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Using IV (Intravenous: Into a vein) infusions to rehydrate after a brutal weight cut seems innocuous to most people. But you might be surprised to find that this practice has been banned in the UFC since 2015 for reasons related to the safety and fairness of the sport.
According to USADA, the ban on IV use prevents some UFC fighters from utilizing IVs to manipulate PED testing results. The exception to this rule is that fighters with medical exemptions can still use IV rehydration.
We will delve deeper into IV rehydration in MMA, including its advantages and potential health risks, as well as why it is prohibited in the UFC.
What Is IV Rehydration in UFC?
In UFC, athletes sometimes use IV therapy to recover faster from brutal weight cuts. They use intravenous infusions to inject the water and nutrients into their blood veins directly.
To perform IV rehydration, a thin tube called a “cannula” is inserted into a vein. This tube is then connected to a fluid bag containing sterile water and essential nutrients, the same as you see in a hospital setting.
IV rehydration is the most efficient and effective method for replenishing lost nutrients after a weight cut. This method delivers essential electrolytes, vitamins, amino acids, and dextrose directly to your cells via veins. IV rehydration method enables fighters to recover and regain weight more efficiently and far quicker than oral rehydration.
Why Is IV Rehydration Banned in the UFC?
According to USADA, one of the main reasons the IV ban was implemented was to improve fighters’ safety and health. It forces UFC fighters to recover only through oral rehydration to prevent severe complications from using IVs to rehydrate.
• The potential risks and complications of IV therapy include infection, cellulitis,
inflammation of the wall of a vein with associated thrombosis, bleeding, hematoma/arterial puncture, unintended leakage of solution into the surrounding
tissue, air embolism, and needle stick to the provider.
• Inappropriate levels of electrolytes given by IV can also have serious cardiac,
muscular, and nervous system effects, which could result in death
USADA explains the health risks of using IVs for rehydration
Another main reason is that the ban on IVs also stops fighters from using IVs to mask the use of PEDs.
Fighters can use IVs to change the blood test results for PED by diluting the blood or injecting prohibited substances to flush out traces of PED much more quickly from the body. Here’s the explanation of the IV ban from USADA:
The IV rule is designed to protect clean sport and athlete health and safety. In terms
of doping control, it is a fact that IVs can be used to change blood test results (such as hematocrit where EPO or blood doping is being used), mask urine test results (by dilution), or administer prohibited substances so they will clear faster from the body.
RELATED: What is Banned/Illegal in the UFC?
How Fighters Cut Massive Weight with IV Rehydration
One other controversial issue is that IV hydration enables fighters to rehydrate much quicker after massive weight cuts. In UFC 284, Islam Makhachev was accused of using an IV to rehydrate himself after a difficult weight cut.
During the weight cuts, fighters are progressively decreasing their intake of fluid, carbs, salt, and other nutrients and they lose up to 15% of their total body weight in five days.
After passing the scale, they have less than 24h to recover. This is often not enough time to recover by oral rehydration, as this method is much slower. Thus, athletes would use IVs to speed up the process and recover their bodies faster than by eating and drinking.
However, in 2015, the United States Anti-Doping Agency (USADA), responsible for testing UFC fighters, came out with the statement that IV rehydration therapy is no longer legal. The only exceptions are fighters who received the therapy for surgical procedures, clinical investigations, or other medical treatments.
Bear in mind that IV rehydration is legal in promotions that are not cooperating with USADA.
What Are the USADA Rules on IV Infusions for UFC fighters?
The initial rules implemented in 2015 restricted the usage of IV rehydration. Athletes could take infusions without Therapeutic Use Exemption (TUE), but only if the non-prohibited substances didn’t exceed 50mL per six-hour period.
However, in 2019, the rules were readjusted to make IV injections stricter, including for those who undergo regular rehydration. Here are the summaries of the new USADA-adjusted rules for 2019.
- Fighters are not allowed to have IV infusions or injections exceeding 100 mL (equivalent to 6.8 tablespoons) within a 12-hour period, both during and outside competitions, unless medically required.
- UFC athletes can receive IV infusions or injections as part of their medical treatment, provided it is within the standard of care and administered by licensed medical professionals during hospital stays, surgical procedures, or other medical treatments without the Therapeutic Use Exemption (TUE).
- If a prohibited substance is to be administered via injection or infusion, fighters must first apply for Therapeutic Use Exemption (TUE) and get approved.
- Whenever a fighter receives an IV infusion, every detail of the infusion, such as IV substance, volume, time, etc., must be recorded in the medical documentation for USADA to verify.
Is IV Rehydration Banned in Other MMA Promotions?
IV rehydration is not officially banned across all MMA promotions. This rehydration method is only banned by the USADA, which cooperates with the UFC. Having USADA service is very expensive, and most MMA promotions cannot afford it.
MMA fighters from different promotions may use IV therapy during and outside of competition, as they are only bound by the state Athletic Commission’s regulations that oversee the event. Nevertheless, UFC fighters must comply with the directives established by both USADA and the state athletic commission.
