QUESTION: I have a pancreatic cancer patient with mets to the liver who is going for blood transfusions every 2-3 weeks RE a suspected GI bleed – 3 transfusions so far. G6PD was tested initially and was WNL. We are doing IV Vit C and IV ALA, Mistletoe, as well as several oral therapies. The patient feels much stronger the day following an IV Vitamin C treatment. Are there any concerns with the patient potentially receiving G6PD deficient blood during transfusion – RE safety of IV Vit C? Does G6PD need to be re-tested on the transfused blood prior to administering it to the patient or once it has been administered? Any advice RE timing of IVC after a transfusion? Any other concerns?
ANSWER: Very good question with a few aspects. First, on the whole, G6PD is synthesized mainly in hepatocytes. In this regard a transfusion will not affect the levels or activity of G6PD in the body. We see many people through transfusion and other blood products, and in practice do not see that change G6PD. Second, G6PD and G6PD activity DO change with other treatments on a temporary basis. For example we do see G6PD “drop” after chemo on some occasions. This said, the person is not actually G6PD deficient but having a transient decrease in hepatic G6PD synthesis (which is affected by things like insulin availability, corticoids and a host of cytokines which can be temporarily slowed down by therapies like chemo. In these patients, both the data on G6PD “repair and stimulation” as well as my experience show that a short time (2-4 weeks) of ReDox stabilizing nutrients will bring these transiently depressed G6PD levels back. Low dose IVC or oral ascorbate, mixed tocopherols or tocotrienols and ALA for 2-4 weeks are sufficient.
(Note that this does not work for genetically deficient G6PD patients).
So, while other factors may alter G6PD status temporarily in a person with initially normal G6PD, as a single intervention, blood products do not generally create such a situation on their own.