Are Energy Drinks Safe?

The use of high energy drinks has become a multibillion dollar business over the last several years with the greatest consumption by athletes, teens and young adults. While some athletes use them as performance enhancers, they are primarily used by adolescents and young adults to keep pace with their hectic lifestyles which include school, sports, extracurricular activities, jobs and social activities. The college application process has gotten so competitive that getting good grades and high SAT scores are no longer a safe bet that you will get into a good college. High school students need to develop their resumes with numerous activities in order to be competitive in the application process. For college students there are the academic rigors that require them to pull “all nighters” while studying for final exams. As a result young people have turned more and more to these high energy products to keep pace with their busy schedules. 

The main ingredients in these drinks are sugar and caffeine. Caffeine works by blocking the effects of adenosine, a brain chemical involved in sleep. When caffeine blocks adenosine, it causes neurons in the brain to fire. Thinking the body is in an emergency, the pituitary gland initiates the body's "fight or flight" response by releasing adrenaline. This hormone makes the heart beat faster and the eyes dilate. It also causes the liver to release extra sugar into the bloodstream for energy. Caffeine affects the levels of dopamine, a chemical in the brain's pleasure center. All of these physical responses make you feel as though you have more energy. Some of the other ingredients can include:

• Ephedrine - A stimulant that works on the central nervous system. It is a common ingredient in weight-loss products and decongestants, but there have been concerns about its effects on the heart.
• Taurine - A natural amino acid produced by the body that helps regulate heart beat and muscle contractions. Many health experts aren't sure what effect it has as a drink additive (and the rumor that taurine comes from bull testicles is false).
• Ginseng - A root believed by some to have several medicinal properties, including reducing stress and boosting energy levels.
• B-vitamins - A group of vitamins that can convert sugar to energy and improve muscle tone.
• Guarana seed - A stimulant that comes from a small shrub native to Venezuela and Brazil.
• Carnitine - An amino acid that plays a role in fatty acid metabolism.
• Creatine - An organic acid that helps supply energy for muscle contractions.
• Inositol - A member of the vitamin B complex (not a vitamin itself, because the human body can synthesize it) that helps relay messages within cells in the body.

·         Ginkgo biloba - Made from the seeds of the ginkgo biloba tree, thought to enhance memory.

Competition among the manufacturers who want to grab a share of this huge market has lead to products that push the outwards bounds of the caffeine amounts in their products. The main problem is that there are no limitations placed on the amount of caffeine that energy drinks contain. The FDA has set a standard for the amount of caffeine that cola type beverages can contain to 71 mg. per 12 ounce beverages. Many manufacturers avoid these limitations by classifying their products as dietary supplements which are not subject to FDA regulations. Some energy drinks can contain in excess of 500 mg of caffeine in one beverage. When you consider that a can of Coca Cola has about 34.5 mg of caffeine the disparity is astounding.

Significant amounts of intake of caffeine can lead to Caffeine Intoxication, a clinical syndrome which is listed in the Diagnostic and Statistics Manual (DSM-IV-R)  published by the American Psychiatric Association categorizes Caffeine Intoxication as:

A.  Recent consumption of caffeine, usually in excess of 250 mg (e.g., more than 2-3 cups of brewed coffee).

B.  Five (or more) of the following signs, developing during or shortly after, caffeine use:

(1)   Restlessness

(2)   Nervousness

(3)   Excitement

(4)   Insomnia

(5)   Flushed face

(6)   Diuresis (increased urine discharge)

(7)   Gastrointestinal disturbance

(8)   Muscle twitching

(9)   Rambling flow of thought and speech

(10) Tachycardia (excessively rapid heartbeat) or heart cardiac arrhythmia (irregular heart      

        beat)  

(11) Periods of inexhaustibility

(12) Psychomotor agitation

C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder (e.g., an Anxiety Disorder).

An extensive study by John’s Hopkins University published in Drug and Alcohol Dependence in September has brought significant attention of the use of energy drinks among young people. Rolland Griffiths, PhD, one of the authors of the article worries that these high energy drinks advertise their products as performance enhancers and stimulants – a marketing strategy that may put young people at risk for abusing even stronger stimulants such as the prescription drugs amphetamine and methylphenidate (Ritalin). A 2008 study of 1,253 college students found that energy drink consumption significantly predicted subsequent non-medical prescription stimulant use, raising the concern that energy drinks might serve as "gateway" products to more serious drugs of abuse. Potentially feeding that "transition" market, Griffiths says, are other energy drinks with alluring names such as the powdered energy drink additive "Blow" (which is sold in "vials" and resembles cocaine powder) and the "Cocaine" energy drink. Both of these products use the language of the illegal drug trade. 

A study of 795 undergraduates by scientist Kathleen E. Miller at the University at Buffalo's Research Institute on Addictions found that students who consumed energy drinks six or more days a month were much more likely to engage in a wide variety of risky behaviors than people who didn’t use energy drinks. White energy drinkers were about three times more likely to smoke cigarettes or abuse prescription drugs. Both whites and non-whites were more likely to have been involved in a serious fight in the year before the survey. 

Another problem with energy drinks is that they have become popular as mixers for alcoholic beverages, often in an effort to counteract drowsiness so that you can drink more alcohol. The combination of large amounts of caffeine and alcohol is especially dangerous, since alcohol by itself is known to trigger fast heart rhythms. Brown University’s Student Services Health website warns their students of the dangers of mixing alcohol with energy drinks:

• Since energy drinks are stimulants and alcohol is a depressant, the combination of effects may be dangerous. The stimulant effects can mask how intoxicated you are and prevent you from realizing how much alcohol you have consumed. Fatigue is one of the ways the body normally tells someone that they've had enough to drink.
• The stimulant effect can give the person the impression they aren't impaired. No matter how alert you feel, your blood alcohol concentration (BAC) is the same as it would be without the energy drink. Once the stimulant effect wears off, the depressant effects of the alcohol will remain and could cause vomiting in your sleep or respiratory depression.
• Both energy drinks and alcohol are very dehydrating (the caffeine in energy drinks is a diuretic). Dehydration can hinder your body's ability to metabolize alcohol and will increase the toxicity, and therefore the hangover, the next day.

Moderate use of caffeine is generally considered safe for most people who do not have underlying health conditions. Taken in moderate doses, it can make the person who uses it temporarily feel better, think more clearly and work harder. But when you start to exceed doses of 300mg or more it can have serious consequences for you health especially if you are mixing it with alcohol. You should also check with your doctor if you are taking medication. High doses of caffeine can increase the side effects of certain medications.