{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T01:50:01Z","timestamp":1788832201427,"version":"build-2803163510"},"reference-count":20,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"\n Importance<\/jats:title>\n While the number of intravenous (IV) hydration spas has grown over the past decade, information regarding their regulation and practices remains sparse, despite concerns about oversight and safety.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To review state-level policies related to IV hydration spa oversight and regulation, and examine US facility practices, including product offerings, product claims, and staffing.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n In June 2024, a cross-sectional content analysis of state-issued, public-facing regulatory laws and statements was conducted for all 50 US states and the District of Columbia (DC). In July and August 2024, the websites of 5 IV hydration spas in each state and DC were reviewed. Finally, from August through October 2024, a secret shopper study was conducted of 2 randomly selected IV hydration spas in each state and DC from the website review.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The policy analysis determined whether states explicitly addressed 4 aspects of IV hydration spa oversight: governance, prescriber credentials, dispensing practices, and compounding practices. Website review ascertained product offerings, product claims, and staffing at each site. The secret shopper script included questions on the availability of licensed health professionals, product offerings, pricing, and potential risks or waiver requirements as well as insurance coverage.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Although 32 states have issued some form of IV hydration spa\u2013related guidance, policies varied widely and only 4 state policies addressed governance, prescriber credentials, dispensing practices, and compounding practices. Review of 255 facility websites found spa practices also varied with respect to product offerings, product claims, and staffing. All offered IV hydration therapy, most commonly combined with magnesium (n\u2009=\u2009146 [57.3%]) and glutathione (n\u2009=\u2009137 [53.7%]) and vitamin injections (n\u2009=\u2009162 [63.5%]) were also commonly offered. All websites also included claims for beneficial uses, although only 2 (0.8%) cited sources for these beneficial health claims. The secret shopper study of 87 randomly selected facilities corroborated the website review: 24 (27.6%) required consultation with a licensed medical professional before treatment, 75 (86.2%) recommended specific therapies for proffered headache and cold symptoms, and 21 (24.4%) described potential risks.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This mixed-methods study found that state-level policies governing IV hydration spas and facility practices vary widely, suggesting more stringent oversight may be necessary to protect public health.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamainternmed.2025.5028","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T15:00:21Z","timestamp":1759762821000},"page":"1455","source":"Crossref","is-referenced-by-count":3,"title":["State Policies and Facility Practices of IV Hydration Spas in the US"],"prefix":"10.1001","volume":"185","author":[{"given":"Anishaa","family":"Sivakumar","sequence":"first","affiliation":[{"name":"Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard P.","family":"Forman","sequence":"additional","affiliation":[{"name":"Yale Department of Radiology & Biomedical Imaging, New Haven, Connecticut"},{"name":"Yale School of Management, Yale School of Public Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Wang","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Lurie","sequence":"additional","affiliation":[{"name":"Center for Science in the Public Interest, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph S.","family":"Ross","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine and the Yale Collaboration for Regulatory Rigor, Integrity, and Transparency, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut"},{"name":"Department of Health Policy and Management, Yale School of Public Health and Center for Outcomes Research & Evaluation, Yale New Haven Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"key":"ioi250060r12","doi-asserted-by":"publisher","DOI":"10.1177\/16094069241231168","article-title":"An examination of the use of large language models to aid analysis of textual data.","volume":"23","author":"Tai","year":"2024","journal-title":"Int J Qual Methods"},{"issue":"11","key":"ioi250060r18","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1056\/NEJMp2306904","article-title":"A doctrine in name only\u2014strengthening prohibitions against the corporate practice of medicine.","volume":"389","author":"Zhu","year":"2023","journal-title":"N Engl J Med"},{"issue":"1","key":"ioi250060r20","doi-asserted-by":"publisher","first-page":"e245018","DOI":"10.1001\/jamahealthforum.2024.5018","article-title":"Online advertising of compounded glucagon-like peptide-1 receptor agonists.","volume":"6","author":"Chetty","year":"2025","journal-title":"JAMA Health Forum"},{"key":"ioi250060r1","unstructured":"Weiland? K. What is IV therapy? benefits, side-effects and costs. Forbes. January 12, 2024. Accessed August 26, 2025. https:\/\/www.forbes.com\/health\/wellness\/iv-therapy\/"},{"key":"ioi250060r2","unstructured":"Gregory? SY. IV vitamin therapy: understanding the lack of proven benefit and potential risks of this health fad. Mayo Clinic Press. October 