Intravenous Nutrient Therapy: the Myers’ Cocktail

[Guest guest]

Intravenous Nutrient Therapy: the " Myers’ Cocktail "

_http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm) By

_Alan R. Gaby, M.D._

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Alan R.

Gaby, M.D.)

Abstract

Building on the work of the late John Myers, MD, the author has used an

intravenous vitamin-and-mineral formula for the treatment of a wide range of

clinical conditions. The modified “Myers’ cocktail,†which consists of

magnesium, calcium, B vitamins, and vitamin C, has been found to be effective

against

acute asthma attacks, migraines, fatigue (including chronic fatigue

syndrome), fibromyalgia, acute muscle spasm, upper respiratory tract

infections,

chronic sinusitis, seasonal allergic rhinitis, cardiovascular disease, and

other

disorders. This paper presents a rationale for reviews the relevant published

clinical research, describes the author’s clinical experiences, and discusses

potential side effects and precautions. (Alternative Medical Review

2002;7(5):389-403)

_Introduction_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Introduct\

ion)

_Theoretical Basis for IV Nutrient Therapy_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Theoretic\

al Basis for IV Nutrient

Therapy)

_The Modified Myers’ Cocktail_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#The

Modified Myers’ Cocktail)

_Table 1. Nutrients in Myers’ Cocktail_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Table 1.

Nutrients in Myers’ Cocktail)

_Asthma_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Asthma)

_Migraine_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Migraine)

_Fatigue_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Fatigue)

_Fibromyalgia_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Fibromyal\

gia)

_Depression_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Depressio\

n)

_Cardiovascular Disease_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Cardiovas\

cular Disease)

_Upper Respiratory Tract Infections_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Upper

Respiratory Tract Infections)

_Seasonal Allergic Rhinitis_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Seasonal

Allergic Rhinitis)

_Narcotic Withdrawal_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Narcotic

Withdrawal)

_Chronic Urticaria_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Chronic

Urticaria)

_Athletic Performance_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Athletic

Performance)

_Hyperthyroidism_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Hyperthyr\

oidism)

_Other Conditions_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Other

Conditions)

_Choice of Ingredients and Administration_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Choice of

Ingredients and Administration)

_Side Effects and Precautions_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Side

Effects and Precautions)

_Cost Considerations_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Cost

Considerations)

_Conclusion_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Conclusio\

n)

_References_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Reference\

s)

_Send for Article_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Send for

Article)

_Copyright_

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm#Reprinted\

)

Introduction

John Myers, MD, a physician from Baltimore, Maryland, pioneered the use of

intravenous (IV) vitamins and minerals as part of the overall treatment of

various medical problems. The author never met Dr. Myers, despite living in

Baltimore, but had heard of his work, and had occasionally used IV nutrients to

treat fatigue or acute infections.

After Dr. Myers died in 1984, a number of his patients sought nutrient

injections from the author. Some of them had been receiving injections monthly,

weekly, or twice weekly for many years – 25 years or more in a few cases.

Chronic problems such as fatigue, depression, chest pain, or palpitations were

well controlled by these treatments; however, the problems would recur if the

patients went too long without an injection.

It was not clear exactly what the “Myers’ cocktail†consisted of, as the

information provided by patients was incomplete and no published or written

material on the treatment was available. It appeared that Myers used a 10-mL

syringe and administered by slow IV push a combination of magnesium chloride,

calcium gluconate, thiamine, vitamin B6, vitamin B12, calcium pantothenate,

vitamin B complex, vitamin C, and dilute hydrochloric acid. The exact doses of

individual components were unknown, but Myers apparently used a two-percent

solution of magnesium chloride, rather than the more widely available

preparations containing 20-percent magnesium chloride or 50-percent magnesium

sulfate.

 

The author took over the care of Myers’ patients, using a modified version

of his IV regimen. Most notably, the magnesium dose was increased by

approximately 10-fold by using 20-percent magnesium chloride, in order to

approximate

the doses reported to be safe and effective for the treatment of

cardiovascular disease.1, 2 In addition, the hydrochloric acid was eliminated

and the

vitamin C was increased, particularly for problems related to allergy or

infection. Folic acid was not included, as it tends to form a precipitate when

mixed

with other nutrients.

This treatment was suggested for other patients, and it soon became apparent

that the modified Myers’ cocktail (hereafter referred to as “the

Myers’â€)

was helpful for a wide range of clinical conditions, often producing dramatic

results. Over an 11-year period, approximately 15,000 injections were

administered in an outpatient setting to an estimated 800-1,000 different

patients.

Conditions that frequently responded included asthma attacks, acute

migraines, fatigue (including chronic fatigue syndrome), fibromyalgia, acute

muscle

spasm, upper respiratory tract infections, chronic sinusitis, and seasonal

allergic rhinitis. A small number of patients with congestive heart failure,

angina, chronic urticaria, hyperthyroidism, dysmenorrhea, or other conditions

were also treated with the Myers’ and most showed marked improvement. Many

relatively healthy patients chose to receive periodic injections because it

enhanced their overall well being for periods of a week to several months.

During

the past 16 years these clinical results have been presented at more than 20

medical conferences to several thousand physicians. Today, many doctors

(probably more than 1,000 in the United States) use the Myers’. Some have made

further modifications according to their own preferences. In querying audiences

from the lectern and from informal discussions with colleagues at conferences,

the author has yet to encounter a practitioner whose experience with this

treatment has differed significantly from his own.

Despite the many positive anecdotal reports, there is only a small amount of

published research supporting the use of this treatment. There is one

uncontrolled trial in which the Myers’ was beneficial in the treatment of

musculoskeletal pain syndromes, including fibromyalgia. Intravenous magnesium

alone

has been reported, mainly in open trials, to be effective against angina, acute

migraines, cluster headaches, depression, and chronic pain. In recent years,

double-blind trials have shown IV magnesium can rapidly abort acute asthma

attacks. There are also several published case reports in which IV calcium

provided rapid relief from asthma or anaphylactic reactions.

This paper presents a rationale for the use of IV nutrient therapy, reviews

the relevant published clinical research, describes personal clinical

experiences using the Myers’, and discusses potential side effects and

precautions.

Theoretical Basis for IV Nutrient Therapy

Intravenous administration of nutrients can achieve serum concentrations not

obtainable with oral, or even intramuscular (IM), administration. For

example, as the oral dose of vitamin C is increased progressively, the serum

concentration of ascorbate tends to approach an upper limit, as a result of

both

saturation of gastrointestinal absorption and a sharp increase in renal

clearance of the vitamin.3 When the daily intake of vitamin C is increased

12-fold,

from 200 mg/day to 2,500 mg/day, the plasma concentration increases by only

25 percent, from 1.2 to 1.5 mg/dL. The highest serum vitamin C level reported

after oral administration of pharmacological doses of the vitamin is 9.3

mg/dL. In contrast, IV administration of 50 g/day of vitamin C resulted in a

mean

peak plasma level of 80 mg/dL.4 Similarly, oral supplementation with

magnesium results in little or no change in serum magnesium concentrations,

whereas

IV administration can double or triple the serum levels,5,6 at least for a

short period of time.

