IVs an Edge for Athletes

Jul 14, 2014
But others say natural rehydration is best for recovering

Originally published in the Austin American-Statesman – Monday, June 16, 2014


Pam LeBlanc – Fit City     Photo Credit: Jimmy Harris

You’ve just crossed the finish line of an Ironman triathlon or finished a four-hour training ride under the beating Texas sun. What’s the best way to rehydrate – chug a bottle of sports drink or head to the doctor’s office for an IV?

The sports drink is cheaper and easier, of course; but a growing number of endurance athletes are opting for IVs because they say it’s faster, more effective and gets them back to rigorous training quicker.

At the Downtown Doctor in Austin, athletes can drop by for a rehydration session, during which a blend of water, electrolytes, minerals and vitamins is administered by IV in one of the clinic’s six private rooms. It takes about 15 or 20 minutes, and patients can recline on a vibrating “zero gravitation” chairs or work on their laptop during the treatment, which Dr. Georgeanne Freeman says can help flush out lactic acid, relieve inflammation and pain and leave patients energized.

“You can only do so much to keep up with hydration when exercising during hot Austin summer,” Freeman said. IVs work more quickly than drinking fluids because they bypass the gut, hydrating the body directly. “It is an advantage, and pro athletes know it’s an advantage.”

The Downtown Doctor markets rehydration IVs to athletes training for marathons, triathlons and other endurance events, as well as people suffering from hangovers. The clinic even set up a tent to offer IVs to finishers of  the Life Time Tri CapTex last month. The infusions start at $189. (Another Austin company, Rolling Revival, also offers rehydration IVs.)

Most experts agree that rehydration is faster with an IV, but not everyone things IVs are better than rehydrating naturally. The World Anti-Doping Agency, which sets the rules for International Triathlon Union events, has banned the use of rehydration IVs by its athletes, both during and outside of races. The only exception is when an IV is deemed medically necessary, such as when a competitor is severely dehydrated at the finish line. Athletes, the agency says, might use them to try to mask the use of prohibited substances or to distort blood tests.

Still, in Austin, where high heat and humidity leave us wringing out sports bras and drip-drying running shorts after a workout, many athletes see rehydration IVs as a competitive edge because they lose less training time while recovering.

Professional triathlete Natasha van der Merwe, who lives in Austin, says she knows first-hand the advantage of rehydrating with an IV. When medical personnel have administered one to her at the finish of an Ironman triathlon because of dehydration, she has bounced back more quickly, she says.

“Its not the same. It’s not even close, “ van der Merwe said. “Three days later I’ll be hitting a workout. It feels like I didn’t even do an Ironman.”

That happened earlier this month at Ironman Kansas 0.3, where she was finished eighth but was dehydrated and given three IV bags in the medical tent. Van der Merwe says it’s not unusual to lose 6 pounds in water weight during a long cycling session. “There’s no way there’s time to replenish that and have a hard workout the next day” just by drinking fluids, she said.

Of course, it’s not always easy to determine who medically needs an IV at a race finish. Once, van der Merwe says, she finished a triathlon exhausted but happy about her performance, and with a smile on her face. Another finisher said to her as they neared the finish line, “Stop smiling or you’re not going to get an IV.”

That worries Dr. Pierre Filardi, an Austin physician and medical director of the Austin Marathon, who says IV rehydration should be reserved only for severe cases.

“I’m a huge believer that the human body, and your natural balancing mechanisms, are smarter than any doctor.” He said. “It may take the better part of a day, but your body can really do a wonderful job of getting itself back in shape.”

He points to a 2008 study led by Dr. Douglas Casa, a kinesiology professor at the University of Connecticut, that compared IV versus oral rehydration and found no performance or physiological advantage to IVs. (The study did note that IVs can be beneficial when an athlete is nauseated or otherwise unable to take fluids orally.)

“No doubt it’s effective, but it probably is not necessary no superior to doing it naturally,” Filardi said. There is a small risk of infection with any IV, and IVs can be dangerous if the athlete is fluid overloaded or has hyponatremia, not enough sodium in the bloodstream. There may be a placebo effect with using an IV, too, he said. “If the athletes believe it to be true, then it tends to have self-fulfilling prophecy.”

“To me it’s kind of an alarming trend. Stretching beyond the bounds of what’s medically necessary opens a whole Pandora’s box – what if they try to start doing it at home or faking symptoms, or someone makes a mistake and they get worse?” he said.


Contact Pam LeBlanc at 512-445-3994.