Vitamin B12 plays an important role in the formation of red blood cells, for neurological health and the production of DNA. B12 injections are available and indicated for people who cannot maintain diet-bound blood serum levels of B12. Foods rich in B12 include beef liver, clams and fortified cereal and milk. Anemia, fatigue, weakness, weight loss and loss of appetite are a few of the symptoms of a B12 deficiency.

B-12 Supplementation is good for the following conditions:

  • Lack of Energy or Fatigue
  • Weakness
  • Nervous System Health
  • Weight Loss
  • Anemia
  • Intestinal Malabsorption
  • Stomach Reduction Surgery
  • Vegetarians
  • Gastrointestinal Disorders

Orthomolecular Nutrition & Wellness offers different forms of B12, Cyanocobalamin, Hydroxocobalomin, Adenosylcobalamin and Methylcobalamin.

Deficient in vitamin B12? Trying to decide on a B12 supplement?

Cyanocobalamin, hydroxocobalamin, methylcobalamin, adenosylcobalamin, what form is best? The better question is what combination is best.

With vitamin B12 playing a vital role in the formation of healthy blood cells, energy production, nervous system, cognitive function and homocysteine regulation, it is important to supplement with the right form and combination for bioavailability and absorption.

One of the forms of B12 that is readily available and inexpensive is cyanocobalamin. However, it is synthetic and requires methylation to be utilized and eliminated from the body. The irony is that many people supplement with B12 for the express purpose of supporting methylation.

So what about hydroxocobalamin?

Hydroxocobalamin is a natural form of B12, attached to a hydroxyl group and if your body easily converts hydroxocobalamin to the active forms of B12 then this may be all you need to supplement a B12 deficiency. However, for those who need help in the conversion process or have methylation or neurological dysfunction then methylcobalamin and adenosylcobalamin will likely be required.

The European Journal of Clinical Nutrition concluded that the best way to address a B12 deficiency is the combination of the active forms MeCbl and AdCbl,


The active coenzyme forms of B12, methylcobalamin and adenosylcobalamin bypass usual mechanisms of absorption that rely on intrinsic factor.

The combination is effective in addressing both the neurological and haematopoietic pathways.

Methylcobalamin is found in the cytosol of cells and interacts with an enzyme called methionine synthase; a critical enzyme involved in DNA synthesis and may be particularly useful for individuals with impaired methylation capacity.

Adenosylcobalamin is the mitochondrial form of the B12 vitamin found in cellular tissues and interacts with an enzyme called methylmalonyl CoA mutase, a metabolic enzyme, and may be useful for those with impaired energy production.

Methylcobalamin and adenosylcobalamin have different functions thus providing a total solution for those with B12 deficiency

Methylcobalamin is an activated form of B12 which is involved in more metabolic functions than cyanocobalamin and requires no conversion by the body prior to use, unlike the Cyanocobalamin B12 that the majority of clinics offer.

Intravenous Nutrient Therapy: the “Myers’ Cocktail”

Dr. Alan Gaby


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 reviews the relevant published clinical research, describes the author’s clinical experiences, and discusses potential side effects and precautions. (Alternative Medical Review 2002;7(5):389-403)


John Myers, MD, a physician from Baltimore, Maryland, pioneered the use of intravenous (IV) vitamins and minerals as part of the overall treatment of various medical problems. The author never met Dr. Myers, despite living in Baltimore, but had heard of his work, and had occasionally 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 injections 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 treatments; however, the problems would recur if the patients went too long without an injection.

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 hydrochloric acid. The exact doses of individual components 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.

Intravenous administration of magnesium, by producing a marked, though transient, increase in the serum concentration, 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 improvement 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.

The author took over the care of Myers’ patients, using a modified version of his IV regimen. Most notably, the magnesium dose was increased by approximately 10-fold by using 20-percent magnesium chloride, in order to approximate the doses reported to be safe and effective for the treatment of cardiovascular disease.  In addition, the hydrochloric acid was eliminated and the vitamin C was increased, particularly for problems 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 clinical conditions, often producing dramatic results. Over an 11-year period, approximately 15,000 injections were administered in an outpatient setting to an estimated 800-1,000 different patients. Conditions that frequently responded included asthma attacks, acute migraines, fatigue (including 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 enhanced 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 medical 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 lectern 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 reports, 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 published clinical research, describes personal clinical experiences using the Myers’, and discusses potential side effects and precautions. May I take oral vitamin C (ascorbic acid) and get the same results as IV vitamin C? Oral ascorbic acid is a vitamin whose absorption and uptake is tightly controlled and is an antioxidant. Intravenous administration of vitamin C attains plasma and tissue level concentrations many times above oral dosing.  The high level of vitamin C allows the development of hydrogen peroxide in the tissues, (which means it is working as a pro-oxidant not an antioxidant like the oral form).

Theoretical Basis for IV Nutrient Therapy

Intravenous administration of nutrients can achieve serum concentrations not obtainable with oral, or even intramuscular (IM), administration. For example, as the oral dose of vitamin C is increased progressively, the serum concentration of ascorbate tends to approach an upper limit, as a result of both saturation of gastrointestinal absorption and a sharp increase in renal clearance of the vitamin.3 When the daily intake of vitamin 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 administration 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 exert pharmacological effects, which are in many cases dependent on the concentration of the nutrient. For example, an antiviral effect of vitamin C has been demonstrated at a concentration of 10-15 mg/dL, 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 effect in vivo. Such an effect would have implications for the treatment of various allergic conditions.

Magnesium ions promote relaxation of both vascular and bronchial smooth muscle – effects that might be useful in the acute treatment of vasospastic angina and bronchial asthma, respectively. It is likely these and other nutrients exert additional, as yet unidentified, pharmacological effects when present in high concentrations.

In addition to having direct pharmacological effects, IV nutrient therapy may be more effective 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 magnesium concentration in myocardial cells is 10 times higher than the extracellular concentration. This ratio is maintained in healthy cells by an active-transport system that continually pumps magnesium ions into cells against the concentration gradient. In certain disease states, the capacity of membrane pumps to maintain normal concentration gradients may be compromised. In one study, the mean myocardial magnesium concentration was 65-percent lower in patients with cardiomyopathy than in healthy controls, implying a reduction 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 failure and lead to a vicious cycle of further intracellular magnesium loss and more severe heart failure.


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