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Re: Injection of H2O2

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Rich,

This should go without saying...unless you're a doctor, don't attempt

injecting H2O2 into your veins. The danger of killing yourself quickly and

painfully is a little too great. A few people now and then have killed

themselves with the accidental mis-use of natural therapies...and the

pharmaceutical companies (and media) are quick to jump on that as a good

excuse to further ban natural products.

l)

w/peace

wes bennett

wesbenn@...

<A HREF= " http://www.wesbennett.com/ " >photography & graphics</A>

> I would like to ask what is the safest maxim % of H2O2

> you can inject, also is it required to inject H2O2

> into a vain. Can you get the same results by inject in

> to a muscle like a penicillin shot in the butt.

>

> Thank you

>

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The IV dose is .075%, not 3% as you stated. A dose of .150% is

considered a overly strong dose. 3% H2O2 is designed for external use.

jim :)

alltogethernow@... wrote:

>

> Rich, it is my understanding that 35% ,(only pharmacutical grade) h202

> must be diluted with pharm. (glucose)down to 3% and dripped. This from

> my Dr.........

--

Light travels faster than sound. This is why some people seem bright

until you hear them speak. --Lou Rubinacci

jlambert@... http://www.entrance.to/madscience

http://www.entrance.to/poetry

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<<Rich, it is my understanding that 35% ,(only pharmacutical grade) h202

must be diluted with pharm. (glucose)down to 3% and dripped. This from

my Dr.........>>

OUCH NO! HE'S 50 TIMES TOO HIGH!!

From an authoratative article.............

Hydrogen Peroxide is available currently

in a 3% USP/NF grade and is ideal for intravenous use. It must be packed in

an open vial however with a vented cap to allow the escape of oxygen

pressure produced by the dismutation. Some physicians are concerned about

sterilization because of the packaging but hydrogen peroxide is self

sterilizing. Proper dilutions are simple. Add 1 mL of the 3% Hydrogen

Peroxide USP/NF solution to each 100 mL carrier solution.

A typical treatment

plan would be to give 100 to 250 mL H202 of 0.03% concentration once or

twice a week. After the initial schedule of 10 to 15 treatments, wait 30 to

60 days and evaluate the response.

Within 1 hour after the intravenous infusion of 250 mL 0.15% H202 a 2% to

10% decrease was noted in the following blood constituents: Bun, Sodium,

Potassium, Chloride, Uric acid, Calcium, Phosphorus, Total protein, Total

bilirubin, Alkaline phosphatase, AST, ALT, GGTP, LDH, Iron and Globulin.

Follow-up studies, 24 hours later, revealed all the above blood constituents

had returned to normal pre-infusion levels.

Here's the rest of this particular article..

_______________________

INTRAVENOUS HYDROGEN PEROXIDE THERAPY

(Quick Overview)

MECHANISMS

Oliver (l) first reported the use of Intravenous Hydrogen Peroxide (H202),

in 1920 in patients with Influenzal Pneumonia. An epidemic in Busrah in June

and July of 1919, had a calculated death-rate over 80 percent. Oliver

treated 25 critical patients with intravenous infusions of H202 and 13 fully

recovered reducing the mortality to 48 percent. He was impressed with the

rapid clinical response and postulated the effects were probably due to the

oxidation of toxins more than the relief of hypoxia.

Hydrogen peroxide used in surgical procedures had caused air embolisms, but

he reasoned if the oxygen was released slowly, embolism should not occur.

Venous oxygen embolism has been reported following the irrigation of anal

fistulae (2), surgical wounds (3), and closed body cavities (4). Ulcerative

colitis (5) has been produced in patients using H202 in enema solutions to

break up fecal impactions. It has been shown, however, to destroy murine

malaria parasites (7), and the bactericidal properties of H202 produced by

neutrophils is well documented (8-10).

Hydrogen peroxide appears to be involved in many intermediate biochemical

pathways. Additionally, it appears to kill certain bacteria, parasites,

yeast, protozoa, inhibit viruses, and oxidize immunocomplexes. T. Ramasarma

(11), in his review on the " Generation of H202 in Biomembranes " , states:

" H202 is a purposeful molecule in cellular metabolism and cannot be

dismissed as a mere undesirable byproduct of oxygen species generation " .

Hydrogen peroxide is generated in most biological membranes; cellular,

mitochondrial, and nuclear. It is important for maintaining membrane

integrity and regulating membrane transport through the alteration of Na-K

ATPase activity. This was confirmed by Garner et al (12). Hydrogen peroxide

fulfills the role of a secondary messenger in several hormonal pathways. As

an example, H202 generation in the uterus is dependent on estrogen and is

necessary for the production of progesterone. The iodination of

thyroglobulin and thyroxine synthesis requires the presence of peroxidase,

H202, and iodide (13). Thyroxine increases and hypothyroidism decreases

hydrogen peroxide production in studies of liver mitochondria (14). Hydrogen

peroxide has an insulin-mimic action and acts as a postbinding site on the

plasma membrane to induce glucose transport (15).

More recent studies of Helm (16) found the insulinomimetic action involves a

common mechanism which links the generation of active oxygen species through

the redox potential of the cell to the activation of a proteinase. It helps

regulate metabolic control through protein modification which alters enzyme

activities.

Thermogenic control (11,14) appears to be exercised through the action of

H202 on the mitochondria. At the mitochondrial level, H202 is generated by a

number of substrates. Flavoproteins converge at ubiquinone which forms a

link between H202 generation and the respiratory chain. Noradrenaline,

thyroxine, and cold stimulate the system to generate heat. Heat increases

the rate of H202 production and is dependent on alpha-adrenergic receptors

which also control non-shivering thermogenesis.

The balance of Ferric (3+) and Ferrous (2+) Iron in the body is critical to

support lipid peroxidation of cellular membranes (27). It has been reported

that a ratio of Fe(3+)/Fe(2+) of 1:1 to 8:1 is optimal to cause the

formation of -OH radicals and lipid peroxidation. At ratios above or below

these levels, lipid peroxidation does not occur. Physiological

concentrations of either H202 or Ascorbic Acid may encourage lipid

peroxidation and at these levels antioxidant protection is important.

Increasing the concentration of H202, as occurs with therapeutic intravenous

infusions, the Ferric/Ferrous ratio is maintained above 8:1 by keeping

excess Ferrous (Fe2+) Iron oxidized to the Ferric (Fe3+) state. A principal

mechanism of action of EDTA Chelation Therapy is reducing Free Radical

damage and lipid peroxidation by complexing EDTA with Ferrous Iron

(Fe3+:EDTA) which helps maintain the Ferric/Ferrous ratio above 8:1 (28)

Weiss (8) reported H202 is an activator of neutrophils including aggregated

immunoglobulin, activated complement components, immune complexes, or

bacterial peptides.

This would suggest the beneficial clinical effects observed with the use of

ascorbic acid in inflammatory reactions, and its protective action against

infections, is acting through the generation of H202. Also, there is no

evidence H202 initiates or supports microsomal lipid peroxidation (51). The

modification of (Na,K)-ATPase(12) by H202 also contributes to an increase in

metabolic rate.

Farr (40) reported whole blood specimens taken before, during, and after

H202 infusions showed color changes consistent with oxyhemoglobin formation.

Numerous blood profiles and CBC studies have been performed before and

immediately after infusions of H202. Although early investigators reported

no changes in blood elements and certain chemical constituents, except when

injected into the carotid arteries, consistent changes have been reported.

Within 1 hour after the intravenous infusion of 250 mL 0.15% H202 a 2% to

10% decrease was noted in the following blood constituents: Bun, Sodium,

Potassium, Chloride, Uric acid, Calcium, Phosphorus, Total protein, Total

bilirubin, Alkaline phosphatase, AST, ALT, GGTP, LDH, Iron and Globulin.

Follow-up studies, 24 hours later, revealed all the above blood constituents

had returned to normal pre-infusion levels.

Some of the biological killing activity of H202 may be attributed to gamma

interferon. Production of gamma interferon by human natural killer cells and

monocytes, is stimulated by H202(58). Both exogenous and endogenous H202

appear to be in part responsible for immunoregulation. The rates of wound

healing, stasis and vascular ulcers (18), peripheral occlusive disease

(59,60), myocardial ischemia (33) and cerebral vascular disease (61) have

all improved when treated with repeated intra-arterial infusions of H202

PHYSICAL PROPERTIES OF HYDROGEN PEROXIDE

Hydrogen Peroxide was discovered in 1818 by the French Chemist Louis-Jacque

Thenard.

Hydrogen Peroxide, hydrogen dioxide (H202), is a colorless (blue in thick

layers) odorless liquid; with a melting point -2 degree C: a boiling point

152 degrees C; decomposes 84 degrees C at 68 mm. pressure (68 degrees C at

26 mm.), soluble in water in all proportions; usually encountered as a

dilute solution (3% H202) solution, that is, one volume of solution yields

10 volumes of oxygen), although available up to 35% strength.

Its remarkable feature is its tendency to decompose readily into water and

oxygen. Decomposition by light begins only in the near ultraviolet. Hydrogen

peroxide solutions dismutate slowly, when undisturbed, at the rate of

approximately 1% per month. The dismutation reaction is rapidly increased in

the presence of particulate contaminates; i.e., dust, flakes of metal or

glass or other particulate matter, at a rate which may be explosive. Cold

retards dismutation and solution may be refrigerated or stored at

temperatures below 0 degrees C. Hydrogen peroxide occurs only in traces in

nature: mostly in rain and snow. It has not yet been detected in

interstellar space.

METABOLIC AND PHYSIOLOGICAL EFFECTS

Numerous physiological effects are attributed to hydrogen peroxide and

documented in the literature. Some of these effects may be broadly

categorized as follows:

1. PULMONARY

A. Increased oxygenation

B. Alveolar debridement (31)

2. METABOLIC RATE

A. Hormonal effect:

Several hormonal effects have been reported to be regulated by the action of

H202.

Examples are:

1.Iodination of thyroglobin(13)

2. Production of thyronine (13)

3. Progestone production (107)

4. Inhibition of bioamines (108); dopamine, noradrenalin and

serotonin

5. Prostaglandin synthesis (46,47,109)

6. Dopamine metabolism (110)

7. Regulates Reticulum Calcium Transport (111)

8. Oxidative stimulation:

Hydrogen peroxide directly and indirectly stimulates oxidative enzyme

systems. Micromolar amounts of infused H202 has been found to increase

oxidative enzymatic activity to the maximum rate of reaction (40).

1. Increases GSH oxidation to GSSG which increases ATP production(112)

2. Activates Hexose Monophosphate Shunt(41)

3. Alters Na-K ATPase activity (12)

4. Regulates cellular (113) and mitochondrial (15) membrane transport

5. Regulates thermogenic control (11)

3. CARDIOVASCULAR RESPONSE

A. Vasodilation

1. Dilation of peripheral vessels (31)

2. Dilation of coronary vessels (114)

3. Aortic strip relaxation response (115)

4. Cerebral arteriolar dilation (116,117)

5. Pulmonary arterial relaxation (118)

B. Vasoconstriction

1. Essential Hypertension effect (31)

2. Peripheral vasoconstriction may occur in normal-tensive patients with

concentrations at or below 0.0375% with no significant increase in mean

pressures(123).

