IV therapy
Myers’ cocktail
The Myers’ cocktail is the oldest and most widely given of the intravenous micronutrient formulations. It is named after John Myers, a physician in Baltimore who gave versions of it from the 1960s onward, and it was standardised in the 1990s by Alan Gaby, who published the formula most clinics still work from: magnesium, calcium, a group of B vitamins and vitamin C, diluted in sterile water and pushed slowly into a vein.
What is in it
Each of these has a defined role in normal physiology. That is a different statement from saying that giving more of it to somebody who is not short of it does anything.
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Magnesium
A cofactor in several hundred enzyme reactions, including those that release energy from food, and a regulator of muscle and nerve excitability. It is the component that decides how fast the infusion can be given: pushed quickly it causes a spreading warmth and can drop blood pressure.
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Calcium
Given as calcium gluconate. Central to muscle contraction, nerve conduction and clotting. Included in the original formula largely to balance the magnesium.
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B vitamins
Thiamine (B1), riboflavin (B2), niacinamide (B3), dexpanthenol (B5), pyridoxine (B6) and hydroxocobalamin or cyanocobalamin (B12). They are coenzymes in the pathways that convert food into usable energy — which is why the word "energy" attaches to them, and why that word is so easily overread.
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Vitamin C
Ascorbic acid. A water-soluble antioxidant and a cofactor for the enzymes that build collagen. The dose in this formula is modest compared with the high-dose vitamin C infusions given separately.
What the session is like
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Given slowly, on purpose
The magnesium sets the pace. Most of the recognisable sensations — warmth spreading through the chest and face, a metallic or vitamin taste at the back of the throat — come from it and from the B vitamins, and they settle if the rate is reduced.
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How long
Usually twenty to forty minutes for the classic formula, seated, with the arm resting.
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Afterwards
Nothing is required. The cannula comes out, pressure is held over the site, and normal activity resumes straight away.
Risks and who should avoid it
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From the magnesium
Flushing, warmth and lightheadedness if the infusion runs quickly, and a fall in blood pressure. People already taking magnesium, and anyone with impaired kidney function, accumulate it.
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From the B vitamins
A harmless bright yellow colour in the urine for a day. Thiamine can very rarely cause a hypersensitivity reaction given intravenously.
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From the vitamin C
A consideration in G6PD deficiency, where it can cause red cell breakdown, and in anyone with a history of kidney stones, because it is metabolised to oxalate.
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When it is not given
Significant kidney disease or heart failure, heart block or other conduction disorders because of the magnesium and calcium, pregnancy and breastfeeding, and any previous reaction to a component.
Common questions
Why does it make me feel warm?
The magnesium. It is expected, it starts in the chest and face within a minute or two, and it settles if the drip is slowed. Tell whoever is giving it rather than waiting for it to pass.
How often is it given?
Protocols vary and no interval is established. What is reasonable is to agree in advance what would count as a reason to continue, and to stop if that has not happened.
Can I get the same thing from tablets?
The same substances, yes, at lower blood levels and more slowly. Whether the higher levels achieved intravenously matter in someone who is not deficient is precisely what is not established.
A wellness service provided under physician supervision. It is not intended to diagnose, treat, cure or prevent any disease. Whether any of it is appropriate for you is decided after an examination — call (201) 408-5151 to ask.
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