In the past few years, intravenous vitamin treatments have exploded in popularity. Rundown customers are finding them as spalike “drip bars,” or are booking house calls by concierge services. In either case, after an initial consultation, they’ll be settled in a comfy chair with an IV line pumping the intravenous vitamin cocktail of their choice into their veins.
A typical visit takes 30 to 60 minutes and costs $100 to $300 (or more). None of the therapies is FDA-approved or likely to be covered by health insurance.
IV vitamin therapy was pioneered by John Myers of Baltimore in the 1960s (the Myers Cocktail, a popular formula, was named after him by a colleague), as a method to treat conditions such as asthma attacks, migraines and fibromyalgia. A clinical study of the effect of the Myers Cocktail on fibromyalgia patients found some improvement but no statistically significant results.
More recently, concentrated vitamin infusions have been popularized by celebrities such as Chrissy Teigen and Gwyneth Paltrow. The dubious claims are that they can cure hangovers, boost energy, “recharge your body’s defenses” or “turn back the hands of time.” Some clinics go further by falsely saying that IV therapy can alleviate symptoms of heart disease, diabetes, cancer and various neurodegenerative disorders.
Vitamin supplementation is not inherently harmful and can be lifesaving for babies born prematurely or people with known deficiencies. But our bodies need them in only trace amounts — often just a few milligrams — 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 dangerous in excess.
Given that we need vitamins in such tiny amounts and have critical mechanisms in our guts to store or eliminate them after absorption, is there any reason to subject yourself to recreational IV vitamin drips?
Experts say no. Here’s why.
The claims are hype
Drip bars make claims that they can boost immunity, delay aging or even prevent serious disease, all of which are myths.
Take the common claim that vitamin C supplements prevent us from coming down with colds and other infections. “Large-scale trials have repeatedly shown that there is no evidence to support this,” said Ariel Igal, a professor at the Institute of Human Nutrition at Columbia University. Studies looking at high-dose vitamin C supplementation in alleviating covid-19 symptoms have also come out empty-handed.
So where does this mind-set come from? “Mostly from deficiency studies,” Igal said. “There is some literature showing associations between vitamin C deficiency and greater susceptibility to illness. People have extrapolated these data to believe that the opposite must also be true. But so far, that just hasn’t been the case.”
Despite some variability, our daily vitamin C needs are estimated to be between 65 to 90 milligrams and can be easily obtained from our diets. The highest daily intake without known risks is about 2,000 mg, about the amount of vitamin C we ordinarily have in our bodies. But some drip bars are pumping in doses as high as 25,000 mg, all of which will be disposed of through urine just a few hours later.
“People need to realize that these massive doses are not stored in your body for prolonged immunity,” Igal said. “Your body is just like a gas tank. When you pump in more than the tank can hold, it doesn’t make the car work any better or faster — the extra gas just leaks out.”
Claims that drips dispensing the vitamin B3-associated molecule NAD+ can fight again are similarly bogus. While there is some evidence that low NAD+ levels may be implicated in brain aging and Alzheimer’s disease, there are no clinical trials that convincingly show that the opposite is also true — i.e., that repleting NAD+ can put the brakes on our naturally occurring aging processes. This comes as no surprise because NAD+ is only one of hundreds of molecules impacted in aging and supplementing one won’t budge the others.
“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.
Drip bars also tout their products’ ability to improve heart disease — the leading cause of death in America. But Tracy K. Paul, a preventive cardiologist at Weill Cornell Medicine, is skeptical. “There is no strong evidence in peer-reviewed literature that antioxidant, vitamin C, selenium and all these infusions are successful in preventing the development or worsening of heart disease,” she said.
The Federal Trade Commission is aware of IV clinics’ deceptive marketing. In 2018, it took its first action against such businesses, by charging a Texas-based IV drip company for making false claims about treating serious illnesses with unproven infusion cocktails. When clinics started advertising that their immunity-boosting cocktails could protect against infection from covid 19, the FTC issued warnings about those claims, as well.
But what about people who swear by the benefits of IV hydration? “The placebo effect can do wonders for your mind,” Igal said. “If you’re dehydrated and getting a saline drip, then sure, you’re going to feel better.”
It might not be safe
IVs are essential to hospital medicine. And 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.
Current regulations allow only a select group of health-care providers to give IV infusions. This includes medical doctors, RNs, PAs, NPs, and licensed practical nurses (LPN) with special certification, making it important for drip bar customers to check the company’s licensing. In 2015, the Florida Department of Health took action against a number of IV clinics where nonlicensed personnel were giving IV treatments.
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.
In October 2021, the FDA published a statement highlighting compounding-related concerns, using as an example the case of a 50-year-old woman who was hospitalized with a systemic infection after receiving an IV-vitamin infusion at home. Upon inspection, they found the compounding area to have peeling paint, dirty equipment, and dusty air vents littered with grime and expired ingredients.
“There are so many things happening behind the scenes in these unregulated businesses that the FDA is only now starting to find out about,” Hirsch said. “I just hope people will maintain caution before buying into these things.”
The explosion of trendy drip bars and at-home services is also coming at a cost by diverting resources and supplies away from patients with actual medical needs. Many commonly used ingredients such as sterile water, amino acids, multivitamins and electrolytes have frequently appeared on the FDA shortage list. Pandemic-related supply chain issues have exacerbated the scarcities.
“We are experiencing critical supply shortages to a point where even neonates in ICUs whose lives depend solely on IV nutrition are unable to get multivitamin products,” Hirsch said. “But irrespective of whether the patient is a neonate, kid or an adult, diversion of ingredients has unfortunately forced many health care providers to ration supplies.”
Frustrated by the lack of accountability of IV vitamin therapy businesses, several medical infusion organizations released a joint statement on the need for state and FDA review. They hope that regulatory agencies investigate the extent to which these businesses are contributing to national shortages, scrutinize claims of health benefits and cures, require them to disclose the lack of evidence and unique risks of administering medically unnecessary compounds, and comply with licensure and applicable regulations.
“Pandemic-related shortages have really pushed us over the edge,” Hirsch said. “For some products — such as multivitamin formulations — we are down to only one manufacturer for the entire country’s needs. This is completely unsustainable, and the impact on our most vulnerable patient populations is profound.”
Lala Tanmoy Das is an MD-PhD student in New York City doing research in molecular cardiology. Follow him on Twitter @TanmoyDasLala