C. Cardiac Responses (12-3)

1. Decreases Heart Rate

2. Decreases Vascular Resistance

3. Increases Stroke Volume

4. Increases Cardiac Output

5. Increases Cardiac Index

4. GLUCOSE UTILIZATION

A. H202 mimics insulin (16)

B. Increases glycogen production from glucose (119)

C. Type II Diabetes Mellitus stabilized with H202 infusions (20)

5. GRANULOCYTE RESPONSE

A. Depressed granulocytes after treatment then rebound measured after 24

hours (31)

B. Secondary resistance to peroxide after exposure (109)

C. Alteration of T4/T8 ratio with increase of T4 Helper cells (28)

6. IMMUNE RESPONSE

A. Stimulates Monocytes (92)

B. Stimulates T Helper cells (109)

C. Stimulates Gamma Interferon production (58)

D. Decreases B-cell activity (121)

E. Responsible for immunoregulation (58)

F. Regulates inflammatory response (122)

INDICATIONS

Intravenous Hydrogen Peroxide is used in the acute reactive conditions ;

i.e., influenza, bronchitis, Herpes Zoster, asthmatic reactions, etc.)

because of its direct killing effect on micro-organisms or its effect on

vasospasm or bronchospasm. The long term effect, to regulate or modify the

immune response through cellular activation or modification of immune

dysfunction, such as EBV, Candida, CMV, Herpes, HIV, Diabetes Type II, COPD,

vascular disease, arthritis, and etc., is an important therapeutic tool for

every physician.

The therapeutic use of intravenous H202 has been reported in the following

diseases or conditions with varying results depending on the clinical

investigator:

l. Peripheral Vascular Disease

2. Cerebral Vascular Disease

3. Alzheimer

4. Cardiovascular Disease

5. Coronary Spasm (angina)

6. Cardioconversion

7. Arrhythmias

8. Chronic Obstructive Pulmonary Disease

9. Emphysema

10. Asthma

11. Influenza

12. Herpes Zoster

13. Herpes Simplex

14. Temporal Arteritis

15. Systemic Chronic Candidiasis

16. Chronic Recurrent Epstein Barr Infection

17. Diabetes Type II

18. HIV infections

19. Metastatic Carcinoma

20. Multiple Sclerosis

21. Rheumatoid Arthritis

22. Acute and Chronic viral infections

23. Chronic unresponsive bacterial infection

24. Parasitic infections

25. Parkinsonism

26. Migraine headaches

27. Cluster headaches

28. Vascular headaches

29. Chronic pain syndromes (multiple etiologies)

30. Environmental allergy reactors (Universal)

Many in-vitro and some in-vivo studies have shown H202 to be bactericidal,

fungicidal, parasiticidal, viricidal, and to lyse certain tumor cell types

in cultures. The therapeutic benefit of H202 infusions in patients with any

of the following infections and/or tumors may not be clinically documented.

Therefore, no recommendation can be made until appropriate studies have been

conducted.

BACTERIA

1. Legionella pneumophila (62)

2. Treponema pallidum (63)

3. Escherichia coli (64)

4. Salmonella typhimurium (65)

5. Mycobacterium leprae (66)

6. Staphylococcus auerus (67)

7. Pseudomonas acruginosa (68)

8. Campylobacter jejuni (69)

9. Salmonella typhi (70)

10. Group B Streptococci (71)

11. Bacillus cereus (72)

12. Actinobacillus actinomycetem comitans (73)

13. Bacteroides (74)

14. Neisseria gonorrhoea (75)

FUNGI

1. Histoplasma capsulatum (76)

2. Candida Albicans (77)

3. Coccidioides (78)

4. Paracoccidiodes (78)

5. Blastomyces (78)

6. Sporothrix (78)

7. Mucoraceae(78)

8. Aspergillus fumigatus (79)

9. Coccidioides immitis (80)

PARASITES

1. Pneumocystis carinii (81)

2. Plasmodium yoelii (82)

3. Plasmodium berghei (82)

4. Toxoplasma gondii (83)

5. Nippostrongycus brasiliensis (84)

6. Naegleria fowleri (85)

7. Leishmania major (86)

8. Schistosoma mansoni (87)

9. Chlamydia psittaci (88)

10. Trichomonas vaginalis (89)

11. Tepanosoma cruzi (90)

12. Endameba histolytica (91)

VIRUS

1. Human Immunodeficiency Virus (92)

2. Cytomegalovirus (67)

3. Lymphocytic choriomeningitis virus (93)

4. Tacaribe virus (93)

TUMOR TYPE

1. Ehrlich carcinoma (94)

2. Neuroblastoma (95)

CONTRAINDICATIONS

PRECAUTIONS:

Hydrogen Peroxide infusions are contraindicated in pregnancy, Chronic

Granulomatous Disease (CGD), and any disorder of cell membrane stability

(i.e. anemias).

SIDE EFFECTS:

The most frequent side effect reported (at concentrations above 0.0375%) is

vasculitis, which may occur in the infused vein and/or its tributaries. This

phenomenon is inconsistent, occurring repeatedly in some patients but rarely

in others. According to Shingu, (97) epithelial and smooth muscle cells

contain very little, if any, catalase and, therefore, may be sensitive to

the effects of H202. There appears to be a critical concentration of H202

which is cytolytic, and will cause vasculitis if exceeded.

It is, therefore, important to consider the concentration being infused and

the size of the vessel. This reaction is less likely to occur if a larger

vein in the antecubital area is used for infusion, and the rate of

administration is reduced. Once the cytolytic concentration is exceeded, the

cells swell up, become toxic and die. The exact mechanism by which H202 is

cytotoxic are not defined, however, *NOTE* Recent studies have revealed the

addition of 0.5 mg Manganese to the intravenous solution to be effective in

controlling the endothelial damage caused by the H202 solution. It is

reported that there may be no microscopic signs of cytotoxicity for 6 hours

or longer after exposure of the cells to H202. Consequently, after you

infuse a patient, the vasculitis may not be apparent until the following

day. The application of heat may make the reaction more severe since heat

speeds up the rate of most biochemical reactions, and this may be no

exception. We recommend you use only the larger veins for infusion, and

reduce the rate of infusion if you suspect the patient's blood flow rate is

slower than usual. It has also been found useful to rotate between the veins

and not use the same vein for two consecutive treatments. Rotate between

veins and alternate treatments from one arm to the other. Some physicians

report they have flushed the vessel post-infusion with additional heparin,

or Decadron, but results have not been changed.

All oral supplements and drugs should be withheld on the day of infusion.

Taking antioxidants on the day of infusion would appear to be

counterproductive and may aggravate the vasculitis. Intravenous H202 delays

clotting by 20%, but reduces bleeding time approximately 50%. Caution should

be exercised when giving H202 to patients taking anticoagulants since

clinical data is not available at this time for comment.

ALLERGIC PHENOMENON:

Occasionally, a non-tender red streak will appear, tracing the route of the

vessel above the point of infusion. This streak will often have a diffused

fanned-out appearance radiating laterally from the central streak. No

relationship has been identified between this superficial vascular

phenomenon and the vasculitis previously described. This vascular phenomenon

occurs randomly in patients and has been observed at a rate of about 1 in 50

infusions in concentrations greater than 0.0375%, but only 1 in 500 at

concentrations at or below 0.0375%. Several hundred infusions have been

given, and no other type of local or systemic allergic vascular reaction has

been observed or reported.

CHEST DISCOMFORT:

Some physicians have reported occasional patient complaints of vague chest

discomfort, sometimes associated with a feeling of shortness of breath. We

received two reports that the chest discomfort was severe enough to

discontinue the treatments. Bronchodilators should be withheld for at least

a day before H202 is administered, if possible.

INFUSION SITE PAIN:

Pain at and above the infusion site is occasionally reported. The pain is

described as a spastic ache and is most likely due to vasospasm. On rare

occasions, the pain may extend from the point of infusion, at or below the

antecubital area, up into the deltoid area. Reducing the rate of infusion,

heat, and ice have all been ineffective in controlling the pain. We have

found, when this occurs, the best thing to do is remove the needle and

restart the infusion in another vein. We

speculate the irritation to the vessel, at the point of penetration, causes

a reflex vasospasm along the vessel. Changing the needle position or

rotating its position in the same vein does little to relieve the

discomfort.

HERXHEIMER TYPE REACTION:

Several physicians have reported an occasional Herxheimer-like reaction when

treating patients with mucocutaneous candidiasis. Following infusions of

H202 the patients were reported to have generalized migratory aching,

nausea, headaches, chills, and fever. It has been reported to occur after

one, two, and sometimes three treatments, but, thereafter, the patients

report an improvement in their overall clinical status, and continue to

improve with each succeeding treatment. No patients have been discontinued

from treatments because of this reaction. It does not occur consistently nor

is it predictable.

TOXICITY

Hydrogen peroxide is a product of intermediate metabolism, widely

distributed throughout the body, and participates in a significant number of

biochemical reactions. It is a principal electron receptor in the body in

many RedOx reactions. A vast amount of knowledge exists about the chemistry

of H202 in tissue slices, tissue cultures, bacteria, parasites, yeast,

protozoa, blood cells, and isolated human, animal, and plant cells. Numerous

examples of biochemical changes have been described in the literature, which

are interpreted as toxic or damaging in the models studied. Clinically,

however, no significant acute toxicity has been observed in several hundred

patients, some receiving up to 40 to 50 infusions with concentrations up to

0.3 %. Also, no chronic or long term toxicity has been observed or

documented up to two years post-multiple infusions. One patient received

3,600 mL of 0.15% of Hydrogen Peroxide intravenously in a period of 10 days

without any side effect. This dosage is approximately 40 times greater than

the currently recommended therapeutic dosage. Other studies suggest doses

500 times smaller than the currently recommended dose will have biological

effect. This suggested intravenous infusions of Hydrogen Peroxide is

extremely safe and has a very wide therapeutic range.

Consequently, the majority of toxic reactions referred to in the literature,

which occur with in-vitro studies under laboratory conditions, which could

not exist in-vitro, have very little clinical application. Some of the

in-vitro toxic effects are:

A. Lipid Peroxidation (49,98)

B. Single strand DNA breakage (99)

C. Cytotoxic (concentrations above 10 mMol) (100)

D. RBC hemolysis (26,101)

E. Chromosomal Aberrations (102)

F. Protein degradation (103)

G. Glutathione Peroxidase depiction (104)

H. Degredates Cytochrome C (105)

I. Platelet Aggregation (106)

FORMULAS

INTRAVENOUS ADMINISTRATION OF H202 SOLUTION

The PROPER DOSAGE is dependent upon the CONCENTRATION used, the VOLUME

INFUSED, and the RATE OF INFUSION.

The infusion mixture is prepared as follows: The preferred carrier is 5%

Dextrose in Water or Normal Saline. Hydrogen Peroxide is available currently

in a 3% USP/NF grade and is ideal for intravenous use. It must be packed in

an open vial however with a vented cap to allow the escape of oxygen

pressure produced by the dismutation. Some physicians are concerned about

sterilization because of the packaging but hydrogen peroxide is self

sterilizing. Proper dilutions are simple. Add 1 mL of the 3% Hydrogen

Peroxide USP/NF solution to each 100 mL carrier solution. If you plan to

give 250 mL treatment you add 2.5 mL of the peroxide in 250 mL of carrier, 5

mL to 500 mL carrier and etc. for the proper dilution. Select a medium to

large vein close to the antecubital area for the infusion. Use a small

winged needle and infuse slowly over a period of 1 to 1 1/2 hours. The rate

of infusion and concentration are both important as explained below.

