One of the most satisfying parts of being a health professional is the opportunity to help people make better health decisions. In between the emails suggesting I’m a paid lackey of the Pharmaceutical-Industrial Complex™ for not endorsing coffee enemas, vitamin C, or homeopathy, I do receive the occasional note thanking me for my advocacy, or for writing about a subject in a way they found helpful. I’m also sent questions – too many to answer, but occasionally opening my eyes to new “concepts” in alternative medicine. And while I spent years working in a pharmacy with a huge “holistic” health section, containing products that, if they worked, would have defied one or more laws of physics or chemistry, I can still be surprised at novel alternative-to-medicine approaches to health care. Last week I was sent a questions about hydrogen peroxide – not for first aid use (where it may not be as useful as thought), but for oral consumption, as some sort of health “cure-all”. I was baffled, but the concept does exist – and the Big Pharma Overlords apparently don’t want you to know about it. There must be a rule 34 of alternative medicine – if it exists, there is an (inappropriate) alternative medicine use for it. The active ingredient in hair bleach and teeth whitening strips is no exception.

If you’re not into holistic healing or alternative medicine, you probably haven’t thought much about hydrogen peroxide since perhaps your last cut or wound, as bottles of peroxide have been a mainstay of first aid kits for decades. Peroxide is chemically two atoms of hydrogen and two atoms of oxygen: H2O2. It can be a potent oxidant and effectively act as a bleach, rapidly breaking down to H2O and O2 (water and oxygen). I recall it being poured onto my knee scrapes when I was a child, and I thought that the fizzing (and searing pain) was a sign that the wound was being cleaned, and bacteria were being killed (in fact, the oxidation was causing superficial tissue damage, and my parents should have been using water or saline). I still have an apprehension of peroxide. I soak my contact lenses in a peroxide solution, and unless they sit a full six hours in the case (with a catalyst that accelerates its conversion to water and oxygen), then the burning eye pain I experience later is a reminder that even low concentrations of peroxide can severely irritate tissues. Consequently, I’ve never thought of drinking peroxide. So how did a first-aid kit disinfectant end up as a health panacea? Like many ideas in alternative medicine, its use is based on prescientific ideas about how the body works that have persisted despite the evidence.

Peroxide: Not “natural”, not effective

Holistic and alternative medicine doesn’t necessarily mean “natural”. There are no natural sources of hydrogen peroxide you can buy. Peroxide is commercially manufactured, and most of the world’s production is used (at high concentrations) to bleach pulp and paper. For household use, peroxide is prepared as a 3% to 10% solution in water, where it’s much less chemically unstable, and is an effective disinfectant. Other common uses include “chlorine free” clothing bleach, as a hair lightener, and to whiten teeth, where direct contact with teeth will bleach stains. Apparently you can buy “food grade” peroxide at 35% which, unless you dilute it, is going to cause serious harm if you consume it.

One of the “facts” you’ll be told when you peruse alternative medicine sites on peroxide is that peroxide is some sort of magical, “super water”. Isn’t it just water with the added goodness of more oxygen? This line of reasoning is akin to saying that ethanol is just methanol with more carbon. Peroxide is a different chemical than water, with different physicochemical properties. So why would someone think of consuming a powerful bleaching oxidant? Isn’t alternative medicine all about antioxidants? The most likely rationale is that peroxide is simply an extension of the purification beliefs I blogged about a few weeks ago. The idea that we’re somehow poisoning ourselves, and we need to “cleanse” ourselves, seems to be a part of human nature, which may explain why purification still persists as an idea. It’s not miasmas or sin that we’re as worried about today, however. It tends to be illnesses like cancer, or other chronic disease. So the thought process seems to be that peroxide, a source of oxygen, will bleach and purify away our toxins, our cancer, our HIV, and our heart disease. That’s where the scientific reasoning seems to begin and end. Now from a scientific perspective, this is ridiculous, but wrap the description with some sciencey-sounding words, and these prescientific ideas sound quite plausible. Consider what Winnipeg naturopath Sean Ceasar says about intravenous peroxide, which is promoted for the treatment of cancer and other serious conditions:

Intravenous Hydrogen Peroxide Therapy is an alternative health therapy with a large number of devoted adherents. Advocates of this therapy claim that injecting 3% hydrogen peroxide intravenously via a drip for approximately an hour and a half per session will cure a number of diverse conditions ranging from the common cold to cancer. When hydrogen peroxide comes into contact with blood it reacts with the enzyme catalase, causing it to break down into water as well as into copious quantities of oxygen.

Any part of the body that might for any reason have been oxygen deprived (due to circulatory problems, for example) will benefit from this increased oxygen. In addition, the released oxygen performs a host of helpful actions within the body including the inhibition and/or destruction of a number of anaerobic organisms such as viruses, bacteria and cancer. (Anaerobic organisms are all pathogens.)

