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Intravenous nutrient therapy: the “myers’ cocktail”
Review “Myers’ Cocktail” Intravenous Nutrient Therapy: the “Myers’ Cocktail” Alan R. Gaby, MD Abstract
It was not clear exactly what the “Myers’
Building on the work of the late John Myers,
cocktail” consisted of, as the information provided
MD, the author has used an intravenous
by patients was incomplete and no published or
vitamin-and-mineral formula for the treatment
written material on the treatment was available. It
of a wide range of clinical conditions. The
appeared that Myers used a 10-mL syringe and
modified “Myers’ cocktail,” which consists of
administered by slow IV push a combination of
magnesium, calcium, B vitamins, and vitamin
magnesium chloride, calcium gluconate, thiamine,
C, has been found to be effective against acute
vitamin B6, vitamin B12, calcium pantothenate,
asthma attacks, migraines, fatigue (including
vitamin B complex, vitamin C, and dilute hydro-
chronic fatigue syndrome), fibromyalgia, acute
chloric acid. The exact doses of individual com-
muscle spasm, upper respiratory tract
ponents were unknown, but Myers apparently used
infections, chronic sinusitis, seasonal allergic
a two-percent solution of magnesium chloride,
rhinitis, cardiovascular disease, and other
rather than the more widely available preparations
disorders. This paper presents a rationale for
containing 20-percent magnesium chloride or 50-
the therapeutic use of intravenous nutrients, reviews the relevant published clinical
The author took over the care of Myers’
research, describes the author’s clinical
patients, using a modified version of his IV regi-
experiences, and discusses potential side
men. Most notably, the magnesium dose was in-
effects and precautions.
creased by approximately 10-fold by using 20-
(Altern Med Rev 2002;7(5):389-403)
percent magnesium chloride, in order to approxi-mate the doses reported to be safe and effective
Introduction
for the treatment of cardiovascular disease.1, 2 Inaddition, the hydrochloric acid was eliminated and
the vitamin C was increased, particularly for prob-
more, Maryland, pioneered the use of intravenous
lems related to allergy or infection. Folic acid was
(IV) vitamins and minerals as part of the overall
not included, as it tends to form a precipitate when
treatment of various medical problems. The au-
thor never met Dr. Myers, despite living in Balti-
more, but had heard of his work, and had occa-
patients, and it soon became apparent that the
sionally used IV nutrients to treat fatigue or acute
modified Myers’ cocktail (hereafter referred to as
“the Myers’”) was helpful for a wide range of clini-
cal conditions, often producing dramatic results.
of his patients sought nutrient injections from the
Over an 11-year period, approximately 15,000
author. Some of them had been receiving injec-tions monthly, weekly, or twice weekly for manyyears – 25 years or more in a few cases. Chronic
Alan R. Gaby, MD – Past president of the American Holistic
problems such as fatigue, depression, chest pain,
Medical Association; author of Preventing and ReversingOsteoporosis, and co-author of The Patient’s Book of
or palpitations were well controlled by these treat-
ments; however, the problems would recur if the
Correspondence address: 301 Dorwood Drive, Carlisle,PA 17013.
patients went too long without an injection. Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002 Page 389
Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
“Myers’ Cocktail” Review
injections were administered in an outpatient set-
Theoretical Basis for IV Nutrient
ting to an estimated 800-1,000 different patients.
Conditions that frequently responded included
asthma attacks, acute migraines, fatigue (includ-
can achieve serum concentrations not obtainable
ing chronic fatigue syndrome), fibromyalgia, acute
with oral, or even intramuscular (IM), adminis-
muscle spasm, upper respiratory tract infections,
tration. For example, as the oral dose of vitamin
chronic sinusitis, and seasonal allergic rhinitis. A
C is increased progressively, the serum concen-
small number of patients with congestive heart
tration of ascorbate tends to approach an upper
failure, angina, chronic urticaria, hyperthyroidism,
limit, as a result of both saturation of gastrointes-
dysmenorrhea, or other conditions were also
tinal absorption and a sharp increase in renal clear-
treated with the Myers’ and most showed marked
ance of the vitamin.3 When the daily intake of vi-
improvement. Many relatively healthy patients
tamin C is increased 12-fold, from 200 mg/day to
chose to receive periodic injections because it en-
2,500 mg/day, the plasma concentration increases
hanced their overall well being for periods of a
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
results have been presented at more than 20 medi-
vitamin is 9.3 mg/dL. In contrast, IV administra-
cal conferences to several thousand physicians.
tion of 50 g/day of vitamin C resulted in a mean
Today, many doctors (probably more than 1,000
peak plasma level of 80 mg/dL.4 Similarly, oral
in the United States) use the Myers’.Some have
supplementation with magnesium results in little
made further modifications according to their own
or no change in serum magnesium concentrations,
preferences. In querying audiences from the lec-
whereas IV administration can double or triple the
tern and from informal discussions with colleagues
serum levels,5,6 at least for a short period of time.
at conferences, the author has yet to encounter a
practitioner whose experience with this treatment
ert pharmacological effects, which are in many
has differed significantly from his own.
