IV Therapy Clinics: The Risks, Costs, and Lack of Evidence

It's a nearly $3 billion market and growing fast. IV therapy clinics—where you can get cocktails of vitamins and other nutrients dripped directly into your veins—are supposed to do everything from detoxing our systems to fighting aging. But a new article in the respected medical journal JAMA highlights some serious concerns [1].

Below is an evidence-based look at the potential benefits alongside an honest assessment of the risks.

Table of Contents

• The Trend
• Do IV Infusions Actually Work?
• Risks and Costs
• Takeaway
• References

The Trend

IV clinics are driving billions in revenue [1]. These IV hydration spas are a growing segment of the booming medical spa market, which in 2022 was a $15 billion industry with nearly 9,000 facilities.

Most treatments combine electrolytes with a mix of vitamins and other nutrients. Take this chain of infusion clinics in the U.S., for instance. They list IV infusions intended to increase energy, speed recovery, boost immunity, and more [2].

They also offer an NAD+ IV drip that's touted for its anti-aging and cellular repair benefits [3].

If we look at a specific infusion example, like "Defender," we can see what it includes. In addition to a base saline solution, there's glutathione, B12, taurine, lysine, vitamin C, and zinc. The claimed impact? It's pretty vague. It's meant to "keep our system resilient and ready for anything" [2].

Here's the crucial question: Do we have good reason to think these infusions will actually work as advertised? The interesting thing about the language used by many IV clinics is that it's sneakily worded to avoid promising anything very specific. In the example above, it's not clear what it would even mean for a system to be "ready for anything."

But each ingredient is tagged with a proposed benefit that's more specific. Below is an evidence review of the key ones.

Do IV Infusions Actually Work?

Taurine

Consider taurine, for example. Is it really linked to heart health?

An important study looked at how taurine supplements impacted metrics related to metabolic syndrome. Metabolic syndrome is a cluster of interconnected risk factors that significantly increase the likelihood of cardiovascular disease, type 2 diabetes, strokes, and chronic inflammation [4].

The authors conducted a meta-analysis of randomized clinical trials—25 trials involving over 1,000 participants—and found that taurine decreased fasting blood sugar levels, blood pressure, triglycerides, LDL cholesterol, HbA1c, and insulin levels [4].

All this data, however, is for taking taurine orally. There is no clinical evidence that IV delivery is needed to see these benefits—and as discussed below, IV delivery introduces meaningful risks that oral supplementation does not.

The same pattern applies to many of the other ingredients in these infusion cocktails. They are not picked arbitrarily—the underlying ingredient research often has merit. But the leap from "this ingredient has benefits at a studied oral dose" to "infusing it intravenously at a higher dose is safe and effective" is not supported by clinical evidence.

What is needed, in order to have confidence in benefits, is a dose and delivery method backed up by clinical trials. That evidence is largely absent for IV infusion therapies.

Certainly not for taurine infusions. But there is some evidence for vitamin C, which is also included in the "Defender" infusion cocktail and is available as a standalone infusion.

Vitamin C

Interest in vitamin C infusions began in the 1970s in relation to treating cancer, with some promising results from early studies and case reports. One trial, for instance, found that the average survival time in cancer patients who received vitamin C was 4.2 times that of those who didn't [5].

Later, researchers explored the causal connection. Studies in the lab showed that high vitamin C concentrations could inhibit growth in cancer cells, and the same effect was found in animal models [6].

So why not just take it orally? The key advantage to IV delivery is that oral vitamin C produces plasma concentrations that are tightly controlled. Only intravenous administration produces high plasma and urine concentrations that might have antitumor activity [7].

But all the vitamin C infusion studies so far are small, and the current level of evidence is not sufficient to recommend IV vitamin C for cancer treatment or prevention. The same applies to claims about treating fatigue.

There are a number of clinical trials happening right now, and published results will be important for understanding whether any specific dose or context changes the benefit-risk calculus [8].

On the other hand, there are known risks. People with a history of kidney disease have developed kidney failure after IV vitamin C. There are increased risks of kidney stones, fluid overload, and hemolysis, which is when red blood cells are broken down [8].

One study even found that among 872 ICU patients, those who received IV vitamin C had a higher risk of death or persistent organ dysfunction compared to those who received a placebo [9].

The evidence-based conclusion for the "Defender" cocktail and similar IV formulations: there is a lack of evidence of benefit, and there are documented harms. The vitamin C case is illustrative of the broader problem—a plausible biological rationale, some early data, but far too little high-quality clinical evidence to justify routine use with the risks involved.

NAD+

The final infusion worth examining is NAD+. This is a crucial molecule found in our cells that plays a role in energy production, DNA repair, mitochondrial biogenesis, and cellular survival [10].