THERAPEUTIC INFUSION SCHEDULES

The dosage administered is dictated by the therapeutic and objective

experience of the clinician. The physician should consider the clinical

objective after the diagnosis has been properly established. A general rule:

the more acute the pathology the greater the volume and concentration and

the more frequent the infusions. The frequency may be maintained until the

acute problem is considered stable, and then both dose and frequency

reduced. As an example, a patient with acute influenza or Herpes Zoster may

be placed on a schedule of 250 to 500 mL of H202 of 0.03% or less

concentration, daily for 1 to 5 infusions or until clinical response is

obvious.

Occasionally, these patients may require a treatment once or twice a week

for an additional 5 to 10 treatments, particularly in infections which have

a tendency to become chronic such as Herpes or Hepatitis. A therapeutic

regimen for a chronic, low grade infection or chronic illness would be to

schedule smaller doses over a longer period of time. Examples of chronic

illnesses in which long term therapy might be employed would include:

Chronic candidias, chronic obstructive pulmonary disease, peripheral

occlusive disease, chronic EBV, or Hepatitis, and etc. A typical treatment

plan would be to give 100 to 250 mL H202 of 0.03% concentration once or

twice a week. After the initial schedule of 10 to 15 treatments, wait 30 to

60 days and evaluate the response. Depending on the response, you may wish

to give an additional series of 10 to 15 treatments and again wait and

re-evaluate. An alternative is to keep the patient on bimonthly or monthly

maintenance treatments for a year and then reevaluate annually.

The following are examples of treatment schedules which have been employed

in these selected cases.

1. ACUTE PULMONARY INFECTIONS INCLUDING INFLUENZA PNEUMONIA.

Infusions of Hydrogen Peroxide have a rapid 'Alka-seltzer effect' in the

lungs. If the patient has moist lungs and/or a productive cough, the

treatment will usually cause coughing and mucous production to increase

immediately. It may continue throughout the treatment but will subside soon

after the treatment is completed. If the patient is quite ill and febrile,

the initial treatment would be 250 to 500 mL of 0.03%. If the patient

remains febrile the second day, give an additional 250 to 500 mL of 0.03%.

Treat according to response, thereafter, every two to three days until the

desired response is obtained.

2. CHRONIC LUNG DISEASE (COPD, BRONCHITIS, BRONCHIECTASIS, EMPHYSEMA)

Chronic lung disease, which is moist and active, responds best to treatment.

The response in dry emphysema or pulmonary fibrosis is less dramatic. Give

250 mL 0.03% weekly for 10 to 15 weeks. Frequently, the effects will be

dramatic, with coughing and sputum production initially, and the patients

reporting increased energy and ability to breathe within 24 hours. The

effects of treatments are usually progressive improvement for 8 to 10

treatments, and then the effects plateau. Most patients will wish to

continue on monthly maintenance treatments.

3. ALLERGIC REACTIONS, ASTHMA, ENVIRONMENTAL SENSITIVITY, ETC.

The longer the patient has had their allergic reactive problem, the longer

it will be before you will have a positive response. This general rule,

however, does not always apply. Some patients respond rapidly, within 2 to 3

treatments. In these complex patients, schedule weekly treatments for 10

weeks, give the patient a 30 day rest, and repeat an additional 10 weekly

treatments. You may give up to 40 to 50 treatments on this schedule, or

until you feel maximum response has been obtained. Most patients will

realize improvement after their first course of 10 treatments. Thereafter,

patients show a gradual improvement with each successive group of 10

treatments. If the patient shows no improvement after 30 to 40 treatments,

then no response is likely and therapy is discontinued.

4. ACUTE AND CHRONIC PAIN

Angina, headaches, vasospasm, tumor pain, or neurological pain frequently

show an immediate and dramatic response to one or two treatments. Chronic

pain syndromes may require several (8-10) treatments but response is

frequent. There is no good explanation why Hydrogen Peroxide should relieve

pain, but, nevertheless, this has been a frequently reported clinical

observation. Chronic, established pain of Post Herpetic Neuralgia may not

respond to treatments, but the response in Acute Herpes Zoster is often

dramatic.

5. EBV, CMV, HIV, HERPES, HEPATITIS ETC.

Acute infections require frequent daily treatments, whereas, chronic

infections require long term weekly treatments. Symptomatic response may

occur after only 1 or 2 treatments, but antibody titers may not change until

10 to 30 weekly treatments have been given.

6. CEREBRAL VASCULAR, ALZHEIMER, TOXIC DEMENTIA, ETC.

Perhaps the increased oxygenation can explain the sometimes rapid reversal

of symptoms in these patients. Acuity, memory, recall, alertness, and other

cerebral symptoms frequently improve quickly and the improvement appears to

be long lasting. The results may also be related to changes in the bioamines

in the brain because positive results are also seen in anxiety/depressive

non-toxic young adults. Ten weekly treatments are usually given before the

effectiveness of treatment is evaluated.

7. CARDIOVASCULAR AND PERIPHERAL VASCULAR DISEASE

Using weekly treatments of smaller volume; i.e., 100 to 250 mL, can be very

beneficial to these patients if your objective is to restore oxygenation to

the tissue. If the objective is to push a gangrenous digit or extremity to

the point of demarcation for surgical debridement, then 250 to 500 mL are

given daily, for several days, until demarcation is completed.

The following are actual case reports, from the initial studies (31) on the

Intravenous Use of Hydrogen Peroxide. Higher concentrations were used in

these studies than currently recommended. Same or similar cases have been

repeated many times since, at the lower concentration of 0.03%, with equally

good clinical results but WITHOUT vasculitis or other side effects. We,

therefore, recommend you do not exceed the 0.03% concentrations.

1. Acute Herpes Zoster. 250 mL of 0.15% initially, then every two days for a

total of 6 treatments. Comment: Resolved completely in less than 1 week with

no residual.

2. Acute Influenza Syndrome. 250 mL of 0.15% initially, and 500 mL of 0.15%

the second day. Afebrile after second day, but additional treatment the

third day of 250 mL of 0.15%. Comment: Resolution of all symptoms after the

second day with no residual.

3. Chronic Systemic Candidiasis: 250 mL of 0.15% once a week for 10

treatments, and then monthly followup for 10 months. Comment: Clinical

response not observed until after the 4th treatment, then gradual

improvement continued. Maintained on monthly treatments.

4. Severe COPD. Initial 250 mL of 0.15% which caused significant alveolar

debridement and coughing up of copious amount of purulent material.

Continued weekly infusions for 6 weeks, and by the end of the 6th treatment

the patient no longer coughing. Pulmonary function improved and the patient

returned to working full time. Comment: Maintained on treatment according to

patients " feel the need " which re-occurs approximately every 4 to 6 weeks.

5. Acute Asthmatic Attack (12 yr old girl): Attack onset 24 hours prior to

treatment Given 100 mL of 0.15% with complete resolution of the attack

within 6 hours following the infusion. Comment: No followup treatment

necessary.

6. Diabetes Mellitus Type II. 25 year history of diabetes taking 30 units

NPH AM and PM. After 5 treatments of 250 mL of 0.15%, insulin reduced to 30

units AM and 15 units PM. Insulin reduced to 15 units AM only after 3

additional treatments because the patient was having symptoms of

hypoglycemia. Discontinued all insulin after 10 treatments and given H202 on

a monthly maintenance. Followup GTC appears more normal. Comment: Will

maintain on schedule according to fasting blood sugars in future.

7. Chronic Post Herpetic Neuralgia: Post herpetic neuralgia persisting 1

year following a severe Herpes Zoster infection on right anterior and

lateral chest wall. Given 250 mL of 0.075% weekly for 10 weeks. Neuralgic

pain substantially reduced after 5th treatment and completely gone after

10th treatment. Comment: Will followup at 3 month intervals and as

necessary.

8. Impending Cerebral Vascular Accident. 71 year old man with sudden onset

two hours previously of confusion, paralysis, and weakness on left side of

body, and drooling and unable to speak distinctively. Initial brood pressure

190/100, pulse normal. Given 250 mL of 0.03% H202 started immediately. All

symptoms significantly improved within 30 minutes and completely resolved

after 1 hour.

Comment: Patient did not return for followup evaluation but was asymptomatic

with blood pressure of 140/90 when he left the office.

HYDROGEN PEROXIDE PROTOCOL REFERENCES

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62. Levitz SM and Diamond RD: Mechanisms of Resistance of Aspergillus

fumigatus Conidia to Killing by Neutrophils In Vitro. J Infect Dis 1985;

152(l): 33-42

63. Gaigiani J N: Inhibition of Different Phases of Coccidiodides immitis by

Human Neutrophils or Hydrogen Peroxide. J Infect Dis 1986: 153(2): 217-22

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66. Murray HW: Cellular Resistance to Protozoal Infection. Annu Rev Med

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69. Passwell JH, Shor R, Gazit E, et a]: The Effects of Con A-induced

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14(2): 205-13

Duncan

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<<Rich, it is my understanding that 35% ,(only pharmacutical grade) h202

must be diluted with pharm. (glucose)down to 3% and dripped. This from

my Dr.........>>

OUCH NO! HE'S 50 TIMES TOO HIGH!!

From an authoratative article.............

Hydrogen Peroxide is available currently

in a 3% USP/NF grade and is ideal for intravenous use. It must be packed in

an open vial however with a vented cap to allow the escape of oxygen

pressure produced by the dismutation. Some physicians are concerned about

sterilization because of the packaging but hydrogen peroxide is self

sterilizing. Proper dilutions are simple. Add 1 mL of the 3% Hydrogen

Peroxide USP/NF solution to each 100 mL carrier solution.

A typical treatment

plan would be to give 100 to 250 mL H202 of 0.03% concentration once or

twice a week. After the initial schedule of 10 to 15 treatments, wait 30 to

60 days and evaluate the response.

Within 1 hour after the intravenous infusion of 250 mL 0.15% H202 a 2% to

10% decrease was noted in the following blood constituents: Bun, Sodium,

Potassium, Chloride, Uric acid, Calcium, Phosphorus, Total protein, Total

bilirubin, Alkaline phosphatase, AST, ALT, GGTP, LDH, Iron and Globulin.

Follow-up studies, 24 hours later, revealed all the above blood constituents

had returned to normal pre-infusion levels.

Here's the rest of this particular article..

_______________________

INTRAVENOUS HYDROGEN PEROXIDE THERAPY

(Quick Overview)

MECHANISMS

Oliver (l) first reported the use of Intravenous Hydrogen Peroxide (H202),

in 1920 in patients with Influenzal Pneumonia. An epidemic in Busrah in June

and July of 1919, had a calculated death-rate over 80 percent. Oliver

treated 25 critical patients with intravenous infusions of H202 and 13 fully

recovered reducing the mortality to 48 percent. He was impressed with the

rapid clinical response and postulated the effects were probably due to the

oxidation of toxins more than the relief of hypoxia.

Hydrogen peroxide used in surgical procedures had caused air embolisms, but

he reasoned if the oxygen was released slowly, embolism should not occur.

Venous oxygen embolism has been reported following the irrigation of anal

fistulae (2), surgical wounds (3), and closed body cavities (4). Ulcerative

colitis (5) has been produced in patients using H202 in enema solutions to

break up fecal impactions. It has been shown, however, to destroy murine

malaria parasites (7), and the bactericidal properties of H202 produced by

neutrophils is well documented (8-10).

