QUESTION: When doing DCA IV, have you seen side effects of headache, weakness (lower extremity) and loss of equilibrium – more pronounced the day after the IV? How long does it take for these symptoms to resolve? Pt wants to continue DCA, but at reduced dose. I am following the IV DCA and LAMC protocol 1x/week, and pt is receiving DCA and HDIVC 1x/week at another clinic. She is on oral prophylactics daily (benfotamine, ALA, NAC – however I don’t think she is taking vitamin A). She has been on the higher dosage of DCA per Dr. Kahn– 80mg/kg in 250mL NS x 1 hour. Liver enzymes normal . She valiantly tried ketogenic diet but was unable to tolerate, now following low carb diet. I think hydration might be a problem for her. I will add more fluids to her protocol.
ANSWER: Those are quite common side effects. The DCA should never be given without the other supports however, which mitigate those effects. We use appropriate hydration and pre IV with LAMC and see less of those effects and better efficacy with cancer (based on our patient response and a lot of data). Sounds like you are on the right track. Most times I see that there is not enough hydration and that causes the DCA to hit the GSTzeta too hard, and they dump / detox. Also a lot of the CA folks regardless of PO hydration are still dehydrated. In our patients like that we make sure to run the Poly in 250-500 fluid first and the DCA second.