Episode 142 - NEW TREND: IV hydration. Should you do it?

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Proper recovery and performance enhancement have always been top priorities for athletes. But what happens when new trends promise to deliver these benefits with the allure of convenience? Is it worth the investment, or even safe? Today, we delve into the growing trend that is IV hydration and explore whether it truly lives up to the hype.

What is IV Hydration?

In simple terms, IV hydration involves bags of hydration, vitamins, amino acids, or a mix thereof being administered directly into your bloodstream through a cannula. Originally, this practice was strictly for medical use in hospitals to treat severe dehydration and nutrient deficiencies or deliver medication when oral intake wasn’t possible.

Now, companies offering IV hydration have extended these services to healthy individuals for various perceived benefits, such as rapid rehydration, improved skin health, and curing hangovers. For athletes, especially triathletes, they’re even promising quick recovery and performance enhancement post-race.

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Episode Transcription

Episode 142: NEW TREND: IV hydration. Should you do it?

Welcome to the Triathlon Nutrition Academy podcast. The show designed to serve you up evidence-based sports nutrition advice from the experts. Hi, I'm your host Taryn, Accredited Practicing Dietitian, Advanced Sports Dietitian and founder of Dietitian Approved. Listen as I break down the latest evidence to give you practical, easy-to-digest strategies to train hard, recover faster and perform at your best. You have so much potential, and I want to help you unlock that with the power of nutrition. Let's get into it.

[00:00:00] Hello and welcome back to the podcast. My name is Taryn. If you don't know who I am, I'm an advanced sports dietitian and I love long walks along the beach. No, just joking. I love food. I love science. I'm a bit of a nerd and I love triathlon. I also really love breaking down that science into easy to digest strategies for triathletes and helping you actually harness the power of nutrition to get the most out of your performance.

[00:00:47] I hate seeing trends and shiny objects and triathletes doing weird and wonderful things thinking they are going to enhance their performance when really they could be doing harm or are completely wasting their money doing a whole heap of random crap. One of those things that I want to dive into today is IV hydration.

[00:01:08] You have probably heard about it, you've probably seen it, and it's something we've talked about inside the Triathlon Nutrition Academy program with our athletes. So I thought I would come on here and give you the rundown of my thoughts on this, so that you don't do anything too crazy. Okay. Thank you.

[00:01:29] So it's definitely not new. I would say that I've seen it around for quite a while now, actually, like at least 10 years, but I feel like it went away and it's starting to make a resurgence again. It is going gangbusters in the U S and it has made its way to Australia for sure. I did a Google of like, IV hydration near me and a lot of places came up.

[00:01:54] I probably shouldn't have done that actually, because I'm going to get a heap of ads now for places to do that. And it's not something that me personally, I'm going to do. So what on earth am I talking about? If you don't know what I am talking about, there are a lot of companies that are letting you pay them money to cannulate you so stick a needle in your veins to give you bags of hydration or vitamins or a combination of both.

[00:02:21] I've seen amino acids. I've seen ones that will help you fix a hangover with things like pain medication in them as well. And um, Usually, it's a strategy that we would do in a hospital, like when somebody medically needs that, right? When you're properly sick, you're properly injured, and for whatever reason, you're going to need some fluids directly into your veins.

[00:02:44] So maybe your gut's not working, and we can actually give you your whole nutrition through your veins. It was something I did when I worked in the hospitals, it's called TPN, total parenteral nutrition. Everything that your body needs, bypasses the gut, we give it to you straight through the veins. It's amazing.

[00:02:58] Really cool. If you've lost a lot of blood, sometimes they'll hang a bag of blood and replace that for you because it takes quite a long time to build up your blood volume again. If you can't take a medication by mouth, maybe you've got a really, really bad IV antibiotics to like really knock it on its head.

[00:03:17] Or you can't stop vomiting, so you can't keep any medication or fluids down. Sometimes you might, be cannulated and have fluids given straight into the vein because we need to bypass the gut for whatever reason. Okay. Usually it is a medical procedure done by a trained professional, and it's used to increase your chances of survival.

[00:03:37] Right? Help you get over whatever it is you've got going on. But there is this big trend for drip bars to receive IV fluids like on demand without needing a doctor to prescribe it or to be in a hospital to receive it. You can just turn up or you can literally book an appointment online and they will come to your house and do whatever you ask for.