Hydrogen peroxide appears to be involved in many intermediate biochemical

pathways. Additionally, it appears to kill certain bacteria, parasites,

yeast, protozoa, inhibit viruses, and oxidize immunocomplexes. T. Ramasarma

(11), in his review on the " Generation of H202 in Biomembranes " , states:

" H202 is a purposeful molecule in cellular metabolism and cannot be

dismissed as a mere undesirable byproduct of oxygen species generation " .

Hydrogen peroxide is generated in most biological membranes; cellular,

mitochondrial, and nuclear. It is important for maintaining membrane

integrity and regulating membrane transport through the alteration of Na-K

ATPase activity. This was confirmed by Garner et al (12). Hydrogen peroxide

fulfills the role of a secondary messenger in several hormonal pathways. As

an example, H202 generation in the uterus is dependent on estrogen and is

necessary for the production of progesterone. The iodination of

thyroglobulin and thyroxine synthesis requires the presence of peroxidase,

H202, and iodide (13). Thyroxine increases and hypothyroidism decreases

hydrogen peroxide production in studies of liver mitochondria (14). Hydrogen

peroxide has an insulin-mimic action and acts as a postbinding site on the

plasma membrane to induce glucose transport (15).

More recent studies of Helm (16) found the insulinomimetic action involves a

common mechanism which links the generation of active oxygen species through

the redox potential of the cell to the activation of a proteinase. It helps

regulate metabolic control through protein modification which alters enzyme

activities.

Thermogenic control (11,14) appears to be exercised through the action of

H202 on the mitochondria. At the mitochondrial level, H202 is generated by a

number of substrates. Flavoproteins converge at ubiquinone which forms a

link between H202 generation and the respiratory chain. Noradrenaline,

thyroxine, and cold stimulate the system to generate heat. Heat increases

the rate of H202 production and is dependent on alpha-adrenergic receptors

which also control non-shivering thermogenesis.

The balance of Ferric (3+) and Ferrous (2+) Iron in the body is critical to

support lipid peroxidation of cellular membranes (27). It has been reported

that a ratio of Fe(3+)/Fe(2+) of 1:1 to 8:1 is optimal to cause the

formation of -OH radicals and lipid peroxidation. At ratios above or below

these levels, lipid peroxidation does not occur. Physiological

concentrations of either H202 or Ascorbic Acid may encourage lipid

peroxidation and at these levels antioxidant protection is important.

Increasing the concentration of H202, as occurs with therapeutic intravenous

infusions, the Ferric/Ferrous ratio is maintained above 8:1 by keeping

excess Ferrous (Fe2+) Iron oxidized to the Ferric (Fe3+) state. A principal

mechanism of action of EDTA Chelation Therapy is reducing Free Radical

damage and lipid peroxidation by complexing EDTA with Ferrous Iron

(Fe3+:EDTA) which helps maintain the Ferric/Ferrous ratio above 8:1 (28)

Weiss (8) reported H202 is an activator of neutrophils including aggregated

immunoglobulin, activated complement components, immune complexes, or

bacterial peptides.

This would suggest the beneficial clinical effects observed with the use of

ascorbic acid in inflammatory reactions, and its protective action against

infections, is acting through the generation of H202. Also, there is no

evidence H202 initiates or supports microsomal lipid peroxidation (51). The

modification of (Na,K)-ATPase(12) by H202 also contributes to an increase in

metabolic rate.

Farr (40) reported whole blood specimens taken before, during, and after

H202 infusions showed color changes consistent with oxyhemoglobin formation.

Numerous blood profiles and CBC studies have been performed before and

immediately after infusions of H202. Although early investigators reported

no changes in blood elements and certain chemical constituents, except when

injected into the carotid arteries, consistent changes have been reported.

Within 1 hour after the intravenous infusion of 250 mL 0.15% H202 a 2% to

10% decrease was noted in the following blood constituents: Bun, Sodium,

Potassium, Chloride, Uric acid, Calcium, Phosphorus, Total protein, Total

bilirubin, Alkaline phosphatase, AST, ALT, GGTP, LDH, Iron and Globulin.

Follow-up studies, 24 hours later, revealed all the above blood constituents

had returned to normal pre-infusion levels.

Some of the biological killing activity of H202 may be attributed to gamma

interferon. Production of gamma interferon by human natural killer cells and

monocytes, is stimulated by H202(58). Both exogenous and endogenous H202

appear to be in part responsible for immunoregulation. The rates of wound

healing, stasis and vascular ulcers (18), peripheral occlusive disease

(59,60), myocardial ischemia (33) and cerebral vascular disease (61) have

all improved when treated with repeated intra-arterial infusions of H202

PHYSICAL PROPERTIES OF HYDROGEN PEROXIDE

Hydrogen Peroxide was discovered in 1818 by the French Chemist Louis-Jacque

Thenard.

Hydrogen Peroxide, hydrogen dioxide (H202), is a colorless (blue in thick

layers) odorless liquid; with a melting point -2 degree C: a boiling point

152 degrees C; decomposes 84 degrees C at 68 mm. pressure (68 degrees C at

26 mm.), soluble in water in all proportions; usually encountered as a

dilute solution (3% H202) solution, that is, one volume of solution yields

10 volumes of oxygen), although available up to 35% strength.

Its remarkable feature is its tendency to decompose readily into water and

oxygen. Decomposition by light begins only in the near ultraviolet. Hydrogen

peroxide solutions dismutate slowly, when undisturbed, at the rate of

approximately 1% per month. The dismutation reaction is rapidly increased in

the presence of particulate contaminates; i.e., dust, flakes of metal or

glass or other particulate matter, at a rate which may be explosive. Cold

retards dismutation and solution may be refrigerated or stored at

temperatures below 0 degrees C. Hydrogen peroxide occurs only in traces in

nature: mostly in rain and snow. It has not yet been detected in

interstellar space.

METABOLIC AND PHYSIOLOGICAL EFFECTS

Numerous physiological effects are attributed to hydrogen peroxide and

documented in the literature. Some of these effects may be broadly

categorized as follows:

1. PULMONARY

A. Increased oxygenation

B. Alveolar debridement (31)

2. METABOLIC RATE

A. Hormonal effect:

Several hormonal effects have been reported to be regulated by the action of

H202.

Examples are:

1.Iodination of thyroglobin(13)

2. Production of thyronine (13)

3. Progestone production (107)

4. Inhibition of bioamines (108); dopamine, noradrenalin and

serotonin

5. Prostaglandin synthesis (46,47,109)

6. Dopamine metabolism (110)

7. Regulates Reticulum Calcium Transport (111)

8. Oxidative stimulation:

Hydrogen peroxide directly and indirectly stimulates oxidative enzyme

systems. Micromolar amounts of infused H202 has been found to increase

oxidative enzymatic activity to the maximum rate of reaction (40).

1. Increases GSH oxidation to GSSG which increases ATP production(112)

2. Activates Hexose Monophosphate Shunt(41)

3. Alters Na-K ATPase activity (12)

4. Regulates cellular (113) and mitochondrial (15) membrane transport

5. Regulates thermogenic control (11)

3. CARDIOVASCULAR RESPONSE

A. Vasodilation

1. Dilation of peripheral vessels (31)

2. Dilation of coronary vessels (114)

3. Aortic strip relaxation response (115)

4. Cerebral arteriolar dilation (116,117)

5. Pulmonary arterial relaxation (118)

B. Vasoconstriction

1. Essential Hypertension effect (31)

2. Peripheral vasoconstriction may occur in normal-tensive patients with

concentrations at or below 0.0375% with no significant increase in mean

pressures(123).

C. Cardiac Responses (12-3)

1. Decreases Heart Rate

2. Decreases Vascular Resistance

3. Increases Stroke Volume

4. Increases Cardiac Output

5. Increases Cardiac Index

4. GLUCOSE UTILIZATION

A. H202 mimics insulin (16)

B. Increases glycogen production from glucose (119)

C. Type II Diabetes Mellitus stabilized with H202 infusions (20)

5. GRANULOCYTE RESPONSE

A. Depressed granulocytes after treatment then rebound measured after 24

hours (31)

B. Secondary resistance to peroxide after exposure (109)

C. Alteration of T4/T8 ratio with increase of T4 Helper cells (28)

6. IMMUNE RESPONSE

A. Stimulates Monocytes (92)

B. Stimulates T Helper cells (109)

C. Stimulates Gamma Interferon production (58)

D. Decreases B-cell activity (121)

E. Responsible for immunoregulation (58)

F. Regulates inflammatory response (122)

INDICATIONS

Intravenous Hydrogen Peroxide is used in the acute reactive conditions ;

i.e., influenza, bronchitis, Herpes Zoster, asthmatic reactions, etc.)

because of its direct killing effect on micro-organisms or its effect on

vasospasm or bronchospasm. The long term effect, to regulate or modify the

immune response through cellular activation or modification of immune

dysfunction, such as EBV, Candida, CMV, Herpes, HIV, Diabetes Type II, COPD,

vascular disease, arthritis, and etc., is an important therapeutic tool for

every physician.

The therapeutic use of intravenous H202 has been reported in the following

diseases or conditions with varying results depending on the clinical

investigator:

l. Peripheral Vascular Disease

2. Cerebral Vascular Disease

3. Alzheimer

4. Cardiovascular Disease

5. Coronary Spasm (angina)

6. Cardioconversion

7. Arrhythmias

8. Chronic Obstructive Pulmonary Disease

9. Emphysema

10. Asthma

11. Influenza

12. Herpes Zoster

13. Herpes Simplex

14. Temporal Arteritis

15. Systemic Chronic Candidiasis

16. Chronic Recurrent Epstein Barr Infection

17. Diabetes Type II

18. HIV infections

19. Metastatic Carcinoma

20. Multiple Sclerosis

21. Rheumatoid Arthritis

22. Acute and Chronic viral infections

23. Chronic unresponsive bacterial infection

24. Parasitic infections

25. Parkinsonism

26. Migraine headaches

27. Cluster headaches

28. Vascular headaches

29. Chronic pain syndromes (multiple etiologies)

30. Environmental allergy reactors (Universal)

Many in-vitro and some in-vivo studies have shown H202 to be bactericidal,

fungicidal, parasiticidal, viricidal, and to lyse certain tumor cell types

in cultures. The therapeutic benefit of H202 infusions in patients with any

of the following infections and/or tumors may not be clinically documented.

Therefore, no recommendation can be made until appropriate studies have been

conducted.

BACTERIA

1. Legionella pneumophila (62)

2. Treponema pallidum (63)

3. Escherichia coli (64)

4. Salmonella typhimurium (65)

5. Mycobacterium leprae (66)

6. Staphylococcus auerus (67)

7. Pseudomonas acruginosa (68)

8. Campylobacter jejuni (69)

9. Salmonella typhi (70)

10. Group B Streptococci (71)

11. Bacillus cereus (72)

12. Actinobacillus actinomycetem comitans (73)

13. Bacteroides (74)

14. Neisseria gonorrhoea (75)

FUNGI

1. Histoplasma capsulatum (76)

2. Candida Albicans (77)

3. Coccidioides (78)

4. Paracoccidiodes (78)

5. Blastomyces (78)

6. Sporothrix (78)

7. Mucoraceae(78)

8. Aspergillus fumigatus (79)

9. Coccidioides immitis (80)

PARASITES

1. Pneumocystis carinii (81)

2. Plasmodium yoelii (82)

3. Plasmodium berghei (82)

4. Toxoplasma gondii (83)

5. Nippostrongycus brasiliensis (84)

6. Naegleria fowleri (85)

7. Leishmania major (86)

8. Schistosoma mansoni (87)

9. Chlamydia psittaci (88)

10. Trichomonas vaginalis (89)

11. Tepanosoma cruzi (90)

12. Endameba histolytica (91)

VIRUS

1. Human Immunodeficiency Virus (92)

2. Cytomegalovirus (67)

3. Lymphocytic choriomeningitis virus (93)

4. Tacaribe virus (93)

TUMOR TYPE

1. Ehrlich carcinoma (94)

2. Neuroblastoma (95)

CONTRAINDICATIONS

PRECAUTIONS:

Hydrogen Peroxide infusions are contraindicated in pregnancy, Chronic

Granulomatous Disease (CGD), and any disorder of cell membrane stability

(i.e. anemias).

