Why would a physician want to give an injection of vitamins, minerals, or other beneficial substances when they could prescribe the same combination via the oral route for less cost and discomfort to the patient? If the physician is not sure of a reasonable answer to that question, then they should take a closer look at the many advantages versus the disadvantages of parenteral micronutrient therapy.

When a person becomes ill, he or she does not have the same energy as when well and healthy. Absorption and transport of nutrients takes energy, so perhaps that is one reason family doctors have recommended simple, easily digested foods when a person comes down with a cold or flu. As people age, the ability to absorb nutrients also decreases, and this is due to a gradual decrease in the secretion of gastric hydrochloric acid and, in turn, pancreatic enzymes needed to break down food or supplements so that intestinal absorption can occur.^1-3

There is an easy and safe method to avoid the nutrient deficiencies brought on by absorption problems and energy deficits associated with aging and illness, and that method is parenteral micronutrient therapy. Parenteral micronutrient therapy, or IV micronutrient therapy, as it is commonly known, has a long safety record. The relative absence of adverse reactions is due to the fact that the infused substances are naturally occurring – that is, they are essential nutrients required for the optimal functioning of the human body. The molecules are relatively simple and thus have low antigenicity and potential for hypersensitivity. Getting the nutrient into the target cell is more assured, because it is delivered directly into the body's circulation. A high-concentration gradient can be achieved, and osmotic mechanisms can act in concert with energy requiring transport.⁴

The disadvantages of IV therapy are higher cost, more time required to administer the IV, and discomfort to the patient (including the needle stick and possible vein discomfort secondary to osmotic and pH irritation of the vein). There are rare adverse reactions that can occur, including hypersensitivity reactions, phlebitis, and thrombosis. Inadequate knowledge or poor application of technique on the part of the physician can lead to infiltration of IV fluids, electrolyte imbalance, circulatory overload, symptoms of nutrient overdose due to both total dose and too high infusion rate and other less common problems.⁵ A well-trained and experienced physician can avoid most of these problems and can treat them effectively if they do occur.

There is an aphorism known as Pfeiffer's Law that is applicable: "We have found that if a drug can be found to do the job of medical healing, a nutrient can be found to do the same job. When we understand how a drug works, we can imitate its action with one of the nutrients." This statement taken in isolation can imply the allopathic application of nutrients, however, a good physician will always support IV micronutrient therapy with beneficial diet, lifestyle, and broad-spectrum oral supplement recommendations. The advantage of using nutrients, herbal extracts, and other naturally derived parenteral substances is the lack of side effects. The principle reason for nutritional IV therapy is to supply elements of normal body metabolism and those required for resolution of illness. When patients are acutely or chronically ill, they often need a jump-start consisting of a high concentration of nutrients to get them on the road to healing, or they need the pharmacological effect of a high-dose nutrient such as vitamin C or glutathione.

The choice of what products to include in an IV infusion needs to be based on three main factors: a deficiency of any nutrient elicited from history, symptoms, or testing; necessary cofactors to ensure proper metabolism and action of a product; and the known action of a nutrient or product on a disease process. An example of the first factor would be magnesium deficiency, as many or most patients are magnesium-deficient secondary to poor dietary choices, poor food quality, or malabsorption. Their symptoms could include muscle cramps, abdominal cramping, or migraine headaches.⁶ An IV push containing 1500 mg magnesium sulfate or an IV drip containing up to 3000 mg can bring dramatic relief from their symptoms. Some patients will tolerate the treatment better when the amino acid taurine is included, as taurine aids magnesium transport into the target cells.⁷

The second factor is exemplified by the use of amino acids, either as combination products or singly in the IV solution. Pyridoxine, vitamin B6, is the most important vitamin for amino acid metabolism, as vitamin B6 is a cofactor for transaminase enzymes that metabolize amino acids.⁸