cases dependent on the concentration of the nutri-
ent. For example, an antiviral effect of vitamin C
ports, there is only a small amount of published
has been demonstrated at a concentration of 10-
research supporting the use of this treatment. There
15 mg/dL,4 a level achievable with IV but not oral
is one uncontrolled trial in which the Myers’ was
therapy. At a concentration of 88 mg/dL in vitro,
beneficial in the treatment of musculoskeletal pain
vitamin C destroyed 72 percent of the histamine
syndromes, including fibromyalgia. Intravenous
present in the medium.7 Lower concentrations
magnesium alone has been reported, mainly in
were not tested, but it is possible the serum levels
open trials, to be effective against angina, acute
of vitamin C attainable by giving several grams
migraines, cluster headaches, depression, and
in an IV push would produce an antihistamine ef-
chronic pain. In recent years, double-blind trials
fect in vivo. Such an effect would have implica-
have shown IV magnesium can rapidly abort acute
tions for the treatment of various allergic condi-
asthma attacks. There are also several published
tions. Magnesium ions promote relaxation of both
case reports in which IV calcium provided rapid
vascular8 and bronchial9 smooth muscle – effects
relief from asthma or anaphylactic reactions.
that might be useful in the acute treatment of va-
This paper presents a rationale for the use
sospastic angina and bronchial asthma, respec-
of IV nutrient therapy, reviews the relevant pub-
tively. It is likely these and other nutrients exert
lished clinical research, describes personal clini-
additional, as yet unidentified, pharmacological
cal experiences using the Myers’, and discusses
effects when present in high concentrations.
potential side effects and precautions.
Page 390 Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002
Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review “Myers’ Cocktail”
In addition to having direct pharmacologi-
the interval between treatments can be gradually
cal effects, IV nutrient therapy may be more ef-
increased, and eventually the injections are no
fective than oral or IM treatment for correcting
intracellular nutrient deficits. Some nutrients are
Other patients require regular injections
present at much higher concentrations in the cells
for an indefinite period of time in order to control
than in the serum. For example, the average mag-
their medical problems. This dependence on IV
nesium concentration in myocardial cells is 10
injections could conceivably result from any of
times higher than the extracellular concentration.
the following: (1) a genetically determined impair-
This ratio is maintained in healthy cells by an ac-
ment in the capacity to maintain normal intracel-
tive-transport system that continually pumps mag-
lular nutrient concentrations;11 (2) an inborn error
nesium ions into cells against the concentration
of metabolism that can be controlled only by main-
gradient. In certain disease states, the capacity of
taining a higher than normal concentration of a
membrane pumps to maintain normal concentra-
particular nutrient; or (3) a renal leak of a nutri-
tion gradients may be compromised. In one study,
ent.12 In some cases, continued IV therapy may be
the mean myocardial magnesium concentration
necessary because a disease state is too advanced
was 65-percent lower in patients with cardiomy-
opathy than in healthy controls,10 implying a re-duction in the intracellular-to-extracellular ratio
The Modified Myers’ Cocktail
to less than 4-to-1. As magnesium plays a key role
See Table 1 for the nutrients that make up
in mitochondrial energy production, intracellular
magnesium deficiency may exacerbate heart fail-
ure and lead to a vicious cycle of further intracel-
able injectable form of pantothenic acid (vitamin
lular magnesium loss and more severe heart fail-
B5). One milliliter of B complex 100 contains 100
mg each of thiamine and niacinamide, and 2 mg
each of riboflavin, dexpanthenol, and pyridoxine.
by producing a marked,though transient, increasein the serum concen-tration, provides awindow of opportunity for
Table 1. Nutrients in Myers’ Cocktail
ailing cells to take upmagnesium against asmaller concentration
Magnesium chloride hexahydrate 20% (magnesium)
gradient. Nutrients takenup by cells after an IV
Calcium gluconate 10% (calcium)
infusion may eventuallyleak out again, but perhaps
Hydroxocobalamin 1,000 mcg/mL (B12)
some healing takes placebefore they do. If cells are
Pyridoxine hydrochloride 100 mg/mL (B6)
repeatedly “flooded” withnutrients, the improve-
Dexpanthenol 250 mg/mL (B5) B complex 100 (B complex)
It has been the author’sobservation that some
Vitamin C 222 mg/mL (C)
patients who receive aseries of IV injectionsbecome progressivelyhealthier. In these patients,
Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002 Page 391
Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
“Myers’ Cocktail” Review
All ingredients are drawn into one syringe,
and 8-20 mL of sterile water (occasionally more)
months, he received a total of 63 IV treatments
is added to reduce the hypertonicity of the solu-
for acute exacerbations of asthma. In most in-
tion. After gently mixing by turning the syringe a
stances, a single injection resulted in marked im-
few times, the solution is administered slowly,
provement or complete relief within two minutes,
usually over a period of 5-15 minutes (depending
and the acute symptoms did not recur. Occasion-
on the doses of minerals used and on individual
ally, a second injection was needed after a period
tolerance), through a 25G butterfly needle. Occa-
of 12 hours to two days, and during one episode
sionally, smaller or larger doses than those listed
three treatments were required over a four-day
in Table 1 have been used. Low doses are often
period. As the patient grew, the nutrient doses were
given to elderly or frail patients, and to those with
gradually increased; by age 10 he was receiving
hypotension. Doses for children are lower than
10 mL vitamin C, 3 mL magnesium, 1.5 mL cal-
those listed, and are reduced roughly in propor-
cium, and 1 mL each of B12, B6, B5, and B com-
tion to body weight. The most commonly used
regimen has been 4 mL magnesium, 2 mL cal-
cium, 1 mL each of B12, B6, B5, and B complex,
once; on that occasion the patient presented with
6 mL vitamin C, and 8 mL sterile water.