SIDE EFFECTS:

The most frequent side effect reported (at concentrations above 0.0375%) is

vasculitis, which may occur in the infused vein and/or its tributaries. This

phenomenon is inconsistent, occurring repeatedly in some patients but rarely

in others. According to Shingu, (97) epithelial and smooth muscle cells

contain very little, if any, catalase and, therefore, may be sensitive to

the effects of H202. There appears to be a critical concentration of H202

which is cytolytic, and will cause vasculitis if exceeded.

It is, therefore, important to consider the concentration being infused and

the size of the vessel. This reaction is less likely to occur if a larger

vein in the antecubital area is used for infusion, and the rate of

administration is reduced. Once the cytolytic concentration is exceeded, the

cells swell up, become toxic and die. The exact mechanism by which H202 is

cytotoxic are not defined, however, *NOTE* Recent studies have revealed the

addition of 0.5 mg Manganese to the intravenous solution to be effective in

controlling the endothelial damage caused by the H202 solution. It is

reported that there may be no microscopic signs of cytotoxicity for 6 hours

or longer after exposure of the cells to H202. Consequently, after you

infuse a patient, the vasculitis may not be apparent until the following

day. The application of heat may make the reaction more severe since heat

speeds up the rate of most biochemical reactions, and this may be no

exception. We recommend you use only the larger veins for infusion, and

reduce the rate of infusion if you suspect the patient's blood flow rate is

slower than usual. It has also been found useful to rotate between the veins

and not use the same vein for two consecutive treatments. Rotate between

veins and alternate treatments from one arm to the other. Some physicians

report they have flushed the vessel post-infusion with additional heparin,

or Decadron, but results have not been changed.

All oral supplements and drugs should be withheld on the day of infusion.

Taking antioxidants on the day of infusion would appear to be

counterproductive and may aggravate the vasculitis. Intravenous H202 delays

clotting by 20%, but reduces bleeding time approximately 50%. Caution should

be exercised when giving H202 to patients taking anticoagulants since

clinical data is not available at this time for comment.

ALLERGIC PHENOMENON:

Occasionally, a non-tender red streak will appear, tracing the route of the

vessel above the point of infusion. This streak will often have a diffused

fanned-out appearance radiating laterally from the central streak. No

relationship has been identified between this superficial vascular

phenomenon and the vasculitis previously described. This vascular phenomenon

occurs randomly in patients and has been observed at a rate of about 1 in 50

infusions in concentrations greater than 0.0375%, but only 1 in 500 at

concentrations at or below 0.0375%. Several hundred infusions have been

given, and no other type of local or systemic allergic vascular reaction has

been observed or reported.

CHEST DISCOMFORT:

Some physicians have reported occasional patient complaints of vague chest

discomfort, sometimes associated with a feeling of shortness of breath. We

received two reports that the chest discomfort was severe enough to

discontinue the treatments. Bronchodilators should be withheld for at least

a day before H202 is administered, if possible.

INFUSION SITE PAIN:

Pain at and above the infusion site is occasionally reported. The pain is

described as a spastic ache and is most likely due to vasospasm. On rare

occasions, the pain may extend from the point of infusion, at or below the

antecubital area, up into the deltoid area. Reducing the rate of infusion,

heat, and ice have all been ineffective in controlling the pain. We have

found, when this occurs, the best thing to do is remove the needle and

restart the infusion in another vein. We

speculate the irritation to the vessel, at the point of penetration, causes

a reflex vasospasm along the vessel. Changing the needle position or

rotating its position in the same vein does little to relieve the

discomfort.

HERXHEIMER TYPE REACTION:

Several physicians have reported an occasional Herxheimer-like reaction when

treating patients with mucocutaneous candidiasis. Following infusions of

H202 the patients were reported to have generalized migratory aching,

nausea, headaches, chills, and fever. It has been reported to occur after

one, two, and sometimes three treatments, but, thereafter, the patients

report an improvement in their overall clinical status, and continue to

improve with each succeeding treatment. No patients have been discontinued

from treatments because of this reaction. It does not occur consistently nor

is it predictable.

TOXICITY

Hydrogen peroxide is a product of intermediate metabolism, widely

distributed throughout the body, and participates in a significant number of

biochemical reactions. It is a principal electron receptor in the body in

many RedOx reactions. A vast amount of knowledge exists about the chemistry

of H202 in tissue slices, tissue cultures, bacteria, parasites, yeast,

protozoa, blood cells, and isolated human, animal, and plant cells. Numerous

examples of biochemical changes have been described in the literature, which

are interpreted as toxic or damaging in the models studied. Clinically,

however, no significant acute toxicity has been observed in several hundred

patients, some receiving up to 40 to 50 infusions with concentrations up to

0.3 %. Also, no chronic or long term toxicity has been observed or

documented up to two years post-multiple infusions. One patient received

3,600 mL of 0.15% of Hydrogen Peroxide intravenously in a period of 10 days

without any side effect. This dosage is approximately 40 times greater than

the currently recommended therapeutic dosage. Other studies suggest doses

500 times smaller than the currently recommended dose will have biological

effect. This suggested intravenous infusions of Hydrogen Peroxide is

extremely safe and has a very wide therapeutic range.

Consequently, the majority of toxic reactions referred to in the literature,

which occur with in-vitro studies under laboratory conditions, which could

not exist in-vitro, have very little clinical application. Some of the

in-vitro toxic effects are:

A. Lipid Peroxidation (49,98)

B. Single strand DNA breakage (99)

C. Cytotoxic (concentrations above 10 mMol) (100)

D. RBC hemolysis (26,101)

E. Chromosomal Aberrations (102)

F. Protein degradation (103)

G. Glutathione Peroxidase depiction (104)

H. Degredates Cytochrome C (105)

I. Platelet Aggregation (106)

FORMULAS

INTRAVENOUS ADMINISTRATION OF H202 SOLUTION

The PROPER DOSAGE is dependent upon the CONCENTRATION used, the VOLUME

INFUSED, and the RATE OF INFUSION.

The infusion mixture is prepared as follows: The preferred carrier is 5%

Dextrose in Water or Normal Saline. Hydrogen Peroxide is available currently

in a 3% USP/NF grade and is ideal for intravenous use. It must be packed in

an open vial however with a vented cap to allow the escape of oxygen

pressure produced by the dismutation. Some physicians are concerned about

sterilization because of the packaging but hydrogen peroxide is self

sterilizing. Proper dilutions are simple. Add 1 mL of the 3% Hydrogen

Peroxide USP/NF solution to each 100 mL carrier solution. If you plan to

give 250 mL treatment you add 2.5 mL of the peroxide in 250 mL of carrier, 5

mL to 500 mL carrier and etc. for the proper dilution. Select a medium to

large vein close to the antecubital area for the infusion. Use a small

winged needle and infuse slowly over a period of 1 to 1 1/2 hours. The rate

of infusion and concentration are both important as explained below.

THERAPEUTIC INFUSION SCHEDULES

The dosage administered is dictated by the therapeutic and objective

experience of the clinician. The physician should consider the clinical

objective after the diagnosis has been properly established. A general rule:

the more acute the pathology the greater the volume and concentration and

the more frequent the infusions. The frequency may be maintained until the

acute problem is considered stable, and then both dose and frequency

reduced. As an example, a patient with acute influenza or Herpes Zoster may

be placed on a schedule of 250 to 500 mL of H202 of 0.03% or less

concentration, daily for 1 to 5 infusions or until clinical response is

obvious.

Occasionally, these patients may require a treatment once or twice a week

for an additional 5 to 10 treatments, particularly in infections which have

a tendency to become chronic such as Herpes or Hepatitis. A therapeutic

regimen for a chronic, low grade infection or chronic illness would be to

schedule smaller doses over a longer period of time. Examples of chronic

illnesses in which long term therapy might be employed would include:

Chronic candidias, chronic obstructive pulmonary disease, peripheral

occlusive disease, chronic EBV, or Hepatitis, and etc. A typical treatment

plan would be to give 100 to 250 mL H202 of 0.03% concentration once or

twice a week. After the initial schedule of 10 to 15 treatments, wait 30 to

60 days and evaluate the response. Depending on the response, you may wish

to give an additional series of 10 to 15 treatments and again wait and

re-evaluate. An alternative is to keep the patient on bimonthly or monthly

maintenance treatments for a year and then reevaluate annually.

The following are examples of treatment schedules which have been employed

in these selected cases.

1. ACUTE PULMONARY INFECTIONS INCLUDING INFLUENZA PNEUMONIA.

Infusions of Hydrogen Peroxide have a rapid 'Alka-seltzer effect' in the

lungs. If the patient has moist lungs and/or a productive cough, the

treatment will usually cause coughing and mucous production to increase

immediately. It may continue throughout the treatment but will subside soon

after the treatment is completed. If the patient is quite ill and febrile,

the initial treatment would be 250 to 500 mL of 0.03%. If the patient

remains febrile the second day, give an additional 250 to 500 mL of 0.03%.

Treat according to response, thereafter, every two to three days until the

desired response is obtained.

2. CHRONIC LUNG DISEASE (COPD, BRONCHITIS, BRONCHIECTASIS, EMPHYSEMA)

Chronic lung disease, which is moist and active, responds best to treatment.

The response in dry emphysema or pulmonary fibrosis is less dramatic. Give

250 mL 0.03% weekly for 10 to 15 weeks. Frequently, the effects will be

dramatic, with coughing and sputum production initially, and the patients

reporting increased energy and ability to breathe within 24 hours. The

effects of treatments are usually progressive improvement for 8 to 10

treatments, and then the effects plateau. Most patients will wish to

continue on monthly maintenance treatments.

3. ALLERGIC REACTIONS, ASTHMA, ENVIRONMENTAL SENSITIVITY, ETC.

The longer the patient has had their allergic reactive problem, the longer

it will be before you will have a positive response. This general rule,

however, does not always apply. Some patients respond rapidly, within 2 to 3

treatments. In these complex patients, schedule weekly treatments for 10

weeks, give the patient a 30 day rest, and repeat an additional 10 weekly

treatments. You may give up to 40 to 50 treatments on this schedule, or

until you feel maximum response has been obtained. Most patients will

realize improvement after their first course of 10 treatments. Thereafter,

patients show a gradual improvement with each successive group of 10

treatments. If the patient shows no improvement after 30 to 40 treatments,

then no response is likely and therapy is discontinued.

4. ACUTE AND CHRONIC PAIN

Angina, headaches, vasospasm, tumor pain, or neurological pain frequently

show an immediate and dramatic response to one or two treatments. Chronic

pain syndromes may require several (8-10) treatments but response is

frequent. There is no good explanation why Hydrogen Peroxide should relieve

pain, but, nevertheless, this has been a frequently reported clinical

observation. Chronic, established pain of Post Herpetic Neuralgia may not

respond to treatments, but the response in Acute Herpes Zoster is often

dramatic.

