Dietary supplement Grade Glutathione Went Into IV Vials. Now the CDC Is Investigating.

By Kate Dee, MD — Founder, MedSpa Board

On September 15, 2026, the CDC updated its public page on an outbreak tied to injectable glutathione. The agency reports more than 25 people sick in at least four states: Texas, Washington, Florida, and New York. At least three patients have been hospitalized, and all three received glutathione intravenously. One became critically ill and required intensive care, including treatment for shock and abnormal blood clotting.

Here is the part every clinic owner needs to hear first. The problem is not glutathione itself. The problem is that dietary supplement grade glutathione that was never meant to be injected into humans was used to prepare injectable glutathione by compounding pharmacies. The CDC describes injectable glutathione formulated with a dietary supplement grade ingredient, and the FDA has said that the compounding pharmacies it is aware of obtained their glutathione, from a single lot, from a single supplier. If your clinic offers glutathione by IV, push, or injection, or uses premixed IV blends that contain it, this is the week to find out exactly what is in your vials and where it came from.

A note on language before we go further. Everything below comes from the CDC, the FDA, and the pharmacies’ own recall notices. A recall is a safety action, not a finding of wrongdoing, and I am not aware of any enforcement action against the pharmacies or the supplier named here. I am naming them only because federal agencies already have.

What the CDC and FDA have said so far

The CDC says the investigation began in July 2026, when the Texas Department of State Health Services notified it about a group of patients who became sick after receiving IV glutathione at an outpatient wellness clinic. Since then the CDC has been working with the FDA and with state and local health departments. The symptoms it lists are what you would expect when a bacterial toxin reaches the bloodstream: fever and chills, body aches, headache, nausea, dizziness, and low blood pressure.

The recalls arrived in sequence:

• August 5. Victory Medical Center Pharmacy recalled three lots of compounded glutathione 200 mg/mL multi-dose vials (lots 1980571, 1981940, and 1984345) for elevated bacterial endotoxin levels. The product was distributed to consumers in Texas, Florida, and New York.

• August 19. Optimal Balance Pharmacy recalled lot LG342009076 of its 30 mL multi-dose glutathione vials. That product reached consumers in fourteen states, Washington among them.

• August 27. The FDA issued its alert, citing “at least 30 patients who experienced adverse events following the administration of intravenous (IV) glutathione alone or in combination with other ingredients.” It said the pharmacies it is aware of “obtained their glutathione (Lot #229536) from Medisca Inc.,” which has its U.S. headquarters in Plattsburgh, New York. Its instruction to compounders was plain: “Compounders are responsible for ensuring all components used in injectable drugs are appropriate for their intended use and should not use dietary supplement grade ingredients when making injectable drugs.”

• September 11. Centric Compounding recalled six lots across three products: glutathione, Myer’s Cocktail, and Tri-Immune Boost, all in 30 mL multidose vials. They shipped nationwide, to prescribers and directly to patients by home delivery. Centric reported nine adverse event reports. The beyond-use dates on those lots (the date after which a compounded product should no longer be used) run as late as September 25, 2026, so some of that product may still be within date today.

The numbers do not line up neatly. The FDA counted at least 30 patients on August 27. The CDC counted more than 25 people on September 15. These are different agencies counting on different dates, and the public pages do not say how each count was defined, so I am not going to force them into one figure. Read them as one message: this is not a single-clinic event.

Why a sterile vial can still make you sick

Endotoxins are toxic compounds found in the outer wall of certain bacteria. They are not living organisms, but they can make you very sick. Sterilization and filtration can kill or remove the bacteria and still leave the endotoxin behind. A vial can pass a sterility test and still carry enough toxin to set off a violent immune reaction when it goes into a vein. Sterility and endotoxin are two separate tests that answer two separate questions. A sterile vial is not the same as a safe vial.

That is where the grade of the ingredient comes in. Injectable-grade ingredients are made, and tested, to a standard designed for material that will bypass the body’s natural barriers. Dietary supplement grade ingredients are made to be swallowed, where the digestive system stands between the ingredient and the bloodstream, and that standard generally does not include the endotoxin testing an injectable requires. The molecule does not change. What changes is what else is in the powder.