generalized urticaria, angioedema, and unusually
severe asthma, after the inadvertent ingestion of
successfully treated with the Myers’. The num-
an artificial food coloring (FD&C red #40) and
bers of patients treated and proportion that re-
other potential allergens. Three separate injections
sponded are, for the most part, estimates.
given over a 60-minute period produced transientimprovement each time. However, the symptoms
returned, and he was taken to the emergency room
with a two-year history of asthma. During the pre-
Despite that single treatment failure, the
vious 12 months he had suffered 20 asthma at-
patient and his parents reported that IV nutrient
tacks severe enough to require a visit to the hospi-
therapy worked faster, produced a more sustained
tal emergency department. His symptoms ap-
improvement, and caused considerably fewer side
peared to be exacerbated by several foods, and
effects than the conventional therapies he had re-
skin tests had been positive for 23 of 26 inhalants
ceived previously in the emergency room.
tested. His initial treatment consisted of identifi-
cation and avoidance of allergenic foods, as well
dozen asthmatics (mainly adults) with the Myers’
as daily oral supplementation with pyridoxine (50
for acute asthma attacks; in most instances, marked
mg), vitamin C (1,000 mg), calcium (200 mg),
improvement or complete relief occurred within
magnesium (100 mg), and pantothenic acid (100
minutes. A few patients received maintenance in-
mg), in two divided doses with meals. On this regi-
jections once weekly or every other week during
men, he experienced marked improvement, and
difficult times and reported the treatments kept
had no asthma attacks requiring medical care un-
til nearly 11 months after his initial visit.
At that time the child, now six years old,
mented as an effective treatment for acute asthma.
presented for an emergency visit with mild but
In one study, 38 patients with an acute exacerba-
persistent wheezing and difficulty breathing. He
tion of moderate-to-severe asthma that had failed
was given a slow IV infusion containing 6 mL
to respond to conventional beta-agonist therapy
vitamin C, 1.4 mL magnesium, and 0.5 mL each
were randomly assigned to receive, in double-blind
of calcium, B12, B6, B5, and B complex. The
fashion, IV infusions of either magnesium sulfate
symptoms resolved within two minutes and did
(1.2 g over a 20-minute period) or placebo (sa-
line).13 Peak expiratory flow rate improved to a
Page 392 Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002
Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review “Myers’ Cocktail”
significantly greater extent in the magnesium
group (225 to 297 L/min) than the placebo group
the Myers’ that has been studied as a treatment
(208 to 216 L/min). In addition, the hospitaliza-
for acute exacerbations of asthma. In an early re-
tion rate was significantly lower in the magnesium
port, a series of IV infusions of calcium chloride
group than in the placebo group (37% vs. 79%; p
relieved asthma symptoms in three consecutive
< 0.01). No patient had a significant drop in blood
patients, with relief occurring almost immediately
pressure or change in heart rate after receiving
after some injections.20 Intravenous and IM ad-
ministration of an unspecified calcium salt tem-
porarily inhibited severe anaphylactic reactions in
tients with acute asthma who were being treated
with inhaled beta-agonists and IV steroids were
randomly assigned to receive an IV infusion of
cium may have contributed to the beneficial ef-
magnesium sulfate (2 g over 20 minutes) or sa-
fect observed in asthma patients. Oral vitamins
line placebo, beginning 30 minutes after presen-
C22 and B623,24 and IM vitamin B1225 have each
tation.14 Among patients with severe asthma (de-
been used with some success against asthma, al-
fined as forced expiratory volume in 1 second
though none of these nutrients has been tested as
[FEV ] less than 25 percent of predicted value)
a treatment for acute attacks. Intramuscular ad-
compared with placebo, magnesium significantly
ministration of niacinamide has been shown to
reduced the hospitalization rate (33.3% vs. 78.6%;
reduce the severity of experimentally induced
p < 0.01) and significantly improved FEV . How-
asthma in guinea pigs,26 and pantothenic acid ap-
ever, magnesium treatment was of no benefit to
pears to have an anti-allergy effect in humans.27
patients with moderate asthma (defined as baseline
On one occasion, a patient’s asthma at-
FEV between 25 and 75 percent of predicted
tack was treated with IV magnesium alone. Al-
though the symptoms resolved rapidly, they re-
In two placebo-controlled studies of asth-
turned within 10-15 minutes. The remaining con-
matic children, IV magnesium sulfate significantly
stituents of the Myers’ (without additional mag-
improved pulmonary function and significantly
nesium) were then administered, and the symp-
reduced hospitalization rates during acute exacer-
toms disappeared almost immediately and did not
bations that had failed to respond to conventional
return. Thus, it seems the Myers’ is more effec-
therapy.15,16 A dose of 40 mg per kg body weight
tive than magnesium alone in the treatment of
(maximum dose, 2 g) given over a 20-minute pe-
riod appeared to be more effective than 25 mg perkg. Higher doses of IV magnesium sulfate (10-20
Migraine
g over 1 hour, followed by 0.4 g per hour for 24
hours) have been used successfully in the treat-
from frequent migraines, which appeared to be
ment of life-threatening status asthmaticus.6 In a
triggered in many instances by exposure to
few studies, IV magnesium failed to improve pul-
environmental chemicals or, occasionally, to
monary function or to reduce the need for hospi-
ingestion of foods to which she was allergic.
