LONDON — For decades, intravenous (IV) nutrition was typically a “last resort” treatment. However, the approach has become much more common among athletes in recent years. Now, a new report published by a team of experts is advocating for a “food first, no needle” approach instead. Study authors stress that there is no evidence indicating IV nutrition works or is even safe to use in this way.
The scientists responsible for this report regularly interact with professional athletes across European and American leagues and their support teams. They say their cautionary message about IV nutrition needs to reach the locker rooms, from Los Angeles to London.
While researchers can’t say for sure just how widespread IV nutrition has become, they do report that certain players receive IV nutrition drips as often as every week as part of a pre or postgame routine.
These playfully nicknamed “drip bars” and concierge IV nutrition services supposedly boost health and performance, restore hydration, and speed up recovery via a variety of nutrients such as B vitamins, amino acids, glutathione, vitamin C, and electrolytes. In many cases, the nutrient levels provided by IVs far exceed those seen within the normal therapeutic range.
These setups may be convenient for players, but researchers warn IV nutrition services have largely escaped regulatory oversight. Additionally, there is no guidance whatsoever on their use for players or practitioners.
Intravenous fluids are typically only for extreme emergencies
A “food first” approach and minimizing the use of needles whenever possible is already part of the curriculum in current sports nutrition courses around the world. Similarly, the Olympics has banned needle use among athletes — aside from appropriate medical situations or if an athlete has a therapeutic use exemption (TUE).
Generally speaking, doctors historically only use IV nutrition drips for serious clinical conditions. Examples include anemia, nutrient deficiencies, or severe dehydration. Nowadays, athletes are using IVs for tiredness, fatigue, or recovery.
“But the evidence is sparse and not supportive. We are aware of just two studies assessing vitamin injections in otherwise healthy participants, neither of which yielded an effect for the injection group,” the study authors write in a media release.
What’s the risk of using IV nutrition?
IVs also come with their own unique set of risks, as they can potentially interfere with the liver and gut microbes — which researchers consider the body’s “powerhouses of detoxification and immunity.”
“Bypassing these mechanisms appears foolhardy unless there is a significant clinical rationale,” researchers write, noting that IV drips also carry infection risks at the needle site and the potential for forming blood clots.
There’s also the risk of having too much of a good thing; studies link excess B6 with peripheral neuropathy, while athletes who habitually receive iron via an IV risk developing liver disease.
“Given that the long-term effects of supratherapeutic doses of B vitamins and other nutrients are unknown in athletes, it does not appear to be worth the risk, especially given the lack of evidence-based benefits,” the research team writes. “More than this is the reputational risk to sport if it is normalized for athletes to regularly partake in self-directed IV [nutrition] use with a worrying shift away from what ‘works’ (according to scientific standards), to that which is unproven.
“Furthermore, some athletes risk an anti-doping violation by participating in self-directed IV [nutrition] use.”
Study authors suggest that scientists collect more data on the prevalence of IV nutrition in pro sports leagues. That information can then help produce accurate recommendations on the potential risks of IV nutrition use. “The ‘food first’ and ‘no needle’ messages need to be amplified among all athletes and multidisciplinary support teams to avoid what was previously a ‘last resort’ treatment becoming normal without scientific evidence of benefit,” they conclude.
The study is published in British Journal of Sports Medicine.