Hongkongers hooked up to IV drips for vitamins and hydration - do they work?

Wellness treatments delivered by intravenous drip are said to have a host of benefits, including anti-ageing properties and relief from hangovers and stress. Critics say there is no concrete evidence to support this

PUBLISHED : Sunday, 31 July, 2016, 7:02am
UPDATED : Monday, 01 August, 2016, 5:09pm

By injecting salty water into the veins of patients with terminal cholera, Dr Thomas Latta was remarkably successful in treating people on the brink of death during the 1831-32 cholera epidemic in Scotland. This pioneering treatment was first reported in The Lancet medical journal in June 1832, and since then intravenous (IV) fluid replacement therapy has become commonplace in hospitals for the severely sick who cannot take fluids orally for various reasons.

But these days even healthy people are hooking up to an IV. The latest wellness trend is getting IV infusions of vitamins, minerals and other enhancing nutrients for ailments of the modern lifestyle like fatigue, stress, poor sleep, hangovers and ageing. Celebrities such as Rihanna, Kelly Osbourne and Miley Cyrus have all posted photos of themselves on the drip on social media.

In June, Reviv, a international medical spa chain dedicated to elective IV hydration, opened a flagship clinic in Hong Kong. In the heart of Central on Duddell Street, the slick clinic has seen an average of about three clients a day for its menu of eight different IV injections and infusions, which cost from HK$298 to HK$3,998.

“We’ve had quite a diverse range of clients but in general, they are people who have that awareness of being healthy,” says Jenny Leung, managing director of Reviv HK.

These include athletes looking to recover quicker from workouts, stressed out professionals like bankers and lawyers, and women interested in anti-ageing and beauty, Leung says. The most popular treatment has been the HK$2,588 Megaboost, Reviv’s signature infusion that contains “a host of vitamins and detoxifying, anti-ageing glutathione” and claims to restore hydration, replenish essential minerals and vitamins, boost the immune system, deliver an energy boost, detoxify the body and cleanse vital organs (I tried it – see Post health editor joins the IV league with wellness drip).

Leung declines to reveal the specific ingredients that go into each Reviv infusion, and would only say they are “set formulas that have gone through many R&D cycles”.

Reviv is not the first in the city to offer IV therapy. Dr Lauren Bramley & Partners, a family medical practice in Central, has prescribed IV infusions since late 2012. Dr Winnie Mui, a family physician in the practice, says about 10 patients get the infusions each week, mostly fatigued athletes, weekend warriors and professionals who travel frequently.

The treatment has been so popular that the practice is expanding to have a special area just for IV therapy. “Sometimes we actually run out of the medications and vitamins, and have to turn patients away,” Mui says.

Unlike Reviv, Mui’s clinic only prescribes the treatment for existing patients. Two types of IV vitamin therapy are offered for boosting immunity and replenishing energy: a vitamin B12 shot (HK$299) and the Myer’s Cocktail (HK$1,500), an infusion that consists of magnesium, calcium and vitamin B complex, B5, B6, B12 and vitamin C.

The clinic, like Reviv HK, declines to reveal the specific dosage of ingredients of the infusion. Often, the infusions are customised based on the patient’s genetics and lab results. Mui says most patients get the shots twice a year; “very sick” patients may come back once a week for up to 10 weeks.

The staff at Dr Lauren Bramley & Partners also receive the treatment twice a year as well, Mui says, usually when they fall ill or feel like a flu is coming on. “It helps,” Mui says, “but not all the time. For fatigue, in general, one shot is enough to make you feel better.”

Proponents of IV wellness therapy claim taking nutrients intravenously rather than orally is advantageous because 100 per cent of the elements go into the system, quickly rehydrating, replenishing nutrients and restoring the body to peak balance. Nutrients taken orally are subject to the absorption barrier in the gastrointestinal tract, and therefore larger amounts are needed in order to achieve a similar result via IV or intramuscular supplementation.