5. EBV, CMV, HIV, HERPES, HEPATITIS ETC.

Acute infections require frequent daily treatments, whereas, chronic

infections require long term weekly treatments. Symptomatic response may

occur after only 1 or 2 treatments, but antibody titers may not change until

10 to 30 weekly treatments have been given.

6. CEREBRAL VASCULAR, ALZHEIMER, TOXIC DEMENTIA, ETC.

Perhaps the increased oxygenation can explain the sometimes rapid reversal

of symptoms in these patients. Acuity, memory, recall, alertness, and other

cerebral symptoms frequently improve quickly and the improvement appears to

be long lasting. The results may also be related to changes in the bioamines

in the brain because positive results are also seen in anxiety/depressive

non-toxic young adults. Ten weekly treatments are usually given before the

effectiveness of treatment is evaluated.

7. CARDIOVASCULAR AND PERIPHERAL VASCULAR DISEASE

Using weekly treatments of smaller volume; i.e., 100 to 250 mL, can be very

beneficial to these patients if your objective is to restore oxygenation to

the tissue. If the objective is to push a gangrenous digit or extremity to

the point of demarcation for surgical debridement, then 250 to 500 mL are

given daily, for several days, until demarcation is completed.

The following are actual case reports, from the initial studies (31) on the

Intravenous Use of Hydrogen Peroxide. Higher concentrations were used in

these studies than currently recommended. Same or similar cases have been

repeated many times since, at the lower concentration of 0.03%, with equally

good clinical results but WITHOUT vasculitis or other side effects. We,

therefore, recommend you do not exceed the 0.03% concentrations.

1. Acute Herpes Zoster. 250 mL of 0.15% initially, then every two days for a

total of 6 treatments. Comment: Resolved completely in less than 1 week with

no residual.

2. Acute Influenza Syndrome. 250 mL of 0.15% initially, and 500 mL of 0.15%

the second day. Afebrile after second day, but additional treatment the

third day of 250 mL of 0.15%. Comment: Resolution of all symptoms after the

second day with no residual.

3. Chronic Systemic Candidiasis: 250 mL of 0.15% once a week for 10

treatments, and then monthly followup for 10 months. Comment: Clinical

response not observed until after the 4th treatment, then gradual

improvement continued. Maintained on monthly treatments.

4. Severe COPD. Initial 250 mL of 0.15% which caused significant alveolar

debridement and coughing up of copious amount of purulent material.

Continued weekly infusions for 6 weeks, and by the end of the 6th treatment

the patient no longer coughing. Pulmonary function improved and the patient

returned to working full time. Comment: Maintained on treatment according to

patients " feel the need " which re-occurs approximately every 4 to 6 weeks.

5. Acute Asthmatic Attack (12 yr old girl): Attack onset 24 hours prior to

treatment Given 100 mL of 0.15% with complete resolution of the attack

within 6 hours following the infusion. Comment: No followup treatment

necessary.

6. Diabetes Mellitus Type II. 25 year history of diabetes taking 30 units

NPH AM and PM. After 5 treatments of 250 mL of 0.15%, insulin reduced to 30

units AM and 15 units PM. Insulin reduced to 15 units AM only after 3

additional treatments because the patient was having symptoms of

hypoglycemia. Discontinued all insulin after 10 treatments and given H202 on

a monthly maintenance. Followup GTC appears more normal. Comment: Will

maintain on schedule according to fasting blood sugars in future.

7. Chronic Post Herpetic Neuralgia: Post herpetic neuralgia persisting 1

year following a severe Herpes Zoster infection on right anterior and

lateral chest wall. Given 250 mL of 0.075% weekly for 10 weeks. Neuralgic

pain substantially reduced after 5th treatment and completely gone after

10th treatment. Comment: Will followup at 3 month intervals and as

necessary.

8. Impending Cerebral Vascular Accident. 71 year old man with sudden onset

two hours previously of confusion, paralysis, and weakness on left side of

body, and drooling and unable to speak distinctively. Initial brood pressure

190/100, pulse normal. Given 250 mL of 0.03% H202 started immediately. All

symptoms significantly improved within 30 minutes and completely resolved

after 1 hour.

Comment: Patient did not return for followup evaluation but was asymptomatic

with blood pressure of 140/90 when he left the office.

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Duncan

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<<Rich, it is my understanding that 35% ,(only pharmacutical grade) h202

must be diluted with pharm. (glucose)down to 3% and dripped. This from

my Dr.........>>

OUCH NO! HE'S 50 TIMES TOO HIGH!!

From an authoratative article.............

Hydrogen Peroxide is available currently

in a 3% USP/NF grade and is ideal for intravenous use. It must be packed in

an open vial however with a vented cap to allow the escape of oxygen

pressure produced by the dismutation. Some physicians are concerned about

sterilization because of the packaging but hydrogen peroxide is self

sterilizing. Proper dilutions are simple. Add 1 mL of the 3% Hydrogen

Peroxide USP/NF solution to each 100 mL carrier solution.

A typical treatment

plan would be to give 100 to 250 mL H202 of 0.03% concentration once or

twice a week. After the initial schedule of 10 to 15 treatments, wait 30 to

60 days and evaluate the response.

Within 1 hour after the intravenous infusion of 250 mL 0.15% H202 a 2% to

10% decrease was noted in the following blood constituents: Bun, Sodium,

Potassium, Chloride, Uric acid, Calcium, Phosphorus, Total protein, Total

bilirubin, Alkaline phosphatase, AST, ALT, GGTP, LDH, Iron and Globulin.

Follow-up studies, 24 hours later, revealed all the above blood constituents

had returned to normal pre-infusion levels.

Here's the rest of this particular article..

_______________________

INTRAVENOUS HYDROGEN PEROXIDE THERAPY

(Quick Overview)

MECHANISMS

Oliver (l) first reported the use of Intravenous Hydrogen Peroxide (H202),

in 1920 in patients with Influenzal Pneumonia. An epidemic in Busrah in June

and July of 1919, had a calculated death-rate over 80 percent. Oliver

treated 25 critical patients with intravenous infusions of H202 and 13 fully

recovered reducing the mortality to 48 percent. He was impressed with the

rapid clinical response and postulated the effects were probably due to the

oxidation of toxins more than the relief of hypoxia.

Hydrogen peroxide used in surgical procedures had caused air embolisms, but

he reasoned if the oxygen was released slowly, embolism should not occur.

Venous oxygen embolism has been reported following the irrigation of anal

fistulae (2), surgical wounds (3), and closed body cavities (4). Ulcerative

colitis (5) has been produced in patients using H202 in enema solutions to

break up fecal impactions. It has been shown, however, to destroy murine

malaria parasites (7), and the bactericidal properties of H202 produced by

neutrophils is well documented (8-10).

Hydrogen peroxide appears to be involved in many intermediate biochemical

pathways. Additionally, it appears to kill certain bacteria, parasites,

yeast, protozoa, inhibit viruses, and oxidize immunocomplexes. T. Ramasarma

(11), in his review on the " Generation of H202 in Biomembranes " , states:

" H202 is a purposeful molecule in cellular metabolism and cannot be

dismissed as a mere undesirable byproduct of oxygen species generation " .

Hydrogen peroxide is generated in most biological membranes; cellular,

mitochondrial, and nuclear. It is important for maintaining membrane

integrity and regulating membrane transport through the alteration of Na-K

ATPase activity. This was confirmed by Garner et al (12). Hydrogen peroxide

fulfills the role of a secondary messenger in several hormonal pathways. As

an example, H202 generation in the uterus is dependent on estrogen and is

necessary for the production of progesterone. The iodination of

thyroglobulin and thyroxine synthesis requires the presence of peroxidase,

H202, and iodide (13). Thyroxine increases and hypothyroidism decreases

hydrogen peroxide production in studies of liver mitochondria (14). Hydrogen

peroxide has an insulin-mimic action and acts as a postbinding site on the

plasma membrane to induce glucose transport (15).

More recent studies of Helm (16) found the insulinomimetic action involves a

common mechanism which links the generation of active oxygen species through

the redox potential of the cell to the activation of a proteinase. It helps

regulate metabolic control through protein modification which alters enzyme

activities.

Thermogenic control (11,14) appears to be exercised through the action of

H202 on the mitochondria. At the mitochondrial level, H202 is generated by a

number of substrates. Flavoproteins converge at ubiquinone which forms a

link between H202 generation and the respiratory chain. Noradrenaline,

thyroxine, and cold stimulate the system to generate heat. Heat increases

the rate of H202 production and is dependent on alpha-adrenergic receptors

which also control non-shivering thermogenesis.

The balance of Ferric (3+) and Ferrous (2+) Iron in the body is critical to

support lipid peroxidation of cellular membranes (27). It has been reported

that a ratio of Fe(3+)/Fe(2+) of 1:1 to 8:1 is optimal to cause the

formation of -OH radicals and lipid peroxidation. At ratios above or below

these levels, lipid peroxidation does not occur. Physiological

concentrations of either H202 or Ascorbic Acid may encourage lipid

peroxidation and at these levels antioxidant protection is important.

Increasing the concentration of H202, as occurs with therapeutic intravenous

infusions, the Ferric/Ferrous ratio is maintained above 8:1 by keeping

excess Ferrous (Fe2+) Iron oxidized to the Ferric (Fe3+) state. A principal

mechanism of action of EDTA Chelation Therapy is reducing Free Radical

damage and lipid peroxidation by complexing EDTA with Ferrous Iron

(Fe3+:EDTA) which helps maintain the Ferric/Ferrous ratio above 8:1 (28)

Weiss (8) reported H202 is an activator of neutrophils including aggregated

immunoglobulin, activated complement components, immune complexes, or

bacterial peptides.

This would suggest the beneficial clinical effects observed with the use of

ascorbic acid in inflammatory reactions, and its protective action against

infections, is acting through the generation of H202. Also, there is no

evidence H202 initiates or supports microsomal lipid peroxidation (51). The

modification of (Na,K)-ATPase(12) by H202 also contributes to an increase in

metabolic rate.

Farr (40) reported whole blood specimens taken before, during, and after

H202 infusions showed color changes consistent with oxyhemoglobin formation.

Numerous blood profiles and CBC studies have been performed before and

immediately after infusions of H202. Although early investigators reported

no changes in blood elements and certain chemical constituents, except when

injected into the carotid arteries, consistent changes have been reported.

Within 1 hour after the intravenous infusion of 250 mL 0.15% H202 a 2% to

10% decrease was noted in the following blood constituents: Bun, Sodium,

Potassium, Chloride, Uric acid, Calcium, Phosphorus, Total protein, Total

bilirubin, Alkaline phosphatase, AST, ALT, GGTP, LDH, Iron and Globulin.

Follow-up studies, 24 hours later, revealed all the above blood constituents

had returned to normal pre-infusion levels.

Some of the biological killing activity of H202 may be attributed to gamma

interferon. Production of gamma interferon by human natural killer cells and

monocytes, is stimulated by H202(58). Both exogenous and endogenous H202

appear to be in part responsible for immunoregulation. The rates of wound

healing, stasis and vascular ulcers (18), peripheral occlusive disease

(59,60), myocardial ischemia (33) and cerebral vascular disease (61) have

all improved when treated with repeated intra-arterial infusions of H202

PHYSICAL PROPERTIES OF HYDROGEN PEROXIDE

Hydrogen Peroxide was discovered in 1818 by the French Chemist Louis-Jacque

Thenard.

