It is nothing short of hilarious that people who drink excessively, to the point where they experience a hangover the next day, are overly concerned about their health. Enter the world of IV hydration and vitamin drips – a largely unregulated industry with a projected revenue of $2.1 billion in 2024. It is huge and growing. But is it real or black magic?
Incongruity time
The irony here should be obvious. As I recently wrote, alcohol is very far from harmless. In the US, it is responsible for 180,000 deaths annually. Of these, about 20,000 are due to excess cancer deaths that can be attributed directly to alcohol consumption.
Perversely, some drinkers view hydration as part of a "healthy lifestyle," but this makes little sense. They poisoned themselves the night before with acetaldehyde (1), and somehow believe that a bag of saline with a few vitamins and minerals chucked in is going to undo the damage. No chance. This is like closing the barn door after the barn burned down.
Does IV hydration work at all?
This depends on the setting. People who become severely dehydrated, often from severe diarrhea or acute gastrointestinal illness, benefit greatly from the IV infusion of water, electrolytes (salt), and glucose. It can be a lifesaver. In 2019, 1.5 million people – a third of them children – died from diarrheal disease worldwide. With access to IV hydration, many could have been saved.
Do vitamins make a difference?
The medical literature reports on a number of clinical trials on this topic, mostly flawed (e.g., no control group, too few participants). Some trials are also in "shaky" journals. I came across a review in the prestigious British Medical Journal, in which Max Pittler and colleagues compiled a systematic review of studies where vitamins, dietary supplements, and some drugs were added to saline and water. The paper included only studies with randomized controlled trials (RCTs). None of it mattered.
Conclusion: No compelling evidence exists to suggest that any conventional or complementary intervention is effective for preventing or treating alcohol hangover. The most effective way to avoid the symptoms of alcohol induced hangover is to practise abstinence or moderation.
M. Pittler, et. al., BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7531.1515 (Published 22 December 2005)
This should not come as a surprise. The vitamin industry touts vitamins (unsurprisingly) as magical potions that heal all our maladies, but in reality, vitamins are simply a group of chemicals that help enzymes carry out reactions (2). There is no reason to expect them to cure a hangover.
Eileen O’Sullivan, M.D., an emergency department physician, in an interview with Forbes, emphasized that the body regulates fluid and vitamin levels naturally, rendering such treatments unnecessary:
"While the notion of high vitamin and hydration levels may sound appealing, the boring truth is that the body has tightly regulated mechanisms that keep our fluid status and vitamin levels in a specific range.”
Eileen O’Sullivan, M.D., "What Is IV Therapy? Benefits, Side-Effects And Costs?" Forbes, January 2024
Dr. Chuck Dinerstein, the ACSH director of medicine, explains that a glass of water (or bag of saline/glucose) will work just as well.
Adding water-soluble vitamins to an intravenous solution intended to rehydrate the walking well makes little sense. But it does show consistency. Anyone spending good money on intravenous hydration that is just as easily obtained from drinking water surely has enough discretionary funds to waste more money on needless vitamins. PT Barnum may be dead, but his customers are alive and getting intravenous vitamins.
Dr. Chuck Dinerstein, (Private communication, 8/7/24)
Finally, ACSH friend Dr. David Seres knows a thing or two about nutrition. He is decidedly negative about the IV vitamin hydration at all, especially for frivolous reasons:
Anyone with a medical license who provides IV vitamins for hangovers should have their licenses revoked. Beyond the uselessness of IV vitamins for hangovers, people with actual medical illnesses making them dependent on these cannot access them because of shortages and jacked-up prices.
David Seres, M.D., ScM, PNS, FASPEN, Director of Medical Nutrition, Columbia University Irving Medical Center and Professor of Medicine, Institute of Human Nutrition. (Private Communication, August 7, 2024.)
Bottom line
There is no solid evidence that IV vitamin hydration does anything at all, except for the saline. Excess water-soluble vitamins are quickly eliminated in the urine, so it is accurate to say that people who spend $300 for this service are pissing their money away.
NOTES:
(1) Alcohol is metabolized in a two-step process. In the first step, it is converted to acetaldehyde, which is highly toxic and also a known carcinogen. (This is why alcohol is characterized as a carcinogen.) Next, the acetaldehyde is further metabolized to form (harmless) acetic acid.
(2) Vitamins are co-factors: molecules that an enzyme uses to elicit a biochemical reaction.
Josh Bloom
Director of Chemical and Pharmaceutical Science
Dr. Josh Bloom, the Director of Chemical and Pharmaceutical Science, comes from the world of drug discovery, where he did research for more than 20 years. He holds a Ph.D. in chemistry.
