Myers' Cocktail

Attribution to John Myers

The formula takes its name from John Myers, a physician. The only account of its origin in the sources opened is the abstract of a 2002 paper by Alan Gaby, who writes that he built on the work of the late John Myers, MD, and used what he called a modified Myers' cocktail, consisting of magnesium, calcium, B vitamins and vitamin C. The sources reviewed do not give the dates, location or original composition of Myers's own work, and none of them is a primary account by Myers.

Publication and later use

Gaby's paper appeared in Alternative Medicine Review in October 2002 and was indexed as a case-report style article. It presented a rationale, a review of published research, the author's clinical experience and a discussion of side effects and precautions. A controlled pilot study followed in 2009. The Merck Manual professional edition describes the cocktail as a popular formula among complementary and alternative medicine providers and notes that medical spas have popularized intravenous multivitamin therapy more generally.

A statement from the American College of Clinical Pharmacology (ACCP) describes a recent proliferation of wellness clinics offering on-site and mobile intravenous hydration and vitamin infusions, and says the number of such clinics is not tracked at federal or state level in the United States.

Names and formulations

The term Myers' cocktail is used both for the specific mixture Gaby described and, loosely, for related vitamin and mineral infusions. The 2009 fibromyalgia trial calls the approach intravenous micronutrient therapy (IVMT). The Merck Manual lists the contents as B vitamins, vitamin C, magnesium and calcium, with named forms of vitamins B12, B6 and B5, mixed with sterile water. The ACCP notes that the mixtures given are not standardized, and that the source, potency and purity of the vitamins used are not clear.

Related terms and Machipedia pages

The Merck Manual distinguishes the cocktail from a banana bag, a multivitamin infusion containing thiamine, folic acid, magnesium and a multivitamin, which clinicians use in routine care for suspected undernutrition, for example in people who drink large amounts of alcohol over long periods. Machipedia describes the wider family on its IV Therapy page. Related Machipedia pages include IV Hydration Therapy, High-Dose Intravenous Vitamin C, Intravenous Glutathione, NAD+ IV Therapy, Nutritional Therapy and Chelation Therapy, which are separate practices with their own evidence.

What the infusion is

The Merck Manual describes intravenous vitamin therapy as a way of reaching rapid, high blood levels of vitamins. The fibromyalgia trial used an infusion of the mixture given by an infusion nurse, with lactated Ringer's solution as the placebo. This page does not describe quantities, rates, preparation or administration, because the sources reviewed are not clinical protocols and the page is information only.

Settings and who delivers it

The ACCP states that treatments in wellness clinics can cost from about $100 for hydration to $300 to $600 for vitamin infusions. It says that in most US states a doctor or nurse practitioner must supervise the administration of an infusion, that some wellness centers have physician oversight and some do not, and that there are reports of unqualified individuals administering infusions. In the 2009 trial the infusions took place at an integrative medicine center affiliated with a teaching hospital.

Professional body statement on delivery

The ACCP position statement recommends that hydration and vitamin infusions be given with physician approval for a valid medical reason, by an appropriately licensed and trained individual such as a doctor or nurse, and compounded by a licensed pharmacist. It also recommends that immediate emergency care be available on the premises, that patients sign informed consent listing the risks, that the primary care provider be coordinated with and follow-up be arranged, and that adverse reactions be reported. These are the statement's recommendations, not a description of common practice. The sources reviewed do not describe a training standard specific to the Myers' cocktail.

Uses described by Gaby

Gaby's 2002 abstract reports that the modified cocktail was 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 is the author's own conclusion from his clinical experience and reviewed reports, and the abstract does not describe a controlled comparison.

Claims in wellness marketing as summarized by reviewers

The Merck Manual lists claims made by advocates of intravenous vitamin therapy, including treating dehydration from exercise or alcohol, boosting immunity, increasing energy, relieving stress, anxiety and depression, eliminating toxins, improving skin, and treating conditions such as asthma, allergies, sinusitis, fibromyalgia, heart disease and migraine. The ACCP says companies advertise that infusions boost the immune system, increase energy and treat everything from colds to hangovers without supportive data. Both are summaries of what promoters say, not findings.

