IV Nutrition: Few Proven Benefits for Growing Trend Among Athletes

What if you could “recover from dehydration and immune challenges, and support athletic recovery and chronic health challenges like fatigue, weight gain, and inflammation,” all with a special vitamin cocktail delivered straight into your bloodstream? Turns out, you probably can’t.

But according to an editorial published in the British Journal of Sports Medicine Tuesday, elite athletes are self-medicating with IV nutrition products that promise similar benefits. The products are found at “drip bars” or through concierge home services, and deliver vitamins and nutrients via an IV drip in the arm. Charles Pedlar, PhD, of St Mary’s University Twickenham in London, and co-authors note that some athletes use the treatment as often as weekly before or after games, paying for treatments “claiming to boost health and performance, restore hydration, accelerate recovery and so on.”

But the benefits remain unproven. Pedlar, a sports physiologist who works with professional athletes in both the U.K. and the U.S., told MedPage Today that he started noticing an uptick in the use of IV treatments in the last 3 or 4 years. As part of his work with athletes, during routine blood tests, “we were noticing that there was definitely a subset of players who were coming through with very, very high values for some nutrients,” he said.

The evidence for benefits of the treatments is “sparse and not supportive,” the editorialists wrote, noting that infusions often contain combinations of B vitamins, amino acids, electrolytes, vitamin C, glutathione, or a coenzyme called nicotinamide adenine dinucleotide. The only two studies — one in 1978 and one in 2020 — evaluating the effects of vitamin injections found no effects.

Pedlar explained that beyond a certain level, the body doesn’t need excess vitamins, and any perceived value could be a result of the placebo effect. The 2020 study showed some benefits in terms of red blood cell parameters with vitamin B12, but not when their vitamin B12 level was beyond 700 pg/mL. What’s more, injecting vitamins didn’t have an advantage over taking them orally, the research showed.

In fact, treatments that promise to “optimize” so many aspects of health have a potential for real harm, the editorialists said. For example, an excess of vitamin B could lead to peripheral neuropathy, and too much iron delivered to the body outside of the intestine can increase the risk for liver disease.

The team also warned about an increased potential for infection and blood clots that come with the use of an IV drip generally. “I’m pouring in this nutrition product that you don’t know exactly where it’s come from, or whether or not it might be contaminated with other products,” Pedlar said.

The body’s “gut-liver axis” is a natural mechanism for regulating nutrients that are ingested as food, and “bypassing these mechanisms appears foolhardy unless there is a significant clinical rationale,” the group wrote.

Elite players are pushed to perform in many arenas, perhaps more now than ever, Pedlar said. “Professional athletes are under a lot of pressure these days from the physical load they’re under, but also the media, the requirements that they have to deal with, social media. They see this as a quick way to be able to tolerate the demands of their sport better.”

IV nutrition has high-profile non-athlete advocates, like Kendall Jenner and Hailey Bieber, helping to popularize it. IV vitamin treatments in the early days of the pandemic popped up, promising to treat COVID-19. The Federal Trade Commission even sent a warning letter to a business called Prana IV Therapy for “unsubstantiated claims.”

And unlike illegal performance-enhancing drugs, for example, the IV treatments are not taboo, Pedlar noted. “It’s become quite matter of fact, you know, [with people saying] ‘I have those weekly,’ so there seems to be a willingness to share that information, which is a surprise to us.”

As with other unproven sports medicine and “wellness” trends, while there’s still a research and data void, it’s better for athletes to stick to what is known to work — i.e., getting nutrients through food, not an IV drip: what those in sports medicine call a “food first” approach. Evidence-based guidance on IV vitamin use is largely absent from sports medicine literature, although “no-needle” policies, which ban athletes from using syringes or injections, apply in some sports and organizations, the editorialists said.

“We’re trying to look for the best training techniques and we’re trying to look for the best nutritional strategies and recovery strategies, but there’s a line somewhere where it becomes too much and it’s too far,” Pedlar said. “It doesn’t feel right to be observing athletes taking IV products when there’s not really a strong case for it.”