talization.17,18 However, a meta-analysis of seven
Allergy desensitization therapy had provided little
randomized trials concluded that IV magnesium
benefit. Over a six-year period, the patient was
reduced the need for hospitalization by 90 per-
given IV therapy on approximately 70 occasions
cent among patients with severe asthma, although
for migraines. Nearly all of these injections
the treatment was not beneficial for patients with
resulted in considerable improvement or complete
relief within several minutes, although a fewtreatments were ineffective. Through trial anderror, it was determined her most effective regimen
Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002 Page 393
Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
“Myers’ Cocktail” Review
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
have responded to the Myers’, with results lasting
to provide better relief than lower calcium doses.
only a few days or as long as several months. Pa-
Over the years, a half dozen other patients
tients who benefited often returned at their own
have presented one or more times with an acute
discretion for another treatment when the effect
migraine. In almost every instance, the Myers’
had worn off. One patient with fatigue associated
produced a gratifying response within a few min-
with chronic hepatitis B experienced marked and
progressive improvement in energy levels with
a treatment for migraine has been demonstrated
in recent clinical trials. In one study, 40 patients
fatigue syndrome (CFS) received a minimum of
with an acute migraine received 1 g magnesium
four treatments (usually once weekly for four
sulfate over a five-minute period.28 Fifteen min-
weeks), with more than half showing clear im-
utes after the infusion, 35 patients (87.5%) re-
provement. One patient experienced dramatic ben-
ported at least a 50-percent reduction of pain, and
efit after the first injection, whereas in other cases
nine patients (22.5%) experienced complete re-
three or four injections were given before improve-
lief. In 21 of 35 patients who benefited, the im-
ment was evident. A few patients became progres-
provement persisted for 24 hours or more. Patients
sively healthier with continued injections and were
with an initially low serum ionized magnesium
eventually able to stop treatment. Several others
concentration (less than 0.54 mMol/L) were sig-
did not overcome their illness, but periodic injec-
nificantly more likely to experience long-lasting
improvement than were patients with initially
There is some research support for the use
higher serum ionized magnesium levels. In a
of parenteral magnesium in patients with fatigue.
single-blind trial that included 30 patients with an
One study found magnesium deficiency, demon-
acute migraine, IV administration of magnesium
strated by an IV magnesium-load test, in 47 per-
sulfate (1 g over 15 minutes) completely and per-
cent of 93 patients with unexplained chronic fa-
manently relieved pain in 13 of 15 patients
tigue, including 50 with CFS.31 In a second study,
(86.6%), whereas no patients in the placebo group
the mean erythrocyte magnesium concentration
became pain free (p < 0.001 for difference between
was significantly lower in 20 patients with CFS
groups).29 In addition, magnesium treatment re-
sulted in rapid disappearance of nausea, vomit-
ing, and photophobia in all 14 patients who had
tients with CFS were randomly assigned to re-
ceive, in double-blind fashion, 1 g magnesium
sulfate IM or placebo, once weekly for six weeks.
has also been reported to abort an episode of clus-
Twelve (80%) of 15 patients given magnesium
ter headaches in seven of 22 patients (32%), and a
reported improvement (e.g., more energy, a better
series of three to five injections provided sustained
emotional state, and less pain) and fatigue was
relief in an additional two patients (9%).30
eliminated completely in seven cases. In contrast,
It is not clear whether the Myers’ is more
only three (18%) of 17 placebo-treated patients
effective than magnesium alone for migraines;
improved (p = 0.0015 for difference between
however, one patient did experience noticeable
groups), and in no case was the fatigue completely
eliminated. According to one report, at least halfof CFS patients with magnesium deficiency ben-efited from oral magnesium supplementation;however, some patients needed IM injections.33
Page 394 Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002
Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review “Myers’ Cocktail”
Other investigators, using the IV magnesium-load
month between treatments. However, they were
test, found no evidence of magnesium deficiency
never as severe as they were before she began re-
in patients with CFS, and observed no improve-
ment in symptoms following a single infusion of
proximately 30 patients with fibromyalgia; half
have experienced significant improvement, in a
to be helpful for patients with unexplained fa-
few cases after the first injection, but more often
tigue,35 as well as those with CFS.36 While the re-
sults obtained with the Myers’ may be attribut-
The beneficial effect of parenteral nutri-
able in part to vitamin B12, many patients who
ent therapy has been confirmed by one study pub-
responded to IV therapy obtained little or no ben-
lished only as an abstract. Eighty-six patients with
chronic muscular complaints, includingmyofascial pain, relapsing soft tissue injuries, and
Fibromyalgia
fibromyalgia, received IM or IV injections of
magnesium, either alone or in combination with
with a six-year history of fairly constant myalgias
calcium, B vitamins, and vitamin C.37 Improve-
and arthralgias, with pain in the neck, back, and
ment occurred in 74 percent of the patients; of
hip, and tightness in the left arm. Six months pre-
those, 64 percent required four or fewer injections
viously she was found to have an elevated sedi-
for optimal results. A minority of patients required
mentation rate (50 mm/hr). She was diagnosed by
long-term oral or parenteral magnesium to main-
a rheumatologist as possibly having polymyalgia
tain improvement. The positive response to
rheumatica, although the diagnosis of fibromyalgia
parenteral magnesium is consistent with the ob-
was also considered. Her history was also signifi-
servation that nearly half of patients with
cant for migraines about eight times per year and
fibromyalgia have intracellular magnesium defi-
chronic nasal congestion. Physical examination
ciency, despite having normal serum levels of the
revealed extremely stiff muscles, with decreased
range of motion in many areas of her body.
