Energy Drinks 

The Danger In Energy Drinks 



It is amazing to see the popularity of energy drinks. So many people are looking for that extra jump-start or energy spurt and are turning to energy drinks, some of which are advertised and known as energy shots, often ignorant of the harm that these ingredients could do to their bodies. Some of these drinks have extreme levels of caffeine and sugar that could cause heart palpitations, anxiety and, in some cases, death.


The following excerpts are red flags that should alert you to the dangers.


Headlines: November 16, 2012. (CNN)—Thirteen deaths have been reported to the Food and Drug Administration as “adverse events” after the consumption of the dietary supplement 5-hour ENERGY, according to an FDA statement. … As a dietary supplement, 5-hour ENERGY is not required to disclose the amount of caffeine in its 2-ounce “energy shot.” Instead, the 5-hour ENERGY label lists 1,870 milligrams of an “Energy Blend,” which includes caffeine, taurine and other ingredients. … A analysis found about 207 milligrams of caffeine in one 5-hour ENERGY. Red Bull, by comparison, contains about 80 milligrams of caffeine in an 8.4-ounce can, while a 16-ounce grande Starbucks Pike Place brewed coffee contains about 330 milligrams of caffeine. … The distributor of 5-hour ENERGY, Living Essentials LLC, said in a statement: “We recommend on product labels and the 5-hour ENERGY website that individuals consume no more than two bottles of 5-hour ENERGY shots per day, spaced several hours apart. Consumers who have caffeine sensitivities should consult with a physician before taking and can consider the ‘decaf’ version.” … Last month, the parents of Anais Fournier, 14, filed a lawsuit alleging that she died after drinking two Monster Energy drinks in a 24-hour period. In her case, an underlying heart condition was complicated by caffeine toxicity, according to the death certificate.


In these so-called energy drinks, a tremendous overload of stimulation from a high dose of caffeine, guarana and taurine is received. Most people are familiar with the effects of caffeine, but what about the effects of the other two?


Guarana: How does it work? Guarana contains caffeine. Caffeine works by stimulating the central nervous system (CNS), heart, and muscles. Guarana also contains theophylline andtheobromine, which are chemicals similar to caffeine.


Guarana is likely safe for most adults when used in typical food amounts or in medicinal amounts short-term. But it is likely unsafe and even deadly, due to its caffeine content, when taken in high doses or long-term. The fatal dose of caffeine is estimated to be 10–14 grams (150-200 mg per kilogram; the “typical” man weighs about 70 kilograms, so a lethal dose of caffeine for this man would be 10,500–14,000 mg). This is quite a high dose. Consider that one cup of brewed coffee provides from 95-200 mg of caffeine. However, serious poisoning can occur at doses lower than 150-200 mg per kilogram depending on an individual’s caffeine sensitivity or smoking behavior, age, and prior caffeine use.


Side effects depend on the dose. At typical doses, the caffeine in guarana can cause insomnia, nervousness and restlessness, stomach irritation, nausea, vomiting, increased heart rate and blood pressure, rapid breathing, tremors, delirium, dieresis, and other side effects. Large guarana doses might cause headache, anxiety, agitation, ringing in the ears, pain when urinating, stomach cramps, and irregular heartbeats. People who take guaranaregularly may experience caffeine withdrawal symptoms if they reduce their usual amount.


Special Precautions & Warnings:

Pregnancy and breast-feeding: If you are pregnant or breast-feeding, guarana should be taken with caution due to the caffeine content. Small amounts are probably not harmful; however, consuming more than 200 mg/day has been linked to an increased risk of miscarriage and other negative effects. See the following for more


Taurine: The multi-billion dollar phenomenon of energy drinks has captured the attention of scientists and nutritionists across the country. One of the main reasons is taurine, a common ingredient found in the caffeine and sugar-laden concoctions. … Taurine is a free form amino acid contained in foods and manufactured in the body from the amino acidcysteine. It was first discovered in the bile of bulls, and now produced synthetically by the truckload. Since taurine is created naturally in the human body, a good diet supplies all you need.


Studies have implicated synthetic taurine in illnesses ranging from high blood pressure to strokes and seizures, to heart disease. For these reasons it has been banned in some Scandinavian countries after being linked to the deaths of three consumers.


Because taurine is utilized by the body during exercise and in times of stress, it has become a popular ingredient in energy drinks. But taurine has a stimulating effect on the central nervous system that’s very unnatural. For more information


Excerpts from: Sandra A. Fryhofer, MD

Clinical Associate Professor of Medicine, Emory University School of Medicine, Atlanta, Georgia; Past President, American College of Physicians, Philadelphia, Pennsylvania


Caffeine Comparisons

A 6-ounce cup of homemade coffee has about 75-100 mg of caffeine. The brew at some coffeehouses can be a bit stronger with caffeine content as high as 150 mg in 6 ounces, but it is no more than 25 mg caffeine per ounce. Of course, you usually drink coffee hot, so you sip it, slowly, and with enjoyment.[1]


Energy drinks, on the other hand, are usually chugged cold. The caffeine content of energy drinks can be as high as 500 mg per serving. There are also “energy shots” that deliver a caffeine punch of 100–350 mg per ounce, 3–7 times the caffeine in a regular soda. A 12-ounce can of soda contains a total of approximately 35–50 mg of caffeine.[1]


