Alan R Gaby
PMID: 12410623
Free article
Abstract
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 the therapeutic use of intravenous nutrients, reviews the relevant published clinical research, describes the author’s clinical experiences, and discusses potential side effects and precautions.

Ather Ali 1, Valentine Yanchou Njike, Veronika Northrup, Alyse B Sabina, Anna-Leila Williams, Lauren S Liberti, Adam I Perlman, Harry Adelson, David L Katz
PMID: 19250003 PMCID: PMC2894814 DOI: 10.1089/acm.2008.0410

Abstract
Objectives: Intravenous micronutrient therapy (IVMT), and specifically the Myers’ Cocktail, is a popular approach for treating fibromyalgia syndrome (FMS) among complementary and alternative medicine practitioners, but its efficacy is uncertain. This trial assessed the feasibility, safety, and provided insights into the efficacy of this therapy.

Design: This was a randomized, double-blind, placebo-controlled pilot study.

Locations: The study locations were an academic research center, teaching hospital, and affiliated Integrative Medicine Center in Derby, CT.

Subjects: The subjects were 34 adults with American College of Rheumatology (ACR)-defined FMS.

Intervention: Subjects were randomly assigned either to treatment (weekly infusions of IVMT) or to placebo (weekly infusions of lactated Ringer’s solution) for 8 weeks.

Outcome measures: Primary outcome was change in the Tender Point Index, assessed 8 and 12 weeks after initiation. Secondary measures included a Visual Analog Scale to assess global pain, and validated measures of physical function (Fibromyalgia Impact Questionnaire), mood (Beck Depression Index), and quality of life (Health Status Questionnaire 2.0).

Results: Clinically significant improvements were noted (of a magnitude similar to other effective interventions). However, in part because of the high placebo response and the small sample size, no statistically significant differences were seen between groups, in any outcome measure, at 8 and 16 weeks. Statistically significant within-group differences were seen in both the intervention and placebo groups, demonstrating a treatment effect for both IVMT and placebo. At 8 weeks, the IVMT group experienced significantly improved tender points, pain, depression, and quality of life directly following treatment (all p < or = 0.02), while the placebo group experienced significantly improved tender points only (p < or = 0.05). The treatment effects of IVMT persisted at 4 weeks postintervention for tender points, pain, and quality of life, while placebo effects persisted only for tender points. A single minor adverse event was noted in one subject in the intervention group.

Conclusions: This first controlled pilot study established the safety and feasibility of treating FMS with IVMT. Most subjects experienced relief as compared to baseline, but no statistically significant differences were seen between IVMT and placebo. The efficacy of IVMT for fibromyalgia, relative to placebo, is as yet uncertain.

Trial registration: ClinicalTrials.gov NCT00067405.

Henry Jay Forman 1, Hongqiao Zhang, Alessandra Rinna
PMID: 18796312 PMCID: PMC2696075 DOI: 10.1016/j.mam.2008.08.006

Free PMC article

Abstract
This review is the introduction to a special issue concerning, glutathione (GSH), the most abundant low molecular weight thiol compound synthesized in cells. GSH plays critical roles in protecting cells from oxidative damage and the toxicity of xenobiotic electrophiles, and maintaining redox homeostasis. Here, the functions and GSH and the sources of oxidants and electrophiles, the elimination of oxidants by reduction and electrophiles by conjugation with GSH are briefly described. Methods of assessing GSH status in the cells are also described. GSH synthesis and its regulation are addressed along with therapeutic approaches for manipulating GSH content that have been proposed. The purpose here is to provide a brief overview of some of the important aspects of glutathione metabolism as part of this special issue that will provide a more comprehensive review of the state of knowledge regarding this essential molecule.

Francesca Silvagno 1, Annamaria Vernone 1, Gian Piero Pescarmona 1
PMID: 32708578 PMCID: PMC7402141 DOI: 10.3390/antiox9070624

Free PMC article

Abstract
The novel COVID-19 pandemic is affecting the world’s population differently: mostly in the presence of conditions such as aging, diabetes and hypertension the virus triggers a lethal cytokine storm and patients die from acute respiratory distress syndrome, whereas in many cases the disease has a mild or even asymptomatic progression. A common denominator in all conditions associated with COVID-19 appears to be the impaired redox homeostasis responsible for reactive oxygen species (ROS) accumulation; therefore, levels of glutathione (GSH), the key anti-oxidant guardian in all tissues, could be critical in extinguishing the exacerbated inflammation that triggers organ failure in COVID-19. The present review provides a biochemical investigation of the mechanisms leading to deadly inflammation in severe COVID-19, counterbalanced by GSH. The pathways competing for GSH are described to illustrate the events concurring to cause a depletion of endogenous GSH stocks. Drawing on evidence from literature that demonstrates the reduced levels of GSH in the main conditions clinically associated with severe disease, we highlight the relevance of restoring GSH levels in the attempt to protect the most vulnerable subjects from severe symptoms of COVID-19. Finally, we discuss the current data about the feasibility of increasing GSH levels, which could be used to prevent and subdue the disease.

