IV Micronutrient Infusion Therapy

IV Micronutrient Infusion Therapy

Course Description

IV Micronutrient Infusion Therapy: The Myers’ Cocktail and Vitamin C Infusions

Intravenous Micronutrient infusion therapy is a method of delivering minerals, vitamins, and other natural substances directly into a patient’s blood stream. Delivering the vitamins, minerals and other natural substances intravenously bypasses the digestive system, thus allowing for a more complete absorption of the nutrients4. Intravenous Micronutrient Infusion Therapy is considered a form of Complementary and Alternative Medicine (CAM) in that it can be used in addition to traditional treatments (Complementary) or can be used instead of conventional treatments (Alternative). Due to the increasing prevalence in use, it is crucial that nurses become familiar with the risks and benefits of the two most common micronutrient infusion therapies: Myers’ Cocktail and Vitamin C infusions.

Accreditation Information: KLA Education Services LLC is accredited by the State of California Board of Registered Nursing, Provider # CEP16145.

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Course Objectives

Upon completion of this course, the course participant will be able to:

  • Identify the risks and benefits of “The Myers’ Cocktail” Micronutrient IV infusion.
  • Identify the risks and benefits of Vitamin C Infusions.


Course Content

The Myers’ Cocktail

The Myers’ cocktail is one of the most recognizable vitamin infusion therapies in the United States. Originally pioneered by the Baltimore, Maryland physician John Myers, MD, it was communicated to a national audience, in large part, due to the work of Alan R. Gaby, MD. 3 The Myers’ is a formula of vitamins and minerals that is administered intravenously as a treatment for a wide range of clinical conditions. 2 The Myers’ Cocktail has been found effective against:

  • Acute Asthma
  • Migraines
  • Chronic Fatigue
  • Fibromyalgia
  • Acute Muscle Spasm
  • Upper Respiratory Tract Infections
  • Chronic Sinusitis
  • Cardiovascular Disease
  • Seasonal Allergic Rhinitis

Nutrients have been shown to display pharmacological effects, depending on the concentration of the nutrient. Administering nutrients intravenously can achieve concentrations not obtainable with oral or intramuscular administration. 3 For example, increasing the daily oral intake of Vitamin C from 200mg/day to 2,500mg/day can result in a plasma concentration increase of 25% percent (1.2 – 1.5 mg/dL). IV administration of 50 g/day of Vitamin C resulted in an average peak plasma level of 80mg/dL. 3 In terms of components, the Myers’ cocktail routinely contains: 2

  • 5mL of Magnesium Chloride Hexahydrate (20%)
  • 3mL of Calcium Gluconate (10%)
  • 1mL of Hydroxocobalamin (1,000μ/mL)
  • 1mL of Pyridoxine Hydrochloride (100mg/mL)
  • 1mL of Dexpanthenol (250mg/mL)
  • 1mL of B-complex 100 containing:
    • 100mg of Thiamine HCl
    • 2mg of Riboflavin
    • 2mg of Pyridoxine HCl, and
    • 2mg of Panthenol
    • 100mg of Niacinamide, 2% Benxyl alcohol
  • 5mL of Vitamin C (500mg/mL)
  • 20mL of Sterile Water

The ingredients are then drawn into a syringe and gently mixed by turning the syringe. The solution should be prepared within one hour of administration. The solution is bright yellow and contains 37mL of water soluble nutrients, vitamins, minerals, and sterile water2. The Myers’ Cocktail is administered slowly using a slow-push infusion over the course of 10-20 minutes through a 25G butterfly needle2. Depending on the patient, they can receive infusions weekly, bi-monthly, monthly, etc.

Benefits

The Meyers’ cocktail may be beneficial for patients looking for a comparative or alternative method of treatment for the conditions listed earlier. Patient’s with digestive issues that prevent them from fully absorbing oral vitamins may benefit as well. 5 If the patient is currently taking any other medication, it is recommended to check with a physician in order to avoid any adverse effects. Although the clinical evidence displaying the concrete advantages of the Meyers’ is inconclusive; thousands of patients suffering from the conditions listed earlier have claimed that regular vitamin infusions have improved their overall quality of life.

Risks

Recipients of the Meyers’ often describe a sensation of heat that moves throughout the body. 3 This effect is primarily due to the magnesium, and rapid administration of magnesium can cause hypotension, lightheadedness, and even syncope. Patients should be advised to report any onset of excessive heat and the infusion should be stopped and resumed once the symptoms have resolved. Children, elderly, or frail individuals should start with lower doses then those listed above. 3 Patients taking Digoxin or other potassium-depleting drugs should avoid treatment and be evaluated by their physician. 2 Anaphylactic reactions to intravenously administered thiamine have been reported on very rare occasions, and as such the nurse should be prepared to deal with a rare reaction. 2 Also, all regular safety and sanitation measures must be followed during the preparation and infusion of the solution.

Vitamin C Infusions

Intravenous vitamin C (also known as L-ascorbic acid or Ascorbate) can reach much higher levels in the blood than when administered orally. 7 The specific anti-cancer effect of Vitamin C involves a chemical reaction that produces hydrogen peroxide, which may kill cancer cells. 7 When given in conjunction with an existing chemotherapy program, it has been found that Vitamin C may augment the effectiveness of a chemotherapy or radiation program. 9 Laboratory studies have shown the following:

  • High-dose Vitamin C slowed the growth and spread of prostate, pancreatic, liver, colon, and malignant mesothelioma.
  • Combining high-dose vitamin C with certain types of Chemotherapy may be more effective than chemotherapy alone: 7
    • Ascorbic acid with arsenic trioxide may be more effective in ovarian cancer cells.
    • Ascorbic acid with gemcitabine may be more effective in pancreatic cancer cells.
    • Ascorbic acid with gemcitabine and epigallocatechin-3-gallate (EGCG) may be more effective against malignant mesothelioma cells.

