In an article published online by Forbes on 10/22/12 by David DiSalvo, titled, Can Energy Drinks Cause Heart Attacks?, Mr. DiSalvo reports that the FDA is conducting an ongoing investigation into the deaths of several people who had consumed large amounts caffeine through energy drinks, including the recent death of a 14-year old girl who died after drinking two 24-oz Monster energy drinks in a 24 hour period. Her death is now suspected to be from the combination of excessive caffeine intake and an underlying condition of her blood vessels.
Mr. DeSalvo concluded that killing yourself with coffee or energy drinks is highly unlikely, mostly because the lethal dose of caffeine for an adult is 10 grams, which is significantly higher than any adult is likely to consume. Ten grams of caffeine? Let’s see, that would be 50 tablets of maximum strength No-Doz®, 66 cups of brewed coffee, or 125 cans of Red Bull®.
Caffeine is found in a variety of plants from all over the world which are prized for their ability to stimulate thinking and improve alertness. Common botanical sources of caffeine include coffee beans, cacoa beans, tea leaves, kola nuts and mate, which are brewed into a hot or cold beverage. More recently, purified caffeine is added to sodas, chewing gum and mints.
Not all caffeine is labeled as caffeine. Guarana and yerba mate are natural sources of caffeine, which should not be overlooked when you read the label of an energy drink or supplement.
Caffeine increases alertness and the ability to perform physical tasks more quickly and relieves signs of fatigue.
Some people can drink multiple cups of coffee with minimal effects, while for others having just one cup of joe keeps them tossing and turning all night. Others are susceptible to elevations in blood pressure or a rapid heart beat, which caffeine can aggravate.
Both pseudoephedrine, which is in the original formulation of Sudafed®, as well as phenylephrine, found in the formulation of Sudafed PE®, can add to caffeine’s effect and cause nausea, stomach burning, and headache.
Although caffeine can be useful to improve alertness during studying or while driving, some of the symptoms of caffeine use can be downright unpleasant, such as an increase in stomach acid secretion and a “burning”sensation, restlessness, tremor, an increase in urination, insomnia, and heart palpitations. If you are taking medicine to decrease heartburn or to slow down a rapid or an irregular heart beat, if you have uncontrolled blood pressure, or if you suffer from a bladder problem such as urinary incontinence, you should minimize your intake of caffeine.
Here are some examples of the amount of caffeine contained in common beverages:
Cola, Mtn Dew® (16 oz): 47-73mg
Espresso, one shot: 60-75 mg
Red Bull®, No Fear®: 80 mg
Black tea, brewed: 40-120mg
Coffee, brewed, 1 cup: 120-150mg
Espresso, two shots: 120-150mg
Full Throttle® (16 oz): 144mg
Monster® (16 oz): 160mg
Some common medicines that contain caffeine are:
Anacin® Max Strength (2 tabs): 64mg
5-Hour Energy®: 120-150mg
Extra Strength 5-Hour Energy®: 180-220mg
Midol® Complete (2 tabs): 120mg
Excedrin® Extra Strength (2 tabs): 130mg
No-Doz®, Vivarin® (1 tablet): 100mg, 200mg
Note: Guarana and Yerba Mate are natural sources of caffeine
Although the maximum dose of caffeine is quite high, mixing caffeine with other weight loss products or decongestants can cause problems at much lower doses such as 500mg daily, the equivalent of 4 cups of brewed coffee or three 16 ounce cans of a Monster energy drink.
In April of 2004, the FDA banned the supplement ephedrine through the Dietary Supplement Health and Education Act (DSHEA) of 1994. Ephedrine was an ingredient in popular weight loss products and in energy boosters for improved athletic performance. Steve Baechler, a major league pitcher for the Boston Orioles, was taking a product containing ephedra when he died suddenly at the age of 23. Taking ephedra along with caffeine can increase your risk of experiencing serious side effects such as heart palpitations, heart attacks, strokes, seizures, and even death.
If you aren’t looking to give up your morning cup of coffee but are interested in how much caffeine is in some of the products you consume, visit www.mayoclinic.com/health/caffeine/AN01211 for details, or stop by this website, completely devoted to caffeine: www.energyfiend.com.
Dr. Louise Achey, Doctor of Pharmacy is a 30-year veteran of pharmacology. She’d love to answer your question about medication and explain how to prevent misadventures with medicines. Send your questions and comments to www.AskDrLouise.com.
