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What  is  a  Myers'  Cocktail  IV?



A Myers' cocktail is an increasingly popular intravenous therapy. The late John Myers, MD, was the first to introduce this vitamin and mineral treatment. He designed this formula to potentially treat several clinical conditions including fatigue, fibromyalgia, muscle spasms, and many more. 

Although the original Myers' cocktail may work for many ailments, healthcare providers often tailor similar treatments for their patients to meet their specific needs. 


What Ingredients are Included in a Myers’ Cocktail? 


The standard Myers' cocktail includes: 


  • Vitamins: Vitamin C, B-Complex vitamins, Vitamin B12
  • Calcium: Calcium aids bone formation and strength. It also can help control irregular heartbeats. 
  • Magnesium: Generally stored in bones, muscles, and soft tissues. It has been found to reduce fatigue, migraines, muscle spasms and may even help those at risk of cardiovascular diseases.3 
  • Zinc: Zinc has been proven to help regulate the immune system. Zinc is not naturally created in the body. Deficiency of zinc can lead to subsequent health issues. 
  • Glutathione: Glutathione is a potent antioxidant that naturally occurs in the body. Glutathione aids the immune system and has been found to help in the prevention of cancer, cystic fibrosis, HIV, and the normal aging process. 
  • Saline Solution: All ingredients for the Myers’ cocktail are combined in an IV bag usually consisting of normal saline. 

Other ingredients may also be included, depending on the type of infusion a patient is receiving. Although this cocktail is made with generally safe components, medical providers should consider underlying conditions when treating patients. Healthcare providers often increase, decrease, add, or exclude certain vitamins and minerals to create a focused treatment for their patient's specific goals. 

A revised formulation of the Myers' cocktail may include:1

A common booster used to accompany IV infusions is a potent antioxidant, glutathione. Glutathione may aid in disease prevention, immune function and energy levels. 


Who Needs a Myers’ Cocktail? 


When asked who should consider a Myers' cocktail infusion, there is no single answer. Because of the high dose of antioxidants, nutrients, and other immune-boosting factors, individuals who have weakened immune systems or diseases that negatively impact immune resilience may benefit from receiving a Myers' cocktail IV treatment. 

Studies have found the Myers' cocktail may be benefit patients who: 

  • Suffer from low energy 
  • Perform athletic exercises 
  • Suffer from chronic fatigue 
  • Require intravenous hydration 
  • Seek relief from hangover or withdrawal symptoms2
  • Suffer from depression or anxiety 

According to Myers' cocktail studies and reviews, since the cocktails are made of vitamins and minerals, they tend to be well tolerated by many patients. Since treatment is administered intravenously vs. passing the digestive system, higher concentrations of the vitamins are more easily absorbed and thus bioavailable to the body. 


Benefits of a Myers' Cocktail Infusion 

Health benefits may come from receiving a Myers' cocktail with for many patients. 

For example, magnesium has been found to prevent or reduce asthma attacks, chronic fatigue, cardiovascular diseases, fibromyalgia, chronic sinusitis, rhinitis, upper respiratory tract infections, migraines, and more. Magnesium with vitamin B may increase the efficacy when paired together for those who suffer from cardiovascular diseases.3 

Indications have been found that vitamin B6 (up to 50 mg per day) and B12 may relieve muscle weakness associated with hyperthyroidism. Those who suffer from acute muscle spasms, poor sleep at night, or high levels of stress, may have a magnesium deficiency and may benefit from receiving intravenous treatment to bring their magnesium levels to an optimum state.


Benefits  of  NAD+  I V  Therapy



General Information on NAD+ 


First discovered in the early eighteenth century, Nicotinamide Adenine Dinucleotide (NAD) is an essential ingredient in metabolic processes and reactions that occur in cells within the human body. All significant cellular events within the human body cannot occur without the presence of NAD. Examples of some processes that are dependent on NAD are glycolysis (the breakdown of glucose into pyruvate and hydrogen), citric acid or tricarboxylic acid cycle (the release of stored energy from carbohydrates, proteins and fats through the oxidation of acetyl CoA), the oxidation or breakdown of fatty acids, DNA repair, inflammatory responses, among many other processes. NAD usually undergoes either oxidation or reduction as it exerts its effects on the body's metabolic processes; the oxidized variant of NAD is referred to as NAD+.12 


