Intravenous infusions and the burgeoning world of boutique bloodwork

It’s a weird feeling, scheduling a hangover. 

Because I am a woman of a certain age (that age is 32), I can no longer drink more than four beers without feeling like a trash muppet. In a sense, all of my hangovers are scheduled because they are inevitable—a progressive vice tax with per-drink brackets. 

Still, something felt different about booking an appointment with Liquid Mobile IV, one of many local businesses that promise to relieve hangovers through the power of intravenous fluids. Maybe it was all the foreshadowing. After filling out a short medical history and signing a consent form, my appointment was secured. 

10 days from now, I would be miserable enough to let a stranger put a needle in my arm. 

Elective IV businesses or “drip bars” aren’t new, but until recently, they seemed like a niche option, reserved for Vegas bachelor parties or the ultra-rich. Gwyneth Paltrow and Chrissy Teigen have publicly proclaimed their love for IV infusions; the heiress to the Getty oil fortune was lauded in Vogue France for supplying IV drips for guests at an extravagant, multi-day wedding officiated by Nancy Pelosi.

In the last couple of years, drip bars have proliferated throughout the metro, making the mainline a little more mainstream. That doesn’t mean the treatments are cheap. An IV infusion locally might run anywhere from $100 to more than $300, depending on the location and volume of fluids. 

But I wanted to see how the other half lived. Mostly, I wanted to know if buying my way out of a hangover was as orgiastic as it seemed. I wanted IV fluids to inflate my crumpled, hungover body like a bounce castle until I had enough vim and vigor to berate Witherkins about the state of the carriage house.  

With 10 days to kill before my next hangover, I decided to book another IV infusion for a sober comparison point. I grabbed the first open slot at another business: IV Nutrition Now, a chain clinic that operates out of a strip mall in Overland Park next to the Beef Jerky Experience. 

The inside didn’t look like a clinic. It looked like a spa. The infusion room had a plant wall (all pothos) and the kind of leather recliner chairs you might see in a swank movie theater. I nestled myself into one and perused a glossy menu of services while a friendly employee named Monica checked my blood pressure and blood oxygen levels.

The menu had more than 20 different cocktails of vitamins and amino acids, most of which had alliterative names like “Ache Absolver™” and “Insane Immune™” (nearly every menu item was trademarked). I was overwhelmed by choice. Did I want “Hefty Hydration™” or “Hella Hydration™”? Did I want to order one of the house formulations or build my own bear by adding zinc, taurine, or tryptophan ($2.50 per mL)? 

Monica tried to guide me by asking me about my goals. 

“I’m planning to be hungover in the future and wanted to try it out,” I said, then realized this sounded insane. “Also, I run and lift weights—“

“An athlete.” She nodded knowingly. 

I hesitated. I was an athlete in the way that drip bars were health clinics—true in a technical sense, but it felt embarrassing for everyone involved to refer to it that way. Still, I seized on the idea and opted for a shorter “express” infusion called Rapid Repair™, which promised to replenish my amino acids and enhance my muscle recovery.  

Monica wheeled out a small, neon-yellow bag (250 mL) and plugged me in. She had warned that I might be able to taste the infusion, and she was right. For the first few minutes, my mouth tasted like the inside of a Flintstones vitamin jar. It was more unsettling than unpleasant.

Supplements for sale at IV Nutrition Now. // Photo by Kaitlyn McCullagh

The actual infusion only took about 15 minutes and was far more comfortable than I had expected. Monica even put a heating pack on my arm so it wouldn’t get cold (IV fluids are room temperature; your body is not). She checked my blood pressure and blood oxygen levels again, then asked me to pee in a cup so they could check my kidney function. I am inherently suspicious of anyone who asks for my urine, but Monica didn’t look like a narc, so I complied. My urine was the exact same shade as the bag of fluids that had helped create it. (A wild, intrusive thought—was this how they filled the bags?) 

On the ride home—after a Beef Jerky Experience—I surveyed my body for clues. If my muscles were repairing themselves, they were doing it quietly. I thought I felt a little more energetic, but it was hard to tell. 

For this vague feeling, I paid $109. 

Like the rest of the wellness industry, drip bars promise a host of benefits, many of which are abstract nominalizations: optimization, detoxification, regeneration. A lot of people are introduced to the industry through hangover treatments, but hangovers don’t keep the lights on. Most clients come for the vitamins. 