The fibromyalgia pilot trial

Ali and colleagues published a randomized, double-blind, placebo-controlled pilot study in 2009 of adults with fibromyalgia as defined by the American College of Rheumatology. Participants received weekly infusions of the mixture or lactated Ringer's solution for 8 weeks. The analysis included 34 adults (16 in the treatment group and 18 in the placebo group), and the primary outcome was change in the Tender Point Index. The study was funded by US federal research grants.

The authors report no statistically significant differences between groups on any outcome measure at 8 and 16 weeks, in part because of a high placebo response and the small sample. Both groups improved compared with baseline. They state that the efficacy of the therapy for fibromyalgia relative to placebo is uncertain. Limits they name include the small sample, and participants who were mostly middle-aged white women.

Gaby's case-based paper

Gaby's 2002 paper is a single-author article combining a rationale for intravenous nutrients, a review of published research and the author's clinical experience. It is indexed as case reports and is not a controlled trial. The abstract available in PubMed does not give the number of patients, comparison groups or outcome measures, and the full text could not be opened for this page, so its findings cannot be summarized beyond the abstract.

Reviews and professional statements

The Merck Manual states that there is insufficient scientific evidence that intravenous vitamin therapy has the beneficial effects listed by advocates or is effective for treating any disease. The ACCP statement says there is little evidence of benefit because of a lack of clinical trial data, except for some specific therapeutic situations. It adds that even in vitamin deficiency there is no evidence that infusion is superior to oral administration, that the Myers' cocktail has been tried in fibromyalgia unsuccessfully, and that it concludes there is little to no evidence that the benefits outweigh the risks.

PubMed searches run for this page for the Myers' cocktail, intravenous micronutrient therapy and fibromyalgia, asthma, migraine and fatigue found the Ali trial and Gaby's paper as the only items specific to the formula. They did not identify controlled trials of the full mixture in migraine, asthma or fatigue, or a systematic review of it. A 2020 Canadian health technology report cited by the Merck Manual could not be opened. Evidence on single nutrients given in hospital for diagnosed conditions is a different question and is not evidence for the elective mixture.

Harms reported in professional statements

The ACCP describes numerous accounts of adverse events from hydration and vitamin infusions, ranging from relatively minor infusion-site reactions to thrombophlebitis, cellulitis, hematoma and blood clots, and also fungal infection and septic shock. It notes that side effects often develop in the days after the infusion, when there is no medical oversight. It also states that there are no standards for preparing the administered product and cites infection risk from contamination.

The Merck Manual reports that infusions given to people with abnormal magnesium or potassium levels can cause arrhythmias or muscle weakness, that rapid infusion can lower blood pressure and cause light-headedness or fainting, and that some people have a rise in blood pressure. It also lists depression, insomnia and upset stomach, and reports death from infections introduced into the bloodstream from contaminants due to improper equipment sterilization. The sources do not give how often these events occur.

Case reports

A case report describes a 52-year-old woman who developed nausea, vomiting and diarrhea after a naturopathic intravenous vitamin infusion given at her home and was found to have a Pseudomonas fluorescens bloodstream infection. Another describes a 47-year-old man with massive hemolysis and acute kidney insufficiency one day after an infusion of a vitamin complex; the infusion reportedly contained B and D vitamin complexes, amino acids, magnesium and taurine, and he was later found to have reduced G6PD activity. Neither infusion is described as a Myers' cocktail. In the fibromyalgia trial, one treated participant developed dyspepsia, insomnia, depression and raised blood pressure, judged related to treatment, and withdrew.

Conditions, medicines and pregnancy

The ACCP states that people with kidney disease, heart failure, liver disease and cirrhosis may be more sensitive to volume changes, and that both low blood volume and increased fluid balance may contribute to acute kidney injury. The Merck Manual says safety in pregnant and breastfeeding women has not been studied and that interactions depend on what is infused; its examples include vitamin B6 with erythropoiesis-stimulating drugs, magnesium with blood pressure medicines, and calcium with ceftriaxone. A survey of practitioners giving high-dose intravenous vitamin C names kidney impairment and G6PD deficiency as known complications; that study concerns vitamin C alone and not the mixture.

This page is not a substitute for care. Anyone with a medical condition, or who takes regular medicines, should discuss any infusion with their own physician, and symptoms after an infusion call for prompt medical attention.