Various nutrients have been shown to exert pharmacological effects, which

are in many cases dependent on the concentration of the nutrient. For example,

an antiviral effect of vitamin C has been demonstrated at a concentration of

10-15 mg/dL,4 a level achievable with IV but not oral therapy. At a

concentration of 88 mg/dL in vitro, vitamin C destroyed 72 percent of the

histamine

present in the medium.7 Lower concentrations were not tested, but it is

possible the serum levels of vitamin C attainable by giving several grams in an

IV

push would produce an antihistamine effect in vivo. Such an effect would have

implications for the treatment of various allergic conditions.

Magnesium ions promote relaxation of both vascular8 and bronchial9 smooth

muscle – effects that might be useful in the acute treatment of vasospastic

angina and bronchial asthma, respectively. It is likely these and other

nutrients exert additional, as yet unidentified, pharmacological effects when

present

in high concentrations.

In addition to having direct pharmacological effects, IV nutrient therapy

may be more effective than oral or IM treatment for correcting intracellular

nutrient deficits. Some nutrients are present at much higher concentrations in

the cells than in the serum. For example, the average magnesium concentration

in myocardial cells is 10 times higher than the extracellular concentration.

This ratio is maintained in healthy cells by an active-transport system that

continually pumps magnesium ions into cells against the concentration

gradient. In certain disease states, the capacity of membrane pumps to maintain

normal concentration gradients may be compromised. In one study, the mean

myocardial magnesium concentration was 65-percent lower in patients with

cardiomyopathy than in healthy controls,10 implying a reduction in the

intracellular-to-extracellular ratio to less than 4-to-1. As magnesium plays a

key role in

mitochondrial energy production, intracellular magnesium deficiency may

exacerbate heart failure and lead to a vicious cycle of further intracellular

magnesium loss and more severe heart failure.

Intravenous administration of magnesium, by producing a marked, though

transient, increase in the serum concentration, provides a window of opportunity

for ailing cells to take up magnesium against a smaller concentration gradient.

Nutrients taken up by cells after an IV infusion may eventually leak out

again, but perhaps some healing takes place before they do. If cells are

repeatedly “flooded†with nutrients, the improvement may be cumulative. It

has been

the author’s observation that some patients who receive a series of IV

injections become progressively healthier. In these patients, the interval

between

treatments can be gradually increased, and eventually the injections are no

longer necessary.

Other patients require regular injections for an indefinite period of time

in order to control their medical problems. This dependence on IV injections

could conceivably result from any of the following: (1) a genetically

determined impairment in the capacity to maintain normal intracellular nutrient

concentrations;11 (2) an inborn error of metabolism that can be controlled only

by

maintaining a higher than normal concentration of a particular nutrient; or

(3) a renal leak of a nutrient. 12 In some cases, continued IV therapy may be

necessary because a disease state is too advanced to be reversible.

The Modified Myers’ Cocktail

See Table 1 for the nutrients that make up the modified Myers’ cocktail.

Dexpanthenol is the commercially available injectable form of pantothenic

acid (vitamin B5). One milliliter of B complex 100 contains 100 mg each of

thiamine and niacinamide, and 2 mg each of riboflavin, dexpanthenol, and

pyridoxine.

Table 1. Nutrients in Myers’ Cocktail

Magnesium chloride hexahydrate 20% (magnesium) 2-5 mL Calcium

gluconate 10% (calcium) 1-3 mL Hydroxocobalamin 1,000 mcg/mL (B12) 1 mL

Pyridoxine hydrochloride 100mg/mL (B6) 1 mL Dexpanthenol 250 mg/mL (B5) 1 mL

B

complex 100 (B complex) 1 mL Vitamin C 222 mg/mL © 4-20 mL

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm) All

ingredients are drawn into one syringe, and 8-20 mL of sterile water

(occasionally more) is added to reduce the hypertonicity of the solution. After

gently mixing by turning the syringe a few times, the solution is administered

slowly, usually over a period of 5-15 minutes (depending on the doses of

minerals used and on individual tolerance), through a 25G butterfly needle.

Occasionally, smaller or larger doses than those listed in Table 1 have been

used.

Low doses are often given to elderly or frail patients, and to those with

hypotension. Doses for children are lower than those listed, and are reduced

roughly in proportion to body weight. The most commonly used regimen has been 4

mL magnesium, 2 mL calcium, 1 mL each of B12, B6, B5, and B complex, 6 mL

vitamin C, and 8 mL sterile water.

The following is a review of conditions successfully treated with the Myers’

.. The numbers of patients treated and proportion that responded are, for the

most part, estimates.

Asthma

Case #1: A five-year-old boy presented with a two-year history of asthma.

During the previous 12 months he had suffered 20 asthma attacks severe enough

to require a visit to the hospital emergency department. His symptoms appeared

to be exacerbated by several foods, and skin tests had been positive for 23

of 26 inhalants tested. His initial treatment consisted of identification and

avoidance of allergenic foods, as well as daily oral supplementation with

pyridoxine (50 mg), vitamin C (1,000 mg), calcium (200 mg), magnesium (100 mg),

and pantothenic acid (100 mg), in two divided doses with meals. On this

regimen, he experienced marked improvement, and had no asthma attacks requiring

medical care until nearly 11 months after his initial visit.

At that time the child, now six years old, presented for an emergency visit

with mild but persistent wheezing and difficulty breathing. He was given a

slow IV infusion containing 6 mL vitamin C, 1.4 mL magnesium, and 0.5 mL each

of calcium, B12, B6, B5, and B complex. The symptoms resolved within two

minutes and did not recur.

Over the ensuing eight years and three months, he received a total of 63 IV

treatments for acute exacerbations of asthma. In most instances, a single

injection resulted in marked improvement or complete relief within two minutes,

and the acute symptoms did not recur. Occasionally, a second injection was

needed after a period of 12 hours to two days, and during one episode three

treatments were required over a four-day period. As the patient grew, the

nutrient doses were gradually increased; by age 10 he was receiving 10 mL

vitamin

C, 3 mL magnesium, 1.5 mL calcium, and 1 mL each of B12, B6, B5, and B

complex.

The treatment was unsuccessful only once; on that occasion the patient

presented with generalized urticaria, angioedema, and unusually severe asthma,

after the inadvertent ingestion of an artificial food coloring (FD & C red #40)

and other potential allergens. Three separate injections given over a 60-minute

period produced transient improvement each time. However, the symptoms

returned, and he was taken to the emergency room and hospitalized.

Despite that single treatment failure, the patient and his parents reported

that IV nutrient therapy worked faster, produced a more sustained

improvement, and caused considerably fewer side effects than the conventional

therapies

he had received previously in the emergency room.