Hydrogen Peroxide, hydrogen dioxide (H202), is a colorless (blue in thick

layers) odorless liquid; with a melting point -2 degree C: a boiling point

152 degrees C; decomposes 84 degrees C at 68 mm. pressure (68 degrees C at

26 mm.), soluble in water in all proportions; usually encountered as a

dilute solution (3% H202) solution, that is, one volume of solution yields

10 volumes of oxygen), although available up to 35% strength.

Its remarkable feature is its tendency to decompose readily into water and

oxygen. Decomposition by light begins only in the near ultraviolet. Hydrogen

peroxide solutions dismutate slowly, when undisturbed, at the rate of

approximately 1% per month. The dismutation reaction is rapidly increased in

the presence of particulate contaminates; i.e., dust, flakes of metal or

glass or other particulate matter, at a rate which may be explosive. Cold

retards dismutation and solution may be refrigerated or stored at

temperatures below 0 degrees C. Hydrogen peroxide occurs only in traces in

nature: mostly in rain and snow. It has not yet been detected in

interstellar space.

METABOLIC AND PHYSIOLOGICAL EFFECTS

Numerous physiological effects are attributed to hydrogen peroxide and

documented in the literature. Some of these effects may be broadly

categorized as follows:

1. PULMONARY

A. Increased oxygenation

B. Alveolar debridement (31)

2. METABOLIC RATE

A. Hormonal effect:

Several hormonal effects have been reported to be regulated by the action of

H202.

Examples are:

1.Iodination of thyroglobin(13)

2. Production of thyronine (13)

3. Progestone production (107)

4. Inhibition of bioamines (108); dopamine, noradrenalin and

serotonin

5. Prostaglandin synthesis (46,47,109)

6. Dopamine metabolism (110)

7. Regulates Reticulum Calcium Transport (111)

8. Oxidative stimulation:

Hydrogen peroxide directly and indirectly stimulates oxidative enzyme

systems. Micromolar amounts of infused H202 has been found to increase

oxidative enzymatic activity to the maximum rate of reaction (40).

1. Increases GSH oxidation to GSSG which increases ATP production(112)

2. Activates Hexose Monophosphate Shunt(41)

3. Alters Na-K ATPase activity (12)

4. Regulates cellular (113) and mitochondrial (15) membrane transport

5. Regulates thermogenic control (11)

3. CARDIOVASCULAR RESPONSE

A. Vasodilation

1. Dilation of peripheral vessels (31)

2. Dilation of coronary vessels (114)

3. Aortic strip relaxation response (115)

4. Cerebral arteriolar dilation (116,117)

5. Pulmonary arterial relaxation (118)

B. Vasoconstriction

1. Essential Hypertension effect (31)

2. Peripheral vasoconstriction may occur in normal-tensive patients with

concentrations at or below 0.0375% with no significant increase in mean

pressures(123).

C. Cardiac Responses (12-3)

1. Decreases Heart Rate

2. Decreases Vascular Resistance

3. Increases Stroke Volume

4. Increases Cardiac Output

5. Increases Cardiac Index

4. GLUCOSE UTILIZATION

A. H202 mimics insulin (16)

B. Increases glycogen production from glucose (119)

C. Type II Diabetes Mellitus stabilized with H202 infusions (20)

5. GRANULOCYTE RESPONSE

A. Depressed granulocytes after treatment then rebound measured after 24

hours (31)

B. Secondary resistance to peroxide after exposure (109)

C. Alteration of T4/T8 ratio with increase of T4 Helper cells (28)

6. IMMUNE RESPONSE

A. Stimulates Monocytes (92)

B. Stimulates T Helper cells (109)

C. Stimulates Gamma Interferon production (58)

D. Decreases B-cell activity (121)

E. Responsible for immunoregulation (58)

F. Regulates inflammatory response (122)

INDICATIONS

Intravenous Hydrogen Peroxide is used in the acute reactive conditions ;

i.e., influenza, bronchitis, Herpes Zoster, asthmatic reactions, etc.)

because of its direct killing effect on micro-organisms or its effect on

vasospasm or bronchospasm. The long term effect, to regulate or modify the

immune response through cellular activation or modification of immune

dysfunction, such as EBV, Candida, CMV, Herpes, HIV, Diabetes Type II, COPD,

vascular disease, arthritis, and etc., is an important therapeutic tool for

every physician.

The therapeutic use of intravenous H202 has been reported in the following

diseases or conditions with varying results depending on the clinical

investigator:

l. Peripheral Vascular Disease

2. Cerebral Vascular Disease

3. Alzheimer

4. Cardiovascular Disease

5. Coronary Spasm (angina)

6. Cardioconversion

7. Arrhythmias

8. Chronic Obstructive Pulmonary Disease

9. Emphysema

10. Asthma

11. Influenza

12. Herpes Zoster

13. Herpes Simplex

14. Temporal Arteritis

15. Systemic Chronic Candidiasis

16. Chronic Recurrent Epstein Barr Infection

17. Diabetes Type II

18. HIV infections

19. Metastatic Carcinoma

20. Multiple Sclerosis

21. Rheumatoid Arthritis

22. Acute and Chronic viral infections

23. Chronic unresponsive bacterial infection

24. Parasitic infections

25. Parkinsonism

26. Migraine headaches

27. Cluster headaches

28. Vascular headaches

29. Chronic pain syndromes (multiple etiologies)

30. Environmental allergy reactors (Universal)

Many in-vitro and some in-vivo studies have shown H202 to be bactericidal,

fungicidal, parasiticidal, viricidal, and to lyse certain tumor cell types

in cultures. The therapeutic benefit of H202 infusions in patients with any

of the following infections and/or tumors may not be clinically documented.

Therefore, no recommendation can be made until appropriate studies have been

conducted.

BACTERIA

1. Legionella pneumophila (62)

2. Treponema pallidum (63)

3. Escherichia coli (64)

4. Salmonella typhimurium (65)

5. Mycobacterium leprae (66)

6. Staphylococcus auerus (67)

7. Pseudomonas acruginosa (68)

8. Campylobacter jejuni (69)

9. Salmonella typhi (70)

10. Group B Streptococci (71)

11. Bacillus cereus (72)

12. Actinobacillus actinomycetem comitans (73)

13. Bacteroides (74)

14. Neisseria gonorrhoea (75)

FUNGI

1. Histoplasma capsulatum (76)

2. Candida Albicans (77)

3. Coccidioides (78)

4. Paracoccidiodes (78)

5. Blastomyces (78)

6. Sporothrix (78)

7. Mucoraceae(78)

8. Aspergillus fumigatus (79)

9. Coccidioides immitis (80)

PARASITES

1. Pneumocystis carinii (81)

2. Plasmodium yoelii (82)

3. Plasmodium berghei (82)

4. Toxoplasma gondii (83)

5. Nippostrongycus brasiliensis (84)

6. Naegleria fowleri (85)

7. Leishmania major (86)

8. Schistosoma mansoni (87)

9. Chlamydia psittaci (88)

10. Trichomonas vaginalis (89)

11. Tepanosoma cruzi (90)

12. Endameba histolytica (91)

VIRUS

1. Human Immunodeficiency Virus (92)

2. Cytomegalovirus (67)

3. Lymphocytic choriomeningitis virus (93)

4. Tacaribe virus (93)

TUMOR TYPE

1. Ehrlich carcinoma (94)

2. Neuroblastoma (95)

CONTRAINDICATIONS

PRECAUTIONS:

Hydrogen Peroxide infusions are contraindicated in pregnancy, Chronic

Granulomatous Disease (CGD), and any disorder of cell membrane stability

(i.e. anemias).

SIDE EFFECTS:

The most frequent side effect reported (at concentrations above 0.0375%) is

vasculitis, which may occur in the infused vein and/or its tributaries. This

phenomenon is inconsistent, occurring repeatedly in some patients but rarely

in others. According to Shingu, (97) epithelial and smooth muscle cells

contain very little, if any, catalase and, therefore, may be sensitive to

the effects of H202. There appears to be a critical concentration of H202

which is cytolytic, and will cause vasculitis if exceeded.

It is, therefore, important to consider the concentration being infused and

the size of the vessel. This reaction is less likely to occur if a larger

vein in the antecubital area is used for infusion, and the rate of

administration is reduced. Once the cytolytic concentration is exceeded, the

cells swell up, become toxic and die. The exact mechanism by which H202 is

cytotoxic are not defined, however, *NOTE* Recent studies have revealed the

addition of 0.5 mg Manganese to the intravenous solution to be effective in

controlling the endothelial damage caused by the H202 solution. It is

reported that there may be no microscopic signs of cytotoxicity for 6 hours

or longer after exposure of the cells to H202. Consequently, after you

infuse a patient, the vasculitis may not be apparent until the following

day. The application of heat may make the reaction more severe since heat

speeds up the rate of most biochemical reactions, and this may be no

exception. We recommend you use only the larger veins for infusion, and

reduce the rate of infusion if you suspect the patient's blood flow rate is

slower than usual. It has also been found useful to rotate between the veins

and not use the same vein for two consecutive treatments. Rotate between

veins and alternate treatments from one arm to the other. Some physicians

report they have flushed the vessel post-infusion with additional heparin,

or Decadron, but results have not been changed.

All oral supplements and drugs should be withheld on the day of infusion.

Taking antioxidants on the day of infusion would appear to be

counterproductive and may aggravate the vasculitis. Intravenous H202 delays

clotting by 20%, but reduces bleeding time approximately 50%. Caution should

be exercised when giving H202 to patients taking anticoagulants since

clinical data is not available at this time for comment.

ALLERGIC PHENOMENON:

Occasionally, a non-tender red streak will appear, tracing the route of the

vessel above the point of infusion. This streak will often have a diffused

fanned-out appearance radiating laterally from the central streak. No

relationship has been identified between this superficial vascular

phenomenon and the vasculitis previously described. This vascular phenomenon

occurs randomly in patients and has been observed at a rate of about 1 in 50

infusions in concentrations greater than 0.0375%, but only 1 in 500 at

concentrations at or below 0.0375%. Several hundred infusions have been

given, and no other type of local or systemic allergic vascular reaction has

been observed or reported.

CHEST DISCOMFORT:

Some physicians have reported occasional patient complaints of vague chest

discomfort, sometimes associated with a feeling of shortness of breath. We

received two reports that the chest discomfort was severe enough to

discontinue the treatments. Bronchodilators should be withheld for at least

a day before H202 is administered, if possible.

INFUSION SITE PAIN:

Pain at and above the infusion site is occasionally reported. The pain is

described as a spastic ache and is most likely due to vasospasm. On rare

occasions, the pain may extend from the point of infusion, at or below the

antecubital area, up into the deltoid area. Reducing the rate of infusion,

heat, and ice have all been ineffective in controlling the pain. We have

found, when this occurs, the best thing to do is remove the needle and

restart the infusion in another vein. We

speculate the irritation to the vessel, at the point of penetration, causes

a reflex vasospasm along the vessel. Changing the needle position or

rotating its position in the same vein does little to relieve the

discomfort.

HERXHEIMER TYPE REACTION:

Several physicians have reported an occasional Herxheimer-like reaction when

treating patients with mucocutaneous candidiasis. Following infusions of

H202 the patients were reported to have generalized migratory aching,

nausea, headaches, chills, and fever. It has been reported to occur after

one, two, and sometimes three treatments, but, thereafter, the patients

report an improvement in their overall clinical status, and continue to

improve with each succeeding treatment. No patients have been discontinued

from treatments because of this reaction. It does not occur consistently nor

is it predictable.