I’m a bit shocked and surprised that this kind of service has been introduced to Hong Kong
Anfernee Yim Kin-ming

Critics remain unconvinced, arguing there is no evidence from properly controlled trials of the benefits of these vitamin infusions.

“I’m a bit shocked and surprised that this kind of service has been introduced to Hong Kong,” says Dr Anfernee Yim Kin-ming, chairman of the Hong Kong College of Emergency Medicine’s intensive care subcommittee. “The problem is there is no concrete evidence to support the use of IV fluids to boost immunity, for anti-ageing or other therapeutic use. It’s not really evidence-based medicine.”

Yim, a specialist in emergency medicine and intensive care medicine, says the use of IV fluids is for saving lives rather than promoting health. He calls it “strange” that IV therapy providers do not provide detailed ingredients and dosage information of their infusions. He also questions how such medical treatments are regulated in Hong Kong.

“The first rule of toxicology is ‘the dose makes the poison’,” says Yim. “Anything can be poison – depending on how much you get of it.”

Sharie Ross, Reviv HK director, says her clinic has a licence for a Hong Kong medical doctor in private practice, but declines to provide the doctor’s name.

The doctor does not sit in the Reviv HK clinic. The only medical professionals there are a team of nurses headed by Sarah Chiguer, who has more than six years’ experience as a staff nurse in intensive care units at hospitals in Paris and London. The nurses ensure patients first complete a medical screening questionnaire and undergo vital-sign checks before getting any treatment.

In most cases, nothing dangerous or risky will happen; we just want to be as safe as possible
Sarah Chiguer

There are some cases where patients are referred to the doctor for further consultation prior to treatment. These could be patients with cancer, diabetes and those with particular heart conditions.

“We keep the highest standards possible,” says Chiguer. “In most cases, nothing dangerous or risky will happen; we just want to be as safe as possible. We want to make sure the treatment you’re coming in for is beneficial for you.”

At Dr Lauren Bramley & Partners, Mui turns away women who are pregnant or breastfeeding, people with certain allergies or on certain medications, those with vein problems and heart conditions, among others. “That’s why it is important to have a medical consultation with a qualified medical doctor prior to getting IV therapy,” says Mui.

Taking vitamins via IV rather than orally began some 40 years ago when John Myers, a physician from Baltimore in the US invented the Myer’s Cocktail as an alternative treatment to relieve chronic pain and fatigue, asthma, muscle spasms, upper respiratory infections, seasonal allergies, migraines, and a host of other conditions.

But it is only in recent years that IV nutrient therapy has been used as an elective treatment for wellness and health maintenance. Las Vegas was reportedly the original hot spot for such IV therapy, where in April 2012 Dr Jason Burke, a certified anaesthesiologist, launched his IV clinic Hangover Heaven, a medical service in a bus that picks up and treats patients suffering from “hangovers, whether it be from alcohol, stress, or life in general”.

IVs always carry some, albeit small, risk of bruising, clotting, bleeding and infection, which eating, obviously, does not
Dr David Katz

Reviv, started by four emergency room physicians, first hit Miami in 2012, then branched out to Las Vegas, inside the MGM Grand Hotel & Casino, in August that year. There are now more than 25 Reviv clinics across four continents: in the US, UK, continental Europe, Africa, Canada, Hong Kong and soon Australia and the Middle East.

Clinical data for the efficacy of IV therapy remains sparse. Dr David Katz, director of Yale University’s Prevention Research Centre, conducted a trial of the Myer’s cocktail for fibromyalgia, a disorder characterised by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. The results were not definitive; there was a trend toward improvement with both the active treatment and IV placebo, but they did suggest a beneficial effect.

In an article on the popular health website DoctorOz.com, Katz notes that putting nutrients directly into the bloodstream “invites an array of potential dangers”.

He says: “Digestion regulates the speed at which nutrients enter the blood – IV dosing eliminates that safeguard. IVs always carry some, albeit small, risk of bruising, clotting, bleeding and infection, which eating, obviously, does not... 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.”