Let’s imagine for a moment that we are inside a medical series, of those that portray with such realism the day-to-day lives of professionals in emergency medicine. Two patients, one in Madrid and the other in California, are admitted almost at the same time. The first is an 80-year-old man with a viral respiratory infection accompanied by significant dehydration. He presents a decrease in blood volume, low blood pressure, tachycardia, confusion, scant urine output, and an inability to ingest fluids.
The analysis confirms dehydration and a reduction in blood flow to the kidneys. After administration of 0.9% normal saline via intravenous route, he begins to recover.
Meanwhile, almost 10,000 kilometers away, a famous celebrity ends up in hospital after suffering a reaction associated with the dangers of intravenous vitamin cocktail treatments she underwent in order to arrive at the Oscar ceremony with skin brighter than the moon.
Dangers of Intravenous Vitamin Cocktails
These are two real cases: the first drawn from the emergency protocols of a public hospital in the Community of Madrid. The second comes from a news report. Very different situations that illustrate how the direct administration of liquids, vitamins, minerals and other nutrients into the bloodstream can be a life-saving tool when there is a clear medical indication, but can also put a patient at risk when used unnecessarily.
In recent years, vitamin drips have become one of the most striking trends within the wellness and aesthetic medicine universe. Their proponents promise better hydration, more energy, a strengthened immune system and faster physical recovery. Demand has driven the emergence of clinics specialized in which clients can choose different ‘cocktails’ depending on the benefit they seek.
When Money Is No Object
There are drips to relieve hangovers, combat fatigue, reduce jet lag or accelerate recovery after exercise, among many others.
Models, singers, influencers and other celebrities do not hesitate to share on Instagram pictures of their arm connected to a line, turning a medical procedure into a status symbol. However, behind that apparently sophisticated aesthetics lies a much less attractive reality: these therapies are not risk-free, and outside a medical context they can be unnecessary and even dangerous.
Bypassing the Natural Barrier
The main advantage claimed by promoters is that by avoiding the digestive tract, nutrients reach the bloodstream directly and are absorbed immediately. But that is precisely where the main problem lies. Because, although an intravenous infusion can be indispensable in patients with severe dehydration, major nutritional deficits, or certain diseases, specialists agree that there is no solid scientific evidence to justify its routine use in healthy people.
As explained on his social media by the doctor and longevity expert Patricio Ochoa, “the body has extremely complex metabolic systems to handle nutrients.” When we ingest vitamins, they pass through the gut and liver, where they are absorbed, transformed, regulated and eliminated according to the organism’s real needs. “The body has physiological filters to maintain balance, but when we administer substances directly into the bloodstream, we bypass many of those natural barriers,” he notes.
Unassessed Benefits
As much as we see Hailey Bieber, Rihanna, Adele or Gwyneth Paltrow undergoing this therapy, what they are doing is not regulated. In the United States, the vast majority of clinics offering these treatments are not supervised by the Food and Drug Administration (FDA). To seek caution, some of those offering these services include legal notices stating that the announced benefits have not been evaluated by this agency. Although more commonly these clinics are located in countries with looser sanitary regulation, such as Costa Rica or Thailand.
In Spain, a similar situation occurs. Dr. Carmen Galera, dermatologist with GEDET (Grupo Español de Dermatología Estética y Terapéutica) of the AEDV and director of the Derma forYou Clinic, explains that “injectable vitamin cocktails can only be used if they have a clear classification and authorization as a medicine by the AEMPS.” This means that the Spanish Agency for Medicines and Health Products must have previously evaluated the product and verified that it meets the quality, safety and efficacy requirements before authorizing its commercialization.
“Even when a vitamin cocktail is considered a medicine, its advertising is subject to very strict regulations: therapeutic benefits that have not been scientifically demonstrated cannot be claimed,” she emphasizes.
The All-Purpose Internet Pharmacy
In Spain, the free internet sale of injectables that require a medical prescription is prohibited. But the black market exists, and the risks are doubled: from potential side effects of the drug to not really knowing what is being purchased due to lack of AEMPS oversight. “A cosmetic product cannot be injected, even if it comes in a vial or ampoule. However, it is often marketed online or through unauthorized distributors,” warns the specialist.
Before administering any intravenous treatment, a complete medical assessment and review of the patient’s clinical history is essential. Although complications are infrequent in healthy individuals, the risk is never zero. As Dr. Galera details, “these procedures can cause infections, granulomas, necrosis or inflammatory and allergic reactions—especially when using products whose provenance, sterility or traceability are not guaranteed.”
In patients with pre-existing diseases, the dangers of intravenous vitamin cocktails increase, since rapid administration of large fluid volumes can provoke cardiac or renal overload. Added to this is the legal responsibility for centers performing these practices outside the regulatory framework. The consequences, the expert adds, “can range from administrative sanctions and civil claims to criminal liabilities, in addition to the evident reputational damage.”
And what about peptides and exosomes?
The same logic applies to injectable peptides, biological compounds used for therapeutic, regenerative and increasingly aesthetic purposes. In the European Union, when they are intended for the treatment of diseases, they are considered medicines and must pass the same efficacy, safety and quality controls as any other drug before obtaining authorization.
Something similar happens with exosomes, small cellular vesicles that contain proteins and genetic material. The use of exosomes by injection is not authorized by the AEMPS because there are still insufficient clinical guarantees about their safety and efficacy.
Platelet-rich plasma (PRP), however, does have specific regulation in Spain. According to Dr. Galera, “the AEMPS regards it as a medicine for human use for special needs and allows its use provided it comes from the patient, is manipulated using authorized systems, and protocols, traceability and all current sanitary regulations are respected.”
The fascination with intravenous serums is evident, but not everything that is administered in an elegant clinic, appears on Instagram or is used by a celebrity means it is beneficial. Not by a long shot, safe.
