Energy drinks: The truth may rock your assumptions

That energy drink you think is making you a rock star? It’s not all it’s cracked up (or open) to be. A recent report shows that over the past four years, the number of emergency department visits related to energy drinks has doubled. People who consume these drinks are having bad reactions to them — chiefly because they’re consuming too much caffeine.

Those rainbow–colored liquids with fun–to–say names are today’s crutch for getting us through a busy workday or helping us pull an all–night study session, because they pack a massive caffeine punch — delivering as much as five times the caffeine you’d get from one cup of coffee or one can of soda. Like most of us, David Solondz, M.D., a physician with Providence Medical Group–Cascade, enjoys his cup of coffee — but not past noon. For him, there’s a clear distinction between exercising one’s right to caffeinate and putting your body in harm’s way.

Taking in large amounts of caffeine at one time or consuming caffeine frequently throughout the day can push a person’s body to the brink — especially in the case of energy drinks, which can contain in one drink as much caffeine as five cups of coffee or five cans of soda. "It can be like a sudden shock of adrenaline to your body, sending you into a reactionary fight position of the classic ‘fight or flight’ response, even if you’re not ready for it," says Dr. Solondz.

Common additives to energy drinks — including taurine, creatine, guarana, glucuronolactone and B vitamins — add unpredictability to the mix. Energy drinks are not regulated by the U.S. Food and Drug Administration, so their effects are somewhat unknown. Even less is known about the effects of these additives when combined with caffeine, or when ingested by individuals of varying ages, health and body types. Some manufacturers don’t even include the caffeine content per serving on their product labels, which adds to the unpredictability of their products’ effects. According to a report issued by the Marin Institute, "Alcohol, Energy Drinks, and Youth: A Dangerous Mix," there is little evidence that these additives have any short– or long–term benefits; on the contrary, they "may create health risks, particularly since dosage levels are often not disclosed."

A definite buzz kill

It may not come as a surprise, then, that ER visits related to energy drinks are on the rise. The U.S. Substance Abuse and Mental Health Services Administration, or SAMHSA, tracked these ER visits nationwide from 2007 through 2011. Its report found that the most frequent visitors were young adults between the ages of 18 and 25, with adults between 26 and 39 coming in a close second. And while those folks were the ones most frequently ending up in the ER, the biggest spike in cases came from the 40–and–older set, whose visits to the ER after consuming energy drinks nearly quadrupled from 2007 to 2011. More men than women overall ended up in the emergency department.

What’s to blame? Caffeine toxicity, says Dr. Solondz. The short–term effects of caffeine overconsumption include heart palpitations or a rapid heartbeat; difficulty breathing; dizziness; upset stomach, diarrhea or vomiting; panic attacks; headaches; irrational behavior and hallucinations; itching; and muscle twitching. Consuming large quantities of caffeine over a short period of time also could result in injury to the kidneys, Dr. Solondz says. Caffeine, a natural diuretic, is dehydrating, and it also constricts your blood vessels. When this happens quickly, kidney damage can occur.

"Caffeine can significantly exacerbate underlying abnormal heart rhythms, and it may also put individuals who have a predisposition to heart disease or stroke at greater risk," says Dr. Solondz.

The most common long–term effects of caffeine overconsumption are altered sleep habits and insomnia, both of which can take significant time to correct. When the body is in a sleep deficit, both memory and judgment are compromised. "Prolonged lack of sleep can have effects similar to those of alcohol intoxication with regard to decision–making," says Dr. Solondz, adding that inadequate sleep also can negatively affect learning and long–term memory. In addition, he says, irregular sleep patterns can increase the body’s cortisol levels and other stress hormones, which can lead to a general state of inflammation. Inflammation is a key player in many chronic diseases including diabetes, heart disease, stroke and autoimmune conditions, including eczema.

