By David L. Katz, MD, MPH, FACPM, FACP Director, Yale University Prevention Research Center Director, Integrative Medicine Center at Griffin Hospital
Proponents of intravenous nutrients can at times make them sound like the best thing since sliced bread. Or, for the low-carb devotees among you, the best thing since turkey bacon. Claims are made that intravenous nutrients in various combinations can act as a veritable fountain of youth, a tonic for low energy and, perhaps, an effective remedy for whatever ails you.
But of course if it sounds too good to be true, it probably is. And IV nutrients as a magic formula fits that bill.
To start the process of putting intravenous nutrients in proper context, let’s recall that by definition, a nutrient is something found in food, and a food is something we eat. This has many important implications. Nutrients in foods are, generally, ingested in the company of other nutrients and often act in concert with them. They are digested and enter our blood stream slowly. They are routed through the liver in what is called “the first pass effect” before being set loose on the body as a whole.
The fact that we are here – and surviving despite a diet that has gone from the simple, raw foods of the early Stone Age to the donuts and diet sodas of the modern age – is testimony to how robust this system is. It is the product of millions of years of evolutionary biology and is extraordinarily fine-tuned.
Putting nutrients directly into the bloodstream bypasses all of this native engineering, and in so doing, invites an array of potential dangers. Digestion regulates the speed at which nutrients enter the blood – IV dosing eliminates that safeguard. IV’s always carry some, albeit small, risk of bruising, clotting, bleeding and infection, which eating, obviously, does not.
IV nutrients are used routinely in hospitals for patients too sick to eat. This practice has made it quite clear that the IV approach is a last resort, and not nearly as good as the native route. When all nutrients are provided by intravenous, atrophy of the gastrointestinal tract becomes a serious problem, with associated immune-system dysfunction due to "leaky gut" and a much-increased risk of serious infection.
With such precautions in mind, though, it’s important to note the injectable nutrients can indeed be important when used in the right people at the right times for the right reasons. As noted, some patients are too sick to eat, and IV nutrients may be essential for preventing malnutrition in such circumstances. When older people can’t absorb vitamin B12 due to stomach atrophy, injecting the nutrient is the only way to ensure normal blood levels. Low levels of vitamin D or iron may require repletion by injection. And various conditions resulting in malabsorption, including surgical removal of portions of the intestine, may result in a need for nutrients by injection.
There is also a case to be made for the use of nutrients by injection as “medicine” in the treatment of a specific condition. The Myer’s Cocktail, a mix of minerals, B vitamins, and vitamin C, has long been used in alternative medicine circles for such conditions as chronic fatigue and chronic pain. In my own lab, we conducted a trial of this mix for fibromyalgia. Our results were not definitive; we saw a trend toward improvement with both the active treatment and IV placebo, but they did suggest a beneficial effect. We continue to offer the treatment, selectively, in my clinic.
If intravenous nutrients do have the power to act like “medicine,” then they have the power to do harm as well. Those two things come as a package, inevitably. So it makes sense to proceed with caution.
What about reports by those getting IV nutrients that they feel good? I suggest caution there as well. For one thing, this could be a placebo effect. But even if it’s due to the nutrients, feeling good is not the same as good for us. As an example, recreational drugs reportedly make people feel good in the short term, but clearly do harm over time. That’s not to say that IV nutrients are necessarily harmful – just that feeling good and doing good for your health are not reliably the same thing. So, buyer beware!
Nutrients, in general, should be ingested and digested – that’s just what our gastrointestinal tract is for. There is a role for injected nutrients, certainly. But the notion that nutrients should be infused is an argument with biology and the genius of natural selection. That’s biting off a lot more than we can chew – and I advise strongly against swallowing it.