The patient was given a therapeutic trial
Depression
consisting of 6 mL vitamin C, 4 mL magnesium,
2.5 mL calcium, and 1 mL each of B12, B6, B5,
with a history of depression and anxiety since
and B complex. At the end of the injection, she
childhood. He had been in psychoanalysis for the
got off the table and, with a look of amazement,
past eight years. A therapeutic trial with IV nutri-
announced her muscle aches and joint pains were
ents was considered because the patient reported
gone for the first time in six years. This treatment
that consumption of alcohol (known to deplete
was repeated after a week (at which time her symp-
magnesium) aggravated his symptoms, and be-
toms had not returned), followed by every other
cause he was taking a magnesium-depleting thi-
week for several months, then once monthly for
azide diuretic for hypertension. He was initially
three years. Her initial regimen also included the
given 1 mL each of magnesium, B12, B6, B5, and
identification and avoidance of allergenic foods
B complex, which resulted in a 70-80 percent re-
and treatment with low-dose desiccated thyroid
duction in his symptoms for one week. A second
(eventually stabilized at 60 mg per day). She dis-
injection produced a similar response that lasted
covered that eating refined sugar caused myalgias
two weeks. Through trial and error it was deter-
and arthralgias, and that thyroid hormone im-
mined the most effective treatment was 5 mL
proved her energy level, mood, and overall well
magnesium, 3 mL B complex, and 1 mL each of
being. During the three years of monthly mainte-
B12, B6, and B5. The addition of calcium to the
nance injections she reported symptoms would
injection appeared to block some of the benefit.
begin to recur if she went much longer than a
Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002 Page 395
Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
“Myers’ Cocktail” Review
Both oral and IM administration of the same nu-
patient that his heart would not last more than
trients were tried but found to be ineffective.
another month, so the patient declined the ampu-
Weekly injections provided almost complete re-
lief from symptoms and allowed him to discon-
tinue psychotherapy. The patient noted that rap-
of magnesium sulfate (1 g) for eight weeks, and
idly administered injections provided longer-last-
prescribed oral supplementation with vitamins C
ing relief than did slower injections. The infusion
and E, B complex, folic acid, and zinc. The mag-
rate was therefore carefully and progressively in-
nesium injections appeared to reduce the pain in
creased, without causing any adverse side effects
his gangrenous toes considerably, with the ben-
or changes in blood pressure or heart rate. The
efit lasting about five days each time. Six weeks
patient reported that when the treatment was given
after the first injection, his ejection fraction had
over a one-minute period, the effect would last
increased from 19 percent to 36 percent and he no
approximately two weeks, whereas a slower in-
longer required supplemental oxygen. After eight
jection (such as five minutes) would last only a
weeks, the IM injections were replaced by weekly
week. Approximately four years after initial treat-
IV injections, consisting of 5 mL magnesium, 1
ment, he was able to reduce the frequency of in-
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, se-
or anxiety have shown a positive response to the
lenium, and manganese). After a total of 18
Myers’. However, this treatment should not be
months, his weight had increased from 113 to 147
considered first-line therapy for major depression.
pounds, which was remarkable as cardiac cachexia
It seems to be helpful only for certain subsets of
is generally considered to be irreversible. In addi-
depressed individuals, such as those who also suf-
tion, the gangrenous areas on his toes had sloughed
fer from fibromyalgia, migraines, excessive stress,
and been replaced almost entirely by healthy tis-
or alcohol-induced exacerbations. Shealy et al
sue. Intravenous therapy was continued and even-
have observed an antidepressant effect of IV mag-
tually reduced to every other week. The patient
nesium in some patients with chronic pain.39
lived for eight years and died at age 87 from mul-tiple organ failure. Cardiovascular Disease
Of the handful of other patients with an-
gina or heart failure who received IV or IM injec-
home in end-stage heart failure, after having suf-
tions of magnesium (with or without B vitamins),
fered four myocardial infarctions. During the pre-
all showed significant improvement. The results
vious 12 months, spent mostly in the hospital, he
with angina are consistent with those reported by
had become progressively worse; his ejection frac-
others using parenteral magnesium therapy.40-42
tion had fallen to 19 percent and his body weighthad declined from 171 pounds to a severely
Upper Respiratory Tract Infections
cachectic 113 pounds. He was confined to bed and
required supplemental oxygen much of the time.
with a cold and a one-day history of fatigue, nasal
He also had severe peripheral occlusive arterial
congestion, and rhinorrhea. He was given an IV
disease, which had resulted in the development of
infusion of 16 mL vitamin C, 3 mL magnesium,
gangrene of six toes. A peripheral angiogram re-
1.5 mL calcium, and 1 mL each of B12, B6, B5,
vealed complete occlusion of both femoral-
and B complex. By the end of the 10-minute treat-
popliteal arteries, with no detectable blood flow
ment he was symptom free. The cold symptoms
to the distal extremities. Two independent vascu-
did return the next day but were only 10 percent
lar surgeons had recommended bilateral above-
the-knee amputations to prevent development ofsepticemia. However, the cardiologist advised the
Page 396 Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002
Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review “Myers’ Cocktail”
received the Myers’ for an acute respiratory in-
Narcotic Withdrawal
fection experienced marked improvement, either
immediately or by the next morning. Approxi-
morphine came to the office in the early stages of
mately half of patients given this treatment re-
withdrawal, with diaphoresis and extreme agita-
ported that it shortened the duration of their ill-
tion. He was given an IV infusion of 16 mL vita-
ness. Patients who benefited tended to have a simi-
min C, 5 mL magnesium, 2.5 mL calcium, and 1
lar response if treated for a subsequent infection,
mL each of B12, B6, B5, and B complex. In his
whereas non-responders tended to remain non-re-
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
history of chronic sinusitis. Avoidance of aller-
injection, he was able to sit still, and by the end of
genic foods and oral supplementation with vita-
the injection his withdrawal symptoms were alle-
min C and other nutrients had provided only mini-
viated. The symptoms returned 36 hours later; he
mal benefit. She was given an IV infusion of 20
therefore came for another treatment, which again
mL vitamin C, 4 mL magnesium, 2 mL calcium,
relieved the symptoms within minutes. He re-
and 1 mL each of B12, B6, B5, and B complex;
turned the next day, still symptom free, for a third
this protocol was repeated the next day. At the time
injection, which carried him uneventfully through
these injections were given she had been experi-
the remainder of the withdrawal period.
