Intravenous Nutritional Therapy

by Susan Silverman, Certified Family Nurse Practitioner and Naturopath

Goals of Intravenous Nutritional Therapy

The goal of IntraVenous (IV) nutritional therapy goes well beyond providing general nutritional needs for a healthy body. IV therapy can be given in a doctor’s office by trained personnel. It can take the form of a brief “IV push” lasting from 10 to 30 minutes, or a larger volume of fluid delivered from several minutes to several hours, depending on how much time and fluid is needed to complete the treatment. The patient typically reclines in a comfortable lounge chair, and may eat, drink, bring in a portable music player to enjoy, read, talk to others, watch a video presentation (if available), or sleep. The treatment generally involves very minimal discomfort and the patient is free to resume all normal activities immediately afterwards.

First, some definitions:

Nutrition (also called nourishment or aliment) is the provision, to cells and organisms, of the materials necessary (in the form of food) to support life. Many common health problems can be prevented or alleviated with good nutrition. Good nutrition depends upon proper eating and proper digestion.

The diet of an organism refers to what it eats. Poor diet can have an injurious impact on health, causing deficiency diseases such as scurvy, beriberi, and kwashiorkor; health-threatening conditions like obesity and metabolic syndrome, and such common chronic systemic diseases as cardiovascular disease, diabetes, and osteoporosis.

Digestion is the breaking down of food in the body, into a form that can be absorbed and used or excreted. It is also the process by which the body breaks down food into smaller components that can be absorbed by the blood stream. In mammals, preparation for digestion begins with saliva produced in the mouth and digestive enzymes produced in the stomach. Mechanical and chemical digestion begin in the mouth where food is chewed and mixed with saliva to break down starches. The stomach continues to break food down mechanically and chemically through the churning of the stomach and mixing with enzymes. Absorption occurs in the stomach and gastrointestinal tract, and the process finishes with excretion, or elimination from the body.

Oral nutrition: nutrition which is taken into the body through the mouth, broken down by the digestive system, and selectively absorbed into the body. This is the most common route, used by people with basically good digestion. Those who are not obtaining what they need from their foods, or who are just not eating enough of the right foods, may choose to supplement. For example, many pregnant women are advised by their doctors to take prenatal vitamins. Many other people decide to take daily vitamins, minerals, essential fatty acids, antioxidants, and probiotics to insure good nutrition, help prevent illness, and pursue goals of life-enhancement and/or life-extension.

Parenteral nutrition: alternate routes of supplying nutrition to the body which may be used when oral intake is not feasible. Some forms of parenteral routes of delivery include:

The sublingual route (under the tongue), used when a nitroglycerin pill is dissolved in the mouth and the medication is absorbed into the bloodstream through the mucous membranes lining the mouth.
The intramuscular injection, such as used in the “vitamin B12 shot” for those who cannot absorb this important vitamin from the digestive system.
The intravenous route, where nutrients or medications are delivered to the body directly through a vein.
Intravenous Nutrition may be used when the person is not able to take food or fluids by mouth, or the digestive system has been damaged and cannot properly break down and absorb nutrients from food. In extreme cases, such as in coma or severe pancreatitis, a person may receive a full complement of vitamins, minerals, amino acids and essential fatty acids intravenously in a treatment called TPN or total parenteral (not through the oral route) and is given. Those who are very ill, undergoing treatments which make oral absorption difficult, or seeking a fast way to remove toxic metals and other poisons from the body may also choose this route.