Additionally, hydrogen peroxide stimulates the body’s production of white blood cells, helps to break down calcium deposits within blood vessels, dissolves cholesterol, and converts the waste products and toxins that are the by-products of cellular processes into a form that is easily eliminated.

Furthermore, Intravenous Hydrogen Peroxide Therapy helps form adenosine triphosphate (ATP), a nucleotide that is responsible for providing the energy necessary for the proper functioning of cells. ATP is made in a cell’s mitochondria. Some researchers believe chronic fatigue syndrome and fibromyalgia are caused by faulty mitochrondrial and ATP performance.

IV hydrogen peroxide works to regulate mitochondrial membrane exchanges, and people who suffer with these conditions benefit from this treatment. In addition, hydrogen peroxide improves and/or cures a host of other ailments — Lyme disease, viruses including herpes, HIV influenza [sic] and the Epstein-Barr virus, sinus infections, hardening of the arteries (Arteriosclerosis), strokes (if treatment is initiated rapidly enough, damage can be reversed), Transischemic Attacks (TIAs, or so-called “mini-strokes), asthma, emphysema, chronic obstructive pulmonary disease (COPD), and more.

Cancer cannot thrive in the presence of oxygen, and therefore IV hydrogen peroxide is a potent anti-cancer treatment, one that is used alone, but which can also be used in conjunction with other treatments. Hydrogen peroxide is widely considered to be one of the most impressive of all the natural therapies that are available because of how many useful benefits it offers.

It is true that the body does produce peroxide naturally. However this is under very tightly controlled conditions, at the cellular level. Consuming or injecting peroxide, and hoping for some sort of medicinal effect, is the medical equivalent to spraying gasoline all over your car’s engine and interior and then wondering why it doesn’t make the car run better. Like gasoline in an engine, you need the right substance in the right place at the right time and under the right conditions in order to have a useful effect. And perhaps not surprisingly, there is no evidence to show that peroxide, either consumed orally, or injected intravenously, has any useful medical effects. You can search PubMed yourself – there are no clinical trials with hydrogen peroxide that study its use for cancer or any other medical conditions, other than trials for dental purposes. Yet it is regularly and repeatedly promoted for the treatment of cancer and other conditions – without any evidence demonstrating it does anything useful. Calgary-based naturopath Kin Leung also promotes peroxide injections, and claims the following:

Hydrogen Peroxide and Cancer: In 1966, Doctor Otto Warburg discovered that the key precondition for the development of cancer is a lack of oxygen at the cellular level. Cancer cells need 60% less oxygen than normal, healthy cells and perform poorly in the presence of excess oxygen. Therefore, cancer cells may be destroyed in the high-oxygen environment that is produced through hydrogen peroxide therapy. Hydrogen peroxide is an antineoplastic, meaning that it inhibits the growth of new tissues, like tumours. Hydrogen peroxide also increases production of interferon and tumour necrosis factors, which the body uses to fight infections and cancers. Cancer cells in the presence of increased oxygen tension become more sensitive to irradiation, and this increased oxygen tension is produced by hydrogen peroxide.

Hydrogen Peroxide and Lung Disease : Hydrogen peroxide administered intravenously works very well against emphysema, asthma and chronic lung disease. It cleans the lungs by producing oxygen bubbles in the alveoli, the tiny air sacs in the lungs, and lifting the mucus deposits out. This allows you to cough out the deposits, making the procedure natural and non-invasive.

Perhaps not surprisingly, there’s no evidence to demonstrate any of this is correct (the Warburg Effect is a real thing, but of course is more complicated and less of a road to the cure for cancer than portrayed here).

No evidence of safety

Hydrogen peroxide isn’t necessarily safe. It can cause harm in three ways: corrosive damage, the unwanted formation of oxygen gas, and by lipid peroxidation. At low concentrations, the risks of serious harms are remote. At high concentrations, peroxide is highly toxic. Peroxide can cause significant tissue damage. As a tooth whitener, it can irritates gums. When swallowed in larger volumes, it can cause nausea and vomiting. High concentrations of peroxide will cause mucosal burns. The secondary harm is due to oxygen release. Peroxide can cause an oxygen embolism in the bloodstream, which can cause strokes. In other body cavities, like the stomach, it can cause distension and painful gas. Deaths have been associated with injectable use – a “naturopath” was convicted of criminally negligent homicide for administering intravenous peroxide to a cancer patient that died the day after treatment. Lethargy, confusion, coma, cardiorespiratory arrest have been reported following consumption of hydrogen peroxide. Quackwatch has a nice summary of how the harm can occur:

Hemoglobin in red cells of arterial blood gives up about 25% of its oxygen when it passes through the tissues, so the hemoglobin of the venous blood leaving the tissues is oxygen-poor. When hydrogen peroxide is injected into venous blood, the oxygen released by the action of catalase is taken up by oxygen-poor hemoglobin. When this venous blood reaches the lungs, it is carrying more oxygenated-hemoglobin than normal. Less oxygen from inspired air is required to saturate it. When arterial blood leaves the lungs it is almost fully (98%) saturated with oxygen and so it becomes impossible for the intravenous infusion of hydrogen peroxide advocated by “oxygenation” proponents to further increase the amount of oxygen carried to the tissues.

