Vegan Support IV

Full ingredient list

Exact amounts delivered in each size. Formulas are compounded per patient and can be adjusted by your provider.

Supporting studies

• 1

  Injected B12 bypasses the gut absorption machinery entirely, which is why clinicians reach for it first when they want a guaranteed response.

  In this expert 'How I Treat' review in Blood, the author explains that oral B12 absorption depends on intrinsic factor and an intact terminal ileum, and states plainly: 'I always begin with intramuscular cobalamin to bypass potential barriers to immediate effectiveness.' A single 1000 mcg injection is enough to correct the anemia, with up to 150 mcg retained from that dose in most patients. Neurologic improvement typically begins within the first week. The same logic underlies parenteral B12 given by IV.

  Expert clinical review Carmel R How I treat cobalamin (vitamin B12) deficiency. Blood. 2008. PMID 18606874 ↗

• 2

  A year of methylcobalamin B12 measurably improved nerve function, pain and quality of life in people with diabetic neuropathy.

  In a 1-year randomized, double-blind, placebo-controlled trial of 90 people with type 2 diabetes and both peripheral and autonomic neuropathy, participants received either 1000 mcg of methylcobalamin daily or placebo (oral route). The treated group showed significant improvement in vibration perception threshold, neuropathy screening scores, pain scores, sural nerve conduction velocity, sural nerve action potential, sudomotor (sweat gland) function, and overall quality of life. Blood B12 rose from 232.0 to 776.7 pmol/L (p<0.0001).

  Randomized controlled trial Didangelos T, et al. Vitamin B12 Supplementation in Diabetic Neuropathy: A 1-Year, Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients. 2021. PMID 33513879 ↗

• 3

  Intravenous high-dose methylcobalamin was well tolerated and improved muscle strength in patients with peripheral neuropathy.

  A phase I/II open-label clinical trial gave 25 mg of methylcobalamin intravenously each day for 10 days, then monthly for 5 months, to 14 patients with immune-mediated or hereditary neuropathy involving chronic axonal degeneration. Among the 12 patients evaluated, MRC muscle strength sum scores improved in seven, and no adverse effects occurred in any of the 12. The authors concluded that IV ultra-high-dose methylcobalamin is a safe and potentially effective therapy for peripheral neuropathy. This is direct intravenous-route evidence.

  Clinical trial (phase i/ii, open label) Shibuya K, et al. Safety and efficacy of intravenous ultra-high dose methylcobalamin treatment for peripheral neuropathy: a phase I/II open label clinical trial. Internal Medicine. 2014. PMID 25175124 ↗

• 4

  Folate plus B12 reliably lowers homocysteine — the methylation-cycle marker — by roughly a quarter to a third.

  This meta-analysis pooled 12 randomized controlled trials in 1,114 participants. Folic acid at 0.5-5 mg daily reduced blood homocysteine by 25% (95% CI 23-28%), and adding about 0.5 mg of vitamin B12 produced a further 7% reduction (95% CI 3-10%). Together, the authors estimated the combination would move a typical Western homocysteine level from about 12 micromol/L down to 8-9 micromol/L. Homocysteine is the direct readout of how well the one-carbon methylation cycle is turning over; the trials used oral dosing.

  Meta-analysis of randomized controlled trials Homocysteine Lowering Trialists' Collaboration Lowering blood homocysteine with folic acid based supplements: meta-analysis of randomised trials. BMJ. 1998. PMID 9569395 ↗

• 5

  L-carnitine is the molecule that physically carries long-chain fats across the mitochondrial membrane — without it, cells cannot burn fat for energy.

  This peer-reviewed review details how carnitine is essential for transferring long-chain fatty acids across the inner mitochondrial membrane so they can undergo beta-oxidation and generate ATP. Carnitine enters cells through the high-affinity OCTN2 transporter; when that transporter is defective, intracellular carnitine falls and fatty acid oxidation is impaired, producing low blood sugar without ketones, muscle weakness and cardiomyopathy. The review also notes that at higher supplemental doses carnitine can enter cells through alternative lower-affinity transporters. This is the mechanistic basis for using carnitine as an energy and fat-metabolism nutrient.

  Mechanistic review Longo N, Frigeni M, Pasquali M Carnitine transport and fatty acid oxidation. Biochimica et Biophysica Acta - Molecular Cell Research. 2016. PMID 26828774 ↗

• 6

  A meta-analysis of randomized trials found L-carnitine significantly reduced muscle soreness after exercise at every time point measured, from immediately after through 96 hours.