[00:04:00] Basically, I didn't see any kind of red flags or hoops you have to jump through to have this happen. There didn't seem to be a very strict and stringent process to have this happen. It was just like, if you want to pay me to do that, I will do it. No questions asked. Now, obviously it's not surprising that the early adopters were the rich and famous.

[00:04:25] outside of like what is considered medically necessary or prescribed by a doctor, you can do this. And I've seen, you know, post race rehydration, which is what I've come on here to talk to you about. So not from a medical tent, like I've seen advertised, it's actually been pulled down from a Facebook group from a local race here in Australia that advertised doing it, but I know that it's happening in the U. S. as well, where you go and do a triathlon and you can go to this tent and ask for a bag of fluid to be delivered and get rapidly rehydrated. And you're thinking that is awesome, Taryn. Like, why are we not doing that? Hold, hold the phone. Stay with me. They're advertised like as IV vitamins is the other big one.

[00:05:12] And when I look at the vitamin dosage for what is available to buy, you pay for it. The more vitamins you get or ask for the more it costs, but the doses that they give you. are ginormous. They are way beyond the recommended dietary intake or recommended dietary, what is the A? RDA in America. I actually don't know what that stands for.

[00:05:35] What's the A stand for? I should look that up. RDI, RDA, wherever you live in the world. So they're advertised as, you know, rapid rehydration. Maybe you have done a big race and you need that, or you want that you are hung over or, you know, you jet lagged. And particularly in the health and beauty space, you're getting like an instant glow and, you know, it's great for your skin type thing.

[00:05:58] that's kind of what we're dealing with now. You're probably thinking that sounds great. Like what is wrong with that? And, you know, let's go through if it's effective, Is there going to be a performance advantage to that? And what are the risks and what are the costs? And then I'll give you my, take home message when it comes to these things?

[00:06:16] So is it effective? Yes. Keep listening, but it's effective if you're properly sick, right? Or you need something like that to get better or get rapidly rehydrated because you're like, curled over on the finish line, vomiting your guts up, you can't move, you can't function.

[00:06:36] If you are like that, then you need medical input, dude. Like, there's no point going to a tent to be like, yep, rehydrate me. If you were in a bad state, and you need something like this, then you are probably best to go to the medical tent or go to a hospital, right? Get proper medical attention and proper medical help rather than use a company like this.

[00:06:57] In terms of the post race rapid hydration stuff, if you have the ability to drink orally, so in your mouth drink fluids, then you need to do that. As opposed to being rehydrated IV. I know. All right. Stay with me. Like if you are honestly that bad that you can't do that, then you need medical help. that is the bottom line.

[00:07:19] There is no gray zone. It's black and white here. If you can drink, drink to rehydrate. If you can't, then you need medical help.

[00:07:25] And you need a proper assessment too, by an actual medical professional. That is really important because as an endurance athlete, one of our risk factors, or one of the things that you need to be mindful of is hyponatremia. Hypo being low sodium in your blood. And if that's not treated, or you like suddenly get all this extra fluid on board.

[00:07:46] Then you risk death. Now, I know that's, like, really bad and, you know, endgame. It's not something to mess with and you don't want to [00:08:00] be in that state, unaware, and not be assessed medically and then go to the, a rapid IV hydration place because you think that that's what you need and die. Yep, I said it.

[00:08:11] It's blunt. There's no other way of putting it, but it is a real risk and it's something that you need to be really mindful of, which is why I'm not really for this IV hydration thing at the finishing line. Okay, and if you do get in such a bad state that you are either Or you are so badly dehydrated that you need rapid rehydration after an event because you've collapsed or fallen over or you're vomiting so badly that you can't keep any fluids down.

[00:08:42] then you do need medical attention, but we also need to take a step back from that and go, what caused that? Like, what is the problem here? Is this a pre-race strategy that we need to manage and improve? Or is it a during race strategy that we need to manage and improve as well? And hydration is very much an individualized thing.

[00:09:01] It's something that you are going to need to work out for yourself. You can't pull things from the internet. you can't use what your coaches told you to do, you can't use what your training buddy does, you can't use what your partner does or anything like that. Your individual hydration needs are very specific to you.

[00:09:19] And they also do change and evolve depending on the season, the environmental conditions, how fit you are, your genetics, like there are so many different factors that go into your hydration. And it's something we do dive into very deeply inside the Triathlon Nutrition Academy program where I teach you how to.