The infusion of hydrogen peroxide into arterial blood is a completely different situation. A theoretical model [37] predicts the effects of an infusion of a hydrogen peroxide solution into arterial blood. Hemoglobin in arterial blood is already saturated with oxygen, so the oxygen released from hydrogen peroxide would not be taken up by hemoglobin. Therefore it would go into plasma. But the process of solution is slow, so undissolved oxygen gas could linger in the blood as bubbles for as long as 30 minutes. In the model, Johnson used 0.12% peroxide to produce a final level of 0.006 volumes peroxide per 100 ml in rabbit blood. Although this amount of hydrogen peroxide released 3.0 ml of oxygen gas in every 100 ml of arterial blood, most of the gas could be taken up by the small amount of unsaturated hemoglobin (2%) in the arterial blood. If however, the hydrogen peroxide content of the blood was doubled, 6.0 ml of oxygen gas would be generated per 100 ml of blood, and this could not be handled by available hemoglobin. Undissolved arterial oxygen would then create gas embolism. Consistent with this prediction for peroxide levels higher than 0.006 volumes percent, Johnson found that at 0.01 volumes 0.12% peroxide, oxygen gas embolism resulted in complete shut down of capillary blood flow in the treated rabbits.

Embolisms can occur and has been documented with peroxide use – even when used for wound irrigation. The FDA has also warned about the dangers of oral consumption of peroxide:

The U.S. Food and Drug Administration (FDA) is warning consumers not to purchase or to use high-strength hydrogen peroxide products, including a product marketed as “35 Percent Food Grade Hydrogen Peroxide,” for medicinal purposes because they can cause serious harm or death when ingested. FDA recommends that consumers who are currently using high-strength hydrogen peroxide stop immediately and consult their health care provider.

FDA is working to stop companies selling high-strength hydrogen peroxide from making illegal medical claims about their products. These claims are illegal because these products do not have FDA approval and are therefore being sold illegally for medical indications without any proven clinical value. The products can instead cause significant harm. As part of these ongoing efforts, FDA today issued Warning Letters to two firms illegally selling “35 percent hydrogen peroxide” products on Web sites for the treatment of AIDS, cancers, emphysema, and other serious and life-threatening diseases. These Warning Letters are available on FDA’s Web site, at http://www.accessdata.fda.gov/scripts/wlcfm/recentfiles.cfm.

“This concentration is not approved by FDA for any purpose,” said Dr. Steven Galson, Director of FDA’s Center for Drug Evaluation and Research. “No one has presented any evidence that hydrogen peroxide taken internally has any medical value. In fact, consuming hydrogen peroxide in the manner touted by these websites could lead to tragic results.”

FDA has never approved high-strength hydrogen peroxide to be taken internally and considers hydrogen peroxide at 35 percent strength dangerous, even if handled according to the manufacturer’s directions. This high-strength hydrogen peroxide — more than 10 times stronger than the solution used in over-the-counter drugs to disinfect minor cuts — is highly corrosive. Ingesting hydrogen peroxide can cause gastrointestinal irritation or ulceration. Intravenous (IV) administration of hydrogen peroxide can cause inflammation of the blood vessel at the injection site, gas embolisms (bubbles in blood vessels), and potentially life-threatening allergic reactions.

Hydrogen peroxide injection practices reminds me of the Miracle Mineral Supplement (MMS) autism quackery that David Gorski has blogged about before. MMS is 28% sodium chlorite in distilled water, equivalent to industrial strength bleach. And like peroxide, MMS is promoted as a cure-all for virtually everything, from autism to AIDS. Health Canada and other regulators continue to seize this product from retailers, who continue to promote its consumption. Hydrogen peroxide, when sold and purchased for consumption, is little different. There are already case reports in the literature over accidental poisonings from the consumption of high concentration peroxide. As the FDA has noted, there is no need to purchase or own high-concentration peroxide.

TL;DR: Drinking or injecting peroxide is not advisable

As a disinfectant on surfaces, or as a dental bleach for tooth whitening, hydrogen peroxide is safe. But there are no medical benefits to consuming or injecting it, and there are significant risks, including death, when hydrogen peroxide is used inappropriately. The promotion of hydrogen peroxide in the alternative medicine field is yet another example of how there really is no such thing as alternative medicine that works. If it did work, we’d call it medicine. The rest is unproven, or proven ineffective. That’s the state of hydrogen peroxide today. Alternative medicine’s ideas about the medicinal effects of hydrogen peroxide may sound impressive, but they have no basis in reality and there is zero evidence to demonstrate that it is useful.

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Posted by Scott Gavura