IV Therapy Protocols in Functional Medicine
The gastrointestinal tract is a magnificent, tortuous obstacle course. Oral vitamin C achieves maybe 20% bioavailability — your enterocytes have saturable sodium-dependent transporters (SVCT1) that impose a hard ceiling.
IV Therapy Protocols in Functional Medicine
Why Bypass the Gut
The gastrointestinal tract is a magnificent, tortuous obstacle course. Oral vitamin C achieves maybe 20% bioavailability — your enterocytes have saturable sodium-dependent transporters (SVCT1) that impose a hard ceiling. Oral magnesium? Half of it pulls water into the colon before your cells see a molecule. For someone with SIBO, leaky gut, celiac damage, or gastroparesis, that already-poor absorption drops further into the basement.
Intravenous therapy bypasses every gate. One hundred percent bioavailability. The nutrient hits the bloodstream, reaches plasma concentrations impossible through oral routes, and bathes every cell directly. This is not about luxury — it is about clinical necessity when the gut is compromised, when deficiencies are severe, when supraphysiologic doses create pharmacologic effects impossible through food or capsules.
The IFM matrix recognizes that assimilation and elimination are foundational nodes. When the assimilation node is broken, IV therapy becomes bridge medicine — keeping the patient alive and functional while you repair the gut underneath.
The Myers’ Cocktail: Where It All Began
John Myers MD, a Baltimore physician, spent the last 25 years of his practice pushing a cocktail of vitamins and minerals intravenously into patients who had failed everything else. When he died in 1984, his patients sought out Alan Gaby MD, who reverse-engineered the formula and published the first formal protocol in 2002 (Alternative Medicine Review).
Standard Myers’ Cocktail Composition:
- Magnesium chloride: 2-5g (muscle relaxation, vasodilation, enzyme cofactor for 300+ reactions)
- Calcium gluconate: 1-2g (nerve conduction, counterbalances magnesium-induced hypotension)
- B-Complex: Thiamine (B1) 100mg, Riboflavin (B2) 2mg, Niacinamide (B3) 100mg, Dexpanthenol (B5) 250mg, Pyridoxine (B6) 100mg
- Hydroxocobalamin (B12): 1-5mg (superior to cyanocobalamin — longer tissue retention, no cyanide moiety)
- Vitamin C: 5-15g (antioxidant, immune, collagen cofactor)
Infusion: 50-100mL total volume in normal saline or sterile water. Slow IV push over 15-20 minutes or drip over 30-45 minutes. Taste of vitamins in the mouth during push is normal (the B vitamins hit circulation fast).
Indications: Chronic fatigue, fibromyalgia, migraine (acute and prophylactic), acute asthma exacerbation, seasonal allergies (anecdotally dramatic during allergy season), acute viral illness (URI, flu), athletic recovery, depression (the B-vitamin and magnesium effect on neurotransmitters), chronic sinusitis.
Frequency: Weekly for 4-8 weeks as loading phase, then monthly maintenance. Some patients with chronic fatigue need biweekly indefinitely. Gaby reported treating thousands of patients with consistent reproducible results.
High-Dose Intravenous Vitamin C (IVC)
At oral doses, vitamin C is an antioxidant. At intravenous doses of 25-100 grams, it becomes something fundamentally different — a pro-oxidant that generates hydrogen peroxide selectively in diseased tissue.
Mechanism: At plasma concentrations above 350-400 mg/dL (achievable only via IV — oral maxes out around 9 mg/dL), ascorbate donates electrons to free iron in the tumor microenvironment. The Fenton reaction produces H2O2. Normal cells neutralize this with catalase. Cancer cells, which are typically catalase-deficient, cannot — the peroxide destroys them from within. This selectivity is elegant.