How NAD+ is Synthesized 

There are two primary mechanisms by which NAD+ is synthesized in the human body. One of the pathways for NAD+ synthesis is the kynurenine pathway, whereby NAD+ is synthesized from the essential amino acid tryptophan. In this pathway, tryptophan undergoes a process known as oxidative cleavage to form the product formylkynurenine; this process is facilitated by the enzymes tryptophan-2, 3-dioxygenase (TDO) and indoleamine-2, 3-dioxygenase (IDO). Further enzymatic reactions occur after the formation of formylkynurenine and it is then converted into NAD+ by means of several enzymes, once of which is 3-hydroxyanthranilic acid 3, 4-dioxygenase (3-HAAO).3 

The second pathway for NAD+ synthesis is known as the salvage pathway. The salvage pathway is so named because NAD+ is recycled during the consumption of nicotinic acid, nicotine adenine mononucleotide, and nicotinamide. The enzyme nicotinamide phosphoribosyltransferase (Nampt) converts nicotinamide to nicotinamide adenine mononucleotide (NMN) and is then converted into NAD+ using another enzyme known as nicotinamide mononucleotide adenylyltransferase (Nmnat). Alternatively, nicotinic acid may be used as a precursor for NAD+ synthesis; nicotinic acid mononucleotide (NAMN) is generated from nicotinic acid, which is then conjugated to NAD+ by means of the enzyme Nampt. The variety of pathways available for the synthesis of NAD+ is a reflection of its importance within the human body.4


Importance of NAD+ In the Human Body 

As stated earlier, NAD+ is crucial for a number of key physiological processes within the human body. A deficiency in NAD+, or a disruption in NAD+ homeostasis in the body, may impair these physiologic processes, which may result in different illnesses or disease conditions. Discussed below are some of the many physiologic processes that are dependent on NAD+.1567 


1) Genomic Stability 

On a daily basis, reactive oxygen species (ROS) and reactive nitrogen species (RNS) are released endogenously within the body; these substances cause damage to cellular DNA. In addition, exogenous factors such as carcinogens, chemical mutagens, as well as radiation may also result in cellular DNA damage. When cellular DNA damage occurs due to either endogenous or exogenous factors, genomic instability occurs, which may result in cancer development and an increased rate of cellular aging. 

In order to minimize cellular DNA damage and its consequences, there is a process in the body known as DNA-damage response (DDR). DDR is a process that detects and repairs any damaged DNA in the body. DDR is a process that is highly dependent on NAD+; when amounts of NAD+ are low in the body, the DDR process is impaired, resulting in increased damage to the cellular DNA. 

2) Genetic Expression 

The means by which genetic information in cellular DNA is used to produce the relevant proteins or substances in the human body is known as genetic expression. Genetic expression is the process that is responsible for the development of all the physical features that define an individual, such as hair and skin color, among other physical characteristics. 

One of the mechanisms by which genetic expression successfully occurs in the body is through modifying a product known as histones. Histone modification is a NAD+ dependent process; a deficiency in NAD+ levels may disrupt histone modification, which may impair genetic expression. NAD+ deficiency may also result in the methylation of cellular DNA so that genes are not expressed appropriately; this is known as genetic silencing. 

3) Immunity and Inflammation 

Studies have shown that NAD+ levels in the human body determine the extent as well as the effectiveness of immune responses during infection. Increased levels of NAD+ during an infection increase oxidative phosphorylation in macrophages, which makes them better able to neutralize the organism causing the infection. 

In addition to the increased expression of macrophages, NAD+ also exerts anti-inflammatory effects during an infectious process. Studies have shown that the expression of inflammatory markers such as Tumor Necrosis Factor alpha (TNF-a) and Interleukin-6 (IL-6) significantly diminish when there are high cellular levels of NAD+ and its precursors. 

4) Energy Metabolism 

Several metabolic pathways in the human body result in the release of energy. Some examples of the energy metabolic pathways are glycolysis, tricarboxylic acid (Krebs) cycle, oxidative phosphorylation, fatty acid oxidation, and ethanol metabolism. All the energy metabolic pathways require the presence of NAD+ as a coenzyme to function properly. In the glycolytic pathway, NAD+ facilitates the catalytic reactions of Glyceraldehyde-3-phosphate dehydrogenase (GADPH) and lactate dehydrogenase (LDH). In the Krebs cycle, NAD+ functions as a coenzyme for the rate-limiting enzymes alpha ketoglutarate dehydrogenase, isocitrate dehydrogenase, and malate dehydrogenase. Alcohol metabolism, which occurs in liver cells, also requires NAD+ as a cofactor for the process's successful execution. A deficiency of NAD+ in the body may impact all these processes and negatively impact the effectiveness by which energy is generated and utilized by the body. 

