Last week, I met a young man with cerebral palsy, hospitalised with an infection. Not capable of speaking, he lay quietly in his bed. Although he appeared settled, I had no way of knowing how he felt, so imagine my relief when his carer told me that, after 10 years, she could interpret his every expression.
“What do you think about IV fluids?” she asked. “It might perk him up a bit.”
Under normal circumstances, I would have said yes. Instead, I reassured her that he was not dehydrated, had perfect renal function and, if needed, we could administer more water through his feeding tube.
I took this step amid a global shortage of intravenous fluids used to replace fluid losses, resuscitate patients and deliver essential medications including chemotherapy drugs, antibiotics and anaesthetics. Australia does not manufacture its own IV fluids and can’t compel companies to do more. Hence, doctors are receiving daily reminders to save IV fluids for those who need them the most.
Even though I had used my clinical judgment, I felt discomfited by our interaction.
Away from the bedside, I wondered if the carer thought I had denied my patient IV fluids because he was disabled and disenfranchised.
Maybe this is why I found myself reacting more strongly than I’d care to when I read about the latest health fad: the rise of intravenous vitamin cocktails for the worried well.
As an oncologist, I am no stranger to “wellness” cures; my last patient went bankrupt in their wake. When we met, she openly told me that she liked me but was rejecting my advice in favour of “vitamin therapy”. I replied that her chosen therapy could do her harm, but I would still be there when she returned.
Cancer and alternative therapies have long been bedfellows, but the newest vitamin infusions are not aimed at the sick. Instead, they cater to young professionals, executives and celebrity types in search of a “biohack”.
The theory goes like this. Busy people have no time to incorporate these nutrients into their daily life. But without products to “elevate” normal bodily functions, one risks all manner of insults, including loss of beauty, faulty immunity and premature ageing.
Special events (like hangovers) call for special infusions. What better way to invigorate the body than by “bypassing” the digestive system to drip pure ingredients directly into the bloodstream?
For the indecisive or rushed, maybe an intramuscular injection is needed to make one glow, hydrate, recover and rejuvenate. The cheapest ones cost about $250 but you could also “build your own”.
When I play around on several websites, my “customised” package of a bunch of important-sounding “boosters” sets me back several hundred dollars – and that’s just for the initial “treatment”. Maintenance, of course, is key!
But wait, do I also need selenium in my infusion? How about taurine? Why can’t I even pronounce nicotinamide adenine dinucleotide when it is the most expensive medical item in the cart? Opting for these “proven” bestsellers would have parted me from a cool thousand dollars.
At one point, I muse that 15 years of medical training never taught me to stack my selenium or tally my taurine. Maybe because a can of tuna contains all the selenium I need and the same goes for turkey meat and taurine.
Even in the medical setting, complications from IV insertion including inflammation, infection and clots are reported to be as high as 70%. This is why doctors are taught to avoid inserting IVs unless they are necessary.
If they were not so galling for their lack of accuracy, the tall claims about vitamin infusions would be funny. But health illiteracy is rife and magical solutions are irresistible.
The public should know that vitamin infusions are not approved or regulated by health authorities. There is no evidence to suggest that vitamin infusions for well people are any more beneficial than the original biohack: eating and drinking in moderation and getting sufficient sleep, exercise and socialisation. The health regulator, AHPRA, has long issued warnings over the inappropriate marketing of IV infusions that are not supported by scientific evidence.
Amid a supply crunch, my patient with cerebral palsy, and other patients like him, will need to forego IV fluids unless they are absolutely essential. Doctors everywhere will be making difficult decisions at the bedside.
You cannot control your nerves, restore your clarity, reboot your youth or balance your blood with vitamin infusions.
If vitamin infusion centres genuinely care about societal “wellness”, they would do well to reconsider their use of these suddenly precious fluids offered in the name of vanity.
Ranjana Srivastava is an Australian oncologist, award-winning author and Fulbright scholar. Her latest book is called A Better Death