encing persistent sinus problems for a year. Hersymptoms resolved rapidly after the injections and
Chronic Urticaria
she remained relatively symptom free for more
than six months. The same treatment given at a
chronic urticaria with hives present somewhere
later date was also helpful, although the benefit
on her body nearly every day for 10 years. An al-
was not as pronounced as the first time.
lergy-elimination diet and oral supplementation
with vitamin C and other nutrients provided little
had a similar response to back-to-back injections,
or no relief. She was given an IV infusion of 12
while a few others showed no improvement.
mL vitamin C, 3 mL magnesium, 1.5 mL calcium,and 1 mL each of B12, B6, B5, and B complex. Seasonal Allergic Rhinitis
The same treatment was repeated the following
day. After these injections the hives resolved rap-
history of seasonal allergic rhinitis, occurring each
idly and did not recur for more than a year. When
spring and lasting about a month. Symptoms in-
the lesions did recur, the IV treatment was repeated
cluded nasal congestion, itchy eyes, and fatigue.
During a symptomatic period, an IV infusion of12 mL vitamin C, 3 mL magnesium, and 1 mL
Athletic Performance
each of B12, B6, B5, and B complex provided
rapid relief. This treatment was repeated as needed
high school wrestler developed a flu-like illness
during the hay fever season (once weekly or less)
four days before a major tournament. Two days
and successfully controlled his symptoms. In sub-
before the three-day tournament, when it appeared
sequent years he began the IVs shortly before, and
he might have to miss the event, he was given an
repeated them periodically during, the hay fever
IV injection of 16 mL vitamin C, 5 mL magne-
season; this approach prevented the development
sium, 2.5 mL calcium, and 1 mL each of B12, B6,
B5, and B complex. The next morning he remarkedthat he had more energy than he had ever had in
Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002 Page 397
Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
“Myers’ Cocktail” Review
his life. This energy boost persisted for the dura-
treatments. Of three patients with acute dysmen-
tion of the tournament, at which he took second
orrhea treated with the Myers’, two experienced
place, a better performance than at any other time
almost instant pain relief. One patient with chronic
obstructive pulmonary disease intermittently re-
In this era in which many athletes are us-
ceived weekly IV injections and reported the treat-
ing performance-enhancing drugs, it is not the
ments improved his strength and breathing.
author’s intention to encourage athletes to seekanother “boost” with IV nutrients. However, this
Choice of Ingredients and
case does demonstrate that nutritional factors can
Administration
play an important role in athletic performance.
At the time of this writing, cyanocobalamin
is a widely available form of injectable vitamin B12,
Hyperthyroidism
whereas hydroxocobalamin can be obtained only
through a compounding pharmacist. While both
treated with the Myers’ once or twice weekly for
forms of the vitamin are effective, hydroxocobal-
several weeks. In one case, the treatment con-
amin is preferred because it produces more pro-
trolled the symptoms of hyperthyroidism, although
longed increases in serum vitamin B12 levels.48
there was no reduction in thyroid-hormone lev-
It has been the author’s impression (and
els. The injections were discontinued after medi-
that of other clinicians) that some patients who re-
cal therapy had restored the hormone levels to
spond to IM vitamin B12 injections do not experi-
normal. In the other case, symptoms improved
ence the same benefit when vitamin B12 is given
markedly after the first injection and thyroid-func-
as part of the Myers’. It is possible that vitamin C
tion tests, measured two weeks later, returned to
or another component of the Myers’ destroys some
of the vitamin B12,49 or that IV vitamin B12 is lost
The potential value of IV nutrient therapy
more rapidly in the urine than IM vitamin B12.
for patients with hyperthyroidism is supported by
Therefore, for some patients receiving IV nutrient
several studies. Serum and erythrocyte magnesium
therapy, the vitamin B12 is given IM in a separate
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
either as magnesium chloride hexahydrate (20%
solution) for 3-7 weeks reduced the size of the
solution), commonly called magnesium chloride,
thyroid gland and improved the clinical condition
or magnesium sulfate heptahydrate (50% solution),
of three patients with hyperthyroidism.44 Intrave-
commonly called magnesium sulfate. Although
nous vitamin B6 (50 mg per day) was reported to
most clinical research has been done with
relieve muscle weakness in three patients with
magnesium sulfate, some experts prefer magnesium
hyperthyroidism,45 and animal studies indicate
chloride for IV use because of its greater retention
vitamin B12 can counteract some of the adverse
in the body.50 The author has used magnesium
effects of experimentally induced hyperthyroid-
chloride almost exclusively for IV therapy, while
reserving the more concentrated magnesium sulfatefor IM administration. For those using magnesium
Other Conditions
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
provide rapid relief for patients with acute muscle
20-percent solution) of magnesium chloride (each
spasm resulting from sleeping in the wrong posi-
contains 4 mMol of magnesium). In addition, if 50-
tion or from overuse. It also has been observed to
percent magnesium sulfate is given IV instead of
relieve tension headaches in many cases. One pa-
20-percent magnesium chloride, it should be diluted
tient (a 70-year-old female) with chronic torticol-
lis experienced moderate pain relief with periodic
Page 398 Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002
Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review “Myers’ Cocktail”
Injectable vitamin C is currently available
temporarily and not resumed until the symptoms
in concentrations of 222 and 500 mg per mL. The
have resolved (usually after 10-30 seconds). Pa-
author typically uses the lower concentration for
tients with low blood pressure tend to tolerate less
IV therapy. If the higher concentration is used, it
magnesium than do patients with normal blood
should be diluted appropriately with sterile water.