5) Circadian Clock 

The circadian clock, also known as the biological clock or circadian rhythm, is an internal endogenous process that regulates the sleep-wake cycle in the human body. This internal clock helps the body adjust to different times of the day or the different seasons. The accuracy and effectiveness of the circadian clock are due in part to cellular levels of NAD+. A deficiency of NAD+ may disrupt the circadian rhythm and result in effects such as daytime sleepiness, restless sleep, hormonal imbalances, and mood alterations, among others. 

6) Cardiovascular Function 

The heart is the most metabolically active organ in the human body because it is constantly beating. Studies have shown that normal NAD+ levels are essential in maintaining the metabolic activity of the heart. Furthermore, in the event of a significant cardiac event such as a transient ischemic attack or myocardial infarction, normal levels of NAD+ help in the recovery from injury. Other studies have shown that a deficiency in NAD+ may result in cardiac disorders such as cardiac hypertrophy and fibrosis. 

7) Kidney Function 

Generally, renal function has a tendency to decrease as people get older. It is suspected that reduced levels of NAD+ in the elderly may have a role to play in the reduction in renal function. Research has indicated increased protection against acute renal injury when individuals were given NAD+ supplements. In addition, NAD+ supplements stimulated the release of prostaglandin E2, which serves to improve renal function after an acute renal injury. 

8) Liver Function 

Normal NAD+ levels in the body are essential for the optimal functioning of the liver. Specific enzymes in the NAD+ pathways protect the liver from conditions such as hepatic fibrosis, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis. Several studies have been performed that show that giving individuals NAD+ supplements may boost the liver's overall health, protect it from toxic illnesses, and enhance its capacity for regeneration after a hepatic injury. 

9) Neurological Function 

NAD+ and its precursors have been shown to have a protective effect on the neurons in the brain after a significant neurological event such as a stroke. Having normal levels of NAD+ in the body is essential to the normal functioning and survival of cerebral neurons. Additionally, NAD+ supplements have shown some benefits in treating and preventing some neurodegenerative diseases such as Alzheimer's disease; this is not definite, however, and there are several ongoing studies still exploring this possibility. 


Benefits of IV NAD Therapy 

Given the integral role that NAD+ plays in all the body's major processes as detailed in the previous section, it is essential to ensure that NAD+ levels are optimal. If there are signs of NAD+ deficiency, such as in pellagra, which manifests as dermatitis, dementia, or diarrhea, supplemental IV NAD therapy may be warranted. In addition to signs of NAD+ deficiency, there are other reasons for which an individual may consider receiving intravenous NAD+ supplementation; some of these reasons include the following: 

1) Addiction Therapy 


One of the most common reasons why IV NAD+ therapy may be considered in some individuals is in the management of addiction. IV NAD+ may benefit patients weaning off opioid, alcohol, chemical, or prescription drug dependencies; it may also serve to minimize the severity of withdrawal symptoms. While the mechanism of how NAD+ works in this regard is still under investigation, it is believed that IV NAD+ helps flush drugs out of the body and reduce cravings. 


2) Improved Cognition 

As has previously been stated, NAD+ has been shown to exert both protective and stimulatory effects on the brain. For this reason, IV NAD+ therapy may be administered to potentially enhance memory, improve concentration, improve the ability to focus, enhance brain regeneration, and improve overall neurological function. Studies are still ongoing regarding the precise means by which exogenous NAD+ supplementation exerts these effects. 


3) Chronic Fatigue 

IV NAD+ therapy has been used in the management of individuals with chronic fatigue and low energy levels. NAD+ is an essential cofactor in the glycolytic pathway and tricarboxylic acid pathways; these pathways result in Adenosine Triphosphate (ATP) production, which is the energy source of the human body. Through exogenous NAD+ supplementation, ATP levels in the body are increased which may have a resulting effect in boosting energy levels and reducing feelings of fatigue. 


4) Athletic Performance 

Due to its role in ATP production, some athletes have used IV NAD+ therapy to enhance their athletic capabilities and performance. IV NAD+ supplements may boost energy levels, improve cognition, and increase reaction times in athletes during competitions or other athletic events. In addition, studies have shown that NAD+ supplementation may assist in muscle development as well as muscle repair, leading to muscle hypertrophy and muscle hyperplasia. 


5) Pain Management 

One of the more novel reasons why some individuals receive IV NAD+ therapy is in managing pain. NAD+ is known to exert significant anti-inflammatory actions within body and may be used to reduce the inflammation that typically occurs with pain and, thereby, offer some relief from pain. Studies into the use of supplemental NAD+ as a form of pain control are still ongoing and the results so far are not yet definitive. 



