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Staying Up Late

How Safe Are Energy Drinks and Tonics?

By Mark Saltveit

tired-businessmanI’m so tired of people telling me they’re so tired. We’re all tired, right? It’s a cyber speed world where we all work long hours, juggle family duties, and stay jacked into social media and Internet news around the clock.

So it’s awfully seductive when you see a little plastic bottle offering tons of energy without sugar or a nasty “crash,” beckoning you from right next to the cash register. Can it really be that easy? Or are there hidden dangers in that magic vial?

Common sense gives us conflicting messages. These “energy shots” are very popular; if they were really dangerous, they wouldn’t be in every convenience store, right? On the other hand, it seems like this must be some kind of stimulant such as caffeine — or methamphetamine — and you don’t have to watch Breaking Bad to know that speed can kill.

My grandmother used to say, “Have some coffee. It’s good for you. It’s a stimulant!” But those were simpler, perhaps more naïve times. During World War II, the United States provided amphetamines to soldiers and fighter pilots, but no one would likely advocate that today.

A History of the Pick Me Up

5-hour-energyEnergy shots, such as 5-Hour Energy, and energy drinks like Red Bull – similar but with added sugar and water — are big business in the U.S. with sales of more than $12.5 billion in 2012, and the market has grown some 60% since 2008, according to Packaged Facts. But where did they come from? The original, and best known, American energy drink, Coca-Cola, contained cocaine and other alkaloids such as ecgonine, from 1886 to 1903. Today, the biggest kick in Coca-Cola comes from nine spoonfuls of sugar, reports The Guardian (link: http://www.theguardian.com/lifeandstyle/wordofmouth/2013/jan/18/coca-cola-sugar-problem) and about 35 mg of caffeine in a modern 12-ounce can.

Modern energy drinks are based on a combination of caffeine and sugar, like Coca-Cola, along with vitamins and some mild natural stimulants, such as the amino acid taurine (which is naturally found in meats). The original version was a tonic called Lipovitan-B, introduced in Japan in 1962 as a concentrated mix of taurine, B-vitamins, and caffeine. Within three years, manufacturer Taisho was selling 100 million bottles per year.

Fourteen years later, a Thai entrepreneur turned the tonic into a drink by adding water and sugar to these ingredients and sold it as “Krating Daeng” or “Red Guar,” named after a type of water buffalo. It grew popular in Asia, and six years later, an Austrian businessman traveling through the region found it helped him fight jet lag. He renamed it “Red Bull,” tweaked the formula for Western tastes, and became a billionaire by selling it worldwide. The company used unconventional marketing techniques, linking the drink to extreme sports such as hang-gliding and Formula One auto racing. The drink also became popular as a mixer with alcoholic drinks for the purpose of allowing partiers to stay up later.

The latter trend reached its low point with the advent of Four Loko, a combination of alcohol, caffeine, taurine, and guarana designed for partying all night long. After several college students were hospitalized in 2010 – one with a blood alcohol rate of 0.30, four times the limit for drunk driving – the drink was reformulated to remove all stimulants. It survives today only as a flavored malt liquor. The FDA has since prohibited manufacturers from selling high-caffeine energy drinks premixed with alcohol.

Energy shots are actually a return to the original approach of Lipovitan — a small-dose tonic based on B-vitamins, taurine, and caffeine without the added sugar and water, and certainly no alcohol. Like Red Bull, 5-Hour Energy includes a large amount of glucuronolactone, a natural substance the body creates by breaking down glucose and uses in making cartilage. It adds a few amino acids such as tyrosine and phenylalanine, malic acid and citicoline, a widely used supplement that has benefits for brain function after strokes and head trauma.

What’s Inside?

can-question-marksSince energy tonics and energy drinks have been around for fifty years now, we should have a pretty good answer to the basic questions: are they dangerous? And do they work?

In regards to the ingredients, you’re probably familiar with sugar, caffeine, and B-vitamins, but what about the more exotic substances, such as taurine and guarana? Guarana is a plant product that contains a lot of caffeine and taurine.

Taurine is an amino acid necessary for muscle and heart function. It’s present in meat and seafood, and the body levels of taurine are markedly lower in those following a vegan diet. Energy drinks generally have about 5 times the amount that even a big meat eater would ingest, but a 2009 study in Europe found that the amounts of taurine and gluconulate found in energy drinks were safe.

At the same time, it’s not clear how much effect these exotic substances have, good or bad. In fact, a 2003 study in the Journal of the American Pharmacists Association found that “The amounts of guarana, taurine, and ginseng found in popular energy drinks are far below the amounts expected to deliver either therapeutic benefits or adverse events. However, caffeine and sugar are present in amounts known to cause a variety of adverse health effects.”

