Comment; Myers’ cocktails are amazing-I speak from personal experience. I can smell vitamins during the infusion the blood levels of them are so high. Within 12-24 hours I have more energy and focus than I know what to do with. I hope to offer it in my practice again in the future having used them extensively in my Florida practice in the past.
Alan R. Gaby, MD
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
the therapeutic use of intravenous nutrients,
reviews the relevant published clinical
research, describes the author’s clinical
experiences, and discusses potential side
effects and precautions.
(Altern Med Rev 2002;7(5):389-403)
Introduction
John Myers, MD, a physician from Balti-
more, Maryland, pioneered the use of intravenous
(IV) vitamins and minerals as part of the overall
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-
sionally 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 injec-
tions 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 treat-
ments; however, the problems would recur if the
patients went too long without an injection.
Intravenous Nutrient Therapy:
the “Myers’ Cocktail”
Alan R. Gaby, MD
Alan R. Gaby, MD – 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.
Correspondence address: 301 Dorwood Drive, Carlisle,
PA 17013.
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 hydro-
chloric acid. The exact doses of individual com-
ponents 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 regi-
men. Most notably, the magnesium dose was in-
creased by approximately 10-fold by using 20-
percent magnesium chloride, in order to approxi-
mate 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 prob-
lems 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’”) was helpful for a wide range of clini-
cal conditions, often producing dramatic results.
Over an 11-year period, approximately 15,000
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injections were administered in an outpatient set-
ting to an estimated 800-1,000 different patients.
Conditions that frequently responded included
asthma attacks, acute migraines, fatigue (includ-
ing 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 en-
hanced 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 medi-
cal 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 lec-
tern 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 re-
ports, 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 pub-
lished clinical research, describes personal clini-
cal 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), adminis-
tration. For example, as the oral dose of vitamin
C is increased progressively, the serum concen-
tration of ascorbate tends to approach an upper
limit, as a result of both saturation of gastrointes-
tinal absorption and a sharp increase in renal clear-
ance of the vitamin.3 When the daily intake of vi-
tamin 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 administra-
tion 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 ex-
ert pharmacological effects, which are in many
cases dependent on the concentration of the nutri-
ent. 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 ef-
fect in vivo. Such an effect would have implica-
tions for the treatment of various allergic condi-
tions. Magnesium ions promote relaxation of both
vascular8 and bronchial9 smooth muscle – effects
that might be useful in the acute treatment of va-
sospastic angina and bronchial asthma, respec-
tively. It is likely these and other nutrients exert
additional, as yet unidentified, pharmacological
effects when present in high concentrations.
Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002 Page 391
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In addition to having direct pharmacologi-
cal effects, IV nutrient therapy may be more ef-
fective 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 mag-
nesium concentration in myocardial cells is 10
times higher than the extracellular concentration.
This ratio is maintained in healthy cells by an ac-
tive-transport system that continually pumps mag-
nesium ions into cells against the concentration
gradient. In certain disease states, the capacity of
membrane pumps to maintain normal concentra-
tion gradients may be compromised. In one study,
the mean myocardial magnesium concentration
was 65-percent lower in patients with cardiomy-
opathy than in healthy controls,10 implying a re-
duction 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 fail-
ure and lead to a vicious cycle of further intracel-
lular magnesium loss and more severe heart fail-
ure.
Intravenous administration of magnesium,
by producing a marked,
though transient, increase
in the serum concen-
tration, 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 improve-
ment 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 impair-
ment in the capacity to maintain normal intracel-
lular nutrient concentrations;11 (2) an inborn error
of metabolism that can be controlled only by main-
taining a higher than normal concentration of a
particular nutrient; or (3) a renal leak of a nutri-
ent.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 avail-
able 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
2-5 mL
1-3 mL
1 mL
1 mL
1 mL
1 mL
4-20 mL
Magnesium chloride hexahydrate 20% (magnesium)
Calcium gluconate 10% (calcium)
Hydroxocobalamin 1,000 mcg/mL (B12)
Pyridoxine hydrochloride 100 mg/mL (B6)
Dexpanthenol 250 mg/mL (B5)
B complex 100 (B complex)
Vitamin C 222 mg/mL (C)
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All ingredients are drawn into one syringe,
and 8-20 mL of sterile water (occasionally more)
is added to reduce the hypertonicity of the solu-
tion. 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. Occa-
sionally, 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 propor-
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,
6 mL vitamin C, and 8 mL sterile water.
