Introduction

Parenteral administration of compounds usually labelled as dietary supplements for oral consumption is commonly known as “vitamin drips,” “vitamin cocktails,” or “vitamin injections.”1 They are poorly investigated both in terms of efficacy and safety.2,3 Nevertheless, vitamin drips are gaining attention as a novel branch of alternative medicine4 due to marketing campaigns and promotion of these services by celebrities.1,5 To date, most of the reports on this emerging phenomenon were anecdotal and lacked scientific rigor.6

We aimed to cross-sectionally investigate the experience of individuals using parenteral supplementation services in Poland.

Methods

The study’s design was approved by our university’s institutional review board (no. 227/20). Data were collected between February and May 2020.

To date, no professional term has established itself to describe vitamin drips. Here, we referred to these interventions as “parenteral supplementation.” Firstly, most of the ingredients used in intravenous blends are typical constituents of dietary supplements and their palette is not limited to vitamins. Secondly, the services promote their products as “supporting treatment.”1,4,6 Finally, the companies underline that parenteral intake of vitamins and macro- or micronutrients offers unique advantages over the oral form.4,6

We created an original survey to investigate the experience of people who had used parental supplementation services. We decided to develop a new questionnaire tailored for this purpose because this phenomenon had not been studied using such an approach before. We assumed that the results would be preliminary, and that further surveys with more sophisticated designs would follow. Initially, we screened 10 websites of services offering vitamin drips for various aspects that could be included in the questionnaire. The form contained questions on general characteristics, contact with medical professionals, and experience with the services. The initial version of the survey was prepared and used in Polish (Supplementary material, File S1); however, we also attach the English version (Supplementary material, File S2). The form contained mostly closed-ended questions and did not assume standardized outcome measurement. We disseminated the link to the questionnaire in Google Forms via Facebook groups related to health or complementary medicine. We used the Polish zloty (PLN) to the euro (EUR) exchange rate from June 6, 2020. The dataset will be available on Mendeley after publication.

Results

We accessed a total of 70 Facebook groups, and the survey was accepted by administrators in 35 Facebook groups that include over 437 000 members. We obtained 32 answers, and of them, 17 (53.1%) were by individuals who used parenteral supplementation services in Poland. The essential results are presented in table 1, and all details can be found in Supplementary material, table S1 and S2. The respondents tend to have bad experience with physicians. The motivations and chosen supplements varied between the participants, but parenteral vitamin C was most common with over 75% of participants reporting its use. Interestingly, one respondent admitted that he / she used drips to test them, and also admitted to being a physician who was considering preparing infusions for his / her family and relatives (Supplementary material, table S2). The highest declared amount spent on parenteral supplementation was PLN 30 000 (EUR ~6579). Finally, in some cases, patients were not informed about the service in detail, and one respondent was persuaded to give up conventional treatment. None of the responders mentioned the use of nonintravenous supplements.

Table 1. Results of a survey on the use of vitamin drip services

Question

Answers

General characteristics

Female sex

10 (58.8)

Age, y, median (IQR)

39 (33–44)

Experience with medical professionals

What is your trust in doctors?

Very trustful

3 (17.6)

Trustful

1 (5.9)

Neutral attitude

2 (11.8)

Distrustful

8 (41.2)

Very distrustful

3 (17.6)

Do you follow recommendations of a family doctor or medical specialist?

Yes

10 (58.8)

Did you experience incorrect diagnosis?

In your case

7 (41.2)

In case of a loved one

8 (41.2)

Did you experience medical error?

In your case

8 (41.2)

In case of a loved one

5 (29.4)

Did you experience a feeling of being ignored by a doctor?

In your case

9 (52.9)

In case of a loved one

6 (35.3)

Did you experience bad treatment by a doctor?

In your case

10 (58.8)

In case of a loved one

4 (23.5)

Parenteral supplementation

Number of uses, median (IQR)

10 (2–20)

Total amount spent, PLN / EUR, median (IQR)

1000 (350–3000) / 219 (77–658)

Reasons

Improve immunity

10 (58.8)

Fatigue

8 (47.1)

Improve physical endurance

6 (35.3)

Detoxification

5 (29.4)

Vitamin deficiency

5 (29.4)

Hangover

3 (17.6)

Malignancy

2 (11.8)

Autoimmune disease

2 (11.8)

Other

3 (17.6)

Ingredients used

Vitamin C

13 (76.5)

Coenzyme Q10, glutathione, magnesium, multi-electrolyte fluid

6 (35.3)

Hydrogen peroxide, saline, vitamin B1, vitamin B2, vitamin B6

4 (23.5)

Dimethyl Sulfoxide, DMSO, vitamin B3, vitamin B5, vitamin B9

3 (17.6)

Alpha-lipoic acid, ozone, solcoseryl, vitamin A, vitamin D

2 (11.8)

EDTA, monoionic silver, vitamin B12, vitamin E

1 (5.9)

Was the service preceded by

Medical examination

Yes

13 (76.5)

Oral information about contraindications

Yes

14 (82.3)

Presentation of scientific evidence

Yes

9 (52.9)

Presentation of qualification of the person performing infusion

Yes

16 (94.1)

Personal assessment of the service

Very good

14 (82.3)

Good

2 (11.8)

Very bad

1 (5.9)

Have you been offered to give up conventional treatment (eg, prescribed by a doctor), and instead of that, use infusions / drips?

Yes

1 (5.9)

Data are presented as number (percentage) unless otherwise indicated.

Abbreviations: DMSO, dimethyl sulfoxide; EDTA, ethylenediaminetetraacetic acid

Discussion

This is the very first study describing the experience of Polish individuals who used parental supplementation services. Poles consider the performance of the national healthcare system to be poor,7 and this ratio seems to reflect the fraction of individuals who were dissatisfied with doctors. Moreover, most of the respondents follow the recommendations of their physicians. Therefore, vitamin drips might be perceived as an addition to standard care. That hypothesis is also supported by the declared reasons for using parenteral supplementation services: most of the motivations concern general health benefits (immunity, physical endurance, fatigue, detoxification) rather than specific indications. Alternative medicine is often proposed in conditions with highly subjective symptoms.8 When indications and health outcomes are poorly defined, placebo effects may be more perceptible,8 which may result in a good subjective assessment of the intervention as declared in our survey.

Among the declared ingredients, there was dimethyl sulfoxide, which in 2019, caused the death of a 36-year-old woman who used an intravenous supplementation service,9 and hydrogen peroxide, which is a life-threatening substance when given intravenously.10,11 Moreover, there could be cases when customers are persuaded to resign from conventional treatment and purchase more alternative medicine products or procedures. Therefore, there is an emerging need for studies on parenteral supplementation services and the efficacy of current legislation.

Our results should be interpreted with caution. Despite the broad dissemination of the survey, we collected only 17 responses. This is a major limitation of the study, but the collection of more answers might be challenging. We openly admitted on Facebook groups that our study was assessed by an ethical committee, and is performed by our department. This might have discouraged some individuals, who do not trust medical professionals, from completing the questionnaire. The low response rate suggests that acquiring respondents by Facebook groups may be challenging, and that another survey strategy is needed. Therefore, we treat our paper as a preliminary study. We are working on the design of a new study, which would achieve a higher response rate. Nevertheless, we hope that our study paves the way for future investigations of Poland’s parenteral supplementation services.

Conclusions

Polish individuals chose a variety of ingredients, including these potentially harmful, for intravenous drips. Further studies with a higher number of responses are needed.