Posted 02 March 2022
February 21, 2022
On the ground floor of a shopping mall in southern California, nestled between a kiosk selling hot pretzels and another selling mobile phones, customers relax in carefully arranged leather sofas while drip bags containing clear liquids drain slowly through veins in their forearms.
These “treatments,” which cost between $200 and $500, are increasingly popular, with similar kiosks and pop-up stores found along high streets and strip malls in the United States and Europe. Even at the exhibition for the Los Angeles Marathon, where runners flock in tens-of-thousands each year to collect their race credentials, runners were waiting up to forty-five minutes to receive a Fitness Drip or an Energy Drip, convinced the infusion would improve their chances of an elusive personal record.
For every ailment, there’s a nutrient drip.
What Are Nutrient Infusions and How Do They Work?
In a typical “therapy,” a hypodermic needle is inserted into a vein just below the elbow crease, allowing a banana bag of “nutrients” to infuse into the blood. The premise is that bypassing the gut will maximize nutrient availability. There are dozens of companies trying to distinguish themselves in a saturated market, but their infusions are alike, invariably containing water and a mixture of soluble vitamins, minerals, and/or electrolytes in various quantities depending on the customer’s perceived needs. Vendors of nutrient drips cite many of the standard pseudoscientific marketing tropes such as boosting immunity, detoxing, energy, healing, slimming, and fitness. Some specialize in hangover cures, offering white van mobile “concierges” for customers too hungover to go in store, and there are muscle injections available when intravenous infusions (those delivered through a vein) are considered too protracted. These practices have been popularized by celebrity endorsements from the likes of Madonna, Brad Pitt, Gwyneth Paltrow (of course), Rhianna, and many others.
What’s the Appeal of a Nutrient Infusion and Are They Necessary?
Nutrient drip vendors claim to expedite health and wellness and cure medical ailments. One must admit that atoning for poor diet and general lifestyle excesses with a simple infusion is an attractive proposition. But, in making such claims, nutrient drips exploit the same built-in economy heuristic (the mental shortcut) on which the entire health and wellness industry is based. As a quick-fix intervention aimed at improving long-term health, nutrient infusions are both unnecessary and unhelpful.
They’re unnecessary because they target the wrong aspect of nutrient availability. Millions of years of evolution gave us a gastrointestinal tract fully able to digest and absorb all the nutrients we need for normal metabolic function. In healthy people, there’s rarely a need to bypass the gut. The more prominent issue in dietary health is the nutrient supply chain—the diet—which is often insufficient to meet individual needs, and it’s this component that requires the greatest attention. And that’s where nutrient infusions are so unhelpful because they reinforce the popular notion of treating symptoms rather than causes. A drip targets the manifestations of poor nutrition but does nothing to remedy its root cause. As a result, any actual deficiency will simply resurface time and again. And if there’s no preexisting deficiency, then taking excess nutrients by way of supplementation provides no benefit to health or longevity.1
Nor are these drips entirely benign. Excessive levels of certain nutrients can be harmful to health,2 possibly increasing the risk of non-communicable disease.1 At sporting events, the use of commercial (non-medical) intravenous therapies has been criticized, because vendors conduct insufficient screening, monitoring, and follow-up to ensure athlete safety.3 Studies looking at the use of intravenous hydration among teams of the National Football League (NFL) reveal a high prevalence (75 percent) with around half the teams reporting complications from treatment including blood clotting, air bubbles, fluid accumulation on the lung, needle sticks, and accidental puncturing of an artery.4 There’s also evidence that athletes may become mentally dependent on the practice.4
The marketing rhetoric commits several common fallacies in an effort to distract customers from the sheer lack of scientific legitimacy. First, the claims are vague and ambiguous. None of the companies make any testable statements, instead employing very careful language and phrasing to shrewdly imply benefits without explicitly stating them. This type of definitional ambiguity makes the claim easier to defend when/if it’s eventually scrutinized. Claiming to improve “maximal oxygen uptake” is precise and falsifiable; contrast that with the actual claim of “helping you achieve your fitness goals.” Implying a claim and allowing the consumer to infer it any way they choose frees the company from any accountability when the treatment fails.
Second, the design of the websites, the phrasing they employ, the clinical appearance of the treatment lounges, the scrubs worn by the employees: all window dressing to feign clinical legitimacy. It perpetuates the façade that nutrient drips are endorsed by modern medicine, which they’re not. What’s more, many nutrient “treatments” are touted as New Age alternatives to achieving healthy function, invoking terms such as “natural” and claiming to be free from preservatives, gluten, GMOs (don’t get me started), and heavy metals. And yet, I can’t think of many procedures less “natural” than an eighteen-gauge polyurethane cannula fire hosing nutrients into somebody’s forearm.
The ‘Active Ingredients’
There are no valid scientific studies on the efficacy of commercial nutrient infusions, but this doesn’t preclude us from determining their plausibility based on the ingredients. Using one representative website, I obtained a list of ingredients for four randomly selected products: The Fitness Drip, The Detox Drip, The Immunity Drip, and The Energy Drip (see image below). Each contains the same base constituents: potassium, calcium, and sodium chloride are electrolytes that play a role in nerve conduction, among other things, and B-vitamins play a role in maintaining normal metabolic function; all are widely distributed among various food groups including fruits, vegetables, nuts, legumes, meat, and dairy. The other common ingredient, bicarbonate, is a salt often used because of its anti-caking and stabilizing properties. Because these ingredients are common to all the drips (and are the only components of the Basic Hydration Drip), we can deduce that they serve no specific purpose. The “active ingredients,” i.e., those that supposedly endow each infusion with its independent properties, can be assumed to be those unique to each drip (highlighted in blue).
