The duty conducted telephone consultations pretending to be a client to nurses at five intravenous vitamin therapy clinics. All said they used products approved by Health Canada from dispensing pharmacies in Ontario. These products are prescribed by a doctor through a collective prescription. Ways of doing things that leave the experts consulted perplexed.
At the start of the COVID-19 pandemic, Daniel Selcer and his business partner, Daniel Gurman, launched GTR Santé, a company specializing in rapid screening tests. In interview with The dutyMr. Selcer says that, faced with the public’s enthusiasm for the wellness industry, they quickly decided to open four GTR Santé branches offering intravenous vitamin therapies and then to launch VitaBoost, their own branch of product distribution.
“The vitamins are prepared by a Canadian facility that has a compounding pharmacy license. It’s important to us. I can’t say which one since we are in the middle of negotiating with them for a partnership,” Mr. Selcer said over the phone.
Whether it is IV Clinic or GTR Santé, the clinics buy the various components of the injections from dispensing pharmacies in Ontario. These establishments prepare the medicinal recipes (called “masterful preparations”) based on a collective prescription from a doctor.
In the clinic, the nurse introduces, following a predetermined protocol, one by one, into a bag of solute, the products taken from the vials of the pharmacy, necessary for the treatment by injection chosen by her client: “Libido stimulator” , “Athletic performance”, “Diet and detox”, “Hangover” or even “Brain health”.
“Everything that goes into our body must be legal […] These vitamins are approved, they are not people making vitamins in their basement. These are approved establishments, laboratories and dispensing pharmacies, inspected according to very strict regulations,” explains Selcer. “There is a medical director who sits on the board of directors of our company,” he insists.
Products issued by collective prescription
According to the regulations in force, drugs administered intravenously require a medical prescription. “It works by collective prescription”, specifies Mr. Selcer, who did not wish to communicate the name of the prescribing doctor to the Duty.
As opposed to individual prescriptions that require seeing a doctor, collective prescriptions allow nurses at Mr. Selcer’s clinics to intravenously inject a mixture of ingredients from dispensing pharmacies without their clients even meeting with the prescribing doctor.
“Making a collective prescription is not giving a blank check that you sign to someone to inject anything in any situation to anyone,” says Jean-François Desgagné, president of the Order of Pharmacists of Quebec. He finds the practices of these infusion clinics “extremely concerning”.
A magistral preparation, provided by a preparing pharmacy, is usually used in two cases, according to him. “First of all to bridge the gap, to fill a need, when commercial preparations do not exist or are out of stock […] Otherwise, it’s to make a preparation that will be very, very adapted, very individualized, to a person. We will see that, among others, in the case that interests us, in parenteral nutrition (intravenously) […] But it is often with a prescription that will be individualized by a doctor, often in association with a dietitian, […] not in a preventive case, in a cosmetic case or in a performance improvement mode”, he explains.
Mr. Desgagné specifies that, even if the ingredients used are approved by Health Canada, the formula administered intravenously must also be. “Yes, the principle is that vitamin C is approved by Health Canada. But the preparation they use as part of their protocol, this product must also be approved by Health Canada, “he says..
For its part, the College of Physicians of Quebec (CMQ) recalls that the physician signing a collective prescription is responsible for its scientific content. “To the knowledge of the College, this treatment [vitaminothérapie intraveineuse] is not based on solid scientific data”, informed the CMQ to the Duty. “The collective prescription must not serve commercial interests”, also recalls the CMQ.
Confronted with the comments of the Order of Pharmacists and the College of Physicians, Mr. Selcer replied that to his knowledge, “there is nothing wrong or inappropriate in the way in which [ils font] things “. “Until I hear a government body say otherwise, there’s not much I can do about it,” he adds.
“I spoke to people from Health Canada, they came to visit my clinic. They wanted to make sure we were doing things in a particular way. We had a discussion about compounded vitamins versus manufactured vitamins, but also a conversation about marketing and the fact that some guidelines should be followed,” he said.