Methods Mol Biol
. 2011;758:205-14. doi: 10.1007/978-1-61779-170-3_14.
Gennaro Giordano 1, Collin C White, Lucio G Costa
PMID: 21815068 DOI: 10.1007/978-1-61779-170-3_14

Abstract
The tripeptide glutathione (γ-glutamylcysteinylglycine; GSH) is the most abundant antioxidant thiol in the brain. GSH plays a critical role in protecting brain cells from oxidative stress and xenobiotics, as well as maintaining the thiol redox state. High levels of GSH are present in the central nervous system, particularly in astrocytes. GSH is synthesized into two enzymatic steps, the first, and the rate-limiting one, is catalyzed by glutamate-cysteine ligase (GCL) to form a dipeptide which is then converted to GSH by GSH synthetase. In this chapter, we describe assays for the measurements of GSH levels and GCL activity. The first spectrophotometric assay is based on the affinity of 2,3-naphthalenedicarboxaldehyde (NDA) for GSH. In the second assay, GSH levels are measured after being derivatized using the fluorescent thiol reactive compound monobromobimane (MBB) and are detected by high-performance liquid chromatography (HPLC). The third assay allows the assessment of GCL activity, also by HPLC.

Ann N Y Acad Sci
. 2004 Jun;1019:346-9. doi: 10.1196/annals.1297.059.
Honglei Liu 1, Hong Wang, Swapna Shenvi, Tory M Hagen, Rui-Ming Liu
PMID: 15247041 DOI: 10.1196/annals.1297.059

Abstract
The concentration of glutathione (GSH), the most abundant intracellular nonprotein thiol and important antioxidant, declines with age and in some age-related diseases. The underlying mechanism, however, is not clear. The previous studies from our laboratory showed that the age-dependent decline in GSH content in Fisher 344 rats was associated with a downregulation of glutamate cysteine ligase (GCL), the rate-limiting enzyme in de novo GSH synthesis. Our recent studies further indicated that the activity and mRNA content of glutathione synthase (GS), which catalyzes the second reaction in de novo GSH synthesis, were also decreased with age in some tissues. No age-associated change was observed in glutathione reductase or gamma-glutamyl transpeptidase activities. Also, although GSH content declined with age in both male and female mice, male mice experienced more dramatic age-associated decline in many tissues/organs than female mice. Furthermore, we found that GSH content was significantly decreased in the red blood cells from male Alzheimer disease patients, which was associated with decreases in GCL and GS activities. Finally, we showed that estrogen increased GSH content, GS and GR activities, and GCL gene expression in the liver of both male and female mice. Taken together, our results suggest that (1) GCL plays a critical role in maintaining GSH homeostasis under both physiological and pathological conditions; (2) decreased GSH content may be involved in AD pathology in humans; and (3) estrogen increases GSH content in mice by multiple mechanisms.

Henry C Lukaski 1
PMID: 15212745 DOI: 10.1016/j.nut.2004.04.001

Abstract
Public health recommendations encourage the selection of a balanced diet and increasing physical activity to foster health and well-being. Whereas the adverse effects of restricted intakes of protein, fat, and carbohydrate on physical performance are well known, there is limited information about the impact of low intakes of vitamins and minerals on the exercise capacity and performance of humans. Physically active people generally consume amounts of vitamins and minerals consistent with the recommendations for the general public. However, when intakes are less than recommendations, some noticeable functional impairments occur. Acute or short-term marginal deficiencies, identified by blood biochemical measures of vitamin B status, had no impacts on performance measures. Severe deprivation of folate and vitamin B12 result in anemia and reduce endurance work performance. Evidence of vitamin A and E deficiencies in athletic individuals is lacking apparently because body storage is appreciable. In contrast to vitamins, marginal mineral deficiencies impair performance. Iron deficiency, with or without anemia, impairs muscle function and limits work capacity. Magnesium deprivation increases oxygen requirements to complete submaximal exercise and reduces endurance performance. Use of vitamin and mineral supplements does not improve measures of performance in people consuming adequate diets. Young girls and individuals participating in activities with weight classifications or aesthetic components are prone to nutrient deficiencies because they restrict food intake and specific micronutrient-rich foods. This information will be useful to professionals who counsel physically active people and scientific groups who make dietary recommendations to improve health and optimize genetic potential.

Carliene van Dronkelaar 1, Aafke van Velzen 2, Maya Abdelrazek 2, Anouk van der Steen 3, Peter J M Weijs 4, Michael Tieland 2
PMID: 28711425 DOI: 10.1016/j.jamda.2017.05.026

Abstract
Introduction: Minerals may contribute to prevent and treat sarcopenia, the age-related loss of muscle mass, muscle strength, and physical performance. So far, there is no comprehensive review on the impact of minerals on sarcopenia outcomes. The aim of this systematic review is to evaluate the role of calcium, iron, magnesium, phosphorus, potassium, selenium, sodium, and zinc on muscle mass, muscle strength, and physical performance in older adults.

