Heal Thyself—Spotlight on Fibromyalgia

By Jennifer Arnold

No one ever told Pamela Hirth that her aches and pains were all in her head, but she could tell that’s what they were thinking. “I could see the looks on their faces,” says the 48-year-old resident of Orange, Connecticut. And in her visits to doctor after doctor, she got nowhere trying to pinpoint the cause of her fatigue, insomnia, and the constant pain in her arms and legs. So it was a relief when a rheumatologist finally gave her condition a name: fibromyalgia.

But even with the diagnosis, things didn’t get much better for Hirth, a self-employed clothing designer and the mother of three boys. The rheumatologist prescribed an antidepressant, which made her feel spaced out. He recommended exercise, which helped somewhat but was hard to keep up with when she was so exhausted and achy. And a prescription anti-inflammatory drug helped cover up the pain, Hirth says, but didn’t make it go away.

Then a friend convinced her to make an appointment with David Katz, a physician and director of the Integrative Medicine Center at Griffin Hospital in Derby, Connecticut. She figured she had nothing to lose, but she wasn’t terribly optimistic. After five years of dead ends, she thought she had heard it all.

But after an initial consultation, Katz recommended a treatment Hirth hadn’t heard of—intravenous micronutrient therapy, or IVMT. Katz didn’t promise anything, but he said that other fibromyalgia patients had gotten good results from the treatment. Hirth scheduled an appointment for the following week.

“The results were almost instantaneous,” says Hirth. The next day, she got out of bed and began her morning routine—a time when her fibromyalgia pain was usually at its worst. But this morning was different. “I’m sitting there drinking my coffee and suddenly I realize I’m not in pain,” she says. “It was like a miracle.”

Right now as many as eight million people in the United States would give anything to experience such a miracle, since they, too, suffer from fibromyalgia, a chronic condition marked by pain, aches, stiffness, disturbed sleep, and fatigue. Like Hirth, many spend years going from one doctor to another before getting a diagnosis, and even then find that conventional medicine has little to offer. No one knows for sure what causes fibromyalgia; at best, treatment involves a mix of medications and lifestyle changes that require lots of trial and error—and don’t always work.

But for the past 20 years or so, a small but growing number of alternative clinics across the country have been using IVMT with impressive results. Katz, a conventionally trained internist, is a relative newcomer; in the past two and a half years, he estimates he’s treated 60 fibromyalgia patients with IVMT. But he’s also gathered data on several thousand fibromyalgia and chronic fatigue sufferers who’ve been treated at clinics across the country. Together, the findings paint a promising picture.

Overall, Katz has found that about 80 percent of patients get good results from IVMT, and very few experience any side effects. Among his patients, he says, about one in five feels better after the very first treatment, as Hirth did. “Others improve more gradually, reporting changes after four or five treatments,” he says.

So what exactly is IVMT? The “MT” stands for micronutrient therapy, in this case a high-dose combination of B-complex vitamins, vitamin C, magnesium, and calcium. The formula is sometimes referred to as “Myers’ cocktail,” after the late John Myers, a Baltimore doctor who pioneered the therapy in the 1960s and 70s as a treatment for fatigue, depression, and even chest pain.

But why not just pop supplements? That’s where the IV part comes in: When the nutrients are delivered through a slow intravenous drip, the patient can absorb much higher concentrations than she’d get from an oral dose.

No one knows exactly how Myers came up with the specific combination of nutrients. He never published or publicized his work, but he did have a small following of loyal patients who swore by the therapy. After Myers’ death in 1984, some of these patients appealed to Alan Gaby, an alternative-minded physician in Baltimore. Gaby did some research, and began administering his own version of the cocktail. After seeing results in many patients, he began spreading the word.

The therapy isn’t for everyone; Katz doesn’t recommend it for people with blood disorders such as hemophilia, kidney disease, or congestive heart failure. (In different ways, people with each of these conditions could react negatively to either IV administration or excess fluid volume in the body).

But in most cases, IVMT seems safe and effective. Patients may feel a slight pinch and then a warm sensation in their arm at the IV site, but other than that the therapy is painless and takes only about ten to 15 minutes.

Most practitioners recommend a series of eight weekly treatments, followed by a break to assess results. “A lot of patients come back within a month, saying their symptoms are starting to recur,” says Katz. While IVMT doesn’t make the pain go away forever, even short-term relief—from a therapy patients can repeat if they need to—is welcome to people who’ve been suffering for years.

So why aren’t more people using it? Although IVMT has been around for decades, very little research has been published on it, and it’s remained just under the radar. Few physicians—and even fewer patients—have heard of it. (Katz didn’t learn of it until a naturopath who was a resident on his staff brought it to his attention.) After conducting the survey, reading the limited literature, and contemplating the lack of options for his fibromyalgia patients, he decided to give it a go.

“When I’ve exhausted my ability to treat patients based on randomized trials, and they’re still in pain, what do I do then?” asks Katz. “Human needs extend beyond the edge of the evidence, and fibromyalgia is a perfect example.”

Even doctors who have been using IVMT for years can’t fully explain why it works. Some scientists believe the high concentrations of micronutrients help strengthen the immune system, reduce free radical damage, improve cellular membrane quality, or boost cellular energy production.

Katz has his own hypothesis: He believes that the nutrients help blood vessels dilate more effectively, boosting blood flow to muscles. Without adequate blood, muscles are starved for oxygen, and carbon dioxide and other potential toxins can build up in the tissues, causing pain.

“It fits what we know,” says Katz. “We know that physical activity helps relieve fibromyalgia symptoms, and exercise also increases blood flow.” This theory may also help explain why fibromyalgia occurs more often in women than in men. Since women have narrower blood vessels than men, even a slight deterioration in vessel tone could reduce blood flow to the muscles.

While the reputation of IVMT is growing, it can still be difficult to find an experienced practitioner. Katz recommends contacting integrative medicine centers in your area to find local providers (see “Finding IVMT Near You,” page 32, for more information). If you get no reaction to “IVMT,” ask again using the term “Myers’ Cocktail”; not all clinics are familiar with both names.

“IVMT is governed by state requirements on who can do IV therapy,” said Katz. “In some states naturopathic physicians can do it; in some they can’t.” Expect to pay $15 to $100 per session; in some cases, insurance will cover a portion of the cost.

The Yale-Griffin Prevention Research Center in Derby, Connecticut, is currently involved in an IVMT study sponsored by the National Center for Complementary and Alternative Medicine. (The research, which began in June 2004, will conclude in September 2005.) That may provide more answers—but for now, IVMT patients like Hirth are just happy with the improvements they’re seeing.

These days, Hirth visits the clinic every ten days or so for a treatment. Even when she had to skip a few weeks because of travel, she found that her symptoms were less severe than before. “I have more endurance and I can work longer without getting tired,” she says. Her pain is reduced, she’s sleeping better, and she has more energy throughout the day. “In the mornings I can just get up and go,” she says. “I’ve got my life back.”

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