IV Drips: What an ER Physician Actually Thinks About Vitamin Infusions

Written by Korosh Borhani, D.O., board-certified emergency physician and Medical Director of Skin Bio. Clinically reviewed September 10, 2026. Instagram: @DrKoroshBorhani

I’ve hung more bags of IV fluid than I could count. In the emergency department a liter of saline is a tool with a job: the guy who’s been throwing up for two days, the diabetic in crisis, the grandmother whose blood pressure is dropping. It’s never a treat. So when I look at the “IV drip lounge” business, I come at it with a working man’s skepticism, and I want to explain that honestly, because we offer IV therapy at Skin Bio and I think you deserve to know exactly what you’re buying.

What an IV actually does

Your gut is a very good absorber of water and most vitamins. In a healthy person who eats and drinks normally, an IV dose of vitamin C or the B vitamins mostly bumps the blood level for a little while, and then the kidneys clear the extra. The old joke about expensive urine is a joke because it’s mostly true for water-soluble vitamins in people who aren’t deficient.

Where the IV route really changes things is when the gut is out of the picture or the shortage is real: the patient who can’t keep fluids down after a stomach bug, the person who’s badly dehydrated after a day in the heat or a long flight and a late night, the patient with a documented B12 or iron deficiency who isn’t absorbing pills, the migraine patient for whom IV magnesium and fluids are part of a plan. Those are real reasons. I use them in the hospital and I’m comfortable using them at the practice.

What the evidence does and doesn’t support

The best-known wellness infusion is the Myers’ cocktail, a mix of magnesium, calcium, B vitamins and vitamin C that’s been around for decades. The most careful study of it I know of was a small randomized, placebo-controlled trial in patients with fibromyalgia. Both groups got better. There was no meaningful difference between the cocktail and the placebo bag. That’s one small study, and it doesn’t prove the cocktail is worthless, but it does mean the confident claims on lounge menus aren’t coming from the data.

The claims I’d ask you to be most skeptical of:

• “Immune boost.” There’s no good evidence that IV vitamin C prevents colds or flu in healthy adults. Your immune system isn’t a phone battery.
• “Detox.” Your liver and kidneys detox you. If a menu says a drip removes toxins, ask which toxins, how, and measured with what. You won’t get an answer.
• “Anti-aging” and “beauty” drips. Glutathione and biotin infusions are popular. The skin-brightening claims for glutathione sit on weak evidence, and high-dose biotin can throw off common blood tests, including thyroid and heart markers, which is a real problem if you end up in my emergency department.
• “Hangover cure.” Fluids, an anti-nausea medication and an anti-inflammatory will make a dehydrated, queasy person feel better. That’s symptom relief, and it’s fair to sell it as symptom relief. It doesn’t undo what the alcohol did.

The Federal Trade Commission and the Food and Drug Administration have both sent warning letters to IV therapy businesses over unsupported health claims. When the regulators and the ER doctor agree on something, it’s worth a listen.

The risks nobody puts on the menu

An IV is a needle in a vein hooked to a bag of fluid. Done carefully by a trained nurse, the risks are small. They aren’t zero, and they aren’t the same for everybody.

• Fluid overload. A liter of fluid is nothing to a healthy thirty-year-old and a real danger to somebody with heart failure or advanced kidney disease. This is the one I worry about most in a place where nobody took a real history.
• G6PD deficiency. High-dose IV vitamin C can make red blood cells break apart in people with this inherited enzyme deficiency, which is more common than most people think, especially in folks of Mediterranean, African and Middle Eastern descent. A responsible practice checks for it before high-dose vitamin C. A lot of lounges have never heard of it.
• Infection and vein irritation. Any line can let bacteria in or inflame the vein. Clean technique isn’t optional.
• Electrolyte problems. IV magnesium and potassium can change your heart rhythm when they run too fast or go to the wrong person.
• Vitamin toxicity. Long-term high doses of vitamin B6 damage nerves. High-dose vitamin C raises the risk of oxalate kidney stones in people who are prone to them.
• NAD+ infusions commonly cause flushing, nausea and chest tightness when they run too fast. Usually uncomfortable rather than dangerous, but not something to get from someone who doesn’t know why it’s happening.
• Allergic reactions, including rare but serious reactions to thiamine and other additives, which is why an IV should happen somewhere with an emergency plan and the medications to carry it out.

The California rule most lounges hope you don’t know

In California, IV therapy is the practice of medicine. Before you get one, a physician, nurse practitioner or physician assistant has to evaluate you and order it. A registered nurse can then place the line and run the infusion under that order and under physician-approved protocols. An unlicensed “wellness technician” can’t, and a nurse can’t decide on her own that you’re a candidate. Mobile services and storefront lounges are held to the same standard as a clinic.

So the test is simple. If you can walk in, point at a menu, and get hooked up without anyone who can prescribe ever evaluating you, that business isn’t following the rules. And in this case the rule isn’t paperwork. It’s the step where somebody notices you have a heart condition.

How we do it at Skin Bio

A physician or nurse practitioner evaluates you first, including the questions about heart, kidney and liver disease, medications, pregnancy, and, before any high-dose vitamin C, your G6PD status. Our nurses place the lines. We keep emergency medications on hand. We use formulas for specific reasons: hydration and electrolyte replacement, B12 for a documented deficiency, magnesium for patients whose physicians agree it makes sense. We don’t promise any of it will detox you, cure a hangover, or make you immune to anything.

If what you really need is a glass of water and a night’s sleep, I’ll tell you. I’ve told people. It’s the least profitable sentence in this business, and I’m fine with that. I’d rather be the guy in Calabasas you trust than the guy who sold you a drip.

Follow along on Instagram: @DrKoroshBorhani and @skinbio.co

This article is educational and reflects the author’s clinical opinion. It is not medical advice for any individual. IV therapy requires evaluation by a licensed medical provider; risks vary with your health history.