What is IV Nutritional Therapy?


General Information on IV Nutrient Therapy


There are several ways that people refer to IV nutritional therapy. Some people call it IV vitamin therapy, while others call it IV micronutrient therapy. Regardless of name preference, the purpose remains the same: to provide supplemental vitamins and micronutrients into your body to improve the body's state of health and overall well-being. IV stands for intravenous, meaning that the vitamins and micronutrients are administered into the body through the veins. 

IV nutrient therapy administration has become increasingly popular in recent times. Some athletes receive intravenous vitamins after their games to help improve speed up their recovery. Another common reason people seek out IV vitamin therapy is in managing certain medical conditions; some studies that have been performed indicate that supplemental IV vitamin administration may help relieve symptoms of fibromyalgia, migraines, and hypertension, among others.12 

IV vitamin therapy is not a new concept; it has been in existence since the early eighties. One of the earliest types of IV Vitamin therapy developed was by the late Dr. Myers; he came up with the Myers' Cocktail comprising magnesium, calcium, vitamin C, and other B-complex vitamins. As a matter of fact, the Myers' Cocktail played a major role in popularization and generalized adoption of IV Vitamin therapy by individuals all over. Since the Myer's Cocktail's original development, many other combinations of IV Vitamin therapy have been developed. 

A layperson may be interested in finding out if IV Vitamin therapy is beneficial for them. However, given the fact that there are many types of intravenous micronutrients available, a patient should consult with their healthcare provider first. After performing an assessment, a healthcare provider is able to recommend what combination of vitamins and a patient needs to achieve their health goals. Additionally discussed are the types of IV Vitamin therapy available, risks and benefits of its use, components of IV Vitamin compounds, as well as some common use cases. If someone is wondering if IV therapy is right for them they should consult with their doctor. 


How Does IV Micronutrient Therapy Work? 

Most people generally consume their vitamins and micronutrients through their food; some people may also take additional multivitamin supplements. When vitamins and micronutrients are ingested orally, they go down to the stomach and intestines, where they are broken down by gastrointestinal enzymes and then absorbed into the bloodstream. There is a limit to how fast these substances can be absorbed from the gastrointestinal tract; what is not absorbed continues through the body and is excreted as stool. Also, most substances absorbed from the intestine pass through the liver for more processing before it goes to the rest of the body. Other factors that impact the amount of vitamins absorbed from the intestine are an individual's metabolism, age, genetics, and interactions with other orally consumed products. Ultimately, a significant amount of the orally ingested vitamins and micronutrients is lost, and only small amounts pass to the rest of the body. As with most of the vitamins and micronutrients going to waste, the body does not derive the full benefits of these substances when they are orally ingested as food or other supplements. 

With IV Vitamin therapy, the minerals and vitamins are administered into the body through the veins. By this route of administration, vitamins and micronutrients avoid the metabolism in the intestine. Also, the substances get into the bloodstream and around the body faster as they are not limited by how quickly they can be absorbed, as is the case with oral application. Ultimately, only small amounts of vitamins and micronutrients go to waste during IV Vitamin therapy; most of it is absorbed and used by the body. As a result, the body gains the vitamins and micronutrients' full benefits when administered through the veins rather than by mouth.3 


What are the Components of an IV Micronutrient Infusion? 

There are a variety of substances that may be in typical IV micronutrient infusion. Most times, the IV micronutrient infusion components are tailored to the reason for its use; different illnesses or medical conditions may require a particular combination of IV vitamins and micronutrients. Additionally, the components of an IV vitamin bag may also be tailored based on the needs of the individual receiving the infusion; individuals may tolerate some components more than others or be intolerant to specific substances. 

Generally, some substances that may be found in a typical IV vitamin infusion bag include the following: 


  • Vitamin C – Studies have been performed that indicate several of the benefits of intravenous vitamin C. In the critically ill, vitamin C administered intravenously may help in the management of sepsis; it may also be of use in managing certain kinds of cancer. For individuals in good health, intravenous vitamins may serve to boost immunity and increase energy levels.45 
  • Vitamin B complex – Several vitamins make up the B complex group of vitamins. Some of these vitamins are Vitamin B1 (Thiamine), Vitamin B2 (Riboflavin), Vitamin B3 (Niacinamide), Vitamin B5 (Dexpanthenol), and Pyridoxine (Vitamin B6). These vitamins play essential functions in the processes that place in the human body. 
  • Vitamin B12 – This is also known as cyanocobalamin. It serves many purposes in the human body; however, its primary function is in the production of red blood cells. A deficiency of this vitamin may result in a condition known as macrocytic megaloblastic anemia. 
  • Folic acid - This is also known as folate. Similar to cyanocobalamin, folic acid helps in the development of red blood cells. Its deficiency may also result in macrocytic megaloblastic anemia. 
  • Calcium – Calcium is necessary for the development of strong and healthy bones. People who are lacking in calcium in their body may end up with a condition known as osteoporosis. 
  • Glutathione – This is an antioxidant that facilitates many key processes in the body. 