[00:09:35] figure out what your hydration needs are, and then what do we then do with that information in a race so that we're not getting in this bad, horrible state of being so dehydrated that we can't function, or hyponatremic, like you've overdrunk. So it's really important that you do dial that in, and more important, the longer you go as well.

[00:09:56] particularly if you're a really heavy sweater. The 70. [00:10:00] 3 and full distance events are things that you really want to your hydration in for. If you are racing in a hot race and hot environment, then the shorter course is still also really important. You can end up in a pretty bad state after an Olympic distance event.

[00:10:15] Okay? So it's not something to kind of dabble with.

[00:10:17] The other question on your mind is maybe like, is this a performance advantage? Right? I wanna do everything I can. I wanna dot every I cross every t. Like what is wrong with turning up to a race with some IV hydration on board or rapidly rehydrating afterwards so that I can party? Yeah, I know you're having that thought.

[00:10:37] So from a performance perspective, I don't think there's actually any research. in the sports performance space, to be honest. There is quite a lot of papers. There's a fair bit of literature out there, but there is nothing positive. There is nothing saying you should do this so that you can get a performance advantage.

[00:10:57] Now, assuming that you are hydrated and you're not nutrient deficient, then having those things is unlikely to offer any sort of performance advantage, right? And the other thing you want to think about is. The use of that IV fluid replacement after exercise to correct mild dehydration, is not actually clinically indicated.

[00:11:19] Or is in the medical literature. Like when you go to a medical tent, they have an assessment criteria. They go through systematically all the things that they need to do to check you over. If you're mildly dehydrated, IV fluid replacement is not on that checklist of things to do to fix you. It would be to drink.

[00:11:37] Okay. Oral is always going to be the prepared, therapeutic choice. and any physician or any medical professional is going to go down that assessment pathway to go what is best. And if it's mild and you consume liquids orally, then you're best to do that. And there are a million references. for that.

[00:11:57] Okay. All right. What are the risks? Here we go. So the first thought on my mind when someone goes cannula, as in a needle in your veins, is infection risk. Any puncture to your body, anything going into your body like that, there is an infection risk, particularly if you're all sweaty and they don't do a good job of like cleaning you down.

[00:12:17] Uh, , always a risk of infection. So that's a risk. need to be mindful of. Your vein if it's not put in properly can become inflamed, or it also can get blocked or get a clot in it. And there's a risk that the needle doesn't quite go into the vein properly as well, so your arm can swell up and things like that.

[00:12:33] So like that's like doesn't happen very often. If somebody's medically trained to do that, then it's very, very rare, but it is one of the risks. So important to check the qualifications of the person that is cannulating you. I had a quick look at who does the places around me and they are nurses, You would have to be a nurse to do that, but qualifications are something that you want to check.

[00:12:58] There are a few that are a little bit dubious. The other thing that you need to be really mindful of is that if you are injected with fluid either before, during, or after a race, and you are, uh, drug tested randomly, then you will get in trouble. So if you're, you know, aiming for age group champion, world champion, anything like that, WADA have actually prohibited the use of intravenous infusions, anything more than 50 mils per six hour period.

[00:13:31] It's prohibited. Okay. So WADA is our world anti-doping agency.

[00:13:37] Intravenous infusions have been on the banned list under Section M2 since 2005, both in and out of competition. Do I need to say that again? In and out of competition. Now the current wording states that intravenous infusions and or injections of more than 50 mils per six hour period are prohibited except for those legitimately received in the course of hospital admissions or clinical investigations.

[00:14:04] So if you have a prohibited substance, which could just be normal saline, could just be a bag of fluids administered via IV intravenous or an injection, then you need a TUE, is a therapeutic use exemption to have that substance regardless of whether it is an infusion of less than 50 mils or not.

[00:14:24] And now I've had to organize a few of those for athletes in my time at the AIS to have things like an iron infusion. That's an intravenous infusion to improve somebody's iron stores. We have to organize TUE to have that happen and heaps of like hoops to jump through. to make sure that they don't then get banned from the sport because WADA have prohibited the use of any IV injection.

[00:14:48] Now, if you're getting an IV bag of fluids hung, it is likely to be 500 mils. or one liter and potentially more depending on what's going on. Okay. So if you get randomly drug tested, you will lose your spot, lose your medal, lose your spot at worlds or anything like that. You run the risk of being banned from the sport for a couple of years.

