State Oversight and Practices of IV Hydration Spas in the US
Publication Title: State Policies and Facility Practices of IV Hydration Spas in the US
Summary
- Question
- This study aimed to evaluate state-level policies regulating intravenous (IV) hydration spas in the United States and examine the practices of these facilities, including their product offerings, health claims, and staffing requirements.
- Why it Matters
- IV hydration spas, which offer treatments like vitamin and mineral infusions, have grown in popularity despite limited evidence supporting their health benefits. Concerns about safety, regulation, and misleading claims have prompted calls for better oversight. This research is important for protecting public health, ensuring consumer safety, and addressing gaps in state and federal regulation of an industry operating on the fringes of traditional healthcare.
- Methods
- The researchers conducted a mixed-methods study in three phases. First, they reviewed state-level policies for IV hydration spas across all 50 states and Washington, D.C., to assess regulation of governance, prescriber credentials, dispensing, and compounding practices. Second, they analyzed the websites of 255 IV hydration spas to document product offerings, claims, and staffing details. Finally, a 'secret shopper' study involved contacting 87 spas to gather information on consultations, risks, and insurance coverage.
- Key Findings
- State-level policies varied significantly, with only four states addressing all key regulatory aspects. Most spas offered treatments combining IV fluids with additives like magnesium (57.3%) and glutathione (53.7%). While all spas made health claims, only 0.8% cited evidence to support these claims. In the secret shopper study, 86.2% of spas recommended specific therapies for symptoms like headaches, but only 27.6% required a medical consultation. Discussions of risks were rare, and none accepted health insurance.
- Implications
- The lack of consistent regulation and evidence-based practices raises concerns about consumer safety and the legitimacy of health claims made by IV hydration spas. More stringent oversight, such as standardized facility registration, clearer advertising guidelines, and evidence-based claims, may be necessary to protect public health. This research also highlights the need for greater scrutiny of compounding practices and the qualifications of staff providing treatments.
- Next Steps
- The authors recommend further research to evaluate the safety and effectiveness of IV hydration therapies. They also suggest developing standardized regulatory frameworks to ensure consumer protection and public health safety, including stricter oversight of advertising claims and compounding practices.
- Funding Information
- This research was supported by grants from the US Food and Drug Administration, Johnson & Johnson, Medical Device Innovation Consortium, Agency for Healthcare Research and Quality, National Institutes of Health/National Heart, Lung, and Blood Institute, and Arnold Ventures. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Yale University also provided funding and support for this research.
Full Citation
Sivakumar A, Forman H, Wang I, Lurie P, Ross J. State Policies and Facility Practices of IV Hydration Spas in the US. JAMA Internal Medicine 2025, 185: 1455-1461. PMID: 41051745, PMCID: PMC12501857, DOI: 10.1001/jamainternmed.2025.5028.
This AI-assisted summary has been reviewed and approved by at least one of the study's authors to ensure it accurately reflects the research.
Authors
Anishaa Sivakumar
First AuthorJoseph Ross, MD, MHS
Last AuthorProfessor of Medicine (General Medicine) and of Public Health (Health Policy and Management)