Energy Drinks: The Top 3 Need to Know Dangers

Doctors Say These Popular Pick-Me-Ups Can Change the Course of Your Health

If energy drinks had a doctor-prescribed warning label, it would read something like this:

Product contains caffeine and may also include medicinal herbs. People with anxiety or psychiatric disorders, heart conditions and children should avoid their use. Avoid combining them with alcohol. Everyone in general and elderly people in particular should be cautious using them, especially if the person has a known history of fainting spells, lightheadedness, high blood pressure, diabetes or cardiac rhythm disorders.

Did you get the “everyone in general” statement?

Photo by Matt Burke

Energy drinks like Red Bull and Monster and “shots” such as 5-Hour Energy are far more than just a quick pick-me-up — and certainly more complex than soda or a cup of coffee. As more and more patients are discovering, these concoctions may have long-term effects on your health.

Some physicians even go so far as to advise no one should drink them—ever.

He’s not alone. Doctors are becoming more and more concerned as the effects of these energy drinks compound at an alarming rate in America’s emergency rooms. Commonplace on the market, the products are unregulated and have no warning labels, although many, including several local physicians, believe they should.

Dr. Douglas Rigby, a pediatrician at White-Wilson Medical Center in Fort Walton Beach, has a real concern for those using energy drinks — especially the target population of young males. 

“As doctors, we’ve known for a long time that caffeine is a potent drug,” he warns. According to Rigby, doctors use caffeine to stimulate breathing in premature infants, and it can be very useful if used correctly. Unfortunately, most youth (and adults, for that matter) don’t know the dangers the common drug can pose.

Maxing Out

The Centers for Disease Control and Prevention’s studies show that beverages marketed as energy drinks have become a popular source of caffeine, with some brands containing the caffeine equivalent of one to three cups of coffee or cans of soda. While caffeine is the main active ingredient, energy drinks also include other ingredients that claim to boost physical energy or mental alertness, such as herbal substances, amino acids and sugars. About 6 percent of adolescent and young adult males in U.S. civilian and military populations consume energy drinks daily that can have negative side effects, such as caffeine intoxication, overdose, withdrawal and interactions with alcohol.

Rigby says the maximum recommended daily “dose” of caffeine is about 400 milligrams a day for adults. When the total dose reaches 1,000 milligrams in one day, the toxic effects of the drug are real dangers, including tremors, seizure, kidney and liver problems. At 5,000 milligrams in 24 hours, caffeine is a lethal drug.

Typically, these drinks have anywhere from 200–400 mg of caffeine per container. By comparison, 8 ounces of coffee has 163 mg and one Diet Coke has 45. But many people don’t stop with just one energy drink, and they usually have other forms of caffeine that contribute to their daily total intake — and they reach dangerous levels quickly.

A main side effect of large amounts of caffeine and sugar can result in palpitations and a sensation of a racing heart.

“It seems that a cutoff of six cups of coffee a day is a threshold over which people might be at risk of developing arrhythmias such as atrial fibrillation or other abnormal rhythms,” says Dr. Farhat Khairallah, an electrophysiologist in Tallahassee. That could be as few as two cans of energy drink.

Wolf in Sheep’s Clothes

Another problem with energy drinks is how they are used. Most consumers are trying to amp up energy that’s lacking because of a sleep deficit — which has myriad effects on the body. Doctors warn that people should avoid using these drinks to prevent sleep when their body needs rest.

Many young people use them as sports drinks and for general hydration throughout the day. Khairallah believes this is a problem because caffeine, as a stimulant, can increase blood pressure and has diuretic properties. That’s why he and other health professionals warn that you cannot consider drinking coffee or energy drinks as adequate hydration.

One of the main problems with energy drinks from a medical standpoint is how they are marketed. They are almost described as a health food, when in reality it’s more than just the caffeine that is worrisome. And because they are classified as “food products,” the FDA does not regulate them as they do medications.

The vitamins and herbal ingredients in energy drinks can have unintended consequences on health. For instance, taurine is an organic acid used in muscles and brain tissue — it’s one of the body’s building blocks. Too much, however, can be a bad thing. 

Vitamin B-6 is another common energy drink component. While too little B-6 causes neuropathy — a deficiency of peripheral (such as hand or foot) nerves that results in weakness and numbness — the inverse is also true. Too much B-6 in your diet also can cause neuropathy, and it may not be an easy fix.

“An ingredient like Guana has two times as much caffeine as coffee beans, and this is in addition to the ‘add-in’ caffeine that manufacturers list on the label,” Rigby points out. “Often, you can double the listed amount of caffeine to know how much you’re really getting.”

He sees patients of all ages, including a rising number of college-aged individuals, that have anxiety and other health problems that could be caused by energy drinks. As a result, Rigby tries to talk with all adolescent patients about energy drinks. Amazingly, he has seen patients as young as 6 or 7 who are already accustomed to the beverages.

“When you think about it, the 400 mg/day recommendation is for adults,” Rigby says. In the smaller bodies of children, these drugs — and their effects — are more concentrated and thus more dangerous.

These drinks may be linked to cognitive decline, seizures, sleep disturbances, mood disorders such as anxiety and anger, tremors and increased blood pressure — which could lead to a stroke at any age.

Mixing It Up

A simple Google search returns hundreds of recipes for energy drink cocktails, with chilling names such as “The All-Nighter,” “1.21 Gigawatts” and “1-2-3-Floor.” Parents of a Florida State University sophomore sued the makers of Four Loco in 2010 after he drank the high-alcohol malt beverage mixed with caffeine, taurine, guarna and carbonation — sometimes called “blackout in a can” — began acting erratically and accidentally shot himself to death. While Four Loco was banned for a time, it is back on store shelves after being reformulated to eliminate the stimulants.

Physicians have a special warning for mixing energy drinks with alcohol. “Mixing these drinks with alcohol will have a definite increased risk of cardiac arrhythmias — specifically atrial fibrillation,” warned Khairallah. And adults beware: Older people are more susceptible.

Instead of the pharmaceutical pick-me-up, former Blueprint Health Studio owner and trainer Matt Staver has tips for naturally — and healthfully — waking up.

“Stretching and early morning workouts are good for increased blood flow,” he says. “And exercise increases our endorphin levels giving us sharpened focus and a burst of energy.”

In addition, Staver recommends chia seeds as an energy food and essential fatty acid boost, both of which put more pep in your step. Honey is also known as nature’s natural energy booster because it’s a great source of carbohydrates and is known for increasing endurance. Glucose in honey is absorbed quickly by the body, which provides an immediate energy boost.

The long-term effects of an overuse of energy drinks are not yet known. It appears that more than one drink per day in a healthy individual may be too much, and the health consequences can be deadly if seizure or arrhythmia results. There is no lower age limit on the risk for these conditions, and young people often add in additional risk factors to their consumption.

Local physicians hope that energy drinks might one day be regulated as the pharmaceuticals that they really are — with interaction warnings, overdose symptoms and age limitations. Until that day comes, they urge you — with great fervor — to leave them on the shelf.