[00:15:11] Now you're probably like, I'm an age grouper. I don't get drug tested. They randomly do drug test age groupers. And so, we're just going to throw that argument out. Sorry. The last time I heard of wider drug testing age groupers was at Maloola Bar a few years ago now, but they were checking everybody that landed on the podium.

[00:15:32] In fact, the top like five, I think it was back then. So if you are at the pointy end of the field, it's not something that I would suggest doing just in case you do get randomly drug tested. And if you're still thinking I'm going to do this, is the cost worth it is my other question to you. I had to Google Transcribed of the places near me, just to see what they were, in Aussie dollars, and they range from 200 to 300.

[00:15:57] and more than that if you want extra things. If you want extra vitamins, if you want extra amino acids, the more different things you add to your bag, the more expensive it becomes. So it could be upwards of five, six, seven hundred dollars if you're adding additional things. Now I would love to know how much a bag of normal saline costs.

[00:16:16] It's just salty water. It would probably not cost a lot, but I guess you're paying for a qualified person to deliver it But they would be making a killing by doing that. Their, their cost of goods would be very, very low. Okay, absolutely ridiculous. And the thing that I mentioned just before around the vitamin dosage, I think you need to like check in on that too, because the numbers that I were looking at were well beyond the RDI or the RDA.

[00:16:47] astronomical doses of things like vitamin C, like the toxicity upper limit, like blown out of the water type levels. and you know, those are developed for oral use. And so if you're putting them straight into the veins, then yeah, it just freaks me out a little bit. And this is probably a little bit controversial, but the other word that I wanted to just throw into this chat, because I've had a break and I'm feeling refreshed and you know, it's good to be back, is privilege.

[00:17:11] You know, the rich and the famous people do this because they have the funds and if you can afford that, then it is a real privilege. Not, it's not accessible to everyone. It is a privilege to even be considering it, I would say. So bottom line. I would suggest that it's, you know, lazy man or a lazy woman's tool.

[00:17:32] It would be a complete waste of money if you wanted to do that, like, by all means go ahead. But I would suggest that your time and money is probably best spent working on what the problem is and finding a long term solution to fix the problem. Whatever your, nutrient need issue is, your hydration needs and problems are, work to fix those.

[00:17:57] And then you should be good as gold forever. [00:18:00] This is very much a bandaid or a quick fix. And it's a once off quick fix as well. It's not going to fix the issue going forward. And obviously, it's not without risk and you know, it's water prohibited also. If you're able to drink fluids. Drink them. That is the bottom line.

[00:18:20] Don't bypass the gut. Okay? And if you can't physically drink to rehydrate after a race, you know, you're vomiting your guts up and you can't stop vomiting. You have collapsed. You're in a heat, you're heat exhausted. Like maybe you're confused. You could be hyponatremic. Please go to the medical tent. Go and get assessed properly by a medical practitioner.

[00:18:47] Because if you go and hang a bag of normal saline and have all this extra fluid and you're hyponatremic, you run the risk of death. It's not worth the risk. Just go to the medical tent. If you need rehydration because you can't drink it, they will fix you out. It won't cost you anything either. I think the companies offering these products and services are, are like so many things interested in the revenue generation, and they're not actually providing a quality product that's good for your health.

[00:19:17] They don't have the consumer in mind. All right. Let me know what you think about this in the Dietitian Approved Crew Facebook group, pop your details in and we'll let you in. Have you tried it?

[00:19:32] I'm so interested to know and are you going to try it? I'm also very interested to know after listening to this, whether you would do it or not. And then what do you think? Let's start a robust discussion around this trend. I'm really keen to hear your thoughts. Go, go and do that now. All right. I'll talk to you next week.

Thanks for joining me for this episode of the Triathlon Nutrition Academy podcast. I would love to hear from you. If you have any questions or want to share with me what you've learned, email me at [email protected]. You can also spread the word by leaving me a review and taking a screenshot of you listening to the show. Don't forget to tag me on social media, @dietitian.approved, so I can give you a shout out, too. If you want to learn more about what we do, head to dietitianapproved.com. And if you want to learn more about the Triathlon Nutrition Academy program, head to dietitianapproved.com/academy. Thanks for joining me and I look forward to helping you smashed in the fourth leg - nutrition!

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