If you think you’ve consumed too much caffeine, Dr. Solondz recommends getting to a safe place, such as your home, a familiar location or somewhere free of distractions – preferably with access to water and a place to lie down. If you’re intoxicated or unsteady on your feet, stay put rather than driving yourself somewhere. Having someone with you whom you trust, and who is sober, also is a good idea. "Start drinking non–caffeinated fluids, such as water, or electrolyte drinks, such as Gatorade, and try to stay calm," Dr. Solondz says. If you can’t urinate, or if your urine is dark brown (think Coca–Cola); if you experience chest pain or have difficulty breathing due to a racing heart; or if you experience uncontrollable muscle twitching, Dr. Solondz says, you should immediately get to the emergency department, where medical personnel can help you rehydrate with IV fluids.

If all of this leaves you feeling scared straight from caffeine, you should know that withdrawal headaches can be severe, so you may need to wean yourself, rather than go cold turkey.

A responsible way to drink

If you’re unfazed by the warnings and potential consequences, and you don’t you have plans to kick the can (or bottle) any time soon, here’s what you need to know:

  • Young people (or their parents) should just say no. The American Academy of Pediatrics recently recommended that physicians start talking to their adolescent patients about the dangers of energy drinks, and about the dangers of mixing energy drinks and alcohol. These drinks, because of their taboo, may provide some teens with a way to appear rebellious or edgy without engaging in something life–threatening or illegal. But energy drinks can do damage, and it’s hard to say when and how it will happen. "We know adolescents can be moody and suffer from lack of sleep already," says Dr. Solondz. "Adding caffeine to the mix is just adding insult to injury." Excess caffeine will further disrupt sleep, encourage poor sleep habits and worsen mood swings.
  • Avoid drinking to enhance academics or athletics. When consumed in an effort to help "burn the midnight oil," caffeine may backfire: It can worsen stress and anxiety around the academic assignment or exam preparation, and does not encourage healthy stress–management techniques, says Dr. Solondz. Using energy drinks as a means to boost athletic performance is a risky proposition, as well. According to Dr. Solondz, the caffeine in the energy drink increases your heart rate; you’ll perspire and dehydrate more quickly – something that’s already a risk if the day is hot or the equipment you’re wearing is heavy; and your blood vessels will constrict, depriving your organs and muscles of much–needed blood flow.
  • Cheap shots come at a price. According to the SAMHSA study, individuals age 40 and older have taken a shine to energy shots – a concentrated concoction of caffeine and B vitamins or other additives that costs roughly $1 to $3 each. These little bottles of boost can wreak havoc on you if you have a chronic health condition, are highly sensitive to caffeine, are taking certain medications or have already ingested a fair amount of caffeine that day.
  • Mixing alcohol with your energy drink does not give you wings. The most commonly held belief is that the energy–producing effects of these drinks will offset the depressive effects of alcohol. Not so. You are still subject to the same slowed reaction time and impaired judgment, whether your drink mixer is tonic water or something stronger (one energy drink brand earned the nickname "blackout in a can"). College kids, in particular, tend to believe they’re more immune to the effects of alcohol if they mix it with some kind of energy drink (which explains why they are more likely to be involved in accidents). In fact, says Dr. Solondz, you may become more intoxicated with this combination. The caffeine allows you to stay awake longer and consume more alcohol. The longer you stay awake, the less alert you are, and the more alcohol you consume, the more impaired your judgment. To make matters worse, both alcohol and caffeine are dehydrating, which increases inebriation even further.
  • Energy drinks are not an effective path to weight loss. "Caffeine can be a good energy boost and can ‘rev’ your metabolism, assisting with some weight loss," says Dr. Solondz. Many of these beverages, however, contain a lot of sugar, which can increase calorie intake while also leaving you less full (empty calories). And if you don’t feel full, you’ll likely find something to eat that will fill you up – taking in yet more calories. Sweet beverages also tend to increase cravings for other sugary foods.

If you feel unwell after consuming an energy drink or other high–quantity source of caffeine, contact ProvRN, our registered nurse advice line. Our registered nurses are available 24/7 to help you with your concerns. If you are having trouble breathing or you feel weak, dial 911 or have a friend or family member take you to the nearest emergency department. Not sure where the closest hospital is to your home? Use our provider directory to locate your local hospital so you’ll be prepared if and when emergency strikes.