Consult Dr. Anderson

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23 Mar 2016

SODIUM THIOSULFATE, ASCORBATE AND OTHER THIOLS CONT

QUESTION: I am working with an oncologist who is worried about me using glutathione and HDIVC in a shared cancer patient who is also getting sodium thiosulfate, to lessen the side effects (neuropathy) of cisplatin, because he says it is his understanding that there is significant concern about timing and use of anything that can change the landscape of the free radicals. I’ll admit I don’t quite recall the biochemistry cycle in play, but it has something to do with scavenging free radicals at just the right time and if they aren’t available, that can be problematic.

ANSWER: I think the pathway in question is:

thiosulfate + 2 glutathione <—–> sulfite + glutathione disulfide + sulfide

One way to drive the glutathione cycle GSS—> <—-GSSG is to add thiosulfate and another is addition of IV GSH. (There are others but I’ll keep this short). Basically if the sodium thiosulfate and GSH were administered the same day there is no antagonistic effect. Likewise as long as a high dose ascorbate IV is administered on a different date from the sodium thiosulfate as well as GSH that has no antagonistic effect (keeps the antioxidant cycles supported and the ROS generating therapies separate. We have used IV sodium thiosulfate for about five years in the setting of oncologic quality of life and neuropathy as well as pathological calcification. We have also used it in combination with glutathione and (on a different day) high and low dose IV Ascorbate. As of yet we have only seen positive outcome in proper combination for our neuropathic patients.