Compounding, for readers new to the term, means a pharmacy prepares a medication to order rather than manufacturing a standard, FDA-approved product. A compounded glutathione vial is not an FDA-approved drug, and the pharmacy is responsible for what goes into it. The FDA’s August 27 message was that this responsibility includes the grade of every component. The compounding pharmacy cannot use supplement-grade components that are meant to be taken by mouth and formulate them into a compounded drug that is intended for injection. But the clinic is the one hanging the bag, and clinics generally trust that compounding pharmacies are doing the right thing.

This has happened before

In 2018, a group of clinicians in Sydney, Australia, published a report in Epidemiology and Infection describing seven cases of probable endotoxin poisoning after glutathione infusions. Patients developed fever, rigors, and headaches, along with low blood pressure, nausea, and vomiting, with symptoms starting between 15 minutes and 2 hours after the infusion. Every sample tested showed endotoxin levels above the accepted pyrogenic threshold, meaning the level at which a substance can cause fever. The authors traced the problem to a newly imported batch of glutathione powder used by the compounding pharmacy.

In 2019, the FDA warned compounders about L-glutathione powder from Letco Medical that was labeled for dietary supplement use only, after seven patients had reactions following IV glutathione given on a single day in January of that year. The FDA said the manufacturer confirmed the ingredient was not intended for use in sterile drugs.

Different country, different supplier, same failure. Each time the lesson was the same, and each time it had to be learned again. Compounding pharmacies are responsible for obtaining components that are safe to compound.

What to do this week if you offer IV infusion therapy in your clinic

None of these steps is obscure.

• Pull your lot numbers and check them against the recalls. List every glutathione vial, and every blend that contains glutathione, by pharmacy and lot. Compare them with the recall notices above. If anything matches, stop using it, quarantine it, and follow the recall instructions. If you cannot tell what you have, that tells you something about your recordkeeping.

• Ask your pharmacy for the ingredient grade and supplier, in writing. Ask whether the glutathione used to make your vials was intended for injection, who supplied it, which lot it came from, and whether it was tested for endotoxin. The CDC’s instruction to clinicians is direct: “Do not administer injectable glutathione products that were compounded using dietary supplement grade ingredients.” A pharmacy that cannot answer in writing has answered.

• Check your other IV blends. Centric’s recall covers a Myer’s Cocktail and a Tri-Immune Boost alongside plain glutathione. An ingredient problem travels into every product that shares the ingredient.

• Keep the paperwork a regulator would ask for. That means a documented clinical indication and a patient-specific order, a good faith exam (a real medical assessment by a licensed clinician before treatment), treatment-specific consent that says the product is compounded and not FDA-approved, in-person monitoring, and an emergency protocol your staff has actually trained on. Reactions of this kind can begin within minutes to hours. Someone who can recognize low blood pressure and shock has to be in the building, not watching a camera.

• Report what you see. If a patient develops symptoms after glutathione, report the adverse event to FDA MedWatch, and report a cluster to your state or local health department. Do not wait for the second patient.

• Only prescribe IV infusion therapy when clinically appropriate. If the patient is healthy they likely do not have any medical reason for an IV infusion. Prescribe judiciously. Do not sell IV infusions as health or immunity boosters. There must be a medical reason to do an IV infusion or the risk is not warranted.

If you are a patient

If you recently received glutathione by injection or IV, from any clinic, and you develop fever, chills, severe body aches, nausea, vomiting, dizziness, lightheadedness, or pain, swelling, or redness at the injection site, the CDC says to contact your healthcare provider promptly. Difficulty breathing, fainting, or signs of shock call for emergency care right away.

Before you book your next infusion, ask the two questions the CDC suggests: Was the product made with ingredients intended for injection? And who made, meaning compounded, it? Then ask the follow-ups I would ask myself. Which pharmacy? Has that pharmacy issued a recall this year? Ask to see the vial. Make sure it has a real lot number on it. If the answer is a blank look, you have learned what you needed to know. Make sure the provider is licensed to practice medicine and look them up. And lastly why do I need this infusion? Make sure you are not becoming a victim of false claims.

