Adam’s Journal
This is one of those friend-of-a-friend tales, so it’s a bit short on details. But the basic story is this:
A young and generally healthy man was feeling run down, so he went to a wellness spa to receive an IV vitamin infusion. Shortly after the IV was hooked to his arm and the infusion began, he felt like he was blacking out.
He received an injection with an EpiPen, and this seemed to help for a bit. When he again started feeling lightheaded, he received another EpiPen injection and was taken to the hospital.
He apparently recovered quickly and is fine now. What do you think happened?
Dr. Scofield Prescribes
It sounds as if the young man went into anaphylactic shock, a swift and severe allergic reaction. It causes airways to constrict and blood pressure to drop, potentially leading to a loss of consciousness or even death.
So, what might have caused this reaction? I’d hazard two guesses.
My first candidate would be the vitamins in the intravenous solution. In particular, I’d suspect thiamine, which, from my reading about such infusions, is a common ingredient.
At the VA, it is not uncommon to see patients with alcohol use disorder, and when we do, they often suffer from a thiamine deficiency. In these cases, we routinely administer a form of thiamine (thiamine hydrochloride) intravenously.
On multiple occasions, we’ve had patients experience anaphylaxis following these infusions. We’ve immediately treated them with epinephrine injections from an EpiPen, and they’ve recovered quickly.
A search of the medical literature found a case report of an extremely similar situation. There, a patient experienced anaphylactic shock and cardiac arrest following an IV infusion of thiamine. Doctors successfully resuscitated him with repeated epinephrine injections, and he was discharged two weeks later in good health.
It’s worth noting that thiamine is common in our diets, found in lean meats, fish, whole grains, legumes, nuts, seeds, and fortified cereals and breads. Although it’s extremely rare for people to be allergic to thiamine in food, they can nevertheless have a severe allergic reaction to IV thiamine, likely due to the high dosage and the means of administration, which allows the body to absorb it immediately.
Another potential culprit for the anaphylaxis here is latex, which is commonly found in gloves used by healthcare (and, I’d imagine, medical spa) workers.
Latex allergies usually develop after repeated exposure to latex. Also, a significant number of people with latex allergies will also react to certain foods that share a protein with latex. It’s a pretty long list of foods that includes many fruits, including citrus, pineapple and grapes.
Finally, I would urge caution to those considering IV vitamin infusions outside of a medical setting. In these situations, it’s difficult, if not impossible, to know what’s going into your body and how it could affect you.
In the best case, you might end up with urine filled with mega-doses of (expensive) vitamins and supplements your body is unable to process. In the worst, you could jeopardize your health.
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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.
