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History and Evolution of IV Nutrition Therapies

Modern-day intravenous nutrition is preceded by an interesting history founded in wild experimentation, survival, and necessary supplementation. IV and injectable nutrition therapies remain a popular wellness treatment that both patients and physicians regularly inquire about. 

Injectable Micronutrients Timeline

Despite sporadic, informal, and superficial clinical data, common IV nutrition protocols continue to evolve as part of a group of wellness-related medical treatments that remain in high demand.

In fact, infusing or injecting specific micronutrients or nutritional solutions is not a new therapy, as parenteral nutrition use goes back to the early 20th century while the basic IV administration of fluids and electrolytes begins in the 1800s.

Nutrition Therapy in the Early 20th Century

A major step towards a better understanding of parenteral nutrition occurred during the early 20th century when infusions of glucose, plasma, and emulsified fat into humans became possible.

During the 1930s to 1940s, a clinical surgery professor at Washington University named Robert Elman, MD observed that amino acids can be intravenously infused when delivered in the form of protein hydrolysates, peptides, and isolated amino acids.

Prior to this, our knowledge of amino acid metabolism was accumulated over time. Our understanding of the effects of specific amino acids and proteins in humans began to accelerate with Elman’s discoveries along with the work of many others researching protein metabolism in previous years.

In 1948, Elman concluded that the “use of parenteral amino acid mixtures enables the physician to treat disease without protein starvation.”

By the late 1940s, there was product availability of all known vitamins, and advances in technology resulted in stable vitamin solutions for injection and IV administration.

The availability of supplemental vitamins and minerals allowed doctors to treat vitamin deficiencies and the diseases that proceeded or resulted in those deficiencies.

What’s more, supplementation was now available in multiple dosage forms, including injection.

The Development of Complete Nutritional Therapy


At this point, the framework was established for the introduction of a complete nutritional therapy consisting of the necessary vitamins, minerals, proteins, fats, and glucose.

Accumulated discoveries spanning across decades finally started to deliver nutritional products, while newly found methods allowed us to isolate specific micronutrients, then synthesize them into pharmaceutical products that include sterile solutions meant for IV.

The concept of taking in food intravenously began to evolve between the 1950s-60s. Until that time, IV nutrition was limited to specific vitamins, minerals, glucose, and fluids – but there was still nothing available that could replace food entirely in patients who were unable or prohibited from eating food or drinking fluid by mouth.

During the 1950s, physicians were aware of the negative effects of starvation or malnourishment on patient mortality and recovery, but there was still not enough understanding of the correlation between adequate nutritional support in patients and positive clinical outcomes. Feeding patients who were unable to eat remained a major problem to solve.

During this time, it was thought impossible to intravenously administer a complete nutrition formula containing all nutritional necessities in the form of macronutrients and micronutrients.

The status of IV nutrition support changed in the 1960s following the development of an effective total nutrition solution that could be administered intravenously. The first investigation was completed on Beagle puppies by Stanley Dudrick and Douglas Wilmore, surgeon researchers at the University of Pennsylvania.

They continued testing IV nutrition on adult patients malnourished from a variety of surgical complications and gastrointestinal conditions. After that, a human infant was successfully fed intravenously, which then resulted in widespread clinical application of Total Parenteral Nutrition (TPN).

Total Parenteral Nutrition


Total Parenteral Nutrition (TPN), or nutritional treatments designed to intravenously provide everything patients they need to survive, has been available for 50 years. However, history in this field goes back more than 350 years. The first milestone was the discovery of general blood circulation by William Harvey in 1628.

His description became the anatomical basis for intravenous infusion. Many investigations were performed during the following centuries, showing that solutions containing electrolytes and glucose could be given intravenously in humans.

There were a variety of attempts at using intravenous therapies to treat different conditions. Unfortunately, many patients ended up being guinea pigs in experiments that lead to illness or death.

The period of experimentation following William Harvey’s discovery resulted in a variety of dangerous ingredients people attempted to administer intravenously including the blood from different animals to increase their vitality, their libido, or to heal disease. This is prior to understanding the importance of sterility, blood typing, and other important considerations.

Many of these therapies were based on limited scientific knowledge and strongly held religious beliefs common in that time. For example, there are recorded stories of people who attempted IV infusion of lamb’s blood to promote longevity, reportedly based on the biblical references comparing Jesus to a lamb. Unfortunately, many patients died during or after treatment.

However, these experiments paved the way for what we know today about intravenous nutrition.

Another important milestone occurred during the 1830s when there was a cholera outbreak in England in 1831. Many people subsequently died because there was no available treatment as the disease started to spread.

Around that time, a young physician named William O’Shaughnessy from Ireland pursued an interest in studying cholera as he witnessed so many people dying from the disease. He traveled to Europe and, using his knowledge of chemistry, examined the blood and stool of his cholera patients.