The following is a review of conditions
successfully treated with the Myers’. The num-
bers of patients treated and proportion that re-
sponded are, for the most part, estimates.
Asthma
Case #1: A five-year-old boy presented
with a two-year history of asthma. During the pre-
vious 12 months he had suffered 20 asthma at-
tacks severe enough to require a visit to the hospi-
tal emergency department. His symptoms ap-
peared to be exacerbated by several foods, and
skin tests had been positive for 23 of 26 inhalants
tested. His initial treatment consisted of identifi-
cation 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 regi-
men, he experienced marked improvement, and
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,
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 in-
stances, a single injection resulted in marked im-
provement or complete relief within two minutes,
and the acute symptoms did not recur. Occasion-
ally, 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 cal-
cium, and 1 mL each of B12, B6, B5, and B com-
plex.
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 re-
ceived 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 in-
jections once weekly or every other week during
difficult times and reported the treatments kept
their asthma under better control.
Intravenous magnesium is now well docu-
mented as an effective treatment for acute asthma.
In one study, 38 patients with an acute exacerba-
tion 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 (sa-
line).13 Peak expiratory flow rate improved to a
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significantly greater extent in the magnesium
group (225 to 297 L/min) than the placebo group
(208 to 216 L/min). In addition, the hospitaliza-
tion 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 pa-
tients 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 sa-
line placebo, beginning 30 minutes after presen-
tation.14 Among patients with severe asthma (de-
fined 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. How-
ever, 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 asth-
matic children, IV magnesium sulfate significantly
improved pulmonary function and significantly
reduced hospitalization rates during acute exacer-
bations 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 pe-
riod 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 treat-
ment of life-threatening status asthmaticus.6 In a
few studies, IV magnesium failed to improve pul-
monary function or to reduce the need for hospi-
talization.17,18 However, a meta-analysis of seven
randomized trials concluded that IV magnesium
reduced the need for hospitalization by 90 per-
cent 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 re-
port, 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 ad-
ministration of an unspecified calcium salt tem-
porarily inhibited severe anaphylactic reactions in
two other patients.21
Nutrients other than magnesium and cal-
cium may have contributed to the beneficial ef-
fect observed in asthma patients. Oral vitamins
C22 and B623,24 and IM vitamin B1225 have each
been used with some success against asthma, al-
though none of these nutrients has been tested as
a treatment for acute attacks. Intramuscular ad-
ministration of niacinamide has been shown to
reduce the severity of experimentally induced
asthma in guinea pigs,26 and pantothenic acid ap-
pears to have an anti-allergy effect in humans.27
On one occasion, a patient’s asthma at-
tack was treated with IV magnesium alone. Al-
though the symptoms resolved rapidly, they re-
turned within 10-15 minutes. The remaining con-
stituents of the Myers’ (without additional mag-
nesium) were then administered, and the symp-
toms disappeared almost immediately and did not
return. Thus, it seems the Myers’ is more effec-
tive 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
Page 394 Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002
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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 min-
utes.
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 min-
utes after the infusion, 35 patients (87.5%) re-
ported at least a 50-percent reduction of pain, and
nine patients (22.5%) experienced complete re-
lief. In 21 of 35 patients who benefited, the im-
provement persisted for 24 hours or more. Patients
with an initially low serum ionized magnesium
concentration (less than 0.54 mMol/L) were sig-
nificantly 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 per-
manently 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 re-
sulted in rapid disappearance of nausea, vomit-
ing, 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 clus-
ter 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. Pa-
tients 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 im-
provement. One patient experienced dramatic ben-
efit after the first injection, whereas in other cases
three or four injections were given before improve-
ment was evident. A few patients became progres-
sively healthier with continued injections and were
eventually able to stop treatment. Several others
did not overcome their illness, but periodic injec-
tions helped them function better.
There is some research support for the use
of parenteral magnesium in patients with fatigue.
One study found magnesium deficiency, demon-
strated by an IV magnesium-load test, in 47 per-
cent of 93 patients with unexplained chronic fa-
tigue, 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 pa-
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.