Specific Clinical Trials have shown mixed results:

  • Patients with acute myeloid leukemia, refractory metastatic colorectal cancer, or metastatic melanoma treated with vitamin C combined with other drugs had serious side effects and the disease got worse. 7
  • An oxidized form of vitamin C called dehydroascorbic acid has been studied in cell cultures and in animals with tumors. Several studies have found that high doses of dehydroascorbic acid can interfere with the anticancer effects of several chemotherapy drugs. 7

There are notable side effects/risks to the use of Vitamin C infusion Therapy:

  • In patients with a history of kidney disorders, kidney failure has been reported after ascorbic acid treatment. Patients with a tendency to develop kidney stones should not be treated with high-dose vitamin C. 9
  • Case reports have shown that patients with an inherited disorder called G-6-PD deficiency should not be given high doses of vitamin C, due to the risk of hemolysis (a condition in which red blood cells are destroyed). 8
  • Since vitamin C may make iron more easily absorbed and used by the body, high doses of the vitamin are not recommended for patients with hemochromatosis (a condition in which the body takes up and stores more iron than it needs). 7
  • Patient’s with a bleeding disorder, or those taking medication that affects bleeding, are advised to consult their primary care physician before receiving a Vitamin C Infusion. 8
  • The standard risks involved with receiving an IV exist. All standard safety and sterilization methods are necessary.

Although the actual “cancer-fighting” prowess of Vitamin C is still being investigated and debated, existing evidence suggests that Vitamin C infusions (in most cases) may improve a patient’s quality of life. In a recent study involving breast-cancer patients, intravenous Vitamin C administration resulted in a significant reduction of complaints induced by the disease and chemo-/radiotherapy9. The following symptoms were found to be reduced:

  • Nausea
  • Loss of appetite
  • Fatigue and Depression
  • Sleep Disorders
  • Dizziness
  • Haemorrhagic diathesis

The Myers’ Cocktail and Vitamin C Infusions are solutions of vitamins and minerals and as such are classified as dietary supplements and are not regulated by the FDA. The Myers’ Cocktail has been submitted as a preliminary drug to the FDA by several Yale researchers; however, at this time its components are still considered dietary supplements. It is crucial that health care providers offering these solutions prepare and administer them in accordance with the same standards necessary for conventional drugs. IV micronutrient therapy is a form of complementary and alternative medicine that has helped hundreds of thousands of people experience a better quality of life. Both the Myers’ Cocktail and High-Dose Vitamin C infusions have their own risks and benefits and it is recommended that any patient interested in beginning a micronutrient infusion regimen consult their primary health care provider before so.

References

1.Abou-Jawde RM, Reed J, Kelly M, et al.: (2006). Efficacy and safety results with the combination therapy of arsenic trioxide, dexamethasone, and ascorbic acid in multiple myeloma patients: a phase 2 trial. Medical Oncology. 23 (2): 263-72. Doi:
10.1385/MO:23:2:263.
2.Ather Ali, N.D., M.P.H., Valentine Yanchou Njike, M.D., M.P.H., et al: (2009) Intravenous Micronutrient Therapy (Myers’ Cocktail) For Fibromyalgia: A Placebo-Controlled Pilot Study. The Journal of Alternative Complementary Medicine. 15(3): 247–257. doi: 10.1089/acm.2008.0410. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2894814/
3.Gaby, Alan R. MD. (2002). Intravenous Nutrient Therapy: The “Myers’ Cocktail”. Alternative Medicine Review. 7(5): 389-403.
http://www.altmedrev.com/publications/7/5/389.pdf
4.Intravenous Therapies: Myers Cocktail. (2013). Center for Integrative Medicine at George Washington University.
http://www.gwcim.com/services/myers-cocktail/
5.IV Nutrient Infusion Therapy. (2013). The Rothfeld Center for Integrative Medicine.
http://rothfeldcenter.com/about/vitamin-infusion-therapy/#vitc
6.Mikirova, Nina, Casciari, Joseph, et al: (2012). Effect of High-Dose Intravenous Vitamin C on Inflammation in Cancer Patients. Journal of Translational Medicine. 10 (189). doi: 10.1186/1479-5876-10-189. http://www.ncbi.nlm.nih.gov/pubmed/22963460
7.Questions and Answers about High Dose Vitamin C. (2013). National Cancer Institute at the National Institutes of Health.
http://www.cancer.gov/cancertopics/pdq/cam/highdosevitaminc/patient/page2
8.Vitamin C (Ascorbic Acid). (2012). The Mayo Clinic. http://www.mayoclinic.com/health/vitamin-c/NS_patient-vitaminc/DSECTION=safety
9.Vollbracht C, Schneider B, Leendert V, et al.: (2011). Intravenous vitamin C administration improves quality of life in breast cancer patients during chemo-/radiotherapy and aftercare: results of a retrospective, multicentre, epidemiological cohort study in Germany. In Vivo. 25 (6): 983-90.
10.Welsh JL, Wagner BA, et al.: (2010). Pharmacological ascorbate with gemcitabine for the control of metastatic and node-positive pancreatic cancer (PACMAN): results from a phase I clinical trial. Cancer Chemotherapy and Pharmacology. 71 (3): 765-75. doi:10.1007/s00280-010-1418-6

Course Evaluation

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Course Evaluation

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