A case of liver cirrhosis can be used to illustrate the third factor. A 56-year-old male presented to the clinic on recommendation of his hepatologist with the suggestion that "perhaps the naturopaths can help you." The hepatologist also suggested that the patient would require hospice care within three to four months secondary to hepatic encephalopathy. The patient was put on a whole-foods diet with lowered protein and prescribed liver support herbs, including milk thistle, curcumin, dandelion root, and licorice root. At the start of IV therapy, his lab results were as follows:

BUN 7 mg/dL
Albumin 3.4 mg/dL
Total bili 1.6 mg/dL
GGT 85 U/L
ALT 70 U/L
Ammonia 68 micro-mol/L

IV therapy consisted of two phosphatidylcholine drips (500 mg phosphatidylcholine in 250 mL D5W) weekly for three months, interspersed with 35 mL IV pushes (B-vitamins and minerals). At the end of this period, lab results were as follows:

BUN 16 mg/dL
Albumin 4.2mg/dL
Total bili 1.3 mg/dL
GGT 51 U/L
ALT 39 U/L
Ammonia 32 micro-mol/L

For the next three months, the patient was supported with phosphatidylcholine drips and an IV push alternating every other week. Six months after commencing IV therapy, this patient was doing well and showing no mental decline. The IV phosphatidylcholine was able to help heal the liver cells by replacing defective phospholipids within the cell membranes.^9,10 Using the right approach to correct biochemical abnormalities brought on by the cirrhotic liver resulted in a favorable outcome.

Case Examples of Applied IV Micronutrient Therapy:
From Simple IVs to More Complex

Case 1: A 76-year-old male presented with extreme muscular weakness, confusion, and difficulty walking and talking. Family members had driven him to the clinic and had to assist him in walking and sitting down. His vital signs were within normal limits, and his family gave consent for an IV push.¹¹ The push consisted of 100 mg calcium gluconate, 1500 mg magnesium sulfate, 250 mg dexpanthenol, 100 mg pyridoxine, 1000 mcg hydroxocobalamin, 1 cc B complex, and 2000 mg ascorbic acid diluted in 23 cc sterile water. The push was administered at 2 cc per minute, and the patient tolerated the treatment well. By the completion of the treatment, the patient was more alert and talking clearly. After completion of post-treatment vitals signs, the patient stated that he could stand and walk on his own. At a follow-up visit for another IV push, the patient stated that he had driven himself to the clinic and felt better than he had for months.

Case 2: A couple in their mid-40s came in complaining of flu-like symptoms that they had been experiencing over the past three months. During their intake, they stated, "Never able to completely get rid of it," and "We've been passing it back and forth." They had heard from a friend who had success with IV therapy and thought they would give it a try. A complete intake, blood tests, and physical assessment were completed. Diet consisted of a variety of organic foods. Labs for one showed increased LDL (149 mg/dL) and total cholesterol (217 mg/dL), the other elevated glucose (111 mg/dL) and creatinine (1.3 mg/dL). All other labs and vital signs were within normal limits. Each patient had multiple long-term complaints that were addressed after the immune-supporting IV and oral treatments had been given.

The initial IV was an IV Immune push: magnesium sulfate 500 mg/cc, 3 cc; calcium gluconate 100 mg/cc, 3cc; selenium 200 mcg/cc,1cc; pyridoxine 100mg/cc,1cc; dexpanthenol 250mg/cc, 1cc; B-complex 100, 1cc; ascorbic acid 500 mg/cc, 4cc; hydrochloric acid 1:500, 3 cc; sterile water 42cc. They noted improvement by the end of the visit. In addition, they were given a multiple vitamin, an immune-support supplement, and immune-support tincture. The IV push was repeated another 24 hours later, and they stated they were feeling much improved. Returning on the third day, they felt "great." Follow-up visits continued for addressing the chronic conditions.