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 ben-
efited from oral magnesium supplementation;
however, some patients needed IM injections.33
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Other investigators, using the IV magnesium-load
test, found no evidence of magnesium deficiency
in patients with CFS, and observed no improve-
ment 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 fa-
tigue,35 as well as those with CFS.36 While the re-
sults obtained with the Myers’ may be attribut-
able in part to vitamin B12, many patients who
responded to IV therapy obtained little or no ben-
efit 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 pre-
viously she was found to have an elevated sedi-
mentation 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 signifi-
cant 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 symp-
toms 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 dis-
covered that eating refined sugar caused myalgias
and arthralgias, and that thyroid hormone im-
proved her energy level, mood, and overall well
being. During the three years of monthly mainte-
nance 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 re-
ceiving IV therapy.
The author has given the Myers’ to ap-
proximately 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 nutri-
ent therapy has been confirmed by one study pub-
lished 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 Improve-
ment 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 main-
tain improvement. The positive response to
parenteral magnesium is consistent with the ob-
servation that nearly half of patients with
fibromyalgia have intracellular magnesium defi-
ciency, 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 nutri-
ents was considered because the patient reported
that consumption of alcohol (known to deplete
magnesium) aggravated his symptoms, and be-
cause he was taking a magnesium-depleting thi-
azide 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 re-
duction in his symptoms for one week. A second
injection produced a similar response that lasted
two weeks. Through trial and error it was deter-
mined 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.
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Both oral and IM administration of the same nu-
trients were tried but found to be ineffective.
Weekly injections provided almost complete re-
lief from symptoms and allowed him to discon-
tinue psychotherapy. The patient noted that rap-
idly administered injections provided longer-last-
ing relief than did slower injections. The infusion
rate was therefore carefully and progressively in-
creased, 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 in-
jection (such as five minutes) would last only a
week. Approximately four years after initial treat-
ment, he was able to reduce the frequency of in-
jections 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 suf-
fer from fibromyalgia, migraines, excessive stress,
or alcohol-induced exacerbations. Shealy et al
have observed an antidepressant effect of IV mag-
nesium 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 suf-
fered four myocardial infarctions. During the pre-
vious 12 months, spent mostly in the hospital, he
had become progressively worse; his ejection frac-
tion 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 re-
vealed complete occlusion of both femoral-
popliteal arteries, with no detectable blood flow
to the distal extremities. Two independent vascu-
lar surgeons had recommended bilateral above-
the-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 ampu-
tations.
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 mag-
nesium injections appeared to reduce the pain in
his gangrenous toes considerably, with the ben-
efit 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, se-
lenium, 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 addi-
tion, the gangrenous areas on his toes had sloughed
and been replaced almost entirely by healthy tis-
sue. Intravenous therapy was continued and even-
tually reduced to every other week. The patient
lived for eight years and died at age 87 from mul-
tiple organ failure.
Of the handful of other patients with an-
gina or heart failure who received IV or IM injec-
tions 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 treat-
ment he was symptom free. The cold symptoms
did return the next day but were only 10 percent
as severe as before the injection.
Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002 Page 397
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One-quarter to one-third of patients who
received the Myers’ for an acute respiratory in-
fection experienced marked improvement, either
immediately or by the next morning. Approxi-
mately half of patients given this treatment re-
ported that it shortened the duration of their ill-
ness. Patients who benefited tended to have a simi-
lar response if treated for a subsequent infection,
whereas non-responders tended to remain non-re-
sponders.
Case #7: A 32-year-old female had a long
history of chronic sinusitis. Avoidance of aller-
genic foods and oral supplementation with vita-
min C and other nutrients had provided only mini-
mal 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 experi-
encing 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 in-
cluded 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 sub-
sequent 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 agita-
tion. He was given an IV infusion of 16 mL vita-
min 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 alle-
viated. The symptoms returned 36 hours later; he
therefore came for another treatment, which again
relieved the symptoms within minutes. He re-
turned 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 al-
lergy-elimination diet and oral supplementation
with vitamin C and other nutrients provided little
or no relief. She was given an IV infusion of 12
mL 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 rap-
idly 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 magne-
sium, 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
Page 398 Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002
“M ye rs’ C o c k ta il” Re vie w
Copyright©2002 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
his life. This energy boost persisted for the dura-
tion 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 us-
ing performance-enhancing drugs, it is not the
author’s intention to encourage athletes to seek
another “boost” 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 con-
trolled the symptoms of hyperthyroidism, although
there was no reduction in thyroid-hormone lev-
els. The injections were discontinued after medi-
cal therapy had restored the hormone levels to
normal. In the other case, symptoms improved
markedly after the first injection and thyroid-func-
tion 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 Intrave-
nous 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 hyperthyroid-
ism.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 posi-
tion or from overuse. It also has been observed to
relieve tension headaches in many cases. One pa-
tient (a 70-year-old female) with chronic torticol-
lis experienced moderate pain relief with periodic
treatments. Of three patients with acute dysmen-
orrhea treated with the Myers’, two experienced
almost instant pain relief. One patient with chronic
obstructive pulmonary disease intermittently re-
ceived weekly IV injections and reported the treat-
ments 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, hydroxocobal-
amin is preferred because it produces more pro-
longed increases in serum vitamin B12 levels.48
It has been the author’s impression (and
that of other clinicians) that some patients who re-
spond to IM vitamin B12 injections do not experi-
ence 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.
