In the past few years, intravenous hydration, vitamin and mineral treatments have exploded in popularity. Patients are finding them at med spas, “drip bars,” or are booking house calls through concierge services. In any case, after an initial consultation, patients will be settled in a comfy chair with an IV line pumping the intravenous cocktail of their choice into their veins.
In recent years, more and more options have become available to get medical tests or care without actually having a specific medical reason and without the input of your doctor. IVs, recreational oxygen treatment, and genetic testing are among the growing list of options that were once impossible to get without a doctor's order. While patient empowerment is generally a good thing, many of these services are much more about making money for those who are providing the service than delivering a product that's good for your health.
Do IV hydration and vitamin treatments really work?
An IV can be lifesaving for a patient who is severely dehydrated, nutrient deficient or suffering from a massive infection, but many experts say there’s no reason to get an invasive treatment such as an IV unless a doctor recommends it.
"IV hydration is beneficial for those who genuinely need it," says Dr. Robert H. Shmerling, senior faculty editor of Harvard Health Publishing, who has studied IV therapy. "As for on-demand IVs, the short answer is 'buyer beware.' They are costly and lack clear scientific backing."
Additionally, “the placebo effect can do wonders for your mind,” says Ariel Igal, a professor at the Institute of Human Nutrition at Columbia University.
One of the few controlled studies on IV vitamin therapy found that patients with fibromyalgia experienced less pain after receiving a Myers’ cocktail, a combination of magnesium, calcium, and vitamins C and B. Interestingly though, patients who received only saline solution also reported similar positive results, indicating a strong placebo effect.
While it is true that an IV can hydrate you faster than drinking oral fluids, you'll still get all the same benefits from simple oral hydration without any of the potential risks which will be addressed later. Ultimately, if you’re too sick to keep up with your body’s need for fluids by drinking orally, then you really should be in a proper medical facility.
Debunking IV/IM Vitamin and Mineral Claims
Claims that vitamin and mineral drips or injections can cure hangovers, boost energy, “recharge your body’s defenses” or “turn back the hands of time” are largely unfounded.
In general, our bodies DO need vitamins and minerals, but in only trace amounts — often just a few milligrams or less — which can be easily attained from a balanced diet.
Water-soluble vitamins — i.e., vitamin C and the B-vitamin family — are unable to be stored in our bodies and even slight excesses will come out in our urine.
The fat-soluble vitamins — i.e., vitamins A, D, E and K — can be stored in our liver, fatty tissues, and muscles, and can be harmful in excess.
Minerals such as calcium, zinc, and magnesium all have different mechanisms in our bodies and rely on a delicate balance to be beneficial versus harmful when used.
Given that we need vitamins and minerals in such tiny amounts, and our bodies have advanced mechanisms in our guts to store or eliminate them after absorption, is there any reason to subject yourself to recreational IV/IM vitamin or mineral treatments?
Experts say no.
“Large-scale trials have repeatedly shown that there is no evidence to support the common claim that vitamin C supplements prevent us from coming down with colds and other infections,” said Igal.
Our daily vitamin C needs are estimated to be between 65 to 90 milligrams and this amount can be easily obtained from our diets. The highest daily intake of vitamin C without known risks is about 2,000 mg, but some med spas and drip bars are pumping in doses as high as 25,000 mg of vitamin C. These high doses could potentially cause nausea, diarrhea, vomiting, heart burn, headache or abdominal cramps, but what is worse is that in some patients who have a G6PD deficiency, high doses of vitamin C (greater than 6-7000mg) can cause hemolysis (destruction) of red blood cells causing anemia, or even cause a deadly increase in electrolytes such as sodium. A G6PD deficiency is often asymptomatic and not readily known of by patients. Before having high dose vitamin C treatments, a patient should ideally be tested for G6PD deficiency.
Vitamin B12 is another vitamin touted by med spas and IV bars as good for providing energy and sometimes beneficial for weight loss. Vitamin B12 injections are generally considered to be safe, however, supplementing with excessively high levels of B12 has been linked to some negative side effects. Several studies have shown that megadoses of the vitamin can lead to outbreaks of acne and rosacea, a skin condition that causes redness and pus-filled bumps on the face. There is also some evidence suggesting that high doses of B12 may lead to negative health outcomes in those with diabetes or kidney disease. A study from 2010 found that participants who have diabetic neuropathy (decreased kidney function caused by diabetes) had a quicker decline in the functioning of their kidneys when they took high-dose supplements of vitamin B12. The people who took the high doses of vitamin B12 were also more at risk for heart attack, stroke, and death than the participants who took a placebo, but more research is needed to support this claim. The participants in this particular study took a dose of 1mg of oral vitamin B12 supplements each day.
