Solutions for the Mind and Body

The idea behind the term “hidden hunger” describes what functional medicine practitioners call chronic vitamin and mineral deficiency. When foods that a person consumes lack necessary levels of micronutrients, the resulting health impacts may not be fully appreciated. According to the Institute of Functional Medicine, “micronutrient malnutrition has been associated with a wide range of physiological impairments, including metabolic disorders, reduced immune, endocrine, and cognitive function, and delayed or inadequate physical development.”  Some micronutrient deficiencies, such as B3 (Pellagra, depression, memory impairment), Selenium (thyroid disease, fatigue/brain fog), and Vitamin D (Rickets, depression) for instance, are known to be a underlying contributors of some chronic diseases and symptoms. Another example, low magnesium intake has been associated with a greater risk of several chronic diseases, including cardiovascular disease (CVD), type 2 diabetes, metabolic syndrome, depression, and impaired cognition.

Additionally, long-term use of certain medications may also interfere with the body’s ability to absorb and utilize nutrients found in foods. Notable examples are chronically used proton-pump inhibitors for GERD/acid reflux with a decrease in B-vitamin absorption and Statins, used for high cholesterol, which interfere with the normal production of CoQ10 in the body.  Statins block an enzyme that not only inhibits cholesterol production but also the synthesis of CoQ10.

An intravenous (IV) infusion means that a needle is inserted under the skin, a catheter is taped in place, and fluid and medicine is infused into the body through the catheter.

It’s also known as “an IV drip”.

The benefits of an IV infusion:

1. IVs are not affected by stomach or intestinal absorption problems and bypass initial liver and gut elimination.
2. 100% of the infusion is available to the body. Medicines are forced into cells by means of a high concentration gradient.
3. IV injections allow higher than usual dosing

Side effects of IV infusions include:

1. Occasional discomfort, bruising and pain at the catheter site, missing the vein on an attempt
2. Inflammation, mild swelling or redness at the IV site. Possible infiltration (misplacement) of the IV
3. If there is ever a rash or itching at the site, your provider will address that immediately

Examples of commonly administered IV infusions are : Vitamin C, Myer’s Cocktail, NAD, and Alpha Lipoic Acid

An intramuscular (IM) injection means that a needle is inserted into the muscle and that medicine is injected into the body.

In other words, it’s “a shot”.

The benefits of an IM injection:

1. Injectables are not affected by stomach or intestinal absorption problems.
2. Total amount of the injection is available to the body. Medicines are forced into cells by means of a high concentration gradient.
3. IM injections of a long-acting medication reduces the need to take a daily medication

Side effects of IM injections include:

1. Occasional discomfort, bruising and pain at the site of injection
2. Inflammation, mild swelling or redness at the site injection
3. If there is ever a rash or itching at the site, your provider needs to know that

Examples of commonly administered IM injections are : B12, B-complex, Vitamin D, and CoQ10

Water soluble vitamins, such as vitamin C, all of the B vitamins and amino acids, can be mixed in an IV bag and given directly into a vein. They flow through the venous system and then throughout the body with ease, are metabolized by the liver to a degree, and excess is ultimately filtered and removed by the kidneys. Water soluble vitamins require good kidney function for their excretion, otherwise dosing needs to be adjusted to account for the decrease in elimination.

Fat soluble vitamins, such as vitamin D and CoQ10, can not be given intravenously. They are given either orally or as an intramuscular (IM) injection and slowly absorbed by the body. It’s important to monitor the blood level of fat soluble vitamins as they tend to accumulate in the body over time. An exception to this rule is Intralipid Fat Emulsion infusions that can be given through large bore IVs under special circumstances.

Ascorbic acid (Vitamin C) is a co-factor in many enzyme reactions needed for healthy functioning of the body. Humans only obtain Vitamin C through our diets. Unlike other animals,  we lost this ability to synthesize it in our own bodies thousands of years ago. Vitamin C is an antioxidant in lower doses and a pro-oxidant in higher doses. Lower doses (under 12.5 grams) are given for immune support, to enhance collagen production, and to boost the body’s ability to fight oxidative stress. High doses (greater than 25 grams) are given intravenously yield maximal bioavailability without the side effect of diarrhea that can occur with high oral doses. High dose vitamin C is given to support those fighting autoimmune and post-viral issues, chronic inflammation, and cancer.

High dose IV vitamin C, is valuable therapeutically because it has been shown to exert effects similar to prescription antibiotics, anti-inflammatories, anti-histamines and smooth muscle relaxants without many side effects or toxicity.  IV Vitamin C treatment can raise blood levels much higher than oral supplementation, while avoiding the common side effect of diarrhea, normally associated with high dose ORAL Vitamin C. High dose Vitamin C infusions are not given in the presence of kidney disease.

Glutathione, considered the “master antioxidant” and abundant in healthy cells is often given IV along with vitamin C infusions . It helps protect against intracellular damage by reducing oxidative stress. It is a chelator of heavy metals and helps the liver to detox the body. Glutathione is not given to those in the midst of chemotherapy.

Originally discovered in 1905, NAD is also known as the oxidized coenzyme form of vitamin B3 (Niacin). NAD and its chemically reduced form, NADH, are converted into each other and are an essential part of numerous metabolic activities in the body. NAD is necessary in energy production as it is required to convert all macronutrients into ATP via the glycolysis and electron transport chain in themitochondria of cells. ATP is the primary energy source that is needed to fuel most biological processes in the body.