The great irony of energy shots and drinks is that their active ingredients — and biggest health risk — are sugar and caffeine. One shot of 5-Hour Energy contains 207 milligrams of caffeine, compared to 80 mg in a standard cup of home brewed coffee, and 160 in a cup of Starbucks. And while most of us can handle a cup or two of coffee per day, a report published in the February 2013 issue of the journal Pediatrics in Review found that the level of caffeine in these drinks could pose hazards to teens. According to the review’s lead author, Dr. Kwabena Blankson, more than 100 mg of caffeine per day is considered unhealthy for teens.

student-studying-energy-drinksIf you have a deficiency in vitamin-B12 or taurine due to your diet and lifestyle – which is not hard to imagine if you’re stressed, overworked, and tired enough to be considering energy products – then these added ingredients may be very useful. Otherwise, aside from the caffeine and sugar in energy drinks, ingredients like taurine and guarana are probably safe, but effective only as placebos.

However, there is one energy drink ingredient you should avoid at all costs: DMAA. Usually found in bodybuilding supplements, DMAA is, according to the FDA’s websites, “also known as 1,3-dimethylamylamine, methylhexanamine or geranium extract. It is an ingredient found illegally in some dietary supplements and often touted as a “natural” stimulant.”  DMAA has been linked to serious conditions such as heart attacks, seizures, and psychiatric problems.

Earlier this year, the FDA banned its use in energy drinks and dietary supplements and is working to get all products with this ingredient pulled from the shelves. Due to regulatory loopholes, some potions continue to use it. You can check this list of remaining products if you are concerned.  (I would probably avoid drinks named “Infested,” “Yellow Scorpion” and “”Hell Fire EPH 150,” in any case, but that’s just me.)

Mixing energy drinks or shots with alcohol is the most dangerous factor in their use. While the FDA no longer permits manufacturers to premix high-caffeine products with alcohol, consumers are still engaging in the practice. Hopefully, you aren’t considering a Red Bull and vodka as a pick-me-up for a long day at the office. Even in a nightclub setting though, the combination of stimulants and depressants (such as alcohol) has a long and nasty record of deaths and serious physical damage including blackouts and alcohol poisoning. So don’t do it.

Adverse Effects

poison-drinkIn 2012, the Food and Drug Administration summarized eight years of adverse reaction reports on three popular energy products: 5-Hour Energy shots, Monster Energy, and Rockstar Energy drinks. (Manufacturers of these products are required to pass on to the government all reports of problems – verified or not – associated with their use.)

This led to a number of very alarming news reports. “Can 5 Hour Energy Kill You?” Time Magazine asked. The New York Times was more measured: its headline — “Caffeinated Drink Cited in Reports of 13 Deaths” – was followed by an important caution. “The filing of an incident report with the F.D.A. does not mean that a product was responsible for a death or an injury or contributed in any way to it. Such reports can be fragmentary in nature and difficult to investigate.”

Certainly the reports were disturbing. In addition to the 13 deaths, users reported heart attacks, comas, anaphylactic shock, and even one report of “spontaneous abortion.” However, no effort was made to determine the actual causes of these maladies, and the report does not list how many shots the complainants took, or what else they may have been drinking or ingesting. There were also complaints that 5-Hour Energy caused AIDS, discolored the tongue, caused celiac disease, and sneezing. One user reported “fear, malaise” which he or she described as “life threatening.”

Despite these reports, millions of energy drinks are sold annually, and the FDA is currently not limiting availability.

Natural Energy Tips

people-jogging-winterIt’s useful to remember that there are lots of natural methods for fighting drowsiness that have been proven safe and effective—and they are free. First and foremost, making sure to get regular exercise will vastly improve your energy levels. Build physical activity into your daily routine, not just at the gym but around the office. Volunteer to go get those supplies; walk over to Fred’s desk instead of shooting him an email or calling him; walk around on your breaks, even if you’re making phone calls.

You can also stay alert without caffeine by sipping water, and eating small amounts of food throughout the day instead of consuming big meals at set times. Try an apple. Truckers and salesmen who make lots of long drives often eat sunflower seeds, chewed thoroughly one at a time, to keep tiny amounts of food energy streaming.

The best solution of all might be to simply go to bed earlier. Sleep is a highly effective, safe, and delicious solution to fatigue and exhaustion.

As with all exercise routines, consult your physician before increasing your amount of sleep. Actually, wait – you don’t have to! Awesome.

Mark Saltveit lives in Portland, where he writes about sports, Taoism, and palindromes.

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