Case 3: A 34-year-old female called the clinic asking if there were any reliable treatments for what she thought was acute infectious mononucleosis.^12,13 High-dose vitamin C was suggested, and the patient agreed to be seen. The patient presented with extreme fatigue of two-weeks duration. Physical examination revealed significant tender lymph node swelling in the neck, pharyngitis and a fever of 102ºF. Lab tests were ordered and showed a WBC count of 14,400 with absolute lymphocytosis; AST enzyme was slightly increased; and ALT enzyme was about three times the upper limit of normal and heterophil antibodies were positive. A red blood cell G6PD test was normal, indicating that high-dose vitamin C could be administered safely. The first IV consisted of 25 grams ascorbic acid; 4 cc 10% calcium gluconate; 6 cc 50% magnesium sulfate; 400 mcg selenium; 10 mg zinc sulfate; 250 mg dexpanthenol;100 mg pyridoxine; 2000 mcg hydroxocobalamin; 2 cc B complex; and 5 cc 8.4% sodium bicarbonate in 500 cc sterile water. This protocol was administered over four hours. Follow-up was two days later, and the patient remarked she felt better. Another IV was administered, the only change being ascorbic acid was increased to 50 grams. This same high-dose vitamin C protocol was administered twice more the following week.¹⁴ After the fourth IV, the patient stated that she felt well and wanted to return to work. There were no sequelae on follow-up three months later.

Case 4: A 91-year-old female with a chief complaint of age-related macular degeneration came to the clinic for treatment after reading an article about her condition in the Nutrition & Healing Newsletter by Jonathan Wright, MD. The patient was vital, clear-thinking, and delightful to interact with. Her only significant health abnormality was poor eyesight.¹⁵ Vision was checked with a Snellen eye chart with the patient standing five feet away. The first line she could read clearly with her glasses on was 20/100. She agreed to twice weekly treatments with an IV protocol consisting of 2500 mg ascorbic acid; 800 mcg selenium; 20 mg zinc sulfate; 250 mg dexpanthenol; 200 mg pyridoxine; 2 cc B complex; 600 mg glutathione (increased to 1500 mg for subsequent IVs); 250 mg taurine; and 50,000 IU vitamin A in 200 cc normal saline in a glass IV bottle.^16,17 This protocol was given at 4-5 cc per minute. Her vision was checked with the Snellen chart after each treatment, and after the sixth treatment, she was able to read the 20/50 line. After six weeks, treatments were done at weekly intervals for one month, then every other week for one month. The patient then maintained acceptable vision with monthly treatments. Typically, she could read two lines smaller on the eye chart after the IV and commented that traffic signs were readable as her daughter drove her home.

Case 5: Neuro
A 72-year-old with five-year history of progressive supranuclear palsy complained of symptoms including decreased leg strength, balance problems, trouble swallowing liquids, hypophonia and unclear speech, and abnormal vertical gaze. Neurological examination included mental state, which was affected (25/30); cranial nerves showing impairment of downgaze; inability to walk on toes or heels; hyper-reflexic reflexes; rapid alternating movements performed slowly; no abnormalities of sensation. Significant lab values include a normocytic anemia with hemoglobin 11.9 G/dL and increased blood lead and mercury. A DMPS provocation test was performed, and urine collected for six hours to better estimate body burden of toxic metals. The urine toxic metals test revealed increased levels of lead, mercury, and arsenic. Five DMPS chelation infusions were performed: 450 ml sterile water; 12 grams ascorbic acid; 1 gram magnesium sulfate; 500 mg dexpanthenol; 200 mg pyridoxine; 2000 mcg hydroxocobalamin; and 1 ml B-complex 100. After the IV drip was established, 250 mg DMPS was pushed through the Y-port over 12-15 minutes. At the end of the drip, 2000 mg glutathione was pushed at a rate tolerated by the patient.²² During each chelation, the patient's symptoms would decrease: speech was clearer, and movement was more coordinated. Two days after each chelation session, the patient received a nutrient replacement infusion. A follow-up DMPS provocation test showed all toxic metals within the reference range.^23,24 The patient's overall condition had improved markedly.