TOXICITY

Hydrogen peroxide is a product of intermediate metabolism, widely

distributed throughout the body, and participates in a significant number of

biochemical reactions. It is a principal electron receptor in the body in

many RedOx reactions. A vast amount of knowledge exists about the chemistry

of H202 in tissue slices, tissue cultures, bacteria, parasites, yeast,

protozoa, blood cells, and isolated human, animal, and plant cells. Numerous

examples of biochemical changes have been described in the literature, which

are interpreted as toxic or damaging in the models studied. Clinically,

however, no significant acute toxicity has been observed in several hundred

patients, some receiving up to 40 to 50 infusions with concentrations up to

0.3 %. Also, no chronic or long term toxicity has been observed or

documented up to two years post-multiple infusions. One patient received

3,600 mL of 0.15% of Hydrogen Peroxide intravenously in a period of 10 days

without any side effect. This dosage is approximately 40 times greater than

the currently recommended therapeutic dosage. Other studies suggest doses

500 times smaller than the currently recommended dose will have biological

effect. This suggested intravenous infusions of Hydrogen Peroxide is

extremely safe and has a very wide therapeutic range.

Consequently, the majority of toxic reactions referred to in the literature,

which occur with in-vitro studies under laboratory conditions, which could

not exist in-vitro, have very little clinical application. Some of the

in-vitro toxic effects are:

A. Lipid Peroxidation (49,98)

B. Single strand DNA breakage (99)

C. Cytotoxic (concentrations above 10 mMol) (100)

D. RBC hemolysis (26,101)

E. Chromosomal Aberrations (102)

F. Protein degradation (103)

G. Glutathione Peroxidase depiction (104)

H. Degredates Cytochrome C (105)

I. Platelet Aggregation (106)

FORMULAS

INTRAVENOUS ADMINISTRATION OF H202 SOLUTION

The PROPER DOSAGE is dependent upon the CONCENTRATION used, the VOLUME

INFUSED, and the RATE OF INFUSION.

The infusion mixture is prepared as follows: The preferred carrier is 5%

Dextrose in Water or Normal Saline. Hydrogen Peroxide is available currently

in a 3% USP/NF grade and is ideal for intravenous use. It must be packed in

an open vial however with a vented cap to allow the escape of oxygen

pressure produced by the dismutation. Some physicians are concerned about

sterilization because of the packaging but hydrogen peroxide is self

sterilizing. Proper dilutions are simple. Add 1 mL of the 3% Hydrogen

Peroxide USP/NF solution to each 100 mL carrier solution. If you plan to

give 250 mL treatment you add 2.5 mL of the peroxide in 250 mL of carrier, 5

mL to 500 mL carrier and etc. for the proper dilution. Select a medium to

large vein close to the antecubital area for the infusion. Use a small

winged needle and infuse slowly over a period of 1 to 1 1/2 hours. The rate

of infusion and concentration are both important as explained below.

THERAPEUTIC INFUSION SCHEDULES

The dosage administered is dictated by the therapeutic and objective

experience of the clinician. The physician should consider the clinical

objective after the diagnosis has been properly established. A general rule:

the more acute the pathology the greater the volume and concentration and

the more frequent the infusions. The frequency may be maintained until the

acute problem is considered stable, and then both dose and frequency

reduced. As an example, a patient with acute influenza or Herpes Zoster may

be placed on a schedule of 250 to 500 mL of H202 of 0.03% or less

concentration, daily for 1 to 5 infusions or until clinical response is

obvious.

Occasionally, these patients may require a treatment once or twice a week

for an additional 5 to 10 treatments, particularly in infections which have

a tendency to become chronic such as Herpes or Hepatitis. A therapeutic

regimen for a chronic, low grade infection or chronic illness would be to

schedule smaller doses over a longer period of time. Examples of chronic

illnesses in which long term therapy might be employed would include:

Chronic candidias, chronic obstructive pulmonary disease, peripheral

occlusive disease, chronic EBV, or Hepatitis, and etc. A typical treatment

plan would be to give 100 to 250 mL H202 of 0.03% concentration once or

twice a week. After the initial schedule of 10 to 15 treatments, wait 30 to

60 days and evaluate the response. Depending on the response, you may wish

to give an additional series of 10 to 15 treatments and again wait and

re-evaluate. An alternative is to keep the patient on bimonthly or monthly

maintenance treatments for a year and then reevaluate annually.

The following are examples of treatment schedules which have been employed

in these selected cases.

1. ACUTE PULMONARY INFECTIONS INCLUDING INFLUENZA PNEUMONIA.

Infusions of Hydrogen Peroxide have a rapid 'Alka-seltzer effect' in the

lungs. If the patient has moist lungs and/or a productive cough, the

treatment will usually cause coughing and mucous production to increase

immediately. It may continue throughout the treatment but will subside soon

after the treatment is completed. If the patient is quite ill and febrile,

the initial treatment would be 250 to 500 mL of 0.03%. If the patient

remains febrile the second day, give an additional 250 to 500 mL of 0.03%.

Treat according to response, thereafter, every two to three days until the

desired response is obtained.

2. CHRONIC LUNG DISEASE (COPD, BRONCHITIS, BRONCHIECTASIS, EMPHYSEMA)

Chronic lung disease, which is moist and active, responds best to treatment.

The response in dry emphysema or pulmonary fibrosis is less dramatic. Give

250 mL 0.03% weekly for 10 to 15 weeks. Frequently, the effects will be

dramatic, with coughing and sputum production initially, and the patients

reporting increased energy and ability to breathe within 24 hours. The

effects of treatments are usually progressive improvement for 8 to 10

treatments, and then the effects plateau. Most patients will wish to

continue on monthly maintenance treatments.

3. ALLERGIC REACTIONS, ASTHMA, ENVIRONMENTAL SENSITIVITY, ETC.

The longer the patient has had their allergic reactive problem, the longer

it will be before you will have a positive response. This general rule,

however, does not always apply. Some patients respond rapidly, within 2 to 3

treatments. In these complex patients, schedule weekly treatments for 10

weeks, give the patient a 30 day rest, and repeat an additional 10 weekly

treatments. You may give up to 40 to 50 treatments on this schedule, or

until you feel maximum response has been obtained. Most patients will

realize improvement after their first course of 10 treatments. Thereafter,

patients show a gradual improvement with each successive group of 10

treatments. If the patient shows no improvement after 30 to 40 treatments,

then no response is likely and therapy is discontinued.

4. ACUTE AND CHRONIC PAIN

Angina, headaches, vasospasm, tumor pain, or neurological pain frequently

show an immediate and dramatic response to one or two treatments. Chronic

pain syndromes may require several (8-10) treatments but response is

frequent. There is no good explanation why Hydrogen Peroxide should relieve

pain, but, nevertheless, this has been a frequently reported clinical

observation. Chronic, established pain of Post Herpetic Neuralgia may not

respond to treatments, but the response in Acute Herpes Zoster is often

dramatic.

5. EBV, CMV, HIV, HERPES, HEPATITIS ETC.

Acute infections require frequent daily treatments, whereas, chronic

infections require long term weekly treatments. Symptomatic response may

occur after only 1 or 2 treatments, but antibody titers may not change until

10 to 30 weekly treatments have been given.

6. CEREBRAL VASCULAR, ALZHEIMER, TOXIC DEMENTIA, ETC.

Perhaps the increased oxygenation can explain the sometimes rapid reversal

of symptoms in these patients. Acuity, memory, recall, alertness, and other

cerebral symptoms frequently improve quickly and the improvement appears to

be long lasting. The results may also be related to changes in the bioamines

in the brain because positive results are also seen in anxiety/depressive

non-toxic young adults. Ten weekly treatments are usually given before the

effectiveness of treatment is evaluated.

7. CARDIOVASCULAR AND PERIPHERAL VASCULAR DISEASE

Using weekly treatments of smaller volume; i.e., 100 to 250 mL, can be very

beneficial to these patients if your objective is to restore oxygenation to

the tissue. If the objective is to push a gangrenous digit or extremity to

the point of demarcation for surgical debridement, then 250 to 500 mL are

given daily, for several days, until demarcation is completed.

The following are actual case reports, from the initial studies (31) on the

Intravenous Use of Hydrogen Peroxide. Higher concentrations were used in

these studies than currently recommended. Same or similar cases have been

repeated many times since, at the lower concentration of 0.03%, with equally

good clinical results but WITHOUT vasculitis or other side effects. We,

therefore, recommend you do not exceed the 0.03% concentrations.

1. Acute Herpes Zoster. 250 mL of 0.15% initially, then every two days for a

total of 6 treatments. Comment: Resolved completely in less than 1 week with

no residual.

2. Acute Influenza Syndrome. 250 mL of 0.15% initially, and 500 mL of 0.15%

the second day. Afebrile after second day, but additional treatment the

third day of 250 mL of 0.15%. Comment: Resolution of all symptoms after the

second day with no residual.

3. Chronic Systemic Candidiasis: 250 mL of 0.15% once a week for 10

treatments, and then monthly followup for 10 months. Comment: Clinical

response not observed until after the 4th treatment, then gradual

improvement continued. Maintained on monthly treatments.

4. Severe COPD. Initial 250 mL of 0.15% which caused significant alveolar

debridement and coughing up of copious amount of purulent material.

Continued weekly infusions for 6 weeks, and by the end of the 6th treatment

the patient no longer coughing. Pulmonary function improved and the patient

returned to working full time. Comment: Maintained on treatment according to

patients " feel the need " which re-occurs approximately every 4 to 6 weeks.

5. Acute Asthmatic Attack (12 yr old girl): Attack onset 24 hours prior to

treatment Given 100 mL of 0.15% with complete resolution of the attack

within 6 hours following the infusion. Comment: No followup treatment

necessary.

6. Diabetes Mellitus Type II. 25 year history of diabetes taking 30 units

NPH AM and PM. After 5 treatments of 250 mL of 0.15%, insulin reduced to 30

units AM and 15 units PM. Insulin reduced to 15 units AM only after 3

additional treatments because the patient was having symptoms of

hypoglycemia. Discontinued all insulin after 10 treatments and given H202 on

a monthly maintenance. Followup GTC appears more normal. Comment: Will

maintain on schedule according to fasting blood sugars in future.

7. Chronic Post Herpetic Neuralgia: Post herpetic neuralgia persisting 1

year following a severe Herpes Zoster infection on right anterior and

lateral chest wall. Given 250 mL of 0.075% weekly for 10 weeks. Neuralgic

pain substantially reduced after 5th treatment and completely gone after

10th treatment. Comment: Will followup at 3 month intervals and as

necessary.

8. Impending Cerebral Vascular Accident. 71 year old man with sudden onset

two hours previously of confusion, paralysis, and weakness on left side of

body, and drooling and unable to speak distinctively. Initial brood pressure

190/100, pulse normal. Given 250 mL of 0.03% H202 started immediately. All

symptoms significantly improved within 30 minutes and completely resolved

after 1 hour.

Comment: Patient did not return for followup evaluation but was asymptomatic

with blood pressure of 140/90 when he left the office.

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4. Wildberger E, Kohler H, Jenzer H, et al: Inactivation of Peroxidase and

Glucose Oxidase by H202 and Iodide during In Vitro Thyroglobulin lodination.

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5. Swaroop A and Ramasarma T: Heat Exposure and Hypothyroid Conditions

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14(2): 205-13

Duncan

---

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