Ingredients Beyond Caffeine

Energy drinks contain more than coffee-bean-derived caffeine and sugars. Hidden caffeine derivatives in the form of guarana, kola nut, yerba mate, and cocoa can also be found on the list of ingredients. Guarana (also known as Paullinia cupana) on a per-gram basis contains anywhere from 40 to 80 mg of caffeine. This means that the caffeine content listed could underestimate the caffeine punch delivered. These drinks often contain taurine, which has been shown to increase blood pressure and heart rate when combined with caffeine.[2] Ginseng is often added and can interfere with warfarin, estrogen, steroids, and digoxin. Other common ingredients include l-carnitine, and yohimbe. In 2008, German, Hong Kong, andTawain authorities found trace amounts of cocaine in the energy drink Red Bull Cola.[3]


Hazards of Too Much Caffeine

Energy drinks contain too much caffeine. This can cause anxiety, nervousness, sleep problems, elevated blood pressure, and heart palpitations. Although healthy people can tolerate moderate amounts of caffeine, the content in energy drinks exceeds what could be considered moderate. Adverse health consequences of caffeine intoxication include seizures, mania, stroke, and even sudden death.[2,3] Energy drink-related health consequences reported in German studies include liver damage, kidney and respiratory problems, seizures, and agitation, as well as heart rhythm disturbances, heart failure, high blood pressure, and rhabdomyolysis.[3]


Caffeinated Concerns for Kids

A new study in the journal Pediatrics highlights caffeinated energy drink concerns for children with specific medical conditions, including attention-deficit/hyperactivity disorder (ADHD), eating disorders, diabetes, and cardiac conditions. It also points out concerns about the link between caffeine and reduced bone mineralization.[3]


Caffeine and Alcohol: A Dangerous Combination

An even more hazardous trend, college students are mixing energy drinks with alcohol. The consequences can be dangerous and deadly. Although these students may think that caffeine counteracts the alcohol, it doesn’t. You might not get as sleepy, but you’re still impaired and you don’t know it.[1,5,6] The high caffeine content has a stimulant effect that prevents you from feeling drunk. Judgment, reaction time, and motor skills, however, are still impaired. A recent JAMA report calls this “wide awake drunkenness,” and it can lead to bad choices, risky behaviors, and worse.[1]


Billion Dollar Business

But this phenomenon is not limited to college campuses. Non-college going adults are drinking these beverages too. Energy drinks are big business.[5] In 2006, at least $5.4 billion worth was sold in the United States alone.[1] Sales for 2011 are predicted to exceed 9 billion dollars.[3]


Fortunately, the FDA has put the kibosh on premixed alcoholic energy drinks. On November 17, 2010, the FDA warned 4 companies that caffeine added to malt alcohols is an “unsafe food additive.” The companies that got warning letters include Charge Beverages Corporations (makers of Core High Gravity®), New Century Brewing Company (maker of Moon Shot®), Phusion Products (maker of Four Loko®), and United Brands Company (maker of Joose® and Max®).[7]


Final Thoughts

The FDA limit for caffeine in cola drinks is set at two hundredths of a per cent (0.02%), a max of 71 mg per 12 ounce serving.[1] Scientists and many parents, including me, wonder why this doesn’t also apply to energy drinks. The JAMA report ends with a plea:


“Scientists and health professionals cannot wait for further FDA action; available scientific evidence indicates that action is needed—now!”[1]


The average energy drink sold in a can contains 6–7 times the amount of caffeine than a regular cup of coffee. It also far exceeds the maximum amount of caffeine that the United States government allows in a drink. The companies producing these energy drinks get around this limit by selling it as a supplement, not a drink. The government does not regulate nutritional supplements so the FDA cannot do much. But you can do much by turning away from these drinks and preserving your health and warning others.


By the way, a friend of mine made the following observation: “I have recently watched on CNN various stories on this subject, so I headed for the energy drink isle at my local store. It is a huge isle and during the 10 minutes I was hanging out in the isle studying all the drinks there, the only customers I saw loading the cans into their carts were 13–15 year olds. I guess it is because they cannot buy beer, so they drink those? I cannot believe the ignorant parents!”


“It is these hurtful stimulants that are surely undermining the constitution and preparing the system for acute diseases; by impairing nature’s fine machinery and battering down her fortifications erected against disease and premature decay.” Testimonies, vol. 1, 548, 549.



Arria A, O’Brien M. The “high” risk of energy drinks. JAMA. 2011;305:600-601. Abstract

Steinke L, Lanfear D, Dhanapal V, Kalus J. Effect of “energy drink” consumption on hemodynamic and electrocardiographic parameters in healthy young adults. Ann Pharmacother. 2009;43:596-602. Abstract

Seifert S, Schaichter J, Hershorin E, Lipshults S. Health effects of energy drinks on children, and adolescents, and young adults. Pediatrics. 2011;127:511-527. Abstract

Brody J. Scientists see dangers in energy drinks. The New York Times. January 31, 2011.

Howland J, Rohsenow D, Calise T, MacKillop J, Metrik J. Caffeinated alcoholic beverages: an emerging public health problem. Am J Prev Med. 2011;40:268-271. Abstract

Howland J, Rohsenow DJ, Arnedt JT, et al. The acute effects of caffeinated versus non-caffeinated alcoholic beverage on driving performance and attention/reaction time. Addiction. 2011;106:335-341. Abstract

FDA News release. FDA Warning Letters issued to four makers of caffeinated alcoholic beverages. November 17, 2010. Available at: Accessed January 27, 2011.

Judy Hallingstad