Heart, brain and muscle tissue cells contain the highest concentration of NAD. The more NAD present in cells, the more efficiently they function. Damage within cells disrupts active transport, enzyme production and function & cell reproduction, which in turn leads to degenerative changes in the cell, tissues, and eventually the person. Metabolic syndrome, cognitive decline, cancer and aging all involve disruptions in cell signally dependent on NAD.

Research has shown IV NAD is beneficial in the treatment of a variety of conditions. These include traumatic brain injuries, cardiovascular disease, lipid metabolism, blood sugar imbalance & diabetes, autoimmune conditions, fibromyalgia, chronic fatigue syndrome, cancer, kidney & liver disease, and neurodegenerative disease such as dementias, Parkinson’s, spinal cord injury and multiple sclerosis. NAD has also demonstrated improvements in depression, alcohol & drug addiction, exercise capacity, and slow age-related decline.

NAD decline has been found to be at the core of the ten hallmarks of aging, namely DNA damage, epigenetic alteration, deregulated nutrient utilization, altered protein information integrity and cellular communication, cellular aging, stem cell exhaustion, mitochondrial dysfunction, compromised cell self-destruction, and telomere withering. NAD has not only been shown to slow the aging process, but even reverse some signs of aging.

In particular:

• Recovering from addition & substance abuse
• Increasing lifespan and longevity
• Restoring neurological function & cognitive decline
• Improving muscle strength & function; increased exercise capacity
• Supporting weight loss
• Depression & mood disorders
• Reducing fatigue and chronic fatigue states
• Autoimmune disease
• Cancer
• Cardiovascular disease/management support of high cholesterol
• Diabetes/management support of insulin resistance
• Healthy aging

NAD levels naturally decrease as we get older. IV NAD provides powerful support making it readily available to cells for immediate use to support mitochondria function and protects the ends of chromosomes that shorten as the body ages. NAD increases the activity of proteins (SIRT1 & PARP1), which are linked with a slower aging rate and influence DNA repair.

Between IV infusions, we recommend the use of Nicotinamide Riboside (NR) for oral supplementation.

B-Complex

B1 Thiamine – Energy metabolism. Alcohol depletes thiamine

B2 Riboflavin – Antioxidant and needed for energy metabolism. Deficiency is rare but supplementation may benefit migraine treatment.

B3 Niacin – Important for lipid metabolism. Helps reduce skin inflammation. Side-effects: flushing, headaches

B5 Dexpanthanol – Critical for energy production and acetylcholine synthesis. Gastro-Intestinal stimulant for post-op ileus. Toxicity = edema

B6 Pyridoxine – Essential for GABA synthesis (our “relaxing” neurotransmitter), hemoglobin synthesis and protein metabolism. Improves GI problems. Aids the immune system Toxicity = neuropathy, seizures, hypoglycemia, palpitations, and Ca/Mg imbalances that can lead to cramps or cardiac issues.

B9 Folate – Natural folate is found in green leafy vegetables and cold-pressed orange juice. (Folic acid is synthetic).  Needed for nerve and cell growth and blood cell formation, involved in methylation and homocysteine metabolism. In people with the MTHFR mutation, different forms of folate such as l-methylfolate or folinic acid may be necessary.

B12 – Given as a separate injection, either via IV or IM

Needed for cell growth, nucleoprotein and myelin synthesis – good for fatigue, anemia, neuropathy, depression and memory deficits. Contraindications: cobalt sensitivity, Leber’s disease (optic nerve atropy).  B12 comes in several forms. We primarily use Hydroxocobalamin and for specific individuals, methylcobalamin.

Vitamin D – Sunlight is man’s primary source of vitamin D.  Vitamin D was first recognized for its role in the prevention of rickets, a disease of the bones in infants and children. From this humble beginning, making our bones straight and strong, vitamin D is now surfacing as an important prohormone, once activated perhaps protecting us from cancers, autoimmune diseases and much more. Vitamin D influences the growth and regulation of all body cells and systems in amphibians, reptiles, birds, mammals and humans.

CoQ10

Alpha Lipoic Acid

Amino acids are the building blocks of proteins that lead to the formation of neurotransmitters in the brain. The body uses amino acids to digest, grow, and repair. There are three categories of amino acids essential, nonessential, and conditional. Essential amino acids can not be produced by the body and are only obtained through food sources.  The nine essential amino acids are histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine.. Nonessential amino acids are still important, but they can be produced by the body, as long as important enzymes and co-factors are present.  These include alanine, arginine, asparagine, aspartic acid, cysteine, glutamic acid, glutamine, glycine, proline, serine, and tyrosine. Conditional amino acids are only produced by the body when needed and include arginine, cysteine, glutamine, tyrosine, glycine, ornithine, proline, and serine.

The amino acids tryptophan, tyrosine, and phenylalanine can cause changes in sleep, appetite, sensitivity to noxious stimuli, pituitary hormone secretion, blood pressure, and mood. Diets high in tryptophan, for example, have been correlated with the improved mood in patients with depression. Branch chain amino acids (BCAAs) have also been researched as a treatment for manic behavior and a variety of neurodegenerative diseases.