pressure or hypertension. In a small proportion of
Occasionally, trace minerals were included
patients, even a low-dose regimen given very
as part of a nutrient infusion. The usual dose was
slowly causes persistent hypotension; in those
0.2-0.5 mL of MTE-5, which contains (per mL):
cases, the treatment is usually discontinued and
zinc 1 mg, copper 0.4 mg, chromium 4 mcg, sele-
may or may not be attempted at a later date.
nium 20 mcg, and manganese 0.1 mg. The prepa-
ration was diluted six-fold and administered over a
have adverse consequences, some patients appear
period of 1-2 minutes in a separate syringe at the
to experience more pronounced benefits from
end of the Myers’ push. Two adverse reactions have
rapid infusions than from slower ones, presum-
been noted with 10 mg of zinc given by slow IV
ably because of higher peak serum concentrations
push; consequently, when giving trace minerals by
of nutrients. While both the risks and benefits
IV push, very small doses are used. Trace minerals
should be taken into account in determining an
should not be mixed in the same syringe with the
infusion rate, when in doubt one should err on the
components of the Myers’, as doing so often causes
side of safety. When administering the Myers’ to
a patient for the first time, it is best to give 0.5-1.0mL and then wait 30 seconds or so before pro-
Side Effects and Precautions
ceeding with the rest of the infusion. Doing so may
The Myers’ often produces a sensation of
help one distinguish between a vasovagal reac-
heat, particularly with large doses or rapid admin-
tion and a hypotensive response to the injected
istration. This effect appears to be due primarily
compounds. Patients who experience a vasovagal
to the magnesium, although rapid injections of
reaction at the beginning of an infusion can usu-
calcium have been reported to produce a similar
ally tolerate the remainder of the treatment after
effect.22 The sensation typically begins in the chest
and migrates to the vaginal area in women and to
For elderly or frail individuals, it may be
the rectal area in men. For most patients the heat
advisable to start with lower doses than those listed
does not cause excessive discomfort; indeed, some
in Table 1, or to consider IM administration of
patients enjoy it. However, if the infusion is given
magnesium and B vitamins as an alternative to IV
too rapidly, the warmth can be overbearing. Some
therapy. However, many elderly patients have tol-
women experience a sensation of sexual pleasure
erated, and benefited from, IV therapy.
in association with the vaginal warmth; on rare
occasions, an orgasm may occur during an IV in-
nesium and potassium may have an influx of po-
fusion. Other patients have remarked their visual
tassium into the cells after receiving IV magne-
acuity and color perception become sharper im-
sium.51 This occurs because magnesium activates
mediately after an injection, as if someone had
the membrane pump that promotes the intracellu-
turned the lights on. In some cases, this effect lasts
lar uptake of potassium. The shift of potassium
from the serum to the intracellular space can trig-
ger hypokalemia. The author has seen two patients
develop severe muscle cramps several hours after
lightheadedness or even syncope. Patients receiv-
receiving a Myers’; both patients had been taking
ing a Myers’ should be advised to report the onset
medications known to deplete potassium. Hy-
of excessive heat (which can be a harbinger of
pokalemia also increases the risk of digoxin-in-
hypotension) or lightheadedness. If either of these
duced cardiac arrhythmias. As a first-year resident,
symptoms occurs, the infusion should be stopped
Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002 Page 399
Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
“Myers’ Cocktail” Review
unaware of this potential problem, the author ad-
reactions for every million ampules of IV B vita-
ministered IV magnesium in the hospital to an eld-
mins sold, and one report for every 5 million IM
erly woman who was taking digoxin and a potas-
sium-depleting diuretic. She quickly developed an
It is possible the risk of anaphylaxis from
arrhythmia, which required short-term treatment in
the Myers’ is even lower than the low risk associ-
ated with the use of IV thiamine. Many patients
Patients considered to be at risk of potas-
who receive parenteral thiamine are alcoholics, and
sium deficiency include those taking potassium-
alcoholism frequently causes magnesium defi-
depleting diuretics, beta-agonists, or glucocorti-
ciency. Animal studies suggest thiamine supple-
coids; those with diarrhea or vomiting; and those
mentation in the presence of magnesium deficiency
who are generally malnourished. If a patient is hy-
increases the severity of the magnesium defi-
pokalemic, the hypokalemia should be corrected
ciency.54 A deficiency of magnesium can lead to
before IV magnesium therapy is considered. How-
spontaneous release of histamine,55 and has been
ever, a normal serum potassium concentration is
reported to increase the incidence of experimen-
not a guarantee against intracellular potassium
tally induced anaphylaxis in animals.56 The pres-
depletion. For patients considered to be at risk of
ence of magnesium in the Myers’ might, therefore,
potassium deficiency, administration of 10-20 mEq
reduce the risk of an anaphylactic reaction to thia-
of potassium orally just prior to the infusion, and
mine. Moreover, as the Myers’ has been used suc-
again 4-6 hours later is recommended. After this
cessfully to treat asthma and urticaria, it is likely
practice was instituted, no further problems with
the formula as a whole provides prophylaxis against
magnesium-induced muscle cramps were encoun-
anaphylaxis. Nevertheless, practitioners who ad-
minister IV nutrients should be prepared to deal
with the rare anaphylactic reaction.