The Fitness Drip. Priced at $270, it contains additional L-Carnitine (1 g) and Glutamine (1.5 g). Glutamine is the most abundant amino acid in the body and widely available in food (beans, pulses, dairy, chicken, and beef). In fact, a chicken breast contains roughly three times the amount of glutamine one would obtain from the drip (1.5 versus 4.0 g). Glutamine is one of twenty-two amino acids and is not considered an essential one. With respect to L-Carnitine, decades of research has shown that supplementation has little-to-no effect on muscle carnitine content, fat metabolism, exercise performance, or weight loss in overweight, obese, or trained individuals.5 Confused by their claims regarding fitness, I contacted a representative of the brand and asked how L-carnitine promotes fitness; I was told that “L-carnitine activates the metabolism.” It doesn’t. Nor would “activating the metabolism” improve anyone’s fitness.
The Immunity Drip. The only ingredient distinguishing the immunity drip (priced at $170) from the others is vitamin C. The Mayo Clinic advise against exceeding the vitamin C upper-limit of around 2,000 mg per day, because it might cause diarrhea, nausea, vomiting, heartburn, abdominal cramps, headache, and/or insomnia. They also state that, for most people, a healthy diet provides adequate amounts of vitamin C. The recommended daily intake is around 100 mg (depending on the reference you follow), which is roughly the amount contained in a solitary orange.
The Energy Drip. Amino acids are the building blocks of proteins, have an important role in synthesizing hormones and neurotransmitters, and they influence immune function. They have no special role, however, in “energy production” and certainly won’t offer a “boost of energy” as claimed. It’s true that one of the many symptoms of magnesium and/or B12 deficiency is tiredness/fatigue. However, these drips aren’t designed to treat deficiency and rarely screen for it. Again, the required amounts of both nutrients can be obtained easily from a balanced diet.
The Detox Drip. It’s listed here last because it’s a misnomer; the notion of a detox, which we have discussed previously in this column, has no meaning outside clinical treatments for drug addiction or poisoning. The two additional ingredients here are glutathione and vitamin C, which are both found in green and/or cruciferous vegetables and citrus fruits, among others. So, none of the active ingredients contribute to the attainment of the stated purpose. Instead, they’re listed on the assumption that the customer has little-to-no understanding of human physiology or nutrition.
Will Anyone benefit from a Nutrient Infusion?
The answer is: almost nobody, with a few exceptions. Nutrient deficiencies can occur from time-to-time, often caused by poor diet but sometimes the result of a medical condition that causes a malabsorption issue (e.g., bariatric surgery, major burns, or kidney injury). Diagnosis of a nutrient deficiency usually requires a blood test, after which a physician may prescribe a regimen of oral or intravenous supplements in a hospital or outpatient setting.6 Following extreme physical endeavors, such as marathons and ultramarathons, some people become dehydrated or malnourished in which case a medic may choose to infuse saline and electrolytes to expedite recovery. However, both scenarios are medical interventions for diagnosed issues, administered by qualified personnel based on predetermined clinical criteria; none of which are relevant in the commercial space. In fact, most vendors of nutrient infusions admit (in the small print) that their treatments aren’t registered medicines and that most commercial infusions aren’t covered by medical insurance.
Take Home Messages
Amid the trendy New-Age setting, the clinical façade, and the celebrity endorsements, nutrient drips are just a means of getting high dose vitamins and minerals without committing any time or effort to changing the diet. In bypassing the fundamental, evolutionarily derived digestive machinery, nutrient drips represent the ultimate in redundant quick fixes. And this is a shame, because the “healthy balanced diet” we hear about ad nauseum is far from elusive; it’s actually very easy to achieve with a little planning, and such eating habits will almost always preclude nutrient deficiency. It is a victory for modern marketing that many people remain convinced they need direct infusions to stave off poor health. And yet, if somebody is truly malnourished, then a supplement, vitamin injection, or intravenous drip is insufficient to address the cause. Whichever way you slice it, the commercial nutrient infusion is an expensive solution to a nonexistent problem.
1. Chen F, Du M, Blumberg JB, et al. Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study. Ann Intern Med. 2019;170(9):604–613. doi:10.7326/M18-2478
2. Hayes DP. Adverse effects of nutritional inadequacy and excess: a hormetic model. Am J Clin Nutr. 2008;88(2):578S–581S. doi:10.1093/ajcn/88.2.578S
3. Hoffman MD, Hew-Butler T, Roberts WO, Rogers IR, Rosner MH. Is Postevent Intravenous Hydration an Appropriate Service at Endurance Competitions? Wilderness Environ Med. 2016;27(1):7–9. doi:10.1016/j.wem.2015.12.014
4. Fitzsimmons S, Tucker A, Martins D. Seventy-five percent of National Football League teams use pregame hyperhydration with intravenous fluid. Clin J Sport Med Off J Can Acad Sport Med. 2011;21(3):192–199. doi:10.1097/JSM.0b013e31820f3612
5. Kerksick CM, Wilborn CD, Roberts MD, et al. ISSN exercise & sports nutrition review update: research & recommendations. J Int Soc Sports Nutr. 2018;15(1):38. doi:10.1186/s12970-018-0242-y
6. Wells C, Butcher R, McCormack S. Intravenous Multivitamin Therapy Use in Hospital or Outpatient Settings: A Review of Clinical Effectiveness and Guidelines. Canadian Agency for Drugs and Technologies in Health; 2020. Accessed February 8, 2022. http://www.ncbi.nlm.nih.gov/books/NBK567072/