The author has treated approximately a dozen asthmatics (mainly adults) with

the Myers’ for acute asthma attacks; in most instances, marked improvement

or complete relief occurred within minutes. A few patients received

maintenance injections once weekly or every other week during difficult times

and

reported the treatments kept their asthma under better control.

Intravenous magnesium is now well documented as an effective treatment for

acute asthma. In one study, 38 patients with an acute exacerbation of

moderate-to-severe asthma that had failed to respond to conventional

beta-agonist

therapy were randomly assigned to receive, in double-blind fashion, IV

infusions

of either magnesium sulfate (1.2 g over a 20-minute period) or placebo

(saline). 13 Peak expiratory flow rate improved to a significantly greater

extent

in the magnesium group (225 to 297 L/min) than the placebo group (208 to 216

L/min). In addition, the hospitalization rate was significantly lower in the

magnesium group than in the placebo group (37% vs. 79%; p < 0.01). No patient

had a significant drop in blood pressure or change in heart rate after

receiving magnesium.

In a second double-blind study, 149 patients with acute asthma who were

being treated with inhaled beta-agonists and IV steroids were randomly assigned

to receive an IV infusion of magnesium sulfate (2 g over 20 minutes) or saline

placebo, beginning 30 minutes after presentation. 14 Among patients with

severe asthma (defined as forced expiratory volume in 1 second [FEV1] less than

25 percent of predicted value) compared with placebo, magnesium

significantly reduced the hospitalization rate (33.3% vs. 78.6%; p < 0.01) and

significantly improved FEV1. However, magnesium treatment was of no benefit to

patients with moderate asthma (defined as baseline FEV1 between 25 and 75

percent of

predicted value).

In two placebo-controlled studies of asthmatic children, IV magnesium

sulfate significantly improved pulmonary function and significantly reduced

hospitalization rates during acute exacerbations that had failed to respond to

conventional therapy.15,16 A dose of 40 mg per kg body weight (maximum dose, 2

g)

given over a 20-minute period appeared to be more effective than 25 mg per

kg. Higher doses of IV magnesium sulfate (10-20 g over 1 hour, followed by 0.4

g per hour for 24 hours) have been used successfully in the treatment of

life-threatening status asthmaticus.6 In a few studies, IV magnesium failed to

improve pulmonary function or to reduce the need for hospitalization. 17,18

However, a meta-analysis of seven randomized trials concluded that IV magnesium

reduced the need for hospitalization by 90 percent among patients with severe

asthma, although the treatment was not beneficial for patients with moderate

asthma.19

Calcium is the only other component of the Myers’ that has been studied as a

treatment for acute exacerbations of asthma. In an early report, a series of

IV infusions of calcium chloride relieved asthma symptoms in three

consecutive patients, with relief occurring almost immediately after some

injections.20 Intravenous and IM administration of an unspecified calcium salt

temporarily inhibited severe anaphylactic reactions in two other patients.21

Nutrients other than magnesium and calcium may have contributed to the

beneficial effect observed in asthma patients. Oral vitamins C22 and B623,24

and

IM vitamin B1225 have each been used with some success against asthma,

although none of these nutrients has been tested as a treatment for acute

attacks.

Intramuscular administration of niacinamide has been shown to reduce the

severity of experimentally induced asthma in guinea pigs,26 and pantothenic

acid

appears to have an anti-allergy effect in humans.27

On one occasion, a patient’s asthma attack was treated with IV magnesium

alone. Although the symptoms resolved rapidly, they returned within 10-15

minutes. The remaining constituents of the Myers’ (without additional

magnesium)

were then administered, and the symptoms disappeared almost immediately and did

not return. Thus, it seems the Myers’ is more effective than magnesium alone

in the treatment of asthma attacks.

Migraine

Case #2: A 44-year-old female suffered from frequent migraines, which

appeared to be triggered in many instances by exposure to environmental

chemicals

or, occasionally, to ingestion of foods to which she was allergic. Allergy

desensitization therapy had provided little benefit. Over a six-year period,

the

patient was given IV therapy on approximately 70 occasions for migraines.

Nearly all of these injections resulted in considerable improvement or complete

relief within several minutes, although a few treatments were ineffective.

Through trial and error, it was determined her most effective regimen was 16

mL vitamin C, 5 mL magnesium, 4 mL calcium, 2 mL B6, and 1 mL each of B12, B5,

and B complex. The 4-mL dose of calcium was found to provide better relief

than lower calcium doses.

Over the years, a half dozen other patients have presented one or more times

with an acute migraine. In almost every instance, the Myers’ produced a

gratifying response within a few minutes.

The beneficial effect of IV magnesium as a treatment for migraine has been

demonstrated in recent clinical trials. In one study, 40 patients with an

acute migraine received 1 g magnesium sulfate over a five-minute period.28

Fifteen minutes after the infusion, 35 patients (87.5%) reported at least a

50-percent reduction of pain, and nine patients (22.5%) experienced complete

relief.

In 21 of 35 patients who benefited, the improvement persisted for 24 hours

or more. Patients with an initially low serum ionized magnesium concentration

(less than 0.54 mMol/L) were significantly more likely to experience

long-lasting improvement than were patients with initially higher serum ionized

magnesium levels. In a single-blind trial that included 30 patients with an

acute

migraine, IV administration of magnesium sulfate (1 g over 15 minutes)

completely and permanently relieved pain in 13 of 15 patients (86.6%), whereas

no

patients in the placebo group became pain free (p < 0.001 for difference

between groups).29 In addition, magnesium treatment resulted in rapid

disappearance of nausea, vomiting, and photophobia in all 14 patients who had

experienced those symptoms.

A single 1-g dose of magnesium sulfate has also been reported to abort an

episode of cluster headaches in seven of 22 patients (32%), and a series of

three to five injections provided sustained relief in an additional two

patients

(9%).30

It is not clear whether the Myers’ is more effective than magnesium alone

for migraines; however, one patient did experience noticeable benefit from IV

calcium.

Fatigue

Many patients with unexplained fatigue have responded to the Myers’, with

results lasting only a few days or as long as several months. Patients who

benefited often returned at their own discretion for another treatment when the

effect had worn off. One patient with fatigue associated with chronic hepatitis

B experienced marked and progressive improvement in energy levels with

weekly or twice-monthly injections.

Approximately 10 patients with chronic fatigue syndrome (CFS) received a

minimum of four treatments (usually once weekly for four weeks), with more than

half showing clear improvement. One patient experienced dramatic benefit

after the first injection, whereas in other cases three or four injections were

given before improvement was evident. A few patients became progressively

healthier with continued injections and were eventually able to stop treatment.

Several others did not overcome their illness, but periodic injections helped

them function better.