What we do not know yet

As of today, the public record leaves a lot open. The CDC has not said how many clinics are involved, or what kinds of clinics they are beyond the outpatient wellness clinic where the first cluster appeared. It does not say which pharmacy’s product the Washington patients received, although Optimal Balance’s recall lists Washington among the states its product reached. It does not say whether every case traces to Lot #229536. As far as I can tell, the FDA has not published a list of every pharmacy that received that lot. Are more recalls coming? Did the clinics ask about ingredient grade? Did anyone see an endotoxin result before the vials went out? We do not know yet, and I am not going to guess.

What we do know is that the FDA has now put the same point in writing twice, in 2019 and again this August: an ingredient made for swallowing does not belong in a vein. That is the signal owners should be reading.

Where Medspa Board certification fits

No certification can guarantee that a supplier’s paperwork is accurate or that a given lot is clean, and I would be wary of anyone who claims otherwise. What certification does is require the documentation that lets you catch a problem like this early. Medspa Board’s standards call for sourcing from licensed suppliers and compounding pharmacies, with documentation you can produce on request, along with a documented clinical indication, a good faith exam, treatment-specific consent, in-person monitoring, and an emergency protocol your staff has trained on.

If you are already doing this right, certification lets you prove it before anyone asks. If you are not, no badge fixes that; fix the practice first. For patients, this is the difference between hoping and knowing who is holding the needle. Trust, verified. Safety, certified.

If you run a med spa or wellness clinic and your standards are ready to be verified, begin your application at medspaboard.com/certification-application. If you want to see where you stand first, download the free checklist at go.medspaboard.com/certification-checklist.

— Kate Dee, MD

Sources & further reading

• Centers for Disease Control and Prevention, “Adverse Events Linked to Injectable Glutathione Compounded with Dietary Supplement Grade Ingredient: Current Situation,” last updated September 15, 2026. https://www.cdc.gov/healthcare-associated-infections/current-situation/index.html

• U.S. Food and Drug Administration, “FDA reminds compounders not to use dietary supplement grade glutathione for injectables,” August 27, 2026. https://www.fda.gov/drugs/human-drug-compounding/fda-reminds-compounders-not-use-dietary-supplement-grade-glutathione-injectables

• U.S. Food and Drug Administration, “Victory Medical Center Pharmacy Issues Voluntary Nationwide Recall of Certain Lots of Compounded Glutathione 200 mg/mL Multi-Dose Vials Due to Elevated Endotoxin Levels,” company announcement August 5, 2026. https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/victory-medical-center-pharmacy-issues-voluntary-nationwide-recall-certain-lots-compounded

• U.S. Food and Drug Administration, “Optimal Balance Pharmacy Issues Voluntary Nationwide Recall of Certain Lots of Compounded Glutathione 200 mg/mL Multi-Dose Vials Due to Elevated Endotoxin Levels,” company announcement August 19, 2026. https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/optimal-balance-pharmacy-issues-voluntary-nationwide-recall-certain-lots-compounded-glutathione-200

• U.S. Food and Drug Administration, “Centric Compounding Issues Nationwide Recall of Glutathione, Myer’s Cocktail, and Tri-Immune Boost Due to Elevated Endotoxin Levels,” company announcement September 11, 2026. https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/centric-compounding-issues-nationwide-recall-glutathione-myers-cocktail-and-tri-immune-boost-due

• Johnstone T, et al., “Seven cases of probable endotoxin poisoning related to contaminated glutathione infusions,” Epidemiology and Infection, 2018. https://www.cambridge.org/core/services/aop-cambridge-core/content/view/75D6A89CDC422C1961295126AAB36D0D/S0950268818000420a.pdf/seven-cases-of-probable-endotoxin-poisoning-related-to-contaminated-glutathione-infusions.pdf

• U.S. Food and Drug Administration, “FDA highlights concerns with using the dietary ingredient glutathione to compound sterile injectables,” 2019. https://www.fda.gov/drugs/human-drug-compounding/fda-highlights-concerns-using-dietary-ingredient-glutathione-compound-sterile-injectables

• Medspa Board, certification standards and application. https://medspaboard.com/certification-application/