Users of the social media platform TikTok are coming forward to highlight serious heart conditions they believe have been caused by their energy drink consumption, with one user even claiming it caused his heart disease. We asked Ashesh Parikh, D.O., a cardiologist and physician on the medical staff at Texas Health Plano and Presbyterian Heart and Vascular Group, a Texas Health Physicians Group practice, for his insight and what to be mindful of when it comes to energy drink consumption.
Getting to Know Energy Drinks
Energy drinks contain large amounts of caffeine, added sugars, other additives, and legal stimulants such as guarana, taurine, and L-carnitine. While, these legal stimulants can increase alertness, attention, and, well, energy, they can also increase blood pressure, heart rate, and breathing.
A 2017 American Heart Association trial found that people experienced higher blood pressure four hours after consuming either an energy drink or a different caffeinated drink they used as a control for comparison. Only those who had consumed the energy drink still had higher blood pressure six hours later, suggesting that ingredients other than caffeine in these products are helping to play a role in adverse side effects.
One potential culprit is guarana, a plant product native to South America. It’s said that one gram of it is equal to 40 milligrams of caffeine, so it adds to the drink’s overall caffeine content with no indication on the label, according to a 2017 review of ingredients in energy drinks by Harvard researchers.
The U.S. Food and Drug Administration states that up to 400 mg of caffeine per day, or four to five cups of coffee, is allowable for adults. Caffeine is limited to 200 mg per dose in over-the-counter products, but energy drinks are not limited because of how they are classified by the FDA, either as dietary supplements or beverages. That means you can get a massive dose of caffeine in just one can of energy drink if you’re not careful.
For instance, one 16 oz can of Celsius® contains 200mg of caffeine, while a can of their HEAT™ product contains 300mg of caffeine. A 16 oz can of NOS® contains 200 mg of caffeine, while their 24 oz offering contains 300 mg. One 16 oz can of Bang energy drink contains 300 mg of caffeine. With the highest caffeine content we could find, SPIKE® packs 350 mg of caffeine in one 16 oz can.
Research shows that consumption of highly caffeinated drinks can lead to a potentially serious heart condition known as Atrial Fibrillation, or Afib, a type of irregular heartbeat (arrhythmia) occurring in the upper chambers of the heart. If left untreated, Afib could cause heart palpitations, blood clots, stroke, and even heart failure in extreme cases.
In a study published in the Journal of Addiction Medicine, evidence suggests that high levels of caffeine in energy drinks may contribute to cardiac complications, such as arrhythmia. That same study also revealed that in addition to caffeine, energy drinks often contain ingredients that heighten the effects of caffeine and trigger adverse reactions in the heart.
“Energy drinks have long been shown to cause an elevation in your heart and can trigger arrhythmias, such as Afib and rapid heart rate,” Parikh says. “However, it’s very rare for an energy drink on its own to directly cause something such as coronary artery disease. Chances are other factors are playing a role in contributing to heart disease when energy drink consumption is also involved. That being said, there are case reports published that link energy drinks to premature heart disease and cardiomyopathies (dilated heart).”
One report published in 2021 by the British Medical Journal highlights a case of severe biventricular heart failure potentially related to excessive energy drink consumption in a 21-year-old man. In biventricular heart failure, both sides of the heart are affected.
The young man ended up in intensive care after experiencing four months of progressive shortness of breath on exertion, breathlessness while lying down and weight loss. It was then revealed that he habitually drank an average of four cans of an energy drink every day for the past two years. Each can contained around 160 mg of caffeine plus taurine and other stimulating ingredients.
Reports like this add to the growing concerns regarding energy drink consumption, especially among children, teens and young adults.
In 2018, the American College of Sports Medicine (ACSM) released recommendations about the dangers of energy drinks for at-risk populations, including children and adolescents, as well as adults with cardiovascular and other health issues. Researchers published an article in Current Sports Medicine Reportsthe same year focusing on energy drinks and their potentially dangerous side effects.
Researchers in the Current Sports Medicine Reports article explain that negative effects due to energy drink consumption are most likely to affect cardiovascular and neurological systems, as well as gastrointestinal, renal, endocrine and psychiatric systems. These adverse outcomes can be more pronounced in children and adolescents due to the high concentration of caffeine as related to their smaller body size, as well as the likelihood that their systems aren’t accustomed to these potentially heavy and frequent doses of caffeine.
According to the NIH, men between the ages of 18 and 34 years consume the most energy drinks, and almost one-third of teens between 12 and 17 years drink them regularly.
Parikh also acknowledges social media’s role in young people’s consumption, noting the recent TikTok trend called “dry scooping,” encouraging people to take pre-workout powders without water. Pre-workout powders and shakes typically have caffeine as their main ingredient. So ‘dry scooping’ essentially gives you a quick surge of caffeine just like an energy drink would, which can lead to similar cardiac problems just like an energy drink.
“Social media is here to stay and current generations have much easier access to these platforms than previous generations did. So, the risk of being ‘influenced’ onto trends, whether harmless or not, remains high in younger populations,” Parikh says. “There was the cinnamon challenge, then the Tide pod challenge, and now the dry scooping challenge, all causing their own slew of health emergencies and problems. So, my best advice is to not jump on the ‘bandwagon,’ even if it seems harmless, fun or all your friends are doing it. It will most likely almost always have a negative effect on your body in some way shape and form.”
What to Be Mindful Of
While no studies to date have assessed the consequences of energy drink consumption over a long period of time, there is evidence when it comes to long-term caffeine use, which Parikh notes can be considered similar.
Faster heart rates leading to arrhythmias and hypertension are the most common outcomes of high-caffeine consumption. If these conditions are not treated and if caffeine consumption does not stop, or at the very least decrease, then your risk of weakening your heart remains high. When the heart is weakened, it tries to compensate by pumping even faster, which over time stretches or thickens the heart muscle. Both of these things further weaken the heart. A weakened heart can lead to heart failure and a reduced quality of life.
“It is well known that 30-50% of teenagers and young adults consume at least two energy drinks a week. Excessive amounts of caffeine can put you at risk for cardiac problems, even as a teenager,” Parikh says. “So, my main advice for parents, as well as teenagers, regarding the consumption of energy drinks is moderation, moderation, moderation.
“Consuming less than 400mg of daily caffeine is considered safe for adults, but for teens, it’s less than 100mg,” Parikh explains. “So keep these numbers in mind next time you go purchase an energy drink and you read their label before making any purchases.”
Those who should avoid caffeine or energy drinks entirely include anyone with:
- Irritable Bowel Syndrome
- A history of panic attacks
- Gastroesophageal reflux disease (GERD)
- A history of seizures
- A known heart condition or heart rhythm issues
If you or a loved one starts to have any heart-related issues that you think may be stemming from energy drinks or anything else you’re consuming, Parikh recommends speaking with a physician and being honest about your lifestyle, diet and physical activity.
“Transparency is key to safe and healthy treatment,” Parikh adds.