There is some research support for the use of parenteral magnesium in

patients with fatigue. One study found magnesium deficiency, demonstrated by an

IV

magnesium-load test, in 47 percent of 93 patients with unexplained chronic

fatigue, including 50 with CFS.31 In a second study, the mean erythrocyte

magnesium concentration was significantly lower in 20 patients with CFS than in

healthy controls.32

As one arm of the second study, 32 patients with CFS were randomly assigned

to receive, in double-blind fashion, 1 g magnesium sulfate IM or placebo,

once weekly for six weeks. Twelve (80%) of 15 patients given magnesium reported

improvement (e.g., more energy, a better emotional state, and less pain) and

fatigue was eliminated completely in seven cases. In contrast, only three

(18%) of 17 placebo-treated patients improved (p = 0.0015 for difference

between

groups), and in no case was the fatigue completely eliminated. According to

one report, at least half of CFS patients with magnesium deficiency benefited

from oral magnesium supplementation; however, some patients needed IM

injections.33 Other investigators, using the IV magnesium-load test, found no

evidence of magnesium deficiency in patients with CFS, and observed no

improvement

in symptoms following a single infusion of magnesium sulfate (6 g in one

hour).34

Vitamin B12, given IM, has been reported to be helpful for patients with

unexplained fatigue, 35 as well as those with CFS.36 While the results obtained

with the Myers’ may be attributable in part to vitamin B12, many patients who

responded to IV therapy obtained little or no benefit from IM vitamin B12

alone.

Fibromyalgia

Case #3: A 48-year-old woman presented with a six-year history of fairly

constant myalgias and arthralgias, with pain in the neck, back, and hip, and

tightness in the left arm. Six months previously she was found to have an

elevated sedimentation rate (50 mm/hr). She was diagnosed by a rheumatologist

as

possibly having polymyalgia rheumatica, although the diagnosis of fibromyalgia

was also considered. Her history was also significant for migraines about

eight times per year and chronic nasal congestion. Physical examination

revealed

extremely stiff muscles, with decreased range of motion in many areas of her

body.

The patient was given a therapeutic trial consisting of 6 mL vitamin C, 4 mL

magnesium, 2.5 mL calcium, and 1 mL each of B12, B6, B5, and B complex. At

the end of the injection, she got off the table and, with a look of amazement,

announced her muscle aches and joint pains were gone for the first time in

six years. This treatment was repeated after a week (at which time her

symptoms had not returned), followed by every other week for several months,

then

once monthly for three years. Her initial regimen also included the

identification and avoidance of allergenic foods and treatment with low-dose

desiccated

thyroid (eventually stabilized at 60 mg per day). She discovered that eating

refined sugar caused myalgias and arthralgias, and that thyroid hormone

improved her energy level, mood, and overall well being. During the three years

of

monthly maintenance injections she reported symptoms would begin to recur if

she went much longer than a month between treatments. However, they were

never as severe as they were before she began receiving IV therapy.

The author has given the Myers’ to approximately 30 patients with

fibromyalgia; half have experienced significant improvement, in a few cases

after the

first injection, but more often after three or four treatments.

The beneficial effect of parenteral nutrient therapy has been confirmed by

one study published only as an abstract. Eighty-six patients with chronic

muscular complaints, including myofascial pain, relapsing soft tissue injuries,

and fibromyalgia, received IM or IV injections of magnesium, either alone or

in combination with calcium, B vitamins, and vitamin C.37 Improvement occurred

in 74 percent of the patients; of those, 64 percent required four or fewer

injections for optimal results. A minority of patients required long-term oral

or parenteral magnesium to maintain improvement. The positive response to

parenteral magnesium is consistent with the observation that nearly half of

patients with fibromyalgia have intracellular magnesium deficiency, despite

having normal serum levels of the mineral.38

Depression

Case #4: A 46-year-old man presented with a history of depression and

anxiety since childhood. He had been in psychoanalysis for the past eight

years. A

therapeutic trial with IV nutrients was considered because the patient

reported that consumption of alcohol (known to deplete magnesium) aggravated

his

symptoms, and because he was taking a magnesium-depleting thiazide diuretic for

hypertension. He was initially given 1 mL each of magnesium, B12, B6, B5,

and B complex, which resulted in a 70-80 percent reduction in his symptoms for

one week. A second injection produced a similar response that lasted two

weeks. Through trial and error it was determined the most effective treatment

was

5 mL magnesium, 3 mL B complex, and 1 mL each of B12, B6, and B5. The

addition of calcium to the injection appeared to block some of the benefit.

Both

oral and IM administration of the same nutrients were tried but found to be

ineffective. Weekly injections provided almost complete relief from symptoms

and

allowed him to discontinue psychotherapy. The patient noted that rapidly

administered injections provided longer-lasting relief than did slower

injections. The infusion rate was therefore carefully and progressively

increased,

without causing any adverse side effects or changes in blood pressure or heart

rate. The patient reported that when the treatment was given over a one-minute

period, the effect would last approximately two weeks, whereas a slower

injection (such as five minutes) would last only a week. Approximately four

years

after initial treatment, he was able to reduce the frequency of injections

to once monthly or less.

Many other patients with depression and/or anxiety have shown a positive

response to the Myers’. However, this treatment should not be considered

first-line therapy for major depression.

It seems to be helpful only for certain subsets of depressed individuals,

such as those who also suffer from fibromyalgia, migraines, excessive stress,

or alcohol-induced exacerbations. Shealy et al have observed an antidepressant

effect of IV magnesium in some patients with chronic pain.39

Cardiovascular Disease

Case #5: A 79-year-old man was seen at home in end-stage heart failure,

after having suffered four myocardial infarctions. During the previous 12

months,

spent mostly in the hospital, he had become progressively worse; his

ejection fraction had fallen to 19 percent and his body weight had declined

from 171

pounds to a severely cachectic 113 pounds. He was confined to bed and

required supplemental oxygen much of the time. He also had severe peripheral

occlusive arterial disease, which had resulted in the development of gangrene

of

six toes. A peripheral angiogram revealed complete occlusion of both

femoralpopliteal arteries, with no detectable blood flow to the distal

extremities. Two

independent vascular surgeons had recommended bilateral abovethe- knee

amputations to prevent development of septicemia. However, the cardiologist

advised the patient that his heart would not last more than another month, so

the

patient declined the amputations.

He was treated with weekly IM injections of magnesium sulfate (1 g) for

eight weeks, and prescribed oral supplementation with vitamins C and E, B

complex, folic acid, and zinc. The magnesium injections appeared to reduce the

pain

in his gangrenous toes considerably, with the benefit lasting about five days

each time. Six weeks after the first injection, his ejection fraction had

increased from 19 percent to 36 percent and he no longer required supplemental

oxygen. After eight weeks, the IM injections were replaced by weekly IV

injections, consisting of 5 mL magnesium, 1 mL each of B12, B6, B5, and B

complex,

and a low-dose (0.2 mL) trace mineral preparation (MTE-5 containing: zinc,

copper, chromium, selenium, and manganese). After a total of 18 months, his

weight had increased from 113 to 147 pounds, which was remarkable as cardiac

cachexia is generally considered to be irreversible. In addition, the

gangrenous areas on his toes had sloughed and been replaced almost entirely by

healthy

tissue. Intravenous therapy was continued and eventually reduced to every

other week. The patient lived for eight years and died at age 87 from multiple

organ failure.