The recommended daily intake (RDI) of vitamin B12 is actually only 2.4 micrograms (mcg) (or .0024 mg) for both women and men, but women who are pregnant or breastfeeding need more vitamin B12. Pregnant women need 2.6 mcg per day. It is recommended that women who are breastfeeding take 2.8 mcg every day. Studies have found that taking up to 2 milligrams (equivalent to 2,000 mcg) of oral vitamin B12 supplements is safe and effective if you have vitamin B12 deficiency. Only about 10-mcg of a 500-mcg dose is actually absorbed by your body if you do not have vitamin B12 deficiency, therefore, taking high doses is not necessary or beneficial if you do not have an increased need for vitamin B12.
Zinc is common mineral advertised by providers of IV/IM supplements as it is often used for immune system support or to even help your Botox last a little longer. Although consequences of zinc deficiency have been recognized for many years, it is only recently that attention has been directed to the potential consequences of excessive zinc intake. Zinc is considered to be relatively nontoxic, particularly if taken orally. However, manifestations of overt toxicity symptoms (nausea, vomiting, epigastric pain, lethargy, and fatigue) will occur with extremely high zinc intakes. Even lower levels of zinc supplementation, closer in amount to the RDA which is 15mg Zinc/day, have been suggested to interfere with the utilization of copper and iron and to adversely affect HDL cholesterol concentrations. Individuals using zinc supplements should be aware of the possible complications before their use.
Calcium and Magnesium are minerals often used in "vitamin cocktails" provided by med spas and IV bars. While good for bone health and mood, respectively, excessive use of these minerals are not without side effects. Excess calcium can cause kidney stones and magnesium acts as a laxative, causing diarrhea. It is also worth noting that calcium competes with magnesium and zinc for absorption. Getting or taking them together is counterintuitive.
What are the disadvantages, side effects and risks?
Experts say there is little scientific evidence backing IV/IM vitamin or mineral treatments. They also caution that medically unnecessary IV drips could be risky for some people — particularly those who have heart disease or kidney problems.
For these individuals, getting too much fluid too fast could be harmful because their “heart or kidney can’t tolerate a lot of salts and fluids being introduced into their bodies,” says Sam Torbati, M.D., co-chair of the Department of Emergency Medicine at Cedars-Sinai Medical Center in Los Angeles. “Medically speaking, that’s where there is the most potential for harm.”
While putting in an IV line is not inherently unsafe if done properly, it is certainly invasive and not risk-free. There is always a possibility of injection-site infection. And in rare cases, the vein can become inflamed or blocked with a clot. People should also be wary of allergic reactions to ingredients being infused.
Another huge concern is sanitation of the area where the IV cocktails are mixed. “We have absolutely no idea if these infusion suites are using sterile compounding and storage techniques before putting it into people’s veins,” said Adina Hirsch, a board-certified nutrition support pharmacist in Atlanta specializing in IV nutrition.
What about the cost?
While the benefits of IV fluids and vitamins and minerals on demand are unproven and the medical risks are low (but real), the financial costs are clear. Treatment prices vary wildly, ranging from as little as $30 to upwards of $300+. These costs are not covered by insurance.
Keep in mind that the fluids and other therapies offered can be readily obtained in other ways such as drinking fluids, taking generic vitamins often for only a few dollars for a bottle, and eating a well balanced diet.
But what about people who swear by the benefits of IV hydration and vitamins?
“I frequently have patients who’ll say they heard from a friend about some new antioxidant, or some other mood-boosting IV supplement, and ask if I recommend it,” said Zachary Mulvihill, an integrative physician at Weill Cornell Medicine. “I don’t recommend it to anyone unless there’s a medical necessity — such as if someone has trouble with absorption from the stomach.”
Mulvihill’s typical approach involves focusing on diet and lifestyle. “You want antioxidants? Have a cup of blueberries. You want glutathione? Have cruciferous vegetables like kale and broccoli. There’s a lot we can do more naturally that can improve your health and won’t require sticking a needle in you,” he said.
Consumers should be aware that there is no case for vitamin or other supplements in normal healthy people, who are not pregnant or breastfeeding and are consuming a healthy diet.
Bottom line: “There’s nothing magical about getting vitamins in an IV,” Torbati says. “If you want extra nutrition, take a vitamin. If you have a headache, take a Motrin. Instead of spending hundreds on an IV, you can spend a nickel on a pill and get the same benefit.”
While these treatments are (mostly) harmless, they really just result in people making really expensive pee!
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