Articles

Evidence based

Evidence Based

This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of licensed nutritionists and dietitians strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.

Is Liquid I.V. Really the Best Way To Hydrate?

Written by Dr. Michael Ruscio, DC on November 12, 2024

Written by Dr. Michael Ruscio, DC on November 12, 2024 — Reviewed by Kellie Blake

• What is Liquid I.V.?|
• What the Research Says|
• Is Liquid I.V. Necessary?|
• How Much Water Do You Actually Need|
• Dehydration Symptoms|
• Overhydration Symptoms|
• Dietary Electrolytes|

Have ads for Liquid I.V. piqued your curiosity? What is this stuff? Is it any different than Gatorade or electrolytes of traditional sports drinks? Will the specialized formulas really help you sleep? Get more energy? Boost immunity? Do you actually need to supplement any of this stuff, or can you satisfy your hydration needs by eating well and drinking water?

Proper hydration is, in fact, really important for overall health and wellness. Maintaining adequate water intake supports the kidneys’ function in regulating the body’s fluid balance, which is essential for overall healthy functioning 1. If you’ve ever overexerted yourself on a warm day and felt dizzy, fainted, or experienced muscle cramping, you’ve likely experienced dehydration.

But the real question is whether or not electrolyte supplements like Liquid I.V. are necessary. And is there a significant difference between this flashy new product and a generic electrolyte powder or even the salt tabs that distance athletes and through-hikers use?

I decided to do a deep dive into the available research investigating the technology behind Liquid I.V. and other electrolyte drink mixes so that I could share a thorough and measured assessment with you. Let’s take a look and then go over what you actually need to be hydrated, the symptoms of dehydration and overhydration, and various ways to improve hydration and add electrolytes to your diet.

What is Liquid I.V.?

Liquid I.V. is an electrolyte drink mix that’s gone viral due to shrewd social media marketing and seemingly ubiquitous podcast ads. The company claims that their electrolyte supplements deliver essential vitamins and minerals to enhance hydration more efficiently than water alone.

The single-serving packets hit most of the common dietary wants and needs like non-GMO, gluten-free, soy-free, and dairy-free. But, the flagship product, Hydration Multiplier, does contain what I consider to be a lot of sugar—11 grams per stick. And although sodium is necessary and a key ingredient in every electrolyte formula, each stick of Liquid I.V. contains 510 mg of sodium, which is 22% of the recommended daily value.

Considering the American Heart Association’s recommendation for daily sugar intake (no more than 36 grams for men and 25 grams for women), consuming Liquid I.V. could contribute substantially to one’s daily sugar and sodium intake 2.

Although I do believe there’s a time and place for a variety of supplements, I tend to recommend that you get your daily intake of salt and sugar from food, rather than from a single stick of electrolyte mix. This isn’t to say that Liquid I.V. isn’t worth taking sometimes, it’s just something to consider when evaluating the big picture of your nutrition and daily nutrient intake.

Liquid I.V. also offers a sugar-free version of the Hydration Multiplier, which uses allulose and stevia leaf extract instead of sugar. The company claims that by replacing the sugar with a proprietary Amino Acid Allulose Blend, the sugar-free product hydrates just as well as the one containing sugar.

Allulous is a sugar-free sweetener that’s not yet been approved for nutritional use in Europe, although it’s used here in the US in many packaged desserts, salad dressings, gum, and candy. 

Cellular Transport Technology (CTT)

Liquid I.V. leverages what it calls “Cellular Transport Technology (CTT)”—a blend of sodium, potassium, and glucose intended to optimize water and nutrient absorption in the body 3. 

This technology is inspired by the World Health Organization’s Oral Rehydration Solution (ORS)/Oral Rehydration Therapy (ORT), which treats severe dehydration by enhancing water absorption and replenishing electrolytes. It’s also intended to mimic the efficacy of a naturally-occurring protein in our intestines.