Of the handful of other patients with angina or heart failure who received

IV or IM injections of magnesium (with or without B vitamins), all showed

significant improvement. The results with angina are consistent with those

reported by others using parenteral magnesium therapy.40-42

Upper Respiratory Tract Infections

Case #6: A 40-year-old male presented with a cold and a one-day history of

fatigue, nasal congestion, and rhinorrhea. He was given an IV infusion of 16

mL vitamin C, 3 mL magnesium,1.5 mL calcium, and 1 mL each of B12, B6, B5, and

B complex. By the end of the 10-minute treatment he was symptom free. The

cold symptoms did return the next day but were only 10 percent as severe as

before the injection.

One-quarter to one-third of patients who received the Myers’ for an acute

respiratory infection experienced marked improvement, either immediately or by

the next morning. Approximately half of patients given this treatment reported

that it shortened the duration of their illness. Patients who benefited

tended to have a similar response if treated for a subsequent infection,

whereas

non-responders tended to remain non-responders.

Case #7: A 32-year-old female had a long history of chronic sinusitis.

Avoidance of allergenic foods and oral supplementation with vitamin C and other

nutrients had provided only minimal benefit. She was given an IV infusion of 20

mL vitamin C, 4 mL magnesium, 2 mL calcium, and 1 mL each of B12, B6, B5,

and B complex; this protocol was repeated the next day. At the time these

injections were given she had been experiencing persistent sinus problems for a

year. Her symptoms resolved rapidly after the injections and she remained

relatively symptom free for more than six months. The same treatment given at a

later date was also helpful, although the benefit was not as pronounced as the

first time.

One other patient with chronic sinusitis had a similar response to

back-to-back injections, while a few others showed no improvement.

Seasonal Allergic Rhinitis

Case #8: A 38-year-old man had a long history of seasonal allergic rhinitis,

occurring each spring and lasting about a month. Symptoms included nasal

congestion, itchy eyes, and fatigue.

During a symptomatic period, an IV infusion of 12 mL vitamin C, 3 mL

magnesium, and 1 mL each of B12, B6, B5, and B complex provided rapid relief.

This

treatment was repeated as needed during the hay fever season (once weekly or

less) and successfully controlled his symptoms. In subsequent years he began

the IVs shortly before, and repeated them periodically during, the hay fever

season; this approach prevented the development of symptoms.

Narcotic Withdrawal

Case #9: A 35-year-old man addicted to morphine came to the office in the

early stages of withdrawal, with diaphoresis and extreme agitation. He was

given an IV infusion of 16 mL vitamin C, 5 mL magnesium, 2.5 mL calcium, and 1

mL

each of B12, B6, B5, and B complex. In his agitated state he was unable to

sit still on the exam table, so we walked up and down the hall with a

butterfly needle in his arm. Halfway through the injection, he was able to sit

still,

and by the end of the injection his withdrawal symptoms were alleviated. The

symptoms returned 36 hours later; he therefore came for another treatment,

which again relieved the symptoms within minutes. He returned the next day,

still symptom free, for a third injection, which carried him uneventfully

through the remainder of the withdrawal period.

Chronic Urticaria

Case #10: A 71-year-old woman had chronic urticaria with hives present

somewhere on her body nearly every day for 10 years. An allergy-elimination

diet

and oral supplementation with vitamin C and other nutrients provided little or

no relief. She was given an IV infusion of 12mL vitamin C, 3 mL magnesium,

1.5 mL calcium, and 1 mL each of B12, B6, B5, and B complex. The same

treatment was repeated the following day. After these injections the hives

resolved

rapidly and did not recur for more than a year. When the lesions did recur,

the IV treatment was repeated but was ineffective.

Athletic Performance

Case #11: An 18-year-old, 235-pound high school wrestler developed a

flu-like illness four days before a major tournament. Two days before the

three-day

tournament, when it appeared he might have to miss the event, he was given an

IV injection of 16 mL vitamin C, 5 mL magnesium, 2.5 mL calcium, and 1 mL

each of B12, B6, B5, and B complex. The next morning he remarked that he had

more energy than he had ever had in his life. This energy boost persisted for

the duration of the tournament, at which he took second place, a better

performance than at any other time in his career.

In this era in which many athletes are using performance-enhancing drugs, it

is not the author’s intention to encourage athletes to seek another

“boostâ€

with IV nutrients. However, this case does demonstrate that nutritional

factors can play an important role in athletic performance.

Hyperthyroidism

Two patients with hyperthyroidism were treated with the Myers’ once or twice

weekly for several weeks. In one case, the treatment controlled the symptoms

of hyperthyroidism, although there was no reduction in thyroid-hormone

levels. The injections were discontinued after medical therapy had restored the

hormone levels to normal. In the other case, symptoms improved markedly after

the first injection and thyroid-function tests, measured two weeks later,

returned to normal.

The potential value of IV nutrient therapy for patients with hyperthyroidism

is supported by several studies. Serum and erythrocyte magnesium levels have

been found to be low in patients with Graves’ disease.43 In addition, daily

IM injections of magnesium chloride (20 mL of a 14-percent solution) for 3-7

weeks reduced the size of the thyroid gland and improved the clinical

condition of three patients with hyperthyroidism.44 Intravenous vitamin B6 (50

mg

per day) was reported to relieve muscle weakness in three patients with

hyperthyroidism,45 and animal studies indicate vitamin B12 can counteract some

of

the adverse effects of experimentally induced hyperthyroidism.46,47

Other Conditions

The modified Myers’ cocktail seems to provide rapid relief for patients with

acute muscle spasm resulting from sleeping in the wrong position or from

overuse. It also has been observed to relieve tension headaches in many cases.

One patient (a 70-year-old female) with chronic torticollis experienced

moderate pain relief with periodic treatments. Of three patients with acute

dysmenorrhea treated with the Myers’, two experienced almost instant pain

relief.

One patient with chronic obstructive pulmonary disease intermittently received

weekly IV injections and reported the treatments improved his strength and

breathing.

Choice of Ingredients and Administration

At the time of this writing, cyanocobalamin is a widely available form of

injectable vitamin B12, whereas hydroxocobalamin can be obtained only through a

compounding pharmacist. While both forms of the vitamin are effective,

hydroxocobalamin is preferred because it produces more prolonged increases in

serum vitamin B12 levels.48

It has been the author’s impression (and that of other clinicians) that some

patients who respond to IM vitamin B12 injections do not experience the same

benefit when vitamin B12 is given as part of the Myers’. It is possible that

vitamin C or another component of the Myers’ destroys some of the vitamin

B12,49 or that IV vitamin B12 is lost more rapidly in the urine than IM vitamin

B12. Therefore, for some patients receiving IV nutrient therapy, the vitamin

B12 is given IM in a separate syringe.

