Energy Drinks May Give a Killer Buzz

Energy drinks often do not list their caffeine content and overconsumption can have lethal results

December 21, 2012 / Author:  / Reviewed by: Joseph V. Madia, MD

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While energy drinks may give you a lift, consuming too many can be unhealthy. Caffeine levels are currently not listed on these drinks, but recent FDA investigations may change that.

A rise in health problems and the lack of information on caffeine content has led to a call for the US Food and Drug Administration (FDA) to play a more active role in the regulation of energy drinks.

Kent Sepkowitz, MD, with the Infectious Disease Service at the Memorial Sloan-Kettering Cancer Center in New York City, recently published his viewpoint regarding energy drinks online in The Journal of the American Medical Association (JAMA).

According to the author, consumption of energy drinks in the US is at a high. Americans downed an estimated 2.3 billion energy drinks in 2005 and 6 billion in 2010. Dr. Sepkowitz noted that 6 percent of young men in the US report having a daily energy drink. In one year, energy drink sales in this country skyrocketed by 16 percent to almost $9 billion in 2011.

Dr. Sepkowitz highlights how unintentional caffeine overdoses may be causing serious illness and, in a few cases, death.

Caffeine May Be the Culprit

Caffeinated energy drinks have been connected to unexpected deaths in seemingly healthy people. In November, the FDA began investigating claims that an energy drink may have led to 13 deaths and 33 hospitalizations over the past four years.

This report explains that many energy drinks do not have to reveal their caffeine content because they are regulated as dietary supplements rather than as medications.

While most soft drinks, coffees and energy drinks have about 100 mg of caffeine per serving, a few energy drinks have up to 250 mg per serving, according to the author.

Up to 500 mg of caffeine per day is generally considered a safe daily dose. Patients with heart disease or liver disease are advised to consume less caffeine.

“To reach the possibly lethal dose of caffeine, a person would need to ingest at least 12 of the highly caffeinated energy drinks within a few hours,” wrote Dr. Sepkowitz. “It is not known how many energy drinks were ingested by patients thought to have energy drink-related deaths.”

The author states that a first step toward improving public safety might be to require that energy drinks feature their caffeine content on their labels. He suggests that sales restrictions might be placed on beverages containing high doses of caffeine, as well.

Considering that energy drink consumption has been growing, Dr. Sepkowitz advises that physicians should ask their patients about their use of energy drinks, particularly young men, who are the heaviest users.

Alcohol and Energy Drinks Don’t Mix

Carol Wolin-Riklin, MA, RD, LD, an instructor in the department of surgery at The University of Texas Health Science Center at the Houston (UTHealth) Medical School in Houston, told dailyRx News, “These drinks are marketed to produce increased endurance and performance, but ingredients and claims are not regulated by the FDA. One of the first steps is getting the caffeine content on the labels and defining what excess consumption exactly is.”

She also warned about the dangers of mixing energy drinks with alcohol: “Young people who are drinking these energy drinks are all jazzed up. They drink longer and take in more alcohol, which is dangerous. They’re increasing their risk for high blood pressure, increased heart rate and cardiac arrhythmia. Because energy drinks and alcohol are diuretics, those who drink them together get a lot more dehydrated and, at times, it can be severe and cause nausea and vomiting.”

In addition, Dr. Wolin-Rilkin noted that some of her patients were putting on excess pounds from fueling themselves with these drinks. “They’re taking in more calories and, because they’re staying up longer, they’re eating more,” she said. The high acidity in these drinks may also be ruining tooth enamel, Dr. Wolkin-Rilkin says.

Stress on the Heart

John Higgins, MD, a cardiologist and an associate professor of medicine at UTHealth, told dailyRx News that he has seen young, healthy individuals, who have had two or more cans of energy beverages, come into the emergency room with a fast heart rate and feeling light-headed and dizzy.

Dr. Higgins has been working on research showing that caffeine, and possibly other ingredients in energy drinks, slows down the enlargement of arteries in the heart that should occur during exercise. “Normally, arteries should get bigger when you’re working harder,” he said. “At the very time they need more oxygen, these drinks reduce the ability to have the extra blood flow right when needed. We think this demonstrates why people are running into problems. It can lead to heart irregularities and even death.”

This commentary was published online in December in The Journal of the American Medical Association.