Paging Dr. Frischer: Medical Spas

I have, on occasion, seen patients who present with days of diarrhea and vomiting. They literally cannot keep food or fluids down. This leads to a dangerous level of dehydration, and I send them directly to an emergency room for IV hydration. Not only does this make them immediately feel better, but in some cases, it saves their life.

Perhaps you have heard about clinics that perform IV hydration along with supplemental nutrition. This does not require a prescription from your primary care doctor. These facilities may be referred to as hydration bars, drip bars, or medical spas. Many of them are better known for other procedures, such as skin care and cosmetic treatments. Their numbers have ballooned in recent years, and it has become a billion-dollar industry.

When we aren’t able to rehydrate by drinking liquids or through intestinal absorption, IV hydration is effective and can restore correct electrolyte levels. It might be needed due to nausea, vomiting, fevers, excessive sweating, excessive training in heat, or heat prostration. Common conditions that lead to vitamin deficiencies include pernicious anemia, diarrhea, significant issues with nutrition, and a variety of conditions caused by damage to the intestines. The IV treatment will contain a saline solution, and sometimes sugar and other minerals and vitamins.

Here's the thing: Aside from the rare instances where a person belongs in the emergency room, the vast majority of us can simply drink the fluids we need to rehydrate. And, there is little scientific evidence to support claims that IV vitamin therapy can boost the immune system; improve skin health; support weight loss; remove jet lag; or cure fatigue, brain fog, hangovers, or chronic pain. Clinics claim that IV treatments can contain a higher concentration of vitamins than can be taken by mouth, and that vitamins introduced through an IV are absorbed better and more quickly. However, taking vitamins orally and regularly will usually maintain a proper balance, and IV vitamins do not benefit someone who already has normal vitamin levels. In addition, note that each facility may formulate their own combinations and concentrations of vitamins, which may be a selling point for them, but sounds pretty scary to me.

Most medical spas do their best to comply with rules for training, hygiene and medical supervision. However, many of us have read of facilities which used poorly trained or unlicensed workers to inject unapproved products, or where conditions were unsanitary, with infections resulting. There are no federal health regulations or standard operating procedures for medical spas; instead, these facilities fall under the authority of each state. Although doctors or other medical professionals are required to be on staff, there have been cases where these rules have not been well enforced. Unfortunately, it can be difficult for consumers to evaluate the risk.

How do you stay safe? Be well informed. Find out who owns and operates the facility. Who will be administering the treatment, and what are their credentials? Is there a licensed medical practitioner on site in the event of complications?

There may be safer and less costly alternatives. The cost of IV therapy at a medical spa is generally not covered by health insurance, and each infusion can cost hundreds of dollars. Note that in-home IV therapy administered by home health nurses may be covered, if medically necessary, by insurance. Also note that a trip to the emergency room, if necessary, would be under the supervision of doctors and may be covered by insurance. I urge you to consult with your health care practitioner about any expectations you might have regarding IV hydration.

Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 10927 Downey Ave., Suite C, Downey, CA 90241.