3, 2024. Accessed August 26, 2025. https:\/\/mcpress.mayoclinic.org\/living-well\/iv-vitamin-therapy-understanding-the-lack-of-proven-benefit-and-potential-risks-of-this-health-fad\/"},{"key":"ioi250060r3","unstructured":"Edwards? E, Kopf? M. Warnings grow about risky IV drips and injections at unregulated med spas. NBC News. January 1, 2024. Accessed August 26, 2025. https:\/\/www.nbcnews.com\/health\/health-news\/warnings-grow-risky-iv-drips-injections-unregulated-med-spas-rcna131495"},{"key":"ioi250060r4","unstructured":"Moeller? M. The 2022 medical spa state of the industry executive summary in context. American Med Spa Association. January 24, 2023. Accessed August 26, 2025. https:\/\/americanmedspa.org\/blog\/the-2022-medical-spa-state-of-the-industry-executive-summary-in-context"},{"key":"ioi250060r5","unstructured":"Google Trends. Search results: IV hydration. Accessed August 26, 2025. https:\/\/trends.google.com\/trends\/explore?date=all&geo=US&q=iv%20hydration&hl=en"},{"key":"ioi250060r6","unstructured":"Grand View Research. North America IV hydration therapy market size, share & trends analysis report by type (immune boosters, energy boosters), by age (0-18, 18-60), by gender, by end-use (hospitals & clinics, home healthcare), by country, and segment forecasts, 2025 - 2030. Accessed August 26, 2025. https:\/\/www.grandviewresearch.com\/industry-analysis\/north-america-intravenous-iv-hydration-therapy-market-report"},{"key":"ioi250060r7","unstructured":"Food and Drug Administration. Memorandum of understanding addressing certain distributions of compounded human drug products between the state Board of Pharmacy or other appropriate state agency and the Food and Drug Administration. October 27, 2020. Accessed August 26, 2025. https:\/\/www.federalregister.gov\/documents\/2020\/10\/27\/2020-23687\/memorandum-of-understanding-addressing-certain-distributions-of-compounded-human-drug-products"},{"key":"ioi250060r8","unstructured":"Food and Drug Administration. FDA highlights concerns with compounding of drug products by medical offices and clinics under insanitary conditions. October 25, 2021. Accessed August 26, 2025. https:\/\/www.fda.gov\/drugs\/human-drug-compounding\/fda-highlights-concerns-compounding-drug-products-medical-offices-and-clinics-under-insanitary"},{"key":"ioi250060r9","unstructured":"National Association of Boards of Pharmacy. NABP, FSMB, NCSBN join federal agencies in educating regulators and practitioners on risks of IV hydration clinics. August 16, 2023. Accessed August 26, 2025. https:\/\/nabp.pharmacy\/news\/news-releases\/nabp-fsmb-ncsbn-join-federal-agencies-in-educating-regulators-and-practitioners-on-risks-of-iv-hydration-clinics\/"},{"key":"ioi250060r10","unstructured":"Pasternak? A. Close IV hydration bars until the intravenous fluid shortage ends. STAT. October 9, 2024. Accessed August 26, 2025. https:\/\/www.statnews.com\/2024\/10\/09\/iv-fluid-shortage-baxter-elective-intravenous-hydration-bars-spas\/"},{"key":"ioi250060r11","unstructured":"Alabama State Board of Medical Examiners. Declaratory ruling of the Alabama State Board of Medical Examiners\u2014IV therapy. 2022. Accessed August 26, 2025. https:\/\/www.albme.gov\/uploads\/pdfs\/IVTherapy.Declaratory_Ruling_.pdf"},{"key":"ioi250060r13","unstructured":"Calmes? M. Intravenous hydration. The Examiner. 2023. Accessed September 11, 2025. https:\/\/www.lsbn.state.la.us\/wp-content\/uploads\/examiners\/examinerno12023.pdf?v=1736358571.033"},{"key":"ioi250060r14","unstructured":"Vermont Office of Professional Regulation and Boards of Medical Practice, Nursing, Osteopathic Medicine, and Pharmacy. Joint statement regarding IV therapy clinics and medical spas. 2024. Accessed September 11, 2025. https:\/\/www.healthvermont.gov\/sites\/default\/files\/document\/bmp-joint-statement-regarding-IV-therapy-clinics-2024-06-05-approvedbyBMPBOMBOPBON.pdf"},{"key":"ioi250060r15","unstructured":"South Carolina Department of Labor, Licensing and Regulation. Joint advisory opinion of the South Carolina State Boards of Medical Examiners, Pharmacy, and Nursing regarding retail IV therapy businesses. 2023. Accessed September 11, 2025. https:\/\/llr.sc.gov\/med\/Policies\/Joint-Position-Statement-Retail-IV-Therapy.pdf"},{"key":"ioi250060r16","unstructured":"North Carolina Board of Nursing. Administration of intravenous fluids (IV hydration), nutrient therapies, and medications for hydration, health and wellness. 2022. Accessed September 11, 2025. https:\/\/www.ncbon.com\/sites\/default\/files\/documents\/2024-03\/ps-iv-hydration-clinics.pdf"},{"key":"ioi250060r17","unstructured":"North Carolina Board of Pharmacy. State and federal pharmacy law applicable to walk-in IV therapy clinics. 2024. Accessed August 26, 2025. https:\/\/www.ncbop.org\/downloads\/ClinicsOfferingWalkInIVTherapies_UpdatedJan2024.pdf"},{"key":"ioi250060r19","unstructured":"Federal Trade Commission. Business guidance\u2014advertising and marketing. Accessed August 16, 2025. https:\/\/www.ftc.gov\/business-guidance\/advertising-marketing"}],"container-title":["JAMA Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/articlepdf\/2839844\/jamainternal_sivakumar_2025_oi_250060_1763756874.49491.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T16:00:49Z","timestamp":1764604849000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/2839844"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":20,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamainternmed.2025.5028","relation":{},"ISSN":["2168-6106"],"issn-type":[{"value":"2168-6106","type":"print"}],"subject":[],"published":{"date-parts":[[2025,12,1]]}}}