According to the folks at rehydrate.org, you can make your own ORS at home with:

1. Clean Water – 1 liter – 5 cupfuls (each cup is about 200 ml)
2. Sugar – Six level teaspoons
3. Salt – Half-level teaspoon
4. Stir the mixture till the sugar dissolves

Admittedly, drinking that mixture sounds unappetizing. This intervention is really intended for those who are suffering from acute dehydration due to severe diarrhea. This level of dehydration can be life-threatening, so flavor is likely not the top priority in that situation.

Liquid I.V. not only offers more nutritional value than the standard ORS recipe, but it comes in several flavors (acai berry, tropical punch, watermelon, golden cherry, and passionfruit, to name a few).

Some of the key ingredients in Liquid I.V. include 4:

• Dextrose
• Pure cane sugar
• Natural flavors
• Stevia leaf extract
• Mined salt
• Sodium citrate
• Potassium citrate
• Ascorbic acid (vitamin C)
• Niacinamide (a form of vitamin B3)
• Pantothenic Acid (vitamin B5)
• Vitamin B6
• Cyanocobalamin (a form of vitamin B12)
• Citric acid
• Dipotassium phosphate
• Silicon dioxide​  

I’ll explain the research on ORT in the research section below. It’s a well-supported intervention for severe dehydration that is used worldwide. 

Types of Liquid I.V.

Beyond the variety of flavors, Liquid I.V. comes in a few different formulas. In addition to the baseline promise of enhanced hydration across every formula, each type promises something different:

• Boosting energy (in its Energy Multiplier variant, featuring caffeine sources like guayasa and matcha)
• Supporting sleep (in its Sleep Multiplier with ingredients like valerian root, L-theanine, and melatonin)
• Boosting immune function (in its Immune Support with additional vitamin C, zinc, and beta-glucans)

Each of these may offer benefits beyond enhanced hydration. But again, considering the amount of sugar and sodium in these supplements, if you’re looking to enhance energy, support sleep, or boost immunity, you might be better off choosing a sugar-free supplement or herbal remedy geared specifically toward those needs.

What the Research Says

While there aren’t any scientific studies looking into the health benefits of Liquid I.V. and their specific brand’s proprietary blends, there are studies on similar oral hydration therapies. These include carbohydrate–electrolytes (CE) and oral rehydration therapy (ORT).

Additionally, studies exist on the mechanism Liquid I.V. uses to enhance hydration— the sodium/glucose cotransporter protein.

Carbohydrate–electrolytes (CE)

A 2022 systematic review looked at post-exercise rehydration. In a comparison of CE vs water alone, the CE solutions, especially those with 4–9% carbohydrate content, might be more effective in rehydration. The review suggests commercial CE drinks within this carbohydrate range could be beneficial for rehydration post-exercise when whole foods are unavailable 5. (More on whole foods later.)

Oral Rehydration Therapy (ORT)

I mentioned ORT above in the context of Liquid I.V.’s Cellular Transport Technology. The research supporting ORT looks at its use in cases of severe dehydration. Severe dehydration usually occurs after diarrhea, which is the most common context in which ORT is applicable across the world. For temporary or mild dehydration, ORT is likely overkill.

One literature review examining the benefits of ORT found that clients with severe volume loss (decrease in body fluid levels), inability to drink due to various health issues, or rapid fluid loss might face risks like kidney injury or facial edema (swelling) with ORT. In these cases, intravenous rehydration is often necessary 6.

Sodium/Glucose Cotransporter Protein 1 (SGLT1)

SGLT1 is a naturally-occurring protein found in our small intestine. The job of this protein is to help our bodies absorb glucose by pairing it with sodium. This pairing is important because the body must keep sodium levels under control, and by linking glucose absorption to sodium, the body can efficiently take in glucose.

As glucose and sodium are absorbed by the cells in our intestines, this action also affects water in our body. The movement of glucose and sodium into cells creates a condition that makes water flow into the cells as well. This is helpful for keeping us hydrated and ensuring that our bodies retain essential nutrients 7.