Injectable magnesium can be obtained either as magnesium chloride

hexahydrate (20% solution), commonly called magnesium chloride, or magnesium

sulfate

heptahydrate (50% solution), commonly called magnesium sulfate. Although most

clinical research has been done with magnesium sulfate, some experts prefer

magnesium chloride for IV use because of its greater retention in the body.50

The author has used magnesium chloride almost exclusively for IV therapy, while

reserving the more concentrated magnesium sulfate for IM administration. For

those using magnesium sulfate, it should be noted that 1 g (2 mL of a

50-percent solution) is equivalent to 0.8 g (4 mL of a 20-percent solution) of

magnesium chloride (each contains 4 mMol of magnesium). In addition, if

50-percent magnesium sulfate is given IV instead of 20-percent magnesium

chloride, it

should be diluted appropriately with sterile water.

Injectable vitamin C is currently available in concentrations of 222 and 500

mg per mL. The author typically uses the lower concentration for IV therapy.

If the higher concentration is used, it should be diluted appropriately with

sterile water. Occasionally, trace minerals were included as part of a

nutrient infusion. The usual dose was 0.2-0.5 mL of MTE-5, which contains (per

mL): zinc 1 mg, copper 0.4 mg, chromium 4 mcg, selenium 20 mcg, and manganese

0.1 mg. The preparation was diluted six-fold and administered over a period of

1-2 minutes in a separate syringe at the end of the Myers’ push. Two adverse

reactions have been noted with 10 mg of zinc given by slow IV push;

consequently, when giving trace minerals by IV push, very small doses are used.

Trace

minerals should not be mixed in the same syringe with the components of the

Myers’, as doing so often causes formation of a precipitate.

Side Effects and Precautions

The Myers’ often produces a sensation of heat, particularly with large doses

or rapid administration. This effect appears to be due primarily to the

magnesium, although rapid injections of calcium have been reported to produce a

similar effect.22 The sensation typically begins in the chest and migrates to

the vaginal area in women and to the rectal area in men. For most patients

the heat does not cause excessive discomfort; indeed, some patients enjoy it.

However, if the infusion is given too rapidly, the warmth can be overbearing.

Some women experience a sensation of sexual pleasure in association with the

vaginal warmth; on rare occasions, an orgasm may occur during an IV infusion.

Other patients have remarked their visual acuity and color perception become

sharper immediately after an injection, as if someone had turned the lights

on. In some cases, this effect lasts as long as one or two days.

Too rapid administration of magnesium can cause hypotension, which can lead

to lightheadedness or even syncope. Patients receiving a Myers’ should be

advised to report the onset of excessive heat (which can be a harbinger of

hypotension) or lightheadedness. If either of these symptoms occurs, the

infusion

should be stopped temporarily and not resumed until the symptoms have

resolved (usually after 10-30 seconds). Patients with low blood pressure tend

to

tolerate less magnesium than do patients with normal blood pressure or

hypertension. In a small proportion of patients, even a low-dose regimen given

very

slowly causes persistent hypotension; in those cases, the treatment is usually

discontinued and may or may not be attempted at a later date.

Although too rapid administration can have adverse consequences, some

patients appear to experience more pronounced benefits from rapid infusions than

from slower ones, presumably because of higher peak serum concentrations of

nutrients. While both the risks and benefits should be taken into account in

determining an infusion rate, when in doubt one should err on the side of

safety. When administering the Myers’ to a patient for the first time, it is

best

to give 0.5-1.0 mL and then wait 30 seconds or so before proceeding with the

rest of the infusion. Doing so may help one distinguish between a vasovagal

reaction and a hypotensive response to the injected compounds. Patients who

experience a vasovagal reaction at the beginning of an infusion can usually

tolerate the remainder of the treatment after the reaction has worn off.

For elderly or frail individuals, it may be advisable to start with lower

doses than those listed in Table 1, or to consider IM administration of

magnesium and B vitamins as an alternative to IV therapy. However, many elderly

patients have tolerated, and benefited from, IV therapy.

Patients who are deficient in both magnesium and potassium may have an

influx of potassium into the cells after receiving IV magnesium. 51 This occurs

because magnesium activates the membrane pump that promotes the intracellular

uptake of potassium. The shift of potassium from the serum to the intracellular

space can trigger hypokalemia. The author has seen two patients develop

severe muscle cramps several hours after receiving a Myers’; both patients

had

been taking medications known to deplete potassium. Hypokalemia also increases

the risk of digoxin-induced cardiac arrhythmias. As a first-year resident,

unaware of this potential problem, the author administered IV magnesium in the

hospital to an elderly woman who was taking digoxin and a potassium-depleting

diuretic. She quickly developed an arrhythmia, which required short-term

treatment in the intensive care unit.

Patients considered to be at risk of potassium deficiency include those

taking potassium-depleting diuretics, beta-agonists, or glucocorticoids; those

with diarrhea or vomiting; and those who are generally malnourished. If a

patient is hypokalemic, the hypokalemia should be corrected before IV magnesium

therapy is considered. However, a normal serum potassium concentration is not a

guarantee against intracellular potassium depletion. For patients considered

to be at risk of potassium deficiency, administration of 10-20 mEq of

potassium orally just prior to the infusion, and again 4-6 hours later is

recommended. After this practice was instituted, no further problems with

magnesium-induced muscle cramps were encountered.

The addition of even small amounts of potassium to an IV push is strongly

discouraged, because of the theoretical risk of triggering an arrhythmia during

the first pass when the bolus reaches the cardiac conducting system.

Intravenous calcium is contraindicated in patients taking digoxin. In

addition, hypercalcemia can cause cardiac arrhythmias. For that reason, the

author

has tended to leave calcium out of the Myers’ when treating patients with

cardiac disease, although there is no strong evidence it is dangerous for such

patients.

Anaphylactic reactions to IV thiamine have been reported on rare occasions.

Only three such reactions have been identified in the U.S. literature since

1946. However, in the world literature, a total of nine deaths attributed to

thiamine administration were reported between 1965 and 1985.52 These reactions

have occurred after oral, IV, IM, or subcutaneous administration, and are

believed to be due in part to a nonspecific release of histamine. Anaphylactic

reactions have been seen most often after multiple administrations of

thiamine. In the United Kingdom, between 1970 and 1988, there were

approximately

four reports of anaphylactoid reactions for every million ampules of IV B

vitamins sold, and one report for every 5 million IM ampules sold.53

It is possible the risk of anaphylaxis from the Myers’ is even lower than

the low risk associated with the use of IV thiamine. Many patients who receive

parenteral thiamine are alcoholics, and alcoholism frequently causes

magnesium deficiency. Animal studies suggest thiamine supplementation in the

presence

of magnesium deficiency increases the severity of the magnesium deficiency.