Methods: A systematic search was conducted between March 2016 and July 2016, in the PubMed database using predefined search terms. Articles on the role of dietary mineral intake or mineral serum concentrations on muscle mass, muscle strength, physical performance, and/or the prevalence of sarcopenia in healthy or frail older adults (average age ≥ 65 years) were selected. Only original research publications were included. The search and data extraction were conducted in duplicate by 2 independent researchers. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement was followed in constructing this systematic review. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies was used to evaluate the quality of the selected articles.

Results: From the 3346 articles found, a total of 10 studies met the inclusion criteria. Observational studies showed that serum selenium (n = 1) and calcium intake (n = 1) were significantly associated with muscle mass, and magnesium (n = 1), selenium (n = 1), iron (n = 1), and zinc (n = 1) intake were significantly and positively associated with physical performance in older adults. Furthermore, magnesium (n = 2), selenium (n = 2), calcium (n = 2), and phosphorus (n = 1) intake were associated with the prevalence of sarcopenia. Magnesium supplementation improved physical performance based on one randomized controlled trial. No studies on the role of sodium or potassium on muscle mass, muscle strength, or physical performance were found.

Conclusion: Minerals may be important nutrients to prevent and/or treat sarcopenia. Particularly, magnesium, selenium, and calcium seem to be most promising. Most of the included studies, however, were observational studies. Therefore, more randomized controlled trials are needed to elucidate the potential benefits of mineral intake to prevent and/or treat sarcopenia and support healthy aging.

Zeynep Vural 1, Amanda Avery 1, Dimitris I Kalogiros 2, Lisa J Coneyworth 1, Simon J M Welham 1
PMID: 32294896 PMCID: PMC7230219 DOI: 10.3390/nu12041072

Abstract
The global population is ageing with many older adults suffering from age-related malnutrition, including micronutrient deficiencies. Adequate nutrient intake is vital to enable older adults to continue living independently and delay their institutionalisation, as well as to prevent deterioration of health status in those living in institutions. This systematic review investigated the insufficiency of trace minerals in older adults living independently and in institutions. We examined 28 studies following a cross-sectional or cohort design, including 7203 older adults (≥60) living independently in 13 Western countries and 2036 living in institutions in seven Western countries. The estimated average requirement (EAR) cut-off point method was used to calculate percentage insufficiency for eight trace minerals using extracted mean and standard deviation values. Zinc deficiency was observed in 31% of community-based women and 49% of men. This was higher for those in institutional care (50% and 66%, respectively). Selenium intakes were similarly compromised with deficiency in 49% women and 37% men in the community and 44% women and 27% men in institutions. We additionally found significant proportions of both populations showing insufficiency for iron, iodine and copper. This paper identifies consistent nutritional insufficiency for selenium, zinc, iodine and copper in older adults.

Rhonda S Sebastian 1, Linda E Cleveland, Joseph D Goldman, Alanna J Moshfegh
PMID: 17659898 DOI: 10.1016/j.jada.2007.05.010

Abstract
Objective: To measure nutrient intake adequacy of vitamin/mineral supplement users and nonusers aged 51 years and older, determine the efficacy of supplement practices in compensating for dietary deficits, and identify predictors of supplement use.

Design: Analyses of two 24-hour recalls, demographic variables, and attitude questions collected during the Continuing Survey of Food Intakes by Individuals and Diet and Health Knowledge Survey in 1994 to 1996. Data were weighted to be representative of older Americans.

Subjects: Four thousand three hundred eighty-four adults aged 51 years and older (1,777 daily supplement users, 428 infrequent users, and 2,179 nonusers) residing in households in the United States.

Statistical analyses: Usual nutrient intake distributions were estimated using the Iowa State University method. The Estimated Average Requirement (EAR) cutpoint method was applied to determine the proportion of older adults not meeting requirements before and after accounting for nutrient intake from supplements. Student t tests were used to assess differences between users and nonusers. Logistic regression was used to determine sociodemographic and attitudinal predictors of supplement use.

Results: For one or more of the sex-age groups studied, a significantly smaller proportion of supplement users than nonusers had intakes from food alone below the EAR for vitamins A, B-6, and C; folate; zinc; and magnesium. Even so, less than 50% of both users and nonusers met the EAR for folate, vitamin E, and magnesium from food sources alone. Overall, supplements improved the nutrient intake of older adults. After accounting for the contribution of supplements, 80% or more of users met the EAR for vitamins A, B-6, B-12, C, and E; folate; iron; and zinc, but not magnesium. However, some supplement users, particularly men, exceeded Tolerable Upper Intake Levels for iron and zinc and a small percentage of women exceeded the Tolerable Upper Intake Level for vitamin A. Significant sociodemographic factors related to supplement use for older men were age group, metropolitan area, and educational status. Race, region, smoking status, and vegetarian status were significant factors for women. Attitude about the importance of following a healthful diet was a consistent predictor of supplement use for both men and women.

Conclusions: A large proportion of older adults do not consume sufficient amounts of many nutrients from foods alone. Supplements compensate to some extent, but only an estimated half of this population uses them daily. These widespread inadequacies should be considered when developing recommendations for supplement use for clients in this age group. Modifying dietary attitudes may result in a higher rate of supplement use in this at-risk population.