Liquid I.V. uses a mix of sodium, glucose, and potassium to enhance hydration. It taps into the body’s absorption process, like that of SGLT1 in the small intestine, to boost water and nutrient uptake 8.

Is Liquid I.V. Necessary?

Considering the fact that the hydration interventions that inspired Liquid I.V.’s formulation are indicated for severe dehydration, it’s worth asking whether you actually need this type of supplement on a regular basis.

Proper hydration can be achieved through regular water intake for most people, and the benefits of Liquid I.V. might be more pronounced in cases of severe dehydration or specific dietary needs.

If you’re recovering from a food-borne illness, traveler’s diarrhea, or even a nasty hangover, this type of remedy could be a good thing to have handy. If you’re looking to hydrate or rehydrate after an intense athletic competition like distance running, biking, or hiking, then this could be a great addition to your prep kit.

Whether or not Liquid I.V. is worth the investment as a supplement in your regular rotation depends on personal health goals, dietary needs, and lifestyle. While it offers a convenient and potentially faster way to hydrate and replenish electrolytes, plain water and a balanced diet may suffice for most people’s everyday hydration needs.

How Much Water Do You Actually Need to Hydrate Properly?

The National Academy of Medicine provides guidelines indicating that an adequate daily fluid intake is around 3.7 liters for men and 2.7 liters for women 1.

In case it’s easier to measure out using a thermos or mug with standard measurements, here’s a conversion chart to ounces and cups.

This recommendation includes all fluid sources, including non-water beverages and water from foods like cucumbers, celery, melons, and others. These recommendations are aimed at ensuring optimal hydration levels for the majority of people in the United States.

A key marker of hydration is whether your urine is sufficiently diluted. Your urine should be a pale yellow color. Adhering to the National Academy of Medicine’s fluid intake guidelines supports the kidneys’ function in regulating the body’s fluid balance, which is essential for overall health and well-being 1. 

These recommendations can shift with increased physically demanding activity, how much you sweat, the climate you live in (very hot and/or very dry), the season (summer vs a cooler season), and as you age. Using the color of your urine as a marker is helpful, since these other conditions can change over time.

Dehydration Symptoms

Symptoms of dehydration will vary based on severity. As I mentioned earlier, if you’ve felt dizziness or muscle cramping after exercising on a warm day, you’ve likely experienced mild dehydration. Other symptoms of mild to severe dehydration include 9:

• Fatigue or tiredness
• Thirst
• Dry skin
• Dry or cracked lips
• Dark-colored urine or decreased urine output
• Headaches
• Muscle cramps
• Lightheadedness or dizziness
• Syncope (fainting)
• Orthostatic hypotension (a drop in blood pressure when standing up)
• Palpitations (feeling that the heart is racing or fluttering)

If you’re experiencing severe or prolonged dehydration, these additional symptoms might show up 9:

• Lethargy or reduced alertness or consciousness
• Dry mucosa (inside of the mouth)
• Skin tenting (skin that does not quickly return to normal when pinched and released)
• Delayed capillary refill (takes longer than normal for color to return to nail beds after being pressed)
• Cracked lips

• Sunken eyes
• Weakness
• Changes in mental status
• Reduced appetite

Notably, many of these symptoms may indicate something other than or in addition to dehydration. The best measure is a blood test called serum or plasma osmolality. This measurement helps us understand how well our bodies are managing the balance of water inside our cells, which is crucial for staying hydrated 10. 

That being said, if you suspect you’re experiencing dehydration, it’s probably a good idea to increase your water intake before you go to the doctor in case they can’t see you right away. If you’re worried for your safety or the safety of someone exhibiting symptoms of severe dehydration, you might need to seek emergency care.

Overhydration Symptoms

Overhydration is far less commonly reported than dehydration, but it’s still possible to overhydrate. In fact, overhydration followed by a sudden reduction in water intake is sometimes used on purpose in fighting sports and bodybuilding. Athletes who want to quickly drop weight before a competition by “water loading” and then reducing their water intake, leading to a quick drop in water weight 11.