54 A deficiency of magnesium can lead to spontaneous release of histamine,55

and has been reported to increase the incidence of experimentally induced

anaphylaxis in animals.56 The presence of magnesium in the Myers’ might,

therefore, reduce the risk of an anaphylactic reaction to thiamine. Moreover, as

the

Myers’ has been used successfully to treat asthma and urticaria, it is

likely the formula as a whole provides prophylaxis against anaphylaxis.

Nevertheless, practitioners who administer IV nutrients should be prepared to

deal with

the rare anaphylactic reaction.

A small number of patients (approximately one percent) felt “out of sortsâ€

for up to a day after receiving an injection and, in two cases, this reaction

lasted one and two weeks, espectively. It is not clear whether these

reactions were due to the preservatives in some of the injectable preparations

(e.g., benzyl alcohol, methylparabens, or others) or to the nutrients

themselves.

In most cases (including a few patients with asthma) preservative containing

products were used because the use of multi-dose vials reduced the cost of

treatment to the patient. However, for some individuals with known chemical

sensitivities or other significant allergy-related problems, preservative-free

preparations were used.

Although the Myers’ is extremely hypertonic, it rarely seemed to cause

problems related to its hypertonicity. Two or three patients developed phlebitis

at the injection site; for those patients, later treatments were diluted with

sterile water to a total of 60 mL. Some patients experienced a burning

sensation at the injection site during the infusion; this was often corrected

by

re-positioning the needle or by further diluting the nutrients.

When administered with caution and respect, the Myers’ has been generally

well tolerated, and no serious adverse reactions have been encountered with

approximately 15,000 treatments.

Cost Considerations

In 1995, the author’s last year in private practice, the cost of the

materials for a Myers’ was approximately $5.00. The use of preservative-free

nutrients at least doubled the cost of materials. Nursing time and

administrative

factors represented the majority of the cost of IV nutrient therapy. In 1995,

the author’s fee for a Myers’ was $38.00. Other doctors have charged as

little as $15.00 or as much as $100.00 or more. Since 1995, the cost of most of

the injectable preparations has increased by 50-100 percent.

Insurance companies do not generally pay for this treatment. However, in a

few instances, showing them that IV nutrient therapy had greatly reduced the

overall cost of the patient’s health care persuaded them to pay.

Conclusion

The Myers’ has been found by the author and hundreds of other practitioners

to be a safe and effective treatment for a wide range of clinical conditions.

In many instances this treatment is more effective and better tolerated than

conventional medical therapies. Although most of the evidence is anecdotal,

some published research has demonstrated the efficacy of the Myers’ or some

of its components. Widespread appropriate use of this treatment would likely

reduce the overall cost of healthcare, while greatly improving the health of

many individuals. Additional research is urgently needed to confirm the

effectiveness of this treatment and to determine optimal doses of the various

nutrients. Although double-blind trials would be difficult to perform because

of

the obvious sensations induced by IV nutrient infusions, trials comparing the

Myers’ with established therapies would be informative. Practitioners using

this treatment are encouraged to report their findings.

References

1. Malkiel-Shapiro B. Further observations on parenteral magnesium sulfate

therapy in coronary heart disease: a clinical appraisal. S

Afr Med J 1958;32:1211-1215.

2. Browne SE. Intravenous magnesium sulphate in arterial disease.

Practitioner 1969;202:562-564.

3. Blanchard J, Tozer TN, Rowland M. Pharmacokinetic perspectives on

megadoses of ascorbic acid.

Am J Clin Nutr 1997;66:1165-1171.

4. Harakeh S, Jariwalla RJ, Pauling L. Suppression of human immunodeficiency

virus replication by ascorbate in chronically and acutely infected cells.

Proc Natl Acad Sci U S A 1990;87:7245-7249.

5. Okayama H, Aikawa T, Okayama M, et al. Bronchodilating effect of

intravenous magnesium

sulfate in bronchial asthma. JAMA 1987;257:1076-1078.

6. Sydow M, Crozier TA, Zielmann S, et al. High-dose intravenous magnesium

sulfate in the management of life-threatening status asthmaticus. Intensive

Care Med 1993;19:467-471.

7. Uchida K, Mitsui M, Kawakishi S. Monooxygenation of N-acetylhistamine

mediated by L-ascorbate. Biochim Biophys Acta 1989;991:377-379.

8. Iseri LT, French JH. Magnesium: nature’s physiologic calcium blocker. Am

Heart J 1984;108:188-193.

9. Brunner EH, Delabroise AM, Haddad ZH. Effect of parenteral magnesium on

pulmonary function, plasma cAMP, and histamine in bronchial asthma. J Asthma

1985;22:3-11.

10. Frustaci A, Caldarulo M, Schiavoni G, et al. Myocardial magnesium

content, histology, and antiarrhythmic response to magnesium infusion. Lancet

1987;2:1019.

11. Henrotte JG. The variability of human red blood cell magnesium level

according to HLA groups. Tissue Antigens 1980;15:419-430.

12. Booth BE, Johanson A. Hypomagnesemia due to renal tubular defect in

reabsorption of magnesium. J Pediatr 1974;85:350-354.

13. Skobeloff EM, Spivey WH, McNamara RM, Greenspon L. Intravenous magnesium

sulfate for the treatment of acute asthma in the emergency department. JAMA

1989;262:1210-1213.

14. Bloch H, Silverman R, Mancherje N, et al. Intravenous magnesium sulfate

as an adjunct in the treatment of acute asthma. Chest 1995;107:1576-1581.

15. Ciarallo L, Brousseau D, Reinert S. Higherdose intravenous magnesium

therapy for children with moderate to severe acute asthma. Arch Pediatr Adolesc

Med 2000;154:979-983.

16. Ciarallo L, Sauer AH, Shannon MW. Intravenous magnesium therapy for

moderate to severe pediatric asthma: results of a randomized,

placebo-controlled

trial. J Pediatr 1996;129:809-814.

17. Tiffany BR, Berk WA, Todd IK, White SR. Magnesium bolus or infusion

fails to improve expiratory flow in acute asthma exacerbations. Chest

1993;104:831-834.

18. Green SM, Rothrock SG. Intravenous magnesium for acute asthma: failure

to decrease emergency treatment duration or need for hospitalization. Ann

Emerg Med 1992;21:260-265.

19. Rowe BH, Bretzlaff JA, Bourdon C, et al. Intravenous magnesium sulfate

treatment for acute asthma in the emergency department: a systematic review of

the literature. Ann Emerg Med 2000;36:181-190.

20. Pottenger FM. A discussion of the etiology of asthma in its relationship

to the various systems composing the pulmonary neurocellular mechanism with

the physiological basis for the employment of calcium in its treatment. Am J

Med Sci 1924;167:203-249.

21. Undritz E. The therapy of anaphylactic conditions with large amounts of

calcium. J Allergy 1937;8:625.