The Riordan Protocol (Cancer Support): Hugh Riordan MD at the Center for the Improvement of Human Functioning developed the IVC protocol for cancer:
- Start 15g, escalate to 25g, 50g, 75g, up to 100g over sequential sessions
- Target plasma level: 350-400 mg/dL (check peak plasma ascorbate during infusion to calibrate dose)
- Frequency: 2-3 times per week during active treatment
- Duration: Throughout conventional treatment course and beyond
- Supportive, not standalone — complements chemotherapy and radiation (Chen 2008, Monti 2012)
Infection Protocols:
- Acute viral (EBV, influenza, COVID): 25-50g, 1-3 sessions during acute illness
- Chronic infections (Lyme support): 25-50g weekly as part of comprehensive protocol
- Pre-surgical immune optimization: 25-50g 1-2 days before surgery
Critical Safety Screening:
- G6PD deficiency: MUST screen before first IVC. Glucose-6-phosphate dehydrogenase deficiency (affects 400 million people worldwide, especially Mediterranean, African, and Southeast Asian descent) means red blood cells cannot handle oxidative stress. High-dose C causes acute hemolytic anemia. Quantitative G6PD assay required.
- Renal function: High-dose C increases oxalate load. Check eGFR, creatinine. Relative contraindication in renal insufficiency.
- At doses above 25g: Use sterile water, not normal saline. Osmolality of high-dose C in saline becomes dangerously hyperosmolar.
- Infusion rate: 0.5-1g per minute maximum. Faster causes osmotic shifts and patient discomfort.
Glutathione IV/Push
Glutathione — the tripeptide (glutamate-cysteine-glycine) that guards every cell in the body. The master antioxidant, the phase II conjugation workhorse, the heavy metal chelator, the immune modulator. You cannot be well without it, and modern life depletes it relentlessly.
Oral glutathione is notoriously poorly absorbed — peptidases in the gut cleave it before absorption. Liposomal glutathione helps (Sinha 2018 showed 30-35% increase in body stores over 6 months), but for acute clinical needs, IV or direct push delivers the molecule intact.
Protocol:
- Dose: 600-2000mg direct IV push over 10-15 minutes, or added to the tail end of a Myers’ infusion
- Starting dose for toxic patients: 200-400mg (LOW — this is critical)
- Escalate by 200mg per session as tolerated
Why start low: Glutathione mobilizes toxins. In a patient loaded with mold mycotoxins, heavy metals, or chemical exposures, a large glutathione dose can trigger a Herxheimer-like redistribution reaction — headache, fatigue, brain fog, nausea, body aches. The toxins move faster than the elimination pathways can clear them.
Indications:
- Detoxification support: Mold/mycotoxin illness, chemical sensitivity, post-heavy metal chelation
- Parkinson’s disease: Hauser 2009 study — IV glutathione 1400mg three times weekly improved UPDRS motor scores significantly. The dopaminergic neurons of the substantia nigra are exquisitely vulnerable to oxidative damage.
- Liver support: Non-alcoholic fatty liver, hepatitis, post-medication liver stress
- Immune modulation: Enhances NK cell function, supports T-cell proliferation
- Brain fog and cognitive decline: Crosses blood-brain barrier poorly but IV achieves higher CNS levels than oral
- Post-chelation: Replenish what chelation depletes
Critical warning: Do NOT administer glutathione during active IV chelation (EDTA, DMPS). Glutathione can redistribute metals — pulling them from storage but depositing them in vulnerable tissues like the brain. Complete the chelation session, allow clearance, then give glutathione 24-48 hours later.
NAD+ Intravenous Therapy
Nicotinamide adenine dinucleotide — the coenzyme present in every living cell, the electron carrier that makes ATP production possible, the substrate for sirtuins (the longevity enzymes) and PARPs (DNA repair enzymes). NAD+ levels decline 50% between ages 40 and 60. This decline correlates with essentially every marker of aging.
Mechanism: Restoring intracellular NAD+ levels activates SIRT1-SIRT7 (sirtuin family) → improved DNA repair, reduced inflammation, enhanced mitochondrial biogenesis, improved insulin sensitivity. PARPs use NAD+ to repair DNA strand breaks. CD38 (an NAD+-consuming enzyme that increases with aging) is a major driver of NAD+ depletion.
