until they are reduced by antioxidants such as tea or eventually accumulate in different organs easily due to their high binding affinity due to ionic state; if not disposed of by Desferal.

Here is a link explaining the Precautions of Desferal and I've quoted some points relating to it's use with Vitamin C, but it still does not tell about the time line of efficiency of the drug with Vitamin C.

http://www.rxlist.com/cgi/generic2/deferoxamine_wcp.htm#P

• Vitamin C supplements should not be given to patients with cardiac failure.
• Start supplemental vitamin C only after an initial month of regular treatment with Desferal.
• Give vitamin C only if the patient is receiving Desferal regularly, ideally soon after setting up the infusion pump.
• Do not exceed a daily Vitamin C dose of 200 mg in adults, given in divided doses.
• Clinical monitoring of cardiac function is advisable during such combined therapy.

Thanks Sajid. That does answer my question about taking the C over time instead of in one dose.

Do not exceed a daily Vitamin C dose of 200 mg in adults, given in divided doses.

A time release pill or multiple smaller doses or a glass or two of orange juice while chelatiing would seem to be the best policy, rather than taking the whole amount when you're first inserting the needle.

And Novartis, Apotex and Cipla....we are still waiting for research into the effect of vitamin C used with Exjade and L1.

When u take vit C? Before, after or during the  desferal?

Vitamin C is usually taken when desferal is started - some people take it half hour before starting desferal, some take it when they start desferal and others take it half hour after starting desferal.  My son was told to take 250mg of vitamin C when starting desferal.

Sharmin

Thanks Sharmin, I asked because my new doctor in Thessaloniki told me to take it 1 1/2 h after dfo.

Sharmin,

I used to take vit c when starting desferal, but now I take it one or two hours before desferal because I read in this site that vit c helps food iron absorption and since I start desferal after having dinner, I prefer taking vit c before that. Although I think comparing to iron we take from transfusions, food iron is nothing and we should not be bothered by things like that...

Lena.