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Controlled trial of Myers cocktail for fibromyalgia.

Thirty-four adults with fibromyalgia fibromyalgia

Chronic syndrome that is characterized by musculoskeletal pain, often at multiple sites. The cause is unknown. A significant number of persons with fibromyalgia also have mental disorders, especially depression.
 were randomly assigned to receive, in double-blind fashion, weekly intravenous infusions of vitamins and minerals or placebo (Lactated Ringer's solution lactated Ringer's solution
A solution containing sodium chloride, potassium chloride, calcium chloride, and sodium lactate in distilled water, used for the same purposes as Ringer's solution.
) for eight weeks. The infusions contained 5 ml of 20% magnesium chloride magnesium chloride Warning - High-alert drug!

Chloromag, Mag 64, Mag Delay, Slo-Mag

Pharmacologic class: Mineral

Therapeutic class:
 hexahydrate, 3 ml of 10% calcium gluconate calcium gluconate

Pharmacologic class: Mineral

Therapeutic class: Dietary supplement, electrolyte replacement agent

Pregnancy risk category C
, 1000 mcg of hydroxocobalamin, 100 mg of pyridoxine pyridoxine: see coenzyme; vitamin. , 250 mg of dexpanthenol, 1 mg of B complex 100, 2.5 g of vitamin C, and 20 ml of sterile water, and were infused by slow push (10 minutes). Clinically significant improvements were seen in the tender point index, Fibromyalgia Impact Questionnaire, and Beck Depression Inventory Beck Depression Inventory

A trademark for a standardized questionnaire used to diagnose depression.

Beck Depression Inventory 
 compared with baseline. Because of a high placebo response, the improvements in the active-treatment group were only slightly and nonsignificantly greater than the improvements in the placebo group. The treatment effects of intravenous nutrients persisted at four weeks postintervention for tender points, pain, and quality of life, while placebo effects persisted only for tender points.


Comment: The Myers cocktail is a popular treatment for fibromyalgia, and anecdotal reports indicate that it is highly beneficial (see Gaby AR. Intravenous nutrient therapy: the "Myers' cocktail." Altern Med Rev. 2002;7:389-403). This is the first controlled trial to evaluate the Myers cocktail as a treatment for fibromyalgia. While substantial improvements were seen, active treatment was only nonsignificantiy more effective than placebo, because there was a very strong placebo response. Of note, however, is the improvement in the active-treatment group persisted after treatment was discontinued, whereas most of the benefit wore off after placebo treatment was discontinued. That finding suggests that the Myers cocktail does have a beneficial effect. Placebo responses typically last no longer than three months. It would therefore be worthwhile to conduct a repeat study of longer duration.

Ali A et al. Intravenous micronutrient mi·cro·nu·tri·ent
A substance, such as a vitamin or mineral, that is essential in minute amounts for the proper growth and metabolism of a living organism.
 therapy (Myers' cocktail) for fibromyalgia: a placebocontrolled pilot study. / Altern Complement Med. 2009;15:247-257.

by Alan R. Gaby, MD
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Title Annotation:Literature Review & Commentary
Author:Gaby, Alan R.
Publication:Townsend Letter
Article Type:Report
Geographic Code:1USA
Date:Nov 1, 2009
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