He made crude measurements of the electrolytes in both specimens and determined that the patients were severely dehydrated. To treat the dehydration, Dr O'Shaughnessy developed a hypotonic IV solution that resulted in improved survival for the patients who received it. That might be the first recorded clinical implementation of IV nutrition.

The Myers Cocktail and the Development of Modern Nutrition Therapy


Popular modern-day IV nutrition therapy may have started with a John Hopkins internal medicine doctor named John Myers. John Myers was a practicing medical doctor during the 1940s-70s.

Prior to becoming a physician, he was an electrical engineer. He had developed what’s called the Primary Frequency Standard, which was installed in Nebraska, for the U.S. government to assign, monitor, measure, and adjust the broadcast frequencies of radio transmission stations in the U.S.

He decided to change paths as he left engineering to become a physician in 1935. His training as an engineer provided foundational interest in the interrelationships of the biochemistry that fuels cellular function, and the application of nutritional elements, to improve the metabolic function.

Dr. Myers recognized that we have substances including minerals (elements) in our body and that careful manipulation of this chemistry can sometimes influence positive outcomes. He did this through experimenting with micro-nutritional supplementation and was particularly fascinated with elements and vitamins.

His position at John Hopkins allowed him to treat chronically ill patients that needed ongoing management or sometimes with unknown diagnoses. Part of his integrative treatment plans included IV infusion of elements and vitamins in different combinations.

He would often see patients that no one else could diagnose – including those suffering from chronic conditions including fatigue, depression, cough, and allergies – that were unresponsive to treatment. These patients were given different IV formulas while Dr. Myers observed and recorded the outcome.

He was one of the first doctors to record the benefits and the positive outcomes when administering these nutrient infusions. He recorded these outcomes and reported the improvement the patient experienced when given a high dose fluid containing minerals and vitamins.

Dr Myers findings were lost to time and didn’t reemerge until the early 2000s when a physician named Alan Gaby, MD published a book called Nutritional Medicine. There was a chapter dedicated to the Myers’ cocktail with mention of John Myers’ research and protocols.

This publication resulted in the Myers’ cocktail popularity that has spread across the U.S. Dr John Myers’ exact formula is unknown, possibly since he changed it depending on the patient’s condition, but Doctor Gaby was able to identify the common foundational ingredients used in the original Myers’ cocktail.

The ingredients include:

  • Calcium

  • Magnesium

  • Ascorbic acid (vitamin C)

  • B-complex,

  • B6

  • Trace minerals at various levels, depending on the patient

Almost all modern IV infusion clinics offer a modified version of the Myers’ cocktail. Many of the ingredients used in IV nutrition formulas today can only be sourced from a compounding pharmacy that specializes in sterile solutions.

Nutrition Therapy Now


Today, 80% of hospitalized patients receive IV therapy. A large percentage of medications are now administered by IV. IV therapy is becoming more widely used in extended care facilities and home care solutions.

The IV formulations offered at Defy Medical are prescribed for nutritional supplementation.

Nutritional supplementation is used to treat a specific condition or to provide an outcome. These IV infusions, including the Myers cocktail, can provide nutrients and minerals that perform many helpful functions.

TPN solutions, meanwhile, are designed to provide all the nourishment needed for survival and are given to patients who cannot eat on their own. TPN is not possible without first understanding the effects of micronutrients and being able to produce them as stable solutions for injection.

Modern IV nutrition continues to increase in popularity and demand today. Since there is not enough financial incentive for big research around the effects of these therapies, hopefully, the continued development and feedback from practicing physicians contributes to our understanding of the effects nutritional supplementation can have towards clinical outcomes and quality of life in patients.

  1. Dudrick, Stanley J. “Early Developments and Clinical Applications of Total Parenteral Nutrition.” JPEN. Journal of Parenteral and Enteral Nutrition, U.S. National Library of Medicine, 2003,

  2. Elman, Robert. “Amino Acid Mixtures as Parenteral Protein Food.” The American Journal of Medicine, Elsevier, 11 Mar. 2004,

  3. Gaby, Alan. Nutritional Medicine. Fritz Perlberg Publishing, 2017.

  4. Moon, JB. “Sir William Brooke O'Shaughnessy--the Foundations of Fluid Therapy and the Indian Telegraph Service.” The New England Journal of Medicine, U.S. National Library of Medicine, 2 Feb. 1967,

  5. Nakayama, Don K. “The Development of Total Parenteral Nutrition.” The American Surgeon, U.S. National Library of Medicine, 1 Jan. 2017,

  6. Schütte Karl H., and John A. Myers. Metabolic Aspects of Health: Nutritional Elements in Health and Disease. Discovery Press, 1979.

  7. Shils, M E. “Historical Aspects of Minerals and Vitamins in Parenteral Nutrition.” Federation Proceedings, U.S. National Library of Medicine, Apr. 1984,

  8. Wretlind, A, and B Szczygieł. “Total Parenteral Nutrition. History. Present Time. Future.” Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego, U.S. National Library of Medicine, Apr. 1998,

  9. Summary authored by David Bruce, 2019.