Background: The growth of commercial intravenous (IV) micronutrient infusion clinics has resulted in an expansion of this highly unregulated industry designed to operate rather than through a conventional healthcare system. These clinics promote high doses of parenteral therapy for “health and wellness” without sufficient data establishing the need. Lack of accessibility to primary and specialty healthcare leaves marginalized groups susceptible to these unregulated “health and wellness” markets instead of evidence-based patient care. This case examines persistent leukopenia in a post-bariatric patient receiving IV micronutrient infusions.

Methods: A clinical exemplar was used to learn about fragmented healthcare delivery systems, attention gap regulation, and access inequities after post-bariatric surgical follow-up impacting patient use of commercial parenteral infusion services.

Case Context: A 56 year-old African American female with prior history of bariatric surgery in 2021 was being seen in hematology due to a persistently low white blood cell count (4.1 × 10⁹/L) and an absolute neutrophil count of 2.0/L. The patient disclosed spending approximately $1,200 for commercial IV vitamin therapy from a commercial wellness center with no documentation or standardization to determine the clinical need for such therapy.

Population Health Significance: This case study highlights multiple systemic problems, including an uneven regulation of commercial infusion services, differing financial motivations for commercial health care services, a lack of health literacy resources that provide evidence-based use of supplements, and limited access to specialty care.

Implications: Due to the increase to the increasing number of commercial intravenous micronutrient businesses, there needs to be equity-focused policy reform; clarify what regulations will apply to these companies; and implement culturally appropriate, long-term care access solutions.