Notes
1. Champagne ET. Low gastric hydrochloric acid secretion and mineral bioavailability. Adv Exp Med Biol. 1989;249:173-84.
2. Aging of the Gastro-Intestinal Tract. Available at: http://mcb.berkeley.edu/courses/mcb135k/lecture41-GI_Tract.pdf. (190KB .pdf) Accessed October 19, 2005.
3. English J. Gastric balance: heartburn not always caused by excess acid. Available at: http://www.nutritionreview.org/library/gastric.acid.html. Accessed October 19, 2005.
4. Ziegler EE, Filer LJ, Eds. Present Knowledge in Nutrition. 7th ed. Washington: ILSI Press; 1996: 149, 160.
5. Carter D, Osborne V, Raffety S. Parenteral Micronutrient Therapy, Special Edition. Portland: Privately Published; 2004:49-57.
6. Baumgartner TG, et al. Clinical Guide to Parenteral Micronutrition. 3rd ed. Fujisawa USA, Inc.; 1997:158.
7. Braverman ER. The Healing Nutrients Within. 3rd ed. North Bergen, New Jersey: Basic Health Publications; 2003:131.
8. Ziegler EE, Filer LJ, Eds. Op cit. 174-178.
9. Kane PC, Foster JS, Speight N. The Detoxx Book: Detoxification of Biotoxins in Chronic Neurotoxic Syndromes. Privately Published; 2002:25-29.
10. Phosphatidylcholine. Available at: http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/pho_0288.shtml. Accessed October 19, 2005.
11. Gaby AR. Intravenous nutrient therapy: the "Myers' Cocktail." Altern Med Rev. 2002; 7(5):389-403.
12. Hellne C, Helene W. EB virus in the etiology of infectious mononucleosis. Hosp Pract. July 1970.
13. Niderman. College Findings tie Mono to ED virus. Med World News. Dec 1968.
14. Klenner FR. Massive doses of vitamin C and the virus diseases. J. So Med & Surg. April 1951; 113 (4).
15. University of Maryland Medical Center. Macular degeneration. Available at: http://www.umm.edu/altmed/ConsConditions/MacularDegenerationcc.html#Alternative. Accessed October 6, 2005.
16. Warding off macular degeneration. Health News. 2005 Apr;11(4):13-14.
17. Werbach MR. Textbook of Nutritional Medicine. Tarzana, California: Third Line Press;1999: 515-520.
18. Klenner FR. Use of vitamin C as an antibiotic. J. of Appl Nutrit. 1963; 6. (Paper presented at AAN Convention, May 1963, Pasadena, CA.)
19. McCall CE, Copper R. Vitamin C shows promise as a bactericidal agent. Bowman Gray School Med. Alumni News. February 1972; 14:1.
20. Wilkinson JM, Cavanagh HM. Antibacterial activity of 13 honeys against Escherichia coli and Pseudomonas aeruginosa. J Med Food. 2005 Spring;8(1):100-3.
21. Stephen-Haynes J. Evaluation of a honey-impregnated tulle dressing in primary care.
Br J Community Nurs. 2004 Jun;Suppl:S21-7.
22. Ueno Y, Kizaki M, Nakagiri R, Kamiya T, Sumi H, Osawa T. Dietary glutathione protects rats from diabetic nephropathy and neuropathy. J Nutr. 2002 May;132(5):897-900.
23. Hansen JC, Gilman AP. Exposure of Arctic populations to methylmercury from consumption of marine food: an updated risk-benefit assessment. Int J Circumpolar Health. 2005 Apr;64(2):121-36.
24. Lindh U, Hudecek R, Danersund A, Eriksson S, Lindvall A. Removal of dental amalgam and other metal alloys supported by antioxidant therapy alleviates symptoms and improves quality of life in patients with amalgam-associated ill health. Neuro Endocrinol Lett. 2002 Oct-Dec;23(5-6):459-82.