Vitamin B12:
Vitamin B12 is a vitamin found in food and is also used as a dietary supplement. Vitamin B12 helps to utilize fats and carbohydrates for energy and make new proteins. Vitamin B12 is important in the maintenance of our metabolism, blood cells, and nerve function. Most people get enough vitamin B12 in their diet, but some need supplementation.

Certain health conditions such as intestinal or stomach problems, poor nutrition, cancer, HIV, pregnancy, old age, veganism, and alcoholism can cause vitamin B12 deficiency. Low levels of vitamin B12 can lead to fatigue and anemia in milder cases.

More serous B12 deficiencies have the potential to impair heart and neurological function, leading to a wide range of serous symptoms, including but not limited to tinnitus, severe joint pain, memory problems, depression, anxiety, poor muscle function, ataxia, and changes in reflexes. Infertility can also occur in individuals with insufficient B12. Early intervention and treatment of B12 deficiencies are key to maintaining healthy bodily function.

More Benefits:
Vitamin B12 can also help the body convert fat and carbohydrates to energy and may be beneficial as part of a weight loss program. https://drscriptportal.s3.amazonaws.com/docs/nutritional-iv-info/Hydroxycobalamin.pdf

Contraindication, cobalt allergy, optic atrophy, polycythemia Vera
Generally vitamin B12  it is well tolerated. It may cause mild diarrhea, itching, or feel swollen.

Route of Administration:
The IM dose is 1 mg once every 1-2 weeks as needed.
The IV dose is 1-5 mg administered with IV fluid as needed.

Vitamin B complex:

Vitamin B Complex enhances cognition, energy production boosts metabolism, improves cellular repair, supports anti-aging, improves anxiety and depression.

Vitamin B complex include most of vitamin B:

• vitamin B1 (thiamin): assist the body with converting food into energy. Important for heart and nervous system function.
• vitamin B2 (riboflavin) important for RBC production. Promotes healthy muscle, nervous and cardiovascular function.
• vitamin B3 (niacin): assists the body in converting food into energy. Promotes cardiovascular, nervous, and dermatological health.
• vitamin B5 (pantothenic acid): supports metabolism and energy production. Critical for the production of hemoglobin.
• vitamin B6 (pyridoxine): supports healthy brain and cardiovascular function.

Contraindications: hypokalemia, optic atrophy, acute gastritis.
Generally, it is well tolerated. It may cause nausea, digestion, diarrhea.

Route of Administration:
The IM dose is 2mg/ml to be given 1-2 ml weekly as needed.
The IV dose is 1-5 ml added to Myers or normal saline weekly as needed.

Biotin (vitamin B7)

Biotin is a water-soluble vitamin found in foods such as eggs, milk, and bananas. This vitamin is important for overall health, and plays a role in cell growth, carbohydrate metabolism, and fatty acid synthesis. Biotin is involved in a wide range of metabolic processes primarily related to the utilization of fats, carbohydrates, and amino acids. It also influences cell growth and may help in maintaining blood sugar levels. Biotin is commonly supplemented for multiple conditions, such as hair loss, brittle nails, and nerve damage. Biotin is also thought to reduce inflammation, improve cognitive function, and increase HDL (good) cholesterol and decrease LDL (bad) cholesterol. https://drscriptportal.s3.amazonaws.com/docs/nutritional-iv-info/Biotin.pdf

Other benefits
Biotin may improve conditions such as skin rashes, brittle nails, thinning hair, diabetes, or nerve pain.

Adverse effects
Nausea, vomiting, diarrhea, stomach cramping, headache.
It is generally well tolerated. It will skew thyroid lab results post infusion.

Route of Administration:
The IM dose is 0.5 mg as needed.
The IV dose is 0.5-1 mg added to IV solution as needed.

Vitamin D

Cholecalciferol (vitamin D3) is crucial in building and maintaining healthy bones and teeth. Calcium is only properly absorbed by the body when vitamin D is present. Vitamin D is created within the body when direct sunlight converts a chemical in the skin into an active form of the vitamin.  Foods that are rich in vitamin D are fortified milk, fortified cereal, salmon, mackerel, and sardines. Many people cannot get enough vitamin D and the majority need daily Vitamin D supplement.

Cholecalciferol (D3) is the recommended form of vitamin D supplement. It is the natural form of vitamin D that the body makes from sunlight. Cholecalciferol metabolizes to calcitriol, which increases the body’s absorption of calcium and phosphorous. Calcitriol may play a role in the immune system and may inhibit cancer growth and stimulate cell differentiation.

Vitamin D3 injections can treat and prevent symptoms of vitamin D insufficiency, that includes, but not limited to, fatigue and bone pain. Deficiency of vitamin D has been associated with an increased risk of death from cardiovascular disease, cognitive impairment in the elderly, severe childhood asthma and cancer. https://www.olympiapharmacy.com/product/vitamin-d3/

Benefits:
Replete Vitamin D deficiency. Indicated in osteomalacia, osteoporosis diabetes and rickets.
It also boosts the immune system and is essential for bone and nerve health.

Adverse effects:
Usually well tolerated, but may cause stomach cramping, nausea, vomiting, diarrhea or constipation, and it could decrease the appetite.

Contraindications:
Severe atherosclerotic disease (CVD), kidney disease, hypercalcemic sensitive conditions such as hyperparathyroidism, lymphoma, and kidney stones prone individuals.

Requirements:
Lab test is required before treatment. Follow up labs after 8 weeks is needed as well

Route of Administration:  can be injected IM only. The dose depends on vitamin D, 25 hydroxy level  

• Level 30-40: dose is 50,000iu weekly.
• Level 20-30, dose is 65,000iu weekly.
• Level less than 20, dose 80,000iu weekly.
  Level to be rechecked 2 months after the first injection, dose to be readjusted accordingly. The goal is to reach the level of the 40-70 range.

Folic Acid (Vitamin B9)

Folic acid as known as vitamin B9, is a water-soluble, B-complex vitamin that is available orally and parenterally. This vitamin is found in a variety of foods including liver, kidneys, yeast, and leafy, green vegetables.

A deficiency in folic acid can cause a variety of hematologic complications including megaloblastic and macrocytic anemias. In addition to treating megaloblastic and macrocytic anemias as well as tropical sprue, this vitamin is also used as a diagnostic aid for folate deficiency. 

Folic acid can lower homocysteine levels, increase energy, and improve skin/hair quality.

It stimulates production of blood cells, it is important in DNA repair, and play role in converting carbohydrates into glucose.

Adverse effects
Stomach cramping, nausea, vomiting, diarrhea, irritability.

Contraindication:
Benzyl alcohol hypersensitivity, hemochromatosis, iron overload, acute gastritis, colitis.

Route of Administration:
The IM/SQ 0.4- 1 mg once daily
The IV dose 100mcg-1mg added to IV solution.
Level to be rechecked 2 months after the first injection, dose to be readjusted accordingly.