Some reported signs and symptoms of overhydration are 11 12:

• Headache: A common symptom that might occur due to the swelling of brain cells as the body tries to balance the sodium levels inside and outside of cells.
• Scotoma: Visual disturbances or blind spots, which can occur due to changes in brain pressure or swelling.
• Skin coldness with pallor: Pale, cold skin could be a result of the body’s attempt to manage the excess water.
• Puffiness of the face: Swelling in the facial area, likely due to water retention.
• Dry lips

• Lack of taste sensation
• Anorexia
• Nausea and vomiting
• Fatigue
• Headache
• Altered mental status
• Agitation
• Seizures
• Coma 

In the early stages of overhydration, you can be asymptomatic until reaching the point of water intoxication and hyponatremia (lower sodium levels) 11. If you’re drinking more water than you need for more than three days, your kidneys start to adjust by reducing the number of special water channels, known as AQP2, in the cells of the kidney’s collecting ducts 11.

Animal studies have shown this directly, and human studies have suggested it indirectly. This reduction in water channels is the body’s way of dealing with too much water, allowing more of it to be passed out as urine, which matches the increased amount of water being drunk 11.

How To Get Dietary Electrolytes

I’ll start by saying again that there may be an appropriate time to use electrolyte mixes like Liquid I.V. or other brands. CE beverages like Gatorade or Vitaminwater also fall into this category. If you live in a particularly hot climate, are recovering from an illness that was dehydrating, are a regular sauna user, or are an athlete, these options may be suitable for you.

But there are other, less sugary ways to get electrolytes and carbohydrates that will help you stay hydrated.

For example, studies have shown that drinking skim or low-fat milk can lead to a statistically significant improved volume/hydration status compared to drinking water alone. This is attributed to the electrolytes and proteins present in milk, which may help with water retention and hydration 13. If you’re lactose or dairy-intolerant, then this won’t work.

Collagen supplementation may also indirectly aid hydration. It’s been associated with improvements in skin hydration, among other benefits like wound healing and skin elasticity. Collagen hydrolysate, collagen tripeptide, and collagen dipeptide are some forms that have shown positive effects 14.

You may also focus on macrominerals in your diet. Electrolytes such as potassium, chloride, magnesium, and sodium are crucial for maintaining proper hydration levels as well as muscle and nervous system function. A deficiency in these electrolytes can lead to dehydration and its associated symptoms like dizziness, muscle fatigue, and nausea 15.

Whole Food Dietary Sources of Macrominerals/Electrolytes

Here’s a chart of macrominerals and their whole food dietary sources 16.

In general, monitoring your intake of these foods and possibly tracking your dietary consumption using apps or food composition databases can help ensure you’re getting sufficient amounts of macrominerals and staying hydrated.

Pay attention to how you feel, your energy levels, whether your skin looks and feels dry, whether you’re feeling light-headed or experiencing dry mouth, and note the color of your urine throughout the day. It’s a good idea to drink from a thermos or bottle that has measurement tic marks on it and set a goal for daily water consumption of at least 8 cups, leaving the remainder for food and other beverages.

Does Liquid I.V. Live Up to the Hype?

The Liquid I.V. formulation is inspired by interventions for severe dehydration. Sometimes an intervention like that is called for, and sometimes it’s overkill. This product has a lot of sugar and sodium, and it’s very possible to hit your hydration goals in your daily diet without all that added sugar and sodium.

That being said, if you’re recovering from a bout of diarrhea or experiencing extreme dehydration for other reasons, it might be worth considering either Liquid I.V. or other electrolyte mixes. There are a number of products on the market that contain less sugar than Liquid I.V. If I were choosing, I’d opt for a lower-sugar option.

If you’re looking for help on how to ensure you’re properly hydrating or for more in-depth help with your diet and lifestyle, we’d love to help. Reach out to our clinic to set up a time to chat.

The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.