There are many more vitamins and micronutrients that may be included in an intravenous micronutrient therapy infusion. As earlier stated, it is advisable to consult with a healthcare provider before starting on an IV vitamin regimen; this helps ensure the needed vitamins and micronutrients are received and in the correct amounts. 


When Should You Receive an IV Micronutrient Infusion? 

There are no definite answers regarding who should take vitamin C or benefit from intravenous vitamin infusion therapy. A person may start with an IV vitamin therapy if their healthcare provider recommends it. Other considerations that may warrant the need for IV vitamin therapy are the following: 

  • Individuals suffering or recovering from illnesses; IV vitamins may help boost the immune system and speed up recovery. 
  • Individuals who feel run down and have chronic low energy. 
  • Individuals with mood disorders such as depression and anxiety. 
  • Athletes before and after major sporting activities. 

For the most part, anyone can receive an IV vitamin infusion. The components are generally well-tolerated, and the risks of adverse effects, though present, are mild. 


Types of IV Micronutrient Therapy 

There are many types of intravenous vitamin infusions that are available for administration. These types can be categorized based on the reason for which the infusions are administered. The different types of IV vitamin bags often have many similar ingredients; what makes them different is the quantities of the individual ingredients in each vitamin bag type. Some common types of IV micronutrient therapy infusions are: 

  • Myers cocktail: As mentioned earlier, this is one of the earliest and most common IV vitamin therapy types. There are a variety of recipes that can be used to make up the Myers cocktail, depending on the physician as well as the preferences of the individual receiving the infusion. 
  • Immune boosters: These IV bags contain ingredients that have been shown to help the immune system. These infusions are designed to improve the time it takes for healing to occur, reduce inflammation and duration of illnesses, and guard against infection. 
  • Metabolism boosters: These infusions are designed to boost overall body metabolism, restore energy levels, burn off body fat, and improve body performance. 
  • Recovery enhancers: These infusions are mainly for athletes or those who perform frequent high-intensity exercises. The ingredients in these bags have been shown to reduce tissue inflammation, shorten the recovery time after the exercise, replenish essential nutrients, and improve the athletes' overall performance. 

In addition to the ones listed above, there are many other types of intravenous micronutrient types available. By consulting with their healthcare provider, patients can better understand the type of vitamin therapy best suited to them. 


How IV Vitamin Therapy Infusions are Administered 


The administration of an IV vitamin infusion should generally be done in a professional setting such as a healthcare provider's office or any other appropriate outpatient setting. In addition, to minimize the risks of infections or other complications, the infusion should be administered only by familiar and skilled personnel with the process. The general process for the administration of an IV vitamin infusion bag is as follows: 

  • The individual will be seated or laying down comfortably. 
  • A tourniquet should be applied to the upper arm or forearm so that veins below the tourniquet become visible and distended. 
  • Once an appropriate vein has been selected, thoroughly wipe the skin with an alcohol-based solution. 
  • After the skin is dry, an appropriately sized needle or cannula should be used to establish an IV line. 
  • Once the IV line is set, the bag can then be connected to the IV line so that its contents flow into the patient. The rate at which the bag empties through the IV into the body varies; generally, the IV vitamin bags are set to flow for about 30 – 45 minutes. 

There are no clearly set limits regarding how frequently an individual can receive an IV vitamin infusion or how many bags can be received. These mostly depend on the instructions established by the healthcare provider and how quickly the individual responds to the therapy. 


Possible Side Effects 

Intravenous vitamin infusions are generally safe, with minimal side effects. When they do occur, side effects may be due to poor antiseptic conditions during the administration of the infusion. In addition, some side effects may occur as a result of hypersensitivity reactions to one or more of the ingredients in an infusion. For example, magnesium in an infusion bag may cause a flushing sensation around the head, neck, and chest areas. Also, potassium administration may cause cardiac excitability and arrhythmias in some people. For this reason, those receiving an infusion for the first time should have it titrated slowly and should be monitored closely for any side effects. If any side effects are detected, the infusion should be immediately discontinued.






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