Protocol:
- Dose: 250-1000mg per session
- Infusion: MUST be slow — 2-6 hours depending on dose and tolerance
- Why slow: Rapid NAD+ infusion causes intense chest tightness, abdominal cramping, nausea, headache. These are not dangerous but extremely uncomfortable. The rate, not the dose, determines side effects.
- Loading phase: 500-750mg daily for 5-10 consecutive days (the “NAD+ reset”)
- Maintenance: Monthly or quarterly 500mg infusions
BR+NAD Protocol (Addiction Recovery): Richard Mestayer III at Springfield Wellness Center developed the Brain Restoration Plus protocol — high-dose NAD+ (750-1500mg/day) for 10 days alongside amino acid therapy for addiction recovery. Published outcomes (2019) showed significant reduction in cravings, withdrawal symptoms, and relapse rates for alcohol, opioid, and stimulant dependence. The rationale: addictive substances deplete NAD+ in reward circuitry. Restoration normalizes neurochemistry faster than abstinence alone.
Indications: Chronic fatigue and ME/CFS, neurodegeneration (Alzheimer’s, Parkinson’s), post-COVID brain fog and fatigue, TBI recovery, addiction recovery, anti-aging and longevity, athletic performance optimization, post-chemotherapy recovery.
Cost reality: $500-1500 per session, with loading phases running $5,000-15,000. This is not accessible medicine for most people. Emerging alternatives: IM NAD+ (lower dose, 100-200mg, faster), SubQ NAD+ (self-administered at home), NAD+ nasal spray, and oral precursors (NMN 500-1000mg/day, NR 300-600mg/day) as maintenance between IV loading phases.
Phosphatidylcholine (PC) IV: The Plaquex Protocol
Every cell membrane in the body is a phospholipid bilayer. Phosphatidylcholine is the most abundant phospholipid — the structural backbone of cellular architecture. When membranes are damaged by toxins, oxidative stress, or aging, cells malfunction. Lipophilic toxins (mold mycotoxins, pesticides, solvents, heavy metals) embed themselves in these lipid membranes and refuse to leave.
The Patricia Kane Protocol (PK Protocol): Patricia Kane PhD developed the phospholipid exchange therapy specifically for neurotoxic illness. The concept: infuse fresh phosphatidylcholine intravenously, and it physically replaces damaged, toxin-laden membrane phospholipids. The displaced toxins enter circulation and are eliminated through hepatic and renal pathways.
Protocol:
- Plaquex solution: 1-3g phosphatidylcholine + essential phospholipids in 250mL normal saline
- Infusion: Slow drip over 1.5-2 hours
- Series: 20-30 sessions, 2-3 times per week
- Often followed by IV glutathione push (to support hepatic conjugation of mobilized toxins)
Indications:
- Mold and biotoxin illness (the PK protocol’s primary domain)
- Fatty liver disease (NAFLD/NASH): PC is the export vehicle for triglycerides out of hepatocytes. Deficiency = fat accumulation. Gundermann 1993 reviewed extensive European data on PC for liver disease.
- Cardiovascular disease: Plaquex was originally developed in Europe for atherosclerotic plaque regression. Reduces LDL oxidation, improves endothelial function.
- Neurological conditions: MS, peripheral neuropathy, cognitive decline — all involve membrane integrity
- Post-chemotherapy: Chemo damages every membrane it contacts
- Chemical sensitivity and multiple chemical sensitivity syndrome
Alpha-Lipoic Acid (ALA) IV
Alpha-lipoic acid occupies a unique niche — it is both water-soluble and fat-soluble, making it the only antioxidant that operates in every compartment of the cell. It recycles vitamins C and E, regenerates glutathione, and chelates heavy metals (weakly but usefully).
Protocol:
- Dose: 300-600mg in 100-250mL normal saline
- Infusion: 30-60 minutes
- Frequency: 1-3 times per week depending on indication
Primary evidence — Diabetic Neuropathy: The ALADIN trial (Alpha-Lipoic Acid in Diabetic Neuropathy, Ziegler 1995) and SYDNEY trial (2003) demonstrated that IV ALA 600mg daily for 3 weeks significantly reduced neuropathic pain, burning, paresthesia, and numbness compared to placebo. Effect sizes were clinically meaningful. This is one of the strongest evidence bases for any IV nutrient therapy.