It's touted by infusion clinics for anti-aging benefits, but studies on the benefits of trying to boost NAD+ levels usually involve supplementing with its precursors, not NAD+ itself. These precursors can raise NAD+ levels and show promising health effects in animal models [10].

In humans, however, results so far have been disappointing [10].

But the most relevant question is what happens when NAD+ is delivered intravenously. The first study to test this was published in 2019. Researchers found that no change in plasma levels of NAD+ occurred until after 2 hours of infusion [11]. That's because the NAD+ was "rapidly and completely" removed from the blood for at least the first 2 hours [11].

This is likely because the NAD+ was broken down into its building blocks before it could be utilized [11].

The NAD+ molecule itself is too large to be absorbed directly from the bloodstream into cells. So the underlying idea of NAD+ IV infusions is fundamentally flawed.

And there were worrying adverse effects. Most participants experienced nausea, headache, diarrhea, and muscle tightness during treatment [12].

More seriously, the NAD+ infusion group showed clinically significant indications of inflammation, including elevated white blood cell and neutrophil counts [12].

The researchers summed it up well: "Despite its popularity, the science behind the safety and efficacy of NAD+ IV is minimal" [12].

This is what the evidence consistently shows with IV clinics: promoters start with a substance that has benefits in cell or animal studies, then proclaim clinical benefits for healthy adults through an IV infusion—even though, in most cases, there is practically no clinical evidence backing it up.

Risks and Costs

An obvious counterargument: even without solid evidence of effectiveness, these treatments might work—so why not try them?

The problem is that while the benefits remain uncertain, there are very real risks.

• Overdose risk: Even helpful nutrients can be harmful in high doses. This is especially true with fat-soluble vitamins like D, E, and K, which can accumulate and lead to toxicity [13].
• Fluid/electrolyte issues: Improper fluid infusion can cause electrolyte imbalances or fluid overload, which can negatively impact heart and kidney function [13].
• Allergic reactions: Individuals might be sensitive to ingredients in the infusion, with risks ranging from mild symptoms to severe anaphylaxis [13].
• Microplastics: IV infusions can directly introduce microplastics into the body, which may have harmful medical repercussions [14].
• Procedure risks: Inserting needles into veins always carries risk. Infection is a serious concern, especially when sterile technique isn't strictly followed. Repeated sessions can lead to vein-related complications, including phlebitis (inflammation), bruising, and even vein damage or collapse [13].
• Dosing errors and inconsistency: Improper insertion techniques, lack of medical oversight, or dosing errors can lead to complications. Many IV cocktails aren't based on validated clinical evidence, so formulations and amounts can vary greatly between clinics [13].
• Cost: IV therapy is expensive. Individual sessions often range from $100 to over $300. Yet many of these nutrients are available through diet or oral supplements, which are dramatically cheaper [13].
• Regulation: As of June 2024, not a single U.S. state had enacted legislation specifically regulating IV hydration spas [1]. Oversight is weak. Even an industry executive admitted that "enforcement by medical boards and state agencies has been lacking, even nonexistent" [1].
• FDA loophole: Clinics often create their own infusions. These are not regulated by the FDA because they are considered independent compounding pharmacies under Section 503A of the Federal Food, Drug, and Cosmetic Act [1].

Takeaway

Based on the current evidence, the recommendation from a clinical standpoint is clear: avoid IV clinics. The benefits are uncertain, the risks are real and documented, and the costs are high relative to what the evidence actually supports.

Instead, focus on proven interventions that make a measurable impact on health. The most important ones are not trendy, but there is a mountain of evidence that they work:

• Eat a healthy, whole-foods-based diet
• Get plenty of physical activity
• Prioritize quality sleep

References

1. https://jamanetwork.com/journals/jama/fullarticle/2840178
2. https://www.restore.com/iv-drip-menu
3. https://www.restore.com/services/nad-iv-drip-therapy
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC11099170/
5. https://pmc.ncbi.nlm.nih.gov/articles/PMC431183/
6. https://pubmed.ncbi.nlm.nih.gov/22205155/
7. https://pubmed.ncbi.nlm.nih.gov/15068981/
8. https://www.cancer.gov/about-cancer/treatment/cam/patient/vitamin-c-pdq
9. https://www.nejm.org/doi/full/10.1056/NEJMoa2200644
10. https://www.sciencedirect.com/science/article/pii/S0006291X24001256
11. https://pmc.ncbi.nlm.nih.gov/articles/PMC6751327/
12. https://www.medrxiv.org/content/10.1101/2024.06.06.24308565v1.full
13. https://pmc.ncbi.nlm.nih.gov/articles/PMC12182718/
14. https://pmc.ncbi.nlm.nih.gov/articles/PMC12298248/