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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, sele-
nium 20 mcg, and manganese 0.1 mg. The prepa-
ration 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 admin-
istration. 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 in-
fusion. Other patients have remarked their visual
acuity and color perception become sharper im-
mediately 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 receiv-
ing 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). Pa-
tients 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, presum-
ably 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 pro-
ceeding with the rest of the infusion. Doing so may
help one distinguish between a vasovagal reac-
tion and a hypotensive response to the injected
compounds. Patients who experience a vasovagal
reaction at the beginning of an infusion can usu-
ally 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 tol-
erated, and benefited from, IV therapy.
Patients who are deficient in both mag-
nesium and potassium may have an influx of po-
tassium into the cells after receiving IV magne-
sium.51 This occurs because magnesium activates
the membrane pump that promotes the intracellu-
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
receiving a Myers’; both patients had been taking
medications known to deplete potassium. Hy-
pokalemia also increases the risk of digoxin-in-
duced cardiac arrhythmias. As a first-year resident,
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“M ye rs’ C o c k ta il” Re vie w
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unaware of this potential problem, the author ad-
ministered IV magnesium in the hospital to an eld-
erly woman who was taking digoxin and a potas-
sium-depleting diuretic. She quickly developed an
arrhythmia, which required short-term treatment in
the intensive care unit.
Patients considered to be at risk of potas-
sium deficiency include those taking potassium-
depleting diuretics, beta-agonists, or glucocorti-
coids; those with diarrhea or vomiting; and those
who are generally malnourished. If a patient is hy-
pokalemic, the hypokalemia should be corrected
before IV magnesium therapy is considered. How-
ever, 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 encoun-
tered.
The addition of even small amounts of
potassium to an IV push is strongly discouraged,
because of the theoretical risk of triggering an ar-
rhythmia 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, al-
though 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. litera-
ture since 1946. However, in the world literature, a
total of nine deaths attributed to thiamine adminis-
tration 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 hista-
mine. 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 vita-
mins 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 associ-
ated with the use of IV thiamine. Many patients
who receive parenteral thiamine are alcoholics, and
alcoholism frequently causes magnesium defi-
ciency. Animal studies suggest thiamine supple-
mentation in the presence of magnesium deficiency
increases the severity of the magnesium defi-
ciency.54 A deficiency of magnesium can lead to
spontaneous release of histamine,55 and has been
reported to increase the incidence of experimen-
tally induced anaphylaxis in animals.56 The pres-
ence of magnesium in the Myers’ might, therefore,
reduce the risk of an anaphylactic reaction to thia-
mine. Moreover, as the Myers’ has been used suc-
cessfully to treat asthma and urticaria, it is likely
the formula as a whole provides prophylaxis against
anaphylaxis. Nevertheless, practitioners who ad-
minister IV nutrients should be prepared to deal
with the rare anaphylactic reaction.
A small number of patients (approximately
one percent) felt “out of sorts” for up to a day after
receiving an injection and, in two cases, this reac-
tion lasted one and two weeks, respectively. 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 (in-
cluding 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 prepa-
rations were used.
Although the Myers’ is extremely hyper-
tonic, 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.
Alternative Medicine Review ◆ Volume 7, Number 5 ◆ 2002 Page 401
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When administered with caution and re-
spect, the Myers’ has been generally well tolerated,
and no serious adverse reactions have been encoun-
tered 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 repre-
sented 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 clini-
cal conditions. In many instances this treatment is
more effective and better tolerated than conven-
tional 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 ur-
gently 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 obvi-
ous sensations induced by IV nutrient infusions,
trials comparing the Myers’ with established thera-
pies would be informative. Practitioners using this
treatment are encouraged to report their findings.
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