Other indications: Heavy metal support (ALA crosses the blood-brain barrier — important for mercury detoxification, but must be dosed carefully per Andrew Cutler’s protocol to avoid redistribution), liver support (amanita mushroom poisoning treatment protocol includes IV ALA alongside IV silibinin), and metabolic syndrome (improves insulin sensitivity).
IV Ozone: Major Autohemotherapy (MAH)
Ozone — three atoms of oxygen — seems paradoxical as medicine. It is a potent oxidizer. But the principle of hormesis governs its therapeutic use: a controlled oxidative challenge triggers an adaptive response that leaves the organism stronger.
MAH Protocol:
- Draw 100-250mL venous blood into heparin-anticoagulated vacuum bottle
- Expose blood to precise O3/O2 mixture at 20-60 gamma (mcg/mL of gas per mL of blood)
- Gently mix — blood changes from dark venous to bright arterial red
- Reinfuse over 20-30 minutes
Mechanism: The ozone reacts instantly with blood components, generating ozonides (lipid oxidation products — LOPs) that act as secondary messengers. These LOPs activate Nrf2, upregulate glutathione, superoxide dismutase, and catalase. They improve 2,3-DPG in red blood cells (enhancing oxygen delivery to tissues), stimulate cytokine production (immune modulation), and improve mitochondrial respiration.
Indications: Chronic infections (Lyme disease, reactivated EBV, mold illness, hepatitis C), autoimmune conditions, cardiovascular disease (peripheral vascular disease, coronary artery disease), chronic fatigue/ME/CFS, post-COVID syndrome, wound healing, cancer adjunctive support, anti-aging.
Other ozone routes:
- Rectal insufflation: 100-400mL humidified O3 at 20-30 gamma. 65-70% systemic bioavailability compared to MAH. Can be performed at home with a medical-grade ozone generator. Daily or every other day.
- Ozonated water: Drinking O3-bubbled water within 20 minutes for GI infections — H. pylori, Candida, SIBO.
- Prolozone (Shallenberger): Ozone injected directly into joints — combines proliferative therapy with ozone’s regenerative properties.
- 10-Pass Hyperbaric Ozone (Lahodny 2016): Ten cycles of draw-ozonate-reinfuse in a single session using specialized hyperbaric equipment. Much higher total ozone dose. Reserved for severe chronic infections, advanced Lyme, autoimmune, cancer support. Sessions last 1-2 hours.
Absolute contraindication: G6PD deficiency — ozone causes hemolysis in G6PD-deficient red blood cells. Screen every patient before first treatment.
Safety: The Non-Negotiable Foundation
All IV therapy is physician-supervised medicine. The nutrients may be natural, but the delivery route — directly into the bloodstream — demands medical rigor.
Baseline screening before any IV program:
- G6PD quantitative assay (before high-dose vitamin C or ozone)
- Complete metabolic panel (renal function, electrolytes, liver enzymes)
- CBC with differential
- Hepatic function panel
Facility requirements:
- Anaphylaxis kit immediately available (epinephrine, diphenhydramine, dexamethasone, oxygen)
- Compounding pharmacy with USP 797 compliance (sterility standards)
- Trained nursing staff for IV access, monitoring, and adverse reaction management
- Written informed consent addressing risks, benefits, alternatives
Monitoring during infusion: Vital signs at baseline, midpoint, and completion. Watch for: hypotension (magnesium-induced vasodilation), flushing, chest tightness (NAD+), taste changes (normal with B vitamins), and very rarely, anaphylactoid reactions to preservatives in compounded solutions.
The goal is always the same — repair the terrain, restore the matrix, give the body what it needs to heal itself. IV therapy is the express lane when the regular roads are washed out. Use it wisely, use it safely, and always be building the road back to oral self-sufficiency.