potassium to an IV push is strongly discouraged,
A small number of patients (approximately
because of the theoretical risk of triggering an ar-
one percent) felt “out of sorts” for up to a day after
rhythmia during the first pass when the bolus
receiving an injection and, in two cases, this reac-
reaches the cardiac conducting system.
tion lasted one and two weeks, respectively. It is
Intravenous calcium is contraindicated in
not clear whether these reactions were due to the
patients taking digoxin. In addition, hypercalcemia
preservatives in some of the injectable preparations
can cause cardiac arrhythmias. For that reason, the
(e.g., benzyl alcohol, methylparabens, or others)
author has tended to leave calcium out of the Myers’
or to the nutrients themselves. In most cases (in-
when treating patients with cardiac disease, al-
cluding a few patients with asthma) preservative-
though there is no strong evidence it is dangerous
containing products were used because the use of
multi-dose vials reduced the cost of treatment to
Anaphylactic reactions to IV thiamine have
the patient. However, for some individuals with
been reported on rare occasions. Only three such
known chemical sensitivities or other significant
reactions have been identified in the U.S. litera-
allergy-related problems, preservative-free prepa-
ture since 1946. However, in the world literature, a
total of nine deaths attributed to thiamine adminis-
Although the Myers’is extremely hyper-
tration were reported between 1965 and 1985.52
tonic, it rarely seemed to cause problems related to
These reactions have occurred after oral, IV, IM,
its hypertonicity. Two or three patients developed
or subcutaneous administration, and are believed
phlebitis at the injection site; for those patients, later
to be due in part to a nonspecific release of hista-
treatments were diluted with sterile water to a total
mine. Anaphylactic reactions have been seen most
of 60 mL. Some patients experienced a burning
often after multiple administrations of thiamine. In
sensation at the injection site during the infusion;
the United Kingdom, between 1970 and 1988, there
this was often corrected by re-positioning the needle
were approximately four reports of anaphylactoid
or by further diluting the nutrients.
Page 400 Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002
Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review “Myers’ Cocktail” References
spect, the Myers’ has been generally well tolerated,
Malkiel-Shapiro B. Further observations on
and no serious adverse reactions have been encoun-
tered with approximately 15,000 treatments.
coronary heart disease: a clinical appraisal. SAfr Med J 1958;32:1211-1215. Cost Considerations
Browne SE. Intravenous magnesium sulphatein arterial disease. Practitioner 1969;202:562-
In 1995, the author’s last year in private
practice, the cost of the materials for a Myers’ was
Blanchard J, Tozer TN, Rowland M. Pharma-
approximately $5.00. The use of preservative-free
nutrients at least doubled the cost of materials.
ascorbic acid. Am J Clin Nutr 1997;66:1165-
Nursing time and administrative factors repre-
sented the majority of the cost of IV nutrient
Harakeh S, Jariwalla RJ, Pauling L. Suppres-
therapy. In 1995, the author’s fee for a Myers’was
$38.00. Other doctors have charged as little as
replication by ascorbate in chronically andacutely infected cells. Proc Natl Acad SciU S
$15.00 or as much as $100.00 or more. Since 1995,
the cost of most of the injectable preparations has
Okayama H, Aikawa T, Okayama M, et al.
Bronchodilating effect of intravenous magne-
sium sulfate in bronchial asthma. JAMA
for this treatment. However, in a few instances,
showing them that IV nutrient therapy had greatly
Sydow M, Crozier TA, Zielmann S, et al.
reduced the overall cost of the patient’s health care
High-dose intravenous magnesium sulfate in
the management of life-threatening statusasthmaticus. Intensive Care Med 1993;19:467-471. Conclusion
The Myers’ has been found by the author
and hundreds of other practitioners to be a safe
mediated by L-ascorbate. Biochim Biophys
and effective treatment for a wide range of clini-
cal conditions. In many instances this treatment is
Iseri LT, French JH. Magnesium: nature’s
more effective and better tolerated than conven-
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tional medical therapies. Although most of the
evidence is anecdotal, some published research has
Brunner EH, Delabroise AM, Haddad ZH. Effect of parenteral magnesium on pulmonary
demonstrated the efficacy of the Myers’ or some
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bronchial asthma. J Asthma 1985;22:3-11.
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Frustaci A, Caldarulo M, Schiavoni G, et al.
of healthcare, while greatly improving the health
Myocardial magnesium content, histology, and
of many individuals. Additional research is ur-
gently needed to confirm the effectiveness of this
infusion. Lancet 1987;2:1019.
treatment and to determine optimal doses of the
Henrotte JG. The variability of human red
various nutrients. Although double-blind trials
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would be difficult to perform because of the obvi-
groups. Tissue Antigens 1980;15:419-430.
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pies would be informative. Practitioners using this
treatment are encouraged to report their findings.
Greenspon L. Intravenous magnesium sulfatefor the treatment of acute asthma in theemergency department. JAMA 1989;262:1210-1213. Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002 Page 401
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Copyright2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
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