The only exception is the Asian ONE Championship promotion. In ONE, athletes are not allowed to lose weight through dehydration. During fight week, they undergo multiple urine tests and must be within the limits of urine gravity the entire time. They are not allowed to dehydrate their bodies or receive IVs packed with water and nutrients to recover.
Oral Rehydration vs. IV Rehydration: What’s the Difference?
The biggest difference is efficiency—the time the nutrients and fluids take to reach their destination. Receiving IV therapy directly into the vein is the fastest, easiest, and most convenient way athletes can recover from brutal weight cuts. However, there are health risks involved with using an IV.
Oral rehydration is different:
- You need to eat the right food and drink fluids with your mouth.
- The food travels down to your stomach, where digestion begins.
- It takes time for the body to digest the food, break down all the nutrients, and send them through the veins to the other organs in the body.
Unlike IV rehydration, oral rehydration is safe.
How Does USADA UFC Detect IV Use?
The way USADA tests or methods they use to determine if a fighter used an IV to rehydrate remains a mystery.
USADA employs scientific techniques to identify banned substances in blood and urine samples. However, fighters are uncertain about how USADA detects the use of IVs.
For instance, if an IV is utilized solely for rehydration with water and essential nutrients without any banned substances, USADA may not have any leads to detect if a fighter has undergone IV therapy unless the fighter confesses to using it or someone else caught them using it.
USADA may not have the technology to catch fighters using IVs, so they may simply be bluffing. In any case, UFC fighters can still use Therapeutic Use Exemption (TUE) to receive IV therapy, creating possible opportunities to exploit this rule.
Donald Cerrone, for instance, claimed that he received an exemption from the UFC to use IV therapy after weigh-ins because he couldn’t recover as quickly as other fighters in the division due to his medical condition.
One thing is sure — thus far, only two UFC fighters have received suspensions for taking IVs after weigh-ins: BJ Penn in 2016 and Paulo Costa in 2017.
How Do UFC Fighters Rehydrate After Weight Cutting?
Since they are not allowed to use IVs, fighters must focus on oral rehydration. Alone or supported by nutritionists, they will carefully plan which foods and fluids they take at which stages to ensure they recover in the fastest, easiest, and most efficient way possible, especially after brutal weight cuts.
Though the process varies between fighters, the recovery usually goes in this order. In the week leading up to a fight, most of the weight lost is water. So first, the focus is on rehydrating the body by drinking fluids rich in electrolytes, without which the body can’t absorb the water.
As soon as they step off the scale, athletes start drinking electrolyte-based sports drinks, natural coconut water rich in potassium and electrolytes, or other products. In the last 24 hours leading up to a fight, they would drink substantial amounts of water and other drinks to return their bodies to optimal working order.
Next, athletes eat high-energy food to compensate for all the lost nutrients during the weight cut and build strength for the upcoming bout. Each meal has to include lean proteins to speed up muscle recovery, healthy carbs to keep blood sugar levels up, and vegetables.
Fighters may eat small meals every 30 minutes to avoid digestive tract issues until their body fully recovers. You may wonder, “How much weight do UFC athletes regain back?” With a well-planned diet, athletes can regain the majority of their weight. For instance, fighters can regain up to 20 pounds in less than 24 hours. On paper, this gives them a big weight advantage on fight night. Still, since every fighter is weight-cutting, they usually end up fighting against someone similar in size.
Former UFC champ Daniel Cormier explains oral rehydration following USADA’s IV ban
How Often Does USADA Test UFC Fighters?
UFC fighters must provide blood and urine samples around 5–6 times per year on average. In 2022, the USADA tested a total of 755 MMA fighters 4,183 times, which is 5.7 tests per fighter.
Of course, some fighters are tested dozens of times, while others are tested just a few times. The exact number depends on various factors. For example, former UFC champ Kamaru Usman was tested 15 times in 2022. On the other hand, Jiri Prochazka needed to provide samples a whopping 64 times in 2022.
Overall, USADA can test a fighter whenever and wherever they want, 365 days a year. Each active UFC fighter is a part of the “testing pool,” meaning they must provide samples whenever the USADA agent pays a visit. Fighters who try to evade USADA testing will face serious consequences, which could lead to the termination of their UFC contracts.
When traveling, fighters are required to notify USADA of their whereabouts. The location doesn’t matter either, as the agency regularly performs tests across more than 50 countries.
Is IV Rehydration Banned in Boxing?
In contrast to the UFC, not all professional boxers undergo testing by USADA unless USADA is hired as a contractor to conduct testing for specific boxing events.
As a result, if USADA is contracted to conduct drug testing for professional boxing events, boxers who participate will be required to follow the same IV regulations as UFC fighters.
USADA also conducts testing by contract for sports and/or events that fall outside this group, such as professional boxing, dance, and Brazilian Jiu-Jitsu.
It appears IV therapy remains the most efficient and easiest method to recover from brutal weight cuts. However, fighters who compete in the UFC or other promotion that cooperates with USADA cannot use IVs as this is considered illegal. Instead, they must recover through oral rehydration.
This rule does not apply to MMA fighters who compete in other organizations not regulated by USADA. This includes Bellator, PFL, and many other smaller organizations.