Accelerating healing and clinical results with IV nutrition therapy
Hippocrates said, “The natural forces within us are the true healers of disease,” quoted Andrew Wong, MD, IFMCP, at the 2022 Integrative Healthcare Symposium in New York City.
“Through IV nutrient therapy, we can activate a person’s innate active healing mechanisms.”
In his presentation, Wong, co-founder of Capital Integrative Health in Bethesda, MD, described five key reasons to consider IV nutrition therapy. The first, and most obvious reason, was that it provides nutrients, particularly for patients struggling with gut malabsorption. He also explained that nutrition therapy boosts the immune system, improves energy and mood through by triggering ATP production with micronutrients. and improves metabolic health by increasing metabolic flexibility. Finally, Wong said the therapy has been shown to accelerate healing especially with complex patients.
Wong began with a real-life IV nutrient case study of a 56-year-old woman suffering from chronic insomnia. Lynn, his patient, had a problem with sugar and a with a BMI of 33. In addition, she had been diagnosed with stress, anxiety, and depression.
After her initial infusion of an IV immunoboost cocktail (vitamin B complex, vitamin B12, magnesium, vitamin C, glutathione) and zinc, Lynn’s sleep, mood, energy, gut health, and allergies improved. About three to four weeks later, the effects of the IV nutrients wore off but Lynn continued to get IV immunoboosts periodically over the course of a year while she worked to better her diet, lifestyle, and stress levels.
According to Wong, Lynn’s story demonstrated the potential of IV nutrient therapy to accelerate healing and clinical results for patients suffering from nutrient malabsorption or imbalances that require rapid relief. He said the intervention is so effective because it uses an intravenous delivery of nutrients directly into the vein that goes right to the bloodstream, providing nutrients to the cells.
Some practitioners are weary around the safety of IV nutrition therapy. Surrounding the regulatory framework of IV nutrition therapy, Wong explained informed consent is essential. A doctor must explain the benefits as well as risks and alternatives to their patients before beginning treatment. Wong also said that IV nutrients are considered prescription drugs but approved by the FDA on for certain indictations. For instance, IV vitamin C is FDA-approved for the treatment of scurvy, however the correct language when using IV vitamin C for other conditions is to say it supports the immune system.
“If the patient was a pirate and had scurvy you could say, ‘hey I’m going to treat you with IV therapy’ but for other things it’s considered of off label,” said Wong.
Wong advised practitioners to use caution when treating patients with liver, kidney, or heart failure. He also said those suffering from a G6PD deficiency should take no more than 15 grams of vitamin C. When treating cancer patients with IV nutrition, Wong said practitioners must first consult their medical oncologist.
“You always want to keep your medical bridges with people outside of your practice,” said Wong.
Finally, he said doctors should always be screening their patients for COVID-19 symptoms prior to IV nutrition therapy.
Next, Wong detailed the four key IV nutrients including, glutathione (GSH), ascorbic acid (vitamin c), nicotinamide adenine dinucleotide (NAD+), and phosphatidylcholine (PC). These nutrients, according to Wong, are meant to be used together.
“Monotherapy is not the answer. These four IV nutrients all dance together in a symphony,” Wong stated.
Glutathione is considered the “master antioxidant,” according to Wong. It’s found in nearly every cell in the body at the same concentration of other important compounds like glucose, cholesterol, and potassium. One of the main roles of glutathione is to help reduce oxidative stress, helping to promote anti-aging. It also helps with DNA synthesis and immune function as well as homeostasis of nitric oxide, which helps keep arteries open. In addition, it assists in the use of glucose inside the cell and detoxification.
As for the clinical implications of glutathione, Wong talked about how acute and chronic viral infections as well as autoimmune disease have been associated with glutathione depletion. Wong explained that small pilot studies have so fair shown that IV glutathione can be effective when combined with other interventions and lifestyle changes. He said it’s usually given as part of an IV vitamin cocktail, ranging in dosing from 600 to 3,000 milligrams (mg) per dose. He suggested to give the IV infusion for one to two weeks for 10 weeks then review outcomes.
Next, Wong discussed ascorbic acid or vitamin C. Vitamin C was traditionally known to treat scurvy. Vitamin C has a range of physiologic roles. It helps protect glutathione and has its own antioxidant effects as well. Wong explained it helps with chronic infections, reducing oxidative stress, and build up collagen for healthy skin. In addition, Wong said, Vitamin C helps with the process of methylation and improves immune system function.
Vitamin C depletion can be caused by several issues such as oxidative stress and inflammation, hyperglycemia, poor oral intake, and certain medications. Wong explained that IV vitamin C is sometimes more effective than oral use because the bioavailability of the nutrient decreases as the oral dose is increased.
Before using IV vitamin C, Wong cautioned doctors to rule out G6PD deficiency, iron overload, and kidney stones from oxalates. He also said high doses of the IV can induce the release of insulin and instructed doctors to make sure patients eat before had to prevent hypoglycemia.
“I would recommend a high protein meal two hours before the IV,” Wong instructed.
Wong also said a comprehensive metabolic panel (CMP) should be conducted every five to 10 infusions to prevent hypocalcemia and hypokalemia.
Wong then discussed nicotinamide adenine dinucleotide (NAD). NAD is the substance that is needed for the electron transport chain. It helps generate adenosine triphosphate (ATP) for the mitochondria and helps repair the DNA, and in turn, it’s essential for cell survival and cell metabolism.
NAD levels decrease with age and contribute to the aging process. For someone with chronic fatigue or chronic illness, IV NAD can be very helpful, according to Wong. It also can be used for addiction as it mitigates symptoms of withdrawal.
Wong said, although he doesn’t use IV NAD very often in his clinic, in the past he’s administered it in 100 mg increments every hour, with infusions usually lasting between two and six hours. He instructed doctors to begin dosing at 100 mg and increase the dose by 100 mg weeks for a goal of 600 mg IV NAD+.
“A more general rule for IVS is that you want to start low and slow,” Wong said.
Common side effects of NAD IV include nausea and flushing, he added.
Finally, Wong discussed phosphatidylcholine (PC). He described it as the most important phospholipid in the body. Phospholipids are molecules that contain two fatty acids, a glycerol backbone, and a phosphate group modified by an alcohol. They are essential for healthy cell membranes.
According to Wong, health of one’s cell membranes determines the health of their body as a whole. He explained that cell membranes increase the amount of nutrients that enter the cell and increased excretion of toxins outside of the cell.
While oral PC helps with increasing cell nutrients and detoxification, according to Wong, some of the PC gets broken down into choline for phase two liver detox. As a result, Wong suggests a combination of both oral and IV PC which can be used for a range of neurologic conditions. In addition, Wong said PC is effective for treating metabolic syndromes.
Wong explained those with gallbladder dyskinesia/cholecystectomy or an active/historical cancer diagnosis, especially breast, colon ovarian or prostate cancer, should should be cautious and weigh risks and benefits if considering IV PC. He said it should be administered in D5W to avoid extravasation of the vein. Wong instructed doctors to start with a 250 to 500 mg dose of PC which can be increased to 2,500 mg. He said treatments should typically last five to 10 weeks before reassessment.
To end his presentation, Wong described a case study dealing with a patient suffering from long-haul COVID-19 in which he prescribed IVs of glutathione, vitamin C, and PC, in addition to other interventions. After doing so, the patients energy was improved from a four out of 10 to a seven out of 10.
Wong said each of the four key IV nutrients he discussed can be used in treating long-haul COVID-19.
Offering a bit of hope, Wong concluded with a Helen Keller quote, stating, “Although the world is full of suffering, it is also full of the overcoming of it.”