  This systematic review and meta-analysis pooled seven randomized clinical trials of L-carnitine supplementation and markers of exercise-induced muscle damage in healthy adults. L-carnitine significantly reduced muscle soreness at 0, 24, 48, 72 and 96 hours post-exercise, and lowered the muscle-damage markers creatine kinase, myoglobin and lactate dehydrogenase at 24 hours. Benefits were most apparent in resistance-training and untrained populations. Trials used oral supplementation.

  Systematic review and meta-analysis Yarizadh H, et al. The Effect of L-Carnitine Supplementation on Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Journal of the American College of Nutrition. 2020. PMID 32154768 ↗

• 7

  A controlled human feeding study proved choline is truly essential: most adults deprived of it developed fatty liver or muscle changes, which resolved once choline was restored.

  Fischer and colleagues fed healthy adults with normal folate and B12 status a choline-depleted diet under controlled conditions. Seventy-seven percent of men and 80% of postmenopausal women developed fatty liver or elevated muscle enzymes, compared with 44% of premenopausal women, and the organ dysfunction resolved when choline was added back to the diet. Some men developed changes even while consuming the current recommended adequate intake, showing individual choline requirements vary widely. This is the clearest human evidence for choline's role in hepatic fat handling.

  Controlled human feeding (clinical) study Fischer LM, et al. Sex and menopausal status influence human dietary requirements for the nutrient choline. The American Journal of Clinical Nutrition. 2007. PMID 17490963 ↗

• 8

  Choline — the head group of phosphatidylcholine — was formally recognized as an essential nutrient by the Institute of Medicine in 1998, yet most Americans fall well short of the recommended intake.

  Zeisel and da Costa's review documents that the Institute of Medicine designated choline an essential nutrient in 1998, setting Adequate Intakes of 550 mg/day for men and 425 mg/day for women, based in part on the liver damage observed at lower intakes. Because choline supports everything from cell membrane structure to neurotransmitter synthesis, inadequate intake is linked to liver disease and atherosclerosis. The authors note that mean intakes for older children, men, women and pregnant women fall far below the IOM's adequate intake, and call for dietary guidance to increase consumption of choline-rich foods.

  Narrative review / nutritional requirement analysis Zeisel SH, da Costa KA Choline: an essential nutrient for public health. Nutrition Reviews. 2009. PMID 19906248 ↗

• 9

  A meta-analysis of human trials found that taurine meaningfully improves endurance exercise performance.

  This meta-analysis in Sports Medicine pooled 10 peer-reviewed human studies of oral taurine and endurance performance. Taurine produced a moderate positive effect on endurance performance (Hedges' g = 0.40, 95% CI 0.12–0.67, P = 0.004), with a similar effect in the time-to-exhaustion sub-analysis (g = 0.43, 95% CI 0.12–0.75, P = 0.007). Benefits were seen across doses of 1–6 g, including from a single dose. Route: oral.

  Meta-analysis of human trials Waldron M, Patterson SD, Tallent J, Jeffries O The Effects of an Oral Taurine Dose and Supplementation Period on Endurance Exercise Performance in Humans: A Meta-Analysis. Sports Medicine. 2018. PMID 29546641 ↗

• 10

  Taurine lowered blood pressure by more than 7 mm Hg and improved blood vessel flexibility in a 120-person randomized trial.

  This randomized, double-blind, placebo-controlled study assigned 120 people with prehypertension to 1.6 g of taurine daily or placebo for 12 weeks. Clinic systolic blood pressure fell 7.2 mm Hg with taurine versus 2.6 mm Hg with placebo, and diastolic fell 4.7 versus 1.3 mm Hg; 24-hour ambulatory readings improved similarly. Taurine also significantly improved both endothelium-dependent and endothelium-independent vasodilation and raised plasma hydrogen sulfide, a natural vasodilator. Route: oral.

  Randomized double-blind placebo-controlled trial Sun Q, Wang B, Li Y, et al. Taurine Supplementation Lowers Blood Pressure and Improves Vascular Function in Prehypertension: Randomized, Double-Blind, Placebo-Controlled Study. Hypertension. 2016. PMID 26781281 ↗

• 11

  A B-complex increased exercise endurance by 26% and lowered the blood lactate and ammonia that drive the feeling of fatigue.

  In a randomized, double-blind crossover trial, 32 healthy non-athlete adults aged 20-30 took a daily B-complex tablet (B1 33.6 mg, B2 10 mg, B6 50 mg, B12 750 mcg, plus vitamin E, inositol and taurine) or placebo for 28 days, with a 14-day washout between arms. Running time to exhaustion increased 1.26-fold versus placebo (p < 0.0001), and blood lactate and blood ammonia concentrations during exercise were significantly lower (p < 0.05). No adverse effects were reported. Route was oral.