Health Canada has confirmed to Duty conducted a visit to verify compliance of GRT Santé clinics and indicated that a follow-up was underway and that it “will take action in the event of non-compliance” with the Food and Drugs Act and Regulations.
Urine worth $250
In Canada, whether it is a drug or a vitamin, a substance administered by piercing the dermis cannot be considered a natural health product, according to Health Canada, but a drug.
However, the nurses consulted by The duty as part of this survey in intravenous vitamin therapy clinics as well as the co-owner of GRT Santé Daniel Selcer present the ingredients injected by infusion to their customers as “natural” products.
“Vitamin supplements and all of these supplements are already on the shelves. In terms of safety, the biggest difference between what you find on the shelves and what you find with us is the mode of administration,” explains Mr. Selcer. He argues that the intravenous injection is “a better way to take [ses] vitamins. […] The absorption rate is so low with vitamins that you take orally, because metabolized by all parts of your body, all you do is work around it by intramuscular or intravenous injections in order to have a better delivery of the vitamins”.
Statements that are squarely contradicted by the president of the Order of Dietitians Nutritionists of Quebec (ODNQ), Joëlle Emond.
“Dietitian nutritionists always favor the oral route of feeding. It should always be favored to maintain the integrity of the digestive tract and intestine. There is an important filtering role to play in the digestion process to meet our needs for water, vitamins or minerals,” explains Ms.me Emond.
The president of the ODNQ advises, before taking any vitamin supplement, to evaluate with a dietitian nutritionist your real needs in vitamins and minerals. “When we show up at a clinic like that, without having had an assessment of our nutritional status, perhaps we are not meeting any needs. »
In healthy people, she believes that intravenous vitamin therapy represents a rather low risk. “The vitamins that are used are mostly water soluble and the body usually eliminates the excess through urine. It is therefore more likely that the person who uses it will find himself in a situation where his urine is worth $250,” she says.
Mme However, Emond would like to point out that the benefits touted by intravenous vitamin therapy clinics are not based on proven scientific data. “Whether neutral, positive or negative, its effects remain unknown. »
The studies cited on the websites of the various companies, which she has read, are not relevant, according to her, since they refer to “the oral supplementation of a particular vitamin or a particular mineral in a isolated, most often in contexts of illness,” she says.
Significant risks
Vitamin infusion is not without risk. For healthy people, a reaction to the place where the injunction was made or an allergic reaction to the products are possible.
“But where the risk is greater is in people who have a particular condition, known or unknown. We are talking about the possibility of drug/nutrient interactions or the exacerbation of certain medical conditions,” explains Joëlle Emond.
The risks of infections are also to be taken into account since it is an intravenous injection.
In Quebec, in 2008, a man died of sepsis following intravenous vitamin treatment by a Montreal naturopath because one of the vials used was contaminated with a deadly bacteria, according to Health Canada. The naturopath was also found guilty of having illegally practiced medicine by the Superior Court of Quebec in 2021.
In the United States, the Food and Drug Administration (FDA) faces a major problem with the proliferation of clinics offering intravenous vitamin therapy that is not federally approved. In a statement to the general public in 2021, the FDA writes that sterile compounding activities performed “in intravenous hydration clinics pose risks and require ongoing evaluation.”
That same year, Health Canada had to intervene with Galena Pharm Inc, a dispensing pharmacy supplying vitamin infusion clinics in Ontario, Alberta and British Columbia. The establishment is now closed and its owner is the subject of an investigation by the College of Pharmacists of British Columbia for allegedly selling unlicensed products, used in particular in the context of vitamin therapies administered by injection or infusion.
Health Canada has also recalled Glutathione, an antioxidant produced by Galena Pharm, due to reports of poisoning by endotoxin (a bacteria) in British Columbia. This type of poisoning can cause serious health problems that can lead to death. “This risk is particularly high when the body receives the contaminated products by injection or infusion”, specifies Health Canada.
The list of products targeted in the Galena Pharm dossier is contained in the public notice published on the Health Canada website. It contains all the ingredients contained in the infusions used in the clinics in the greater Montreal area listed by The duty in this investigation, including Glutathione.