Requirements for good nutrition:
Eating lots of good stuff and not eating or drinking bad stuff. Consuming food is only the first step. If the food doesn’t contain all the nutritional substances you need, and does contain toxic substances, health can suffer. Ideally, we should be getting all of our nutritional needs met from our food, but unfortunately this is often not the case. In fact the “Standard American Diet” with its reliance on fast and processed foods grown on depleted soils, often picked too early, subject to pesticides, antibiotics, hormones, and various harmful (toxic) chemicals, and possibly irradiated, does not supply enough of the essential substances needed to maintain optimal health.
Proper Chewing is necessary to break down food mechanically. Many people do not or can not chew their food thoroughly, which presents larger particles to the stomach, and makes it more difficult for full digestion to occur.
Proper levels of stomach acid and digestive enzymes to chemically break down the food. People who are taking over the counter or prescription antacids have difficulty digesting food (breaking food down into reusable parts). For example, proteins are like words made of up of various “letters” called amino acids. Large protein molecules from plants and other animals would provoke an allergic response if they get into our blood streams. We have to break them down into their component letters (amino acids) in order to use them and recombine them into human proteins to build and repair our bodies. Many medications, as well as infections and inflammations of the intestinal system prevent the full breakdown and absorption of food.
A healthy intestinal system which can tolerate oral nutrition without causing harm. The presence of disease, infection, inflammation, and certain other conditions may make it difficult or impossible to obtain adequate nutrition through the oral route. The following section discusses those specific conditions in which IV therapy may provide a suitable alternative.
Appropriate conditions for IV Therapy
There are many conditions which make it very difficult to obtain adequate nutrition through food or oral supplements in the form of pills or liquids. In such cases, intravenous therapy performed in a doctor’s office can be a relatively quick and cost-effective way to “jump start” nutrition needed to promote healing.

The protocols for intravenous nutritional supplements are intended for specific metabolic functions, and not to serve any ill-defined goals of prevention of vitamin, mineral and amino acid deficiency states. This is a simple but a very significant point. It is a temporary method used to support the body until normal digestive function can be reestablished. As soon as possible, every effort should also be made to normalize function for proper digestion and absorption of foods and nutritional supplements.

The goals of intravenous nutritional therapy are in essence the same as goals for oral nutritional therapy. The main difference, obviously, is the time frame, immediacy of the desired nutritional support, and the intended clinical results. Following are the principal goals for such therapy.

Possible Indications for IV therapy may include:

Malabsorption. Anatomical or functional disorders preventing proper ingestion, digestion, absorption, and utilization of essential nutrients.
Acute infection. To boost immune function and provide energy to the body.
Pre-operative and Post-Operative support to provide healing tissues with extra supplies of nutrients before and after surgery (times of increased demands). This facilitates wound healing and counterbalances the oxidative and other stresses caused by the surgical procedures.
Autoimmune and immunodeficiency symptoms, where normal absorption is impaired.
*Protection of healthy tissues in cancer patients undergoing radiation and/or chemotherapy (see references below).
*Adjunctive (additional) support to enhance the tumor-destroying effects of standard chemotherapy and radiation.
Injury to the GI tract through infection, allergy, medications, addiction (drug and alcohol), or physical trauma (surgery or injury).
Clinical or sub-clinical malabsorption in cases of food (wheat, dairy) and mold allergy, where malabsorption is common.
Need to deliver necessary nutrients to tissues in optimal proportions, concurrently and for maximal synergistic effects. Special support for those with poor absorption in times of stress. IM or IV delivery of anti-stress nutrients such as B6, B12, Magnesium, Thiamine, etc.
Desire to provide sufficiently high blood levels of specific nutrients where GI function would not permit sufficient rapidity of absorption (Eg. High dose Vitamin C in acute infection, or as in some integrative cancer therapy protocols.
Administration of glutathione, to potentiate the antioxidants and help repair and detoxify the liver. Glutathione is not well absorbed orally.
Giving prescription medicatins, such as IV Rocephin and other antibiotics, that should be given IV for maximum therapeutic benefit.
Enhanced detoxification and support of the gastro-intestinal tract, the liver and gall bladder, and/or the immune system for the elimination of heavy metals and other toxins.
Disturbance of the functional integrity of enzymatic pathways in chronic disorders known to result in vitamin, minerals and amino acid deficiencies.
Disordered Bowel ecology as with severe intestinal infections, dysbiosis, gastritis, and yeast overgrowth.
Chemical sensitivity or impaired metabolism where functional enzymatic defects do not permit nutrients to be metabolized to their biologically active products. Some outstanding examples include the minerals: Mg, Zn, Mn, and vitamins B6 ( as P-5P), and Vitamin B12 (as methylcobalamin).
Lack of sufficient precursors for brain neurotransmitters, with resulting mood disorders. Restoring natural mood balance when oral doses are inadequate.
Support those in recovery from drug and alcohol addiction. To reduce drug and alcohol cravings in order to provide better quality of life and lower the risk of relapse.
References