  Randomized controlled trial (double-blind crossover) Lee MC, et al. A functional evaluation of anti-fatigue and exercise performance improvement following vitamin B complex supplementation in healthy humans, a randomized double-blind trial. International Journal of Medical Sciences. 2023. PMID 37786445 ↗

• 12

  A high-dose B-complex improved vigor, reduced mental tiredness and lowered stress ratings in 215 working adults.

  This randomized, placebo-controlled, double-blind trial enrolled 215 healthy men aged 30-55 in full-time employment and gave them a high-dose B-vitamin complex with vitamin C and minerals, or placebo, for 33 days. The supplemented group showed significantly improved ratings of stress, better mental health scores, and greater vigor, along with improved Serial 3s subtraction performance and reduced mental tiredness both before and after cognitive testing. The authors concluded that 'healthy members of the general population may benefit from augmented levels of vitamins/minerals.' Route was oral.

  Randomized controlled trial Kennedy DO, et al. Effects of high-dose B vitamin complex with vitamin C and minerals on subjective mood and performance in healthy males. Psychopharmacology (Berl). 2010. PMID 20454891 ↗

• 13

  Vitamin C markedly increases how much plant-source (non-heme) iron the body can actually absorb from a meal.

  This landmark human study measured non-heme iron absorption in 299 subjects using meals labeled with two different radio-iron isotopes, served with and without ascorbic acid to the same person. Ascorbic acid produced marked enhancement of iron absorption, with the most pronounced effects in meals high in phytates and tannins — the dietary compounds that normally block iron uptake. Crystalline ascorbic acid and naturally occurring ascorbic acid in foods worked equally well. The authors concluded ascorbic acid has a key physiologic role in facilitating non-heme iron absorption, with about 50 mg per main meal desirable for optimal effect. (Route: oral, with meals.)

  Human isotope-labeled absorption study Hallberg L, Brune M, Rossander L Effect of ascorbic acid on iron absorption from different types of meals. Studies with ascorbic-acid-rich foods and synthetic ascorbic acid given in different amounts with different meals. Human Nutrition. Applied Nutrition. 1986. PMID 3700141 ↗

References

• 1Carmel R. How I treat cobalamin (vitamin B12) deficiency. Blood. 2008. PMID 18606874 ↗
• 2Didangelos T, et al. Vitamin B12 Supplementation in Diabetic Neuropathy: A 1-Year, Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients. 2021. PMID 33513879 ↗
• 3Shibuya K, et al. Safety and efficacy of intravenous ultra-high dose methylcobalamin treatment for peripheral neuropathy: a phase I/II open label clinical trial. Internal Medicine. 2014. PMID 25175124 ↗
• 4Homocysteine Lowering Trialists' Collaboration. Lowering blood homocysteine with folic acid based supplements: meta-analysis of randomised trials. BMJ. 1998. PMID 9569395 ↗
• 5Longo N, Frigeni M, Pasquali M. Carnitine transport and fatty acid oxidation. Biochimica et Biophysica Acta - Molecular Cell Research. 2016. PMID 26828774 ↗
• 6Yarizadh H, et al. The Effect of L-Carnitine Supplementation on Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Journal of the American College of Nutrition. 2020. PMID 32154768 ↗
• 7Fischer LM, et al. Sex and menopausal status influence human dietary requirements for the nutrient choline. The American Journal of Clinical Nutrition. 2007. PMID 17490963 ↗
• 8Zeisel SH, da Costa KA. Choline: an essential nutrient for public health. Nutrition Reviews. 2009. PMID 19906248 ↗
• 9Waldron M, Patterson SD, Tallent J, Jeffries O. The Effects of an Oral Taurine Dose and Supplementation Period on Endurance Exercise Performance in Humans: A Meta-Analysis. Sports Medicine. 2018. PMID 29546641 ↗
• 10Sun Q, Wang B, Li Y, et al. Taurine Supplementation Lowers Blood Pressure and Improves Vascular Function in Prehypertension: Randomized, Double-Blind, Placebo-Controlled Study. Hypertension. 2016. PMID 26781281 ↗
• 11Lee MC, et al. A functional evaluation of anti-fatigue and exercise performance improvement following vitamin B complex supplementation in healthy humans, a randomized double-blind trial. International Journal of Medical Sciences. 2023. PMID 37786445 ↗
• 12Kennedy DO, et al. Effects of high-dose B vitamin complex with vitamin C and minerals on subjective mood and performance in healthy males. Psychopharmacology (Berl). 2010. PMID 20454891 ↗
• 13Hallberg L, Brune M, Rossander L. Effect of ascorbic acid on iron absorption from different types of meals. Studies with ascorbic-acid-rich foods and synthetic ascorbic acid given in different amounts with different meals. Human Nutrition. Applied Nutrition. 1986. PMID 3700141 ↗