As the person who developed the intravenous nutrient infusion that is now called the Myers cocktail, I believe certain comments are in order regarding your article, "Baltimore-area clinics are offering vitamin IVs. But do you really need one?” (Feb. 15). When Dr. John Myers, a Baltimore physician, died in the 1980s, I took over the care of patients who had been receiving IV nutrients. To conform to more recent research, I modified the ingredients and dosages used by Dr. Myers, and the infusion was named the "Myers cocktail" in his honor. During 15 years of medical practice in Baltimore, about 15,000 Myers cocktails were administered in my office. This treatment can knock out acute asthma attacks and acute migraines in most cases within two minutes. One patient suffering acute morphine withdrawal become symptom-free within 5 minutes of receiving this treatment. Other conditions that improved included congestive heart failure, chronic fatigue, respiratory infections and fibromyalgia. Intravenous magnesium has been well-documented by medical research to be effective for acute asthma and acute migraines, but clinical experience suggests that a combination of nutrients works better than magnesium alone.

Your article stated that a study of the Myers cocktail for fibromyalgia found a large placebo effect. However, what was not mentioned was that four weeks after the infusions were discontinued, the benefit had waned in the placebo group but was still present in the nutrient group. Dr. Marc Leavey suggested in your article that the benefits of IV nutrients may be due in part to a hydrating effect. While some clinics give the nutrients in a large IV bag, I used a syringe typically containing less than one ounce of fluid, so the benefits were likely not due to improved hydration.

When I left medical practice in 2003, patients paid $48 for a Myers cocktail. Today, the cost of similar treatments is usually $100 to $250. A major portion of that increase is due to U.S. Food and Drug Administration regulations that make it very difficult for companies to be approved as a manufacturer of sterile injectable nutrients. Many components of the Myers cocktail are now produced by only one manufacturer which has resulted in monopoly pricing. A multi-dose vial of injectable B vitamins cost $5 in 2003 and over $200 today.

Dr. Alan Gaby, Concord, N.H.