22. Anah CO, Jarike LN, Baig HA. High dose ascorbic acid in Nigerian

asthmatics. Trop Geogr Med 1980;32:132-137.

23. Reynolds RD, Natta CL. Depressed plasma pyridoxal phosphate

concentrations in adult asthmatics. Am J Clin Nutr 1985;41:684-688.

24. Collipp PJ, Goldzier S 3rd, Weiss N, et al. Pyridoxine treatment of

childhood bronchial asthma. Ann Allergy 1975;35:93-97.

25. Crocket JA. Cyanocobalamin in asthma. Acta Allergologica

1957;11:261-268.

26. Bekier E, Wyczolkowska J, Szyc H, Maslinski C. The inhibitory effect of

nicotinamide on asthma-like symptoms and eosinophilia in guinea pigs,

anaphylactic mast cell degranulation in mice, and histamine release from rat

isolated peritoneal mast cells by compound 48-80. Int Arch Allergy Appl Immunol

1974;47:737-748.

27. Tuft L, Gregory J, Gregory DC. The effect of calcium pantothenate on

induced whealing and on seasonal rhinitis. Ann Allergy 1958;16:639-655.

28. Mauskop A, Altura BT, Cracco RQ, Altura BM. Intravenous magnesium

sulphate relieves migraine attacks in patients with low serum ionized magnesium

levels: a pilot study. Clin Sci 1995;89:633-636.

29. Demirkaya S, Vural O, Dora B, Topcuoglu MA. Efficacy of intravenous

magnesium sulfate in the treatment of acute migraine attacks. Headache

2001;41:171-177.

30. Mauskop A, Altura BT, Cracco RQ, Altura BM. Intravenous magnesium

sulfate relieves cluster headaches in patients with low serum ionized magnesium

levels. Headache 1995;35:597-600.

31. Manuel y Keenoy B, Moorkens G, Vertommen J, et al. Magnesium status and

parameters of the oxidant-antioxidant balance in patients with chronic

fatigue: effects of supplementation with magnesium. J Am Coll Nutr

2000;19:374-382.

32. Cox IM, Campbell MJ, Dowson D. Red blood cell magnesium and chronic

fatigue syndrome. Lancet 1991;337:757-760.

33. Howard JM, Davies S, Hunnisett A. Magnesium and chronic fatigue

syndrome. Lancet 1992;340:426.

34. Clague JE, Edwards RH, Jackson MJ. Intravenous magnesium loading in

chronic fatigue syndrome. Lancet 1992;340:124-125.

35. Ellis FR, Nasser S. A pilot study of vitamin B12 in the treatment of

tiredness. Br J Nutr 1973;30:277-283.

36. Lapp CW, Cheney PR. The rationale for using high-dose cobalamin (vitamin

B12). CFIDS Chronicle Physicians’ Forum 1993 (Fall):19-20.

37. Reed JC. Magnesium therapy in musculoskeletal pain syndromes —

retrospective review of clinical results. Magnes Trace Elem 1990;9:330.

38. Moorkens G, Manuel y Keenoy B, Vertommen J, et al. Magnesium deficit in

a sample of the Belgian population presenting with chronic fatigue. Magnes Res

1997;10:329-337.

39. Shealy CN, Cady RK, Veehoff D, et al. Magnesium deficiency in depression

and chronic pain. Magnes Trace Elem 1990;9:333.

40. Malkiel-Shapiro B, Bersohn I, Terner PE. Parenteral magnesium sulphate

therapy in coronary heart disease. A preliminary report on its clinical and

laboratory aspects. Med Proc 1956;2:455-462.

41. Browne SE. Magnesium sulphate in arterial disease. Practitioner

1984;228:1165-1166.

42. Cohen L, Kitzes R. Magnesium sulfate in the treatment of variant angina.

Magnesium 1984;3:46-49.

43. Disashi T, Iwaoka T, Inoue J, et al. Magnesium metabolism in

hyperthyroidism. Endocr J 1996;43:397-402.

44. Neguib MA. Effect of magnesium on the thyroid. Lancet 1963;1:1405.

45. Rosenbaum EE, Portis S, Soskin S. The relief of muscular weakness by

pyridoxine hydrochloride. J Lab Clin Med 1941;27:763-770.

46. Sure B, Easterling L. The protective action of vitamin B12 against the

toxicity of dl-thyroxine. J Nutr 1950;42:221-225.

47. Watts AB, Ross OB, Whitehair CK, MacVicar R. Response of castrated male

and female hyperthyroid rats to vitamin B12. Proc Soc Exp Biol Med

1951;77:624-626.

48. Glass GB, Skeggs HR, Lee DH, et al. Applicability of hydroxocobalamin as

a long-acting vitamin B12. Nature 1961;189:138-140.

49. Herbert V. Vitamin B12. Am J Clin Nutr 1981;34:971-972.

50. Durlach J, Bara M, Theophanides T. A hint on pharmacological and

toxicological differences between magnesium chloride and magnesium sulphate, or

of

scallops and men. Magnes Res 1996;9:217-219.

51. Dyckner T, Wester PO. Ventricular extrasystoles and intracellular

electrolytes before and after potassium and magnesium infusions in patients on

diuretic treatment. Am Heart J 1979;97:12-18.

52. Stephen JM, Grant R, Yeh CS. Anaphylaxis from administration of

intravenous thiamine. Am J Emerg Med 1992;10:61-63.

53. Cook CC, Thomson AD. B-complex vitamins in the prophylaxis and treatment

of Wernicke-Korsakoff syndrome. Br J Hosp Med 1997;57:461-465.

54. Itokawa Y, Tanaka C, Kimura M. Effect of thiamine on serotonin levels in

magnesiumdeficient animals. Metabolism 1972;21:375-379.

55. Caddell JL. Magnesium deprivation in sudden unexpected infant death.

Lancet 1972;2:258-262.

56. Ashkenazy Y, Moshonov S, Fischer G, et al. Magnesium-deficient diet

aggravates anaphylactic shock and promotes cardiac myolysis in guinea pigs.

Magnes Trace Elem 1990;9:283-288.

(http://www.mcguffmedical.com/Customer_Knowledge/myers_cocktail_iv.htm) Send

for Article

 

This Article is available from the McGuff company. Please check " Send

Myers' Cocktail Information " on the _Request Information Form_

(http://www.mcguffmedical.com/default.asp?page=requestcatalog)

Alan R. Gaby, M.D.

 

Past president of the American Holistic Medical Association; author of

Preventing and Reversing Osteoporosis, and co-author of The Patient’s Book of

Natural Healing. Doctor Gaby is Medical Editor of the Townsend Letter for

Doctors. Past Chair for Therapeutic Nutrition at Bastyr University.

Correspondence address: 301 Dorwood Drive, Carlisle, PA 17013.

Bastyr University _http://www.bastyr.edu_ (http://www.bastyr.edu/)

14500 Juanita Dr. NE

Kenmore, WA 98028-4966