Vetting the efficacy (let alone the dosage) of vitamin infusions is tricky. Dietary supplements are poorly regulated relative to prescription drugs—there’s no guarantee you’ll receive what the clinic promises. And the pandemic has only inflated some of these businesses’ claims. 

In the past two years, the Federal Trade Commission has sent hundreds of warning letters to IV clinics for claiming that vitamin infusions could protect against COVID-19 (a claim for which there is no reliable evidence). Two of those letters went to local businesses—The Epigenetics Healing Center in Overland Park and the Revive & Rally Health Lounge in the Crossroads. The latter has since closed, citing in an Instagram post “circumstances outside of our control.”

I wanted to better understand this side of the industry, so I called up Dr. Cydney McQueen, a clinical associate professor at the UMKC School of Pharmacy. McQueen has researched and published extensively on dietary supplements and nonprescription drugs, and she’s upfront about the risks. 

Fat-soluble vitamins such as Vitamin A can be dangerous in excessive quantities; even too much saline solution (the base of most IV bags) can be dangerous for patients with heart conditions or kidney disease. And intravenous infusions always carry some risk of contamination and infection relative to oral medication and hydration. 

“If the gut works, use it,” McQueen says. “That’s always the best.” 

But do IV infusions have any advantages? 

“Sure,” she says. “Any time you give a medication IV versus orally, it’s going to work faster because it’s getting in the bloodstream faster.” 

The front desk at IV Nutrition Now. // Photo by Kaitlyn McCullagh

Most of the IVs administered at drip bars aren’t medically necessary, but she lists a few groups of people who might benefit from them anyway, including those who get migraines. The vitamin infusions offered at these bars often contain magnesium, which McQueen says has been shown to help reduce the severity of migraines. Another common ingredient is methylcobalamin, a form of vitamin B-12 that older adults can have a hard time absorbing through food. For people who are clinically dehydrated, an IV can be a faster road to recovery. Plus, as expensive as an IV infusion at a drip bar might be, it’s a hell of a lot cheaper than getting one at a hospital. 

Still, McQueen notes, would-be patients should ask about the sterility of the preparation and the dosage—and do a little research in advance to make sure doses are within a reasonable range. One easy question to ask is when your IV cocktail was prepared. In hospital or pharmacy settings, IV bags are required to be used within 60 minutes of compounding to shorten the window for bacteria growth. If drip bars administer them right away, the infection risks are lower, even if the bags aren’t prepared in a hospital-grade “cleanroom” setting. 

But how much risk should we be taking on at all for a procedure that isn’t medically necessary, especially for something like a hangover? For many people, that calculation depends on whether it works—and reliable evidence is scant.

“There’s no real literature that shows that using IV fluids would benefit people who have a mild hangover,” says Dr. Stanley Goldfarb, a professor at the University of Pennsylvania’s Perelman School of Medicine. 

Goldfarb is a kidney specialist and a long-time skeptic of Big Hydration. More than a decade ago, he and his co-authors made headlines with a study questioning the oft-repeated advice that we should be drinking eight glasses of water a day. His skepticism extends to the elective IV industry, which he compares to Russian roulette.

“To go to an unregulated place and have intravenous material placed in your vein is kind of insane, really, and potentially quite dangerous,” Goldfarb says.

I wanted to talk to Goldfarb because The Kansas City Star had interviewed him in 2019, when a Johnson County man died after growing ill during a vitamin infusion at the Element Wellness Spa and Studio in Brookside. The autopsy report attributed the death to underlying medical conditions. Element Wellness is still operating today, albeit on a concierge basis. But at the time, Goldfarb didn’t seem convinced the IV clinic was blameless. He still isn’t. 

“There was no way they could have held the clinic responsible,” Goldfarb says. “There’s no telltale trace.” 

By way of illustration, he tells me about a time when he served as an expert witness on a case where a physician had given a patient too much potassium. The extra potassium almost certainly killed the patient, he says. But the hospital was held harmless—the coroner couldn’t find any traces of extra potassium in his body.

“What no one told the jury was that it’s impossible to find,” says Goldfarb. “When you die, all the potassium that was in your cells floods out into the tissues and fluids in your body and any extra potassium you might have had is lost in this sea. There was no way to know.”

