Self & Other · The Things That Sound Like They Help (But Mostly Don’t)

IV Vitamin Drips and Wellness Clinics

Second, most products contain strains chosen partly for their ability to survive freezing and shipping rather than for any specific demonstrated health benefit. The label claims a billion or ten billion organisms; most are dead by the time you take the capsule, and the survivors may or may not have any relevant function.

Third, the strongest evidence for probiotic benefit is in specific clinical situations: preventing antibiotic-associated diarrhea (where there is reasonable evidence for some specific strains), shortening certain kinds of infectious diarrhea, and managing certain inflammatory bowel conditions in carefully selected patients. There is also some evidence in preterm infants in neonatal intensive care. The evidence for probiotics in healthy adults to “support general immune function” is much weaker, often null, and almost always involves products and strains different from what is on the shelf.

A fourth issue, sobering: probiotics are not entirely safe in every situation. There have been documented cases of severe infection from probiotic strains in immunocompromised patients, in critically ill patients, and in patients with damaged intestinal walls. For healthy people, probiotics are generally low-risk, but not always benign.

The cleaner version of this advice: if you want to support your microbiome, eat more fiber — Chapter 13 covered this. Fermented foods (yogurt, kefir, kimchi, sauerkraut) provide some live bacteria in a form your body has been handling for a long time. Pills and powders may have a role in specific medical situations, prescribed by someone who knows your case. As a general daily supplement for healthy people, the evidence does not support them.

IV Vitamin Drips and Wellness Clinics

A newer entrant in the immune-support market is the IV vitamin clinic, where for $200 to $500 you can have a saline bag containing various vitamins and electrolytes infused into your bloodstream over an hour. The clinics market these for hangovers, jet lag, immune support, athletic recovery, and “Myers cocktails” of various compositions.

What is being delivered, mostly, is hydration plus vitamins. The hydration is real and may make you feel better, particularly if you came in dehydrated. The vitamins are mostly the same B vitamins and vitamin C you could obtain by eating any reasonable diet, and the question of whether your body can do anything more useful with them in IV form than in dietary form is, mostly, no. The vitamins your body needs, it absorbs through your gut. The vitamins it does not need, it excretes — just as quickly when given by IV as by mouth.

There is no published evidence that IV vitamin therapy in healthy adults provides meaningful immune benefits beyond what the same vitamins would provide in food. The infusions are not without risk: any IV access creates an infection pathway, and complications, while rare, do occur. People with certain heart, kidney, or liver conditions can be harmed by the volume of fluid or the load of certain vitamins. Whether any of this is worth several hundred dollars an hour for a saline bag is a question only the consumer can answer.

Adaptogens, Anti-Inflammatory Diets, and Other Marketing

A few terms have become so common in wellness marketing that they deserve a brief accounting.

“Adaptogens” is a marketing term for a group of herbs (ashwagandha, rhodiola, eleuthero, holy basil, and others) claimed to help the body “adapt” to stress. The term was coined in the 1940s in Soviet research that does not quite meet modern evidentiary standards. Some of these herbs have small effects in some studies, mostly on subjective measures of stress and fatigue. The category as a whole is not a recognized medical concept. Some — ashwagandha in particular — do have real biological activity and can interact with other medications. They are not free of side effects.

“Anti-inflammatory diet” has been used to mean almost everything. The serious version is what Chapter 13 described: diets high in vegetables, fruits, whole grains, fish, and unsaturated fats are associated with lower chronic inflammation. The marketing version is much broader and is used to sell specific products, books, and protocols that often go well beyond what the science supports. Be skeptical of any specific food being branded as “anti-inflammatory.” The term is not a regulated descriptor.

“Detoxifying” foods (lemons, beets, milk thistle, parsley) are similar. These are mostly fine foods. None of them does anything special to your liver, which is doing the actual work regardless of what you put in front of it.

“Boosting” anything, in general, should be a flag. The body is a regulated system. Things that “boost” particular functions are usually either small, nonspecific, or both.

Cold Plunges and Saunas

A category that has become popular, and that has more genuinely interesting evidence than the things above, is deliberate temperature exposure: cold plunges, ice baths, saunas, contrast therapy.

The honest summary, as of the mid-2020s, is that there is real evidence that regular sauna use is associated with lower cardiovascular disease and possibly lower rates of certain other conditions — most of it from Finnish populations, where sauna use is essentially universal and the data are unusually good. Whether the effect is causal, and whether it would apply to people with very different baseline lifestyles, is harder to say. The evidence for cold plunges and ice baths in healthy people is much weaker, more recent, and largely focused on subjective measures of mood and inflammation. Some genuine effects on certain cytokines have been observed; whether they translate to better immune function or better health in the long run is not established.

If you enjoy a sauna or a cold shower, there is no reason not to. These practices are mostly safe in healthy people. They are not a substitute for the high-evidence interventions in the last chapter. Treat them as enjoyable additions, not as treatments.

A Note on the Pattern

Look back at the things in this chapter and you will see a recurring shape.

Most are based on a partial truth. Vitamin C is necessary; severe deficiency is real. The microbiome is important; antibiotics can damage it. Stress is real; chronic stress affects the body. Cold exposure does affect inflammation. None of these underlying facts is wrong. What goes wrong is the leap from the fact to the specific commercial product being sold to you. The leap is almost always larger than the evidence supports.

This is the basic structure of wellness marketing. Take a real biological mechanism. Find a product that intersects with it in some plausible-sounding way. Imply that the product addresses the mechanism. Avoid making claims specific enough to be testable. Charge enough that the product feels serious. Sell to people who, reasonably, want to take care of their health and have been told by an industry of experts and influencers that this is what taking care of one’s health looks like.

The casualties are mostly financial. People spend money they could have used for things that would actually help them. They sometimes delay real medical care because they believe the cleanse or the supplement is going to fix what is wrong. They are sometimes harmed directly by products whose contents are not what the label says, or by interactions with medications they did not know to mention. They are, almost always, distracted from the things that would actually make a difference.

The things that would actually make a difference were in the previous chapter. They are also extraordinarily boring. That is why most people do not read books about them, and why the wellness industry is enormous.

If you have used or are using any of the things in this chapter, this is not a verdict on you. The marketing is good. The cultural pressure is real. Many of the people promoting these products are themselves convinced of their value, which makes them more persuasive than they would be if they were lying on purpose. Almost everyone has, at some point, taken something or done something that turned out not to do what it was claimed to do.

What this chapter is for is the reader wondering whether the supplement aisle, the wellness clinic, or the elaborate cleanse protocol is the missing piece they have been told it is. The honest answer, on the available evidence, is: probably not. The interventions that work are the boring ones from the previous chapter. The ones in this chapter are mostly either small, expensive, or both.

The next chapter is about something that genuinely matters and is genuinely strange: the relationship between the immune system and the rest of you — your nervous system, your relationships, your felt sense of being held or being alone. This is not wellness marketing. It is real biology, and some of the most interesting findings in immunology of the last twenty years.

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