Migraine Treatment: Intravenous Micronutrient Therapy (IVMT)
Intravenous Micronutrient Therapy (IVMT) is an old treatment that is finding resurgence in helping some painful health conditions including fibromyalgia and autoimmune conditions. Although it’s been used for a long time under the name Modified Myers Cocktail, it is not well known. There is evidence pointing to its effectiveness in inflammatory and pain conditions as well as other common problems often comorbid with Migraine, yet it is still considered experimental. Dr. Katz of Yale University and Dr Alan Gaby have collectively written most of the reliable information online about the therapy.
Migraine patients are usually aware that the vast majority of medications and techniques they will try to gain better management over their condition weren’t actually created to help their Migraines, but another health condition entirely.
We use medicines for blood pressure, depression, even epilepsy as we try to gain control over our lives again. Sometimes these medicines are helpful, and sometimes they backfire. Rarely, they can result in serious problems.
Reading the labels of these medicines is scary for most patients as they wonder, “Am I going to be one that has a serious problem with this drug?” or “Will this change my life for the better, or for the worse?”
IVMT is probably not typically used specifically to treat Migraine because not many doctors know about it.
What is IVMT?
IVMT is the therapeutic, regular and frequent infusion of micronutrients directly into the body. These nutrients include vitamins, minerals, amino acids and anti-oxidants. The purpose is to create levels within the body that normally wouldn’t be possible any other way than intravenously.
It’s not well understood why IVMT sometimes works for patients. Some doctors think that particular patients have an inborn inability to process some of these nutrients properly and this can result in physiological problems with some of our systems including our immune system which controls inflammation. Sometimes patients can’t tolerate the nutrients orally and may have absorption or other problems that make them deficient. When it does work, it often results in significant results that can keep the patient off more serious and potentially harmful medicines.
IVMT is not commercially available. It must be compounded by prescription and by a special pharmacy within a few hours of its use. It contains several vitamins and minerals that have been found to be helpful in high doses as a preventive or abortive for some Migraine patients.
The recipe for IVMT is:
- 5ml Magnesium chloride hexahydrate 20%
- 3ml Calcium gluconate 10%
- 1ml Hydroxocobalamin (1000 mcg/ml)
- 1ml Pyridoxine hydrochloride 100 mg/ml
- 1ml Dexpanthenol 250mg/ml
- 1ml B complex 100 (Thiamin, Riboflavin, Pyridoxine, Panthenol, Niacinimide, Benxyl Alcohol)
- Vitamin C 500 mgs/ml
- 20ml sterile water
Some reasons to consider IVMT
Intravenous magnesium is long known to be helpful in a number of health conditions, including Migraine. In fact, we know that many Migraine patients are actually deficient in magnesium tissue levels. Many patients are able to get their levels up by taking magnesium orally, but for those who can’t, regular infusions of magnesium are sometimes helpful for their Migraines.
Riboflavin (B2) is used by headache and Migraine specialists as a preventive for Migraine. Unfortunately, it can result in increased light sensitivity.
Niacin is used by some patients to help their Migraines. Niacin in large doses can cause flushing that some hypothesize shunts blood to the periphery causing a reduction in pain for those with a vascular component to their Migraines.
The combination of B3, B6, magnesium and tryptophan are building blocks in the production of serotonin and are used to treat serotonin deficiency. Serotonin is known to play a role in Migraine pathogenesis.
B12 is necessary for hundreds of chemical reactions in the body, and influences our metabolism. It’s also necessary for neurological health and maintenance of our nerves. Low B12 levels can result in increased homocysteine levels which are found more frequently in Migraine patients than non-Migraineurs.
How is IVMT administered?
The pharmacy will custom mix IVMT into a small bag that is infused intravenously over a period of 30 – 60 minutes, usually in an infusion center or doctor’s office. Another normal saline bag may be piggy-backed, and any remaining nutrients will be flushed into the patient before the line is removed. Some offices prefer to use a syringe to slowly infuse the patient. Patients with minor side effects are often infused over a longer period of time, or the nutrients are further diluted.
Protocol includes weekly loading doses for one to two months, followed by bi-weekly or monthly infusions thereafter.
Are there side effects?
Yes. Anything with the potential to help us also has the potential to hurt us. Just because these are nutrients we eat in our food every day doesn’t mean they are safe in high doses.
Potential side effects include:
- A sensation of spreading heat
- Visual changes lasting from minutes to days
- Hypotension resulting in lightheadedness, fainting
- Vasovagal reactions (fainting without hypotension)
- Low potassium
- Anaphylatic reactions
- Pain in the infused limb during infusion
- Bad *vitamin taste* in the mouth during infusion
- Transient bad *vitamin breath* and mildly increased body odor
Are there contraindications to IVMT?
Yes. Those with potassium problems, certain cardiac problems, or taking specific medications may not be able to use IVMT safely. Others will need smaller doses and stricter monitoring to be sure no side effects occur. Just like other medicines, some patients will not be able to utilize IVMT at all.
Does insurance cover IVMT?
Sometimes. Some companies will see the wisdom in treating with this fairly inexpensive, safe option vs. other more serious medications and treatments. Still others will pay for the treatment so long as a doctor administers it, or during a doctor’s office visit, but only when the patient pays for the prescription.
How much does IVMT cost?
The cost of IVMT will vary greatly. The actual cost of the ingredients is in the range of $5 - $25, however there is often a charge for the compounding if your doctor doesn’t mix them at the office. Ingredients without additives or preservatives may be more expensive. The infusion charge is often separate, as is the office visit. There may be other charges as well. Charges tend to be higher at infusion centers and hospitals.
How can I get IVMT?
A doctor must prescribe IVMT. Although your own physician may not know about IVMT, you might want to start by asking about the process itself. Asking to trial the process is often successful, but may take some time to implement if your doctor is unfamiliar with it. It’s much easier if your doctor works in concert with a local compounding pharmacy or you can refer your doctor to another who is utilizing the protocol. You can find a doctor who uses IVMT by contacting compounding pharmacies who are usually helpful when asked about doctors who prescribe specific compounded medicines.
How much has your migraine disease changed or evolved over time?