Andy Marso, a former health reporter who covered the 2019 incident, came away from the story with questions about the industry’s relative safety operating in a regulatory gray area. 

“If you’re doing everything right in terms of your infection control protocols, then it’s probably relatively low risk,” Marso says. “But consumers don’t know how often that’s the case, because the facilities themselves are not generally regulated.”

Currently, elective IV businesses aren’t regulated or inspected by the Missouri or Kansas state health departments—representatives from both departments referred me to licensing boards for individual practitioners instead. 

“Nurses who work at [IV clinics], they’re subject to licensing and discipline and investigations, but licensing boards are fairly thinly staffed,” Marso explains. “They’re not really proactive either. They’re only going to respond to complaints for the most part.” 

Brochures at IV Nutrition Now. // Photo by Kaitlyn McCullagh

Regulating the industry would likely be costly, but it’s hard to even get a sense of the scope of the challenge. 

Last October, the Food and Drug Administration released a statement about the risks of IV treatments, noting a case from February 2021 in which a 52-year-old woman was hospitalized for septic shock after a home vitamin infusion. But the FDA’s statement also highlighted just how little the organization knows about elective IV businesses, including whether they employ licensed practitioners to evaluate patients or whether they follow sterile compounding practices in sanitary conditions.

Chad Teeter, the clinic director at IV Nutrition Now, helps alleviate a few of my concerns. He tells me that all of IV Nutrition Now’s providers are registered nurses or paramedics. Teeter says they get as close to a hospital’s cleanroom standards as they can: “as clean as physically possible. All of our services are basically prepared underneath a sterile hood and then they go directly from a sterile hood to the client.”

This made me feel better about my experience at his clinic. But I started wondering about my upcoming hangover treatment. The company I had booked, Liquid Mobile IV, had promised a registered nurse for the visit, but it was a house call, and my home is decidedly unsterile. I tried to push these worries out of my mind. After all, the company had a strong incentive not to kill me. Plus, I had a hangover to prepare for.

If curing a hangover is difficult, courting one is a breeze. The night before my Liquid Mobile IV appointment, I went to a holiday party and did everything you’re not supposed to do. I mixed alcohols. I drank three cups of a sugar-y punch. I finished the evening with a glass of champagne and didn’t drink any water before bed. 

I achieved my goal. There’s this expression I hear people use sometimes—“you look like death warmed up.” Hungover me did not look like death warmed up. Hungover me looked like a frozen TV death dinner that had been thawed in the sun and microwaved with the plastic cover still attached. 

Brittany, the Liquid Mobile IV nurse who showed up at my house with a wheeled black case of medical equipment, didn’t seem to mind. She was a former ER nurse, a seasoned pro. She took my blood pressure, injected me with some Zofran—an anti-nausea medication—and then prepared a 1000 mL bag of fluids right in the middle of my living room. She didn’t yelp when my cat jumped on the couch and tried to chew on the IV line. I wondered what Goldfarb would say. 

This time, the infusion took almost an hour. Once again, I took an inventory of my body. Once again, I didn’t notice a difference. I felt a misplaced sense of triumph at my body’s obstinacy, its steadfast determination to suffer.

In a facile sense, you can buy longevity in America. Rich people not only live almost a decade longer than poor people, they also live better as those extra years are more likely to be disability-free. This discrepancy is a function of many things that wealth affords—better health care, better food, more education, less stress.

Part of me felt a sense of intravenous relief that the hangover might be democratic—that there was at least one thing money couldn’t buy. The rest of me just felt tired. My “Hangover Relief Hydration Session” cost $300 not including a 20% tip. If this seems like an odd extension of American tipping culture, I hear you—but I’m also not about to stiff the person who controls whether or not I get sepsis. 

The only difference I noticed after Brittany left was that my pee was, once again, an unsettling highlighter yellow. But I suppose I can’t discount the fact that the infusion kept me from feeling worse. At the very least, I didn’t puke. 

I had cleared my hangover day of all tasks but one: writing this article. I decided to give the IV a little more time to work its magic before I started. I made some soup. I played some Nintendo Switch. I lay with my cheek pressed to the couch cushions until my face felt embroidered. 

The next morning, I texted my editor: the story was going to be late.