Energy drinks like Monster, Rockstar and 5-Hour Energy continue to show up on the radar of the Food and Drug Administration (FDA) as the agency receives more evidence of illnesses and deaths in people who consumed the products. Now, a team of researchers with the University of Alabama at Birmingham (UAB) provides more alarming evidence about the drinks. The researchers have presented the first case study of a patient experiencing a hemorrhagic stroke – or brain bleed – following the consumption of an energy drink.
The study, published in the American Journal of Emergency Medicine, details the case of a 57-year-old man who developed intracranial bleeding within 15 minutes of consuming a popular energy drink. It was the first time he had consumed this particular product. The patient went to the emergency department after suffering symptoms such as tingling and numbness in the right arm and leg, as well as ataxia. He was transferred to the UAB stroke unit, where a CT scan revealed a small hemorrhage near the left thalamus.
The popular energy drink the man consumed contained high levels of caffeine along with several supplements known to increase blood pressure. “This particular drink contains several supplements for which we have little understanding of their potential interactions with each other or with caffeine,” said Anand Venkatraman, M.D., a fourth-year resident in the Department of Neurology at UAB and the lead author of the study. “One is structurally similar to amphetamines, and several are known to stimulate the sympathetic nervous system.”
The sympathetic nervous system triggers the “flight or fight” response. When faced with an urgent, potentially dangerous situation, the response prepares the body to either take extraordinary action (fight) or run away (flight).
“The body begins to marshal all of its resources to respond to the situation at hand — boosting strength and alertness, for example — in part by raising blood pressure to increase blood flow,” Venkatraman said. “For a patient who may be at risk for vascular disease, this increase in blood pressure could be potentially dangerous, as a rise in blood pressure can affect an already weakened blood vessel to the point that it ruptures.”
Energy drinks, as well as dietary supplements, are not regulated by the Food and Drug Administration (FDA) to the same degree as medications. “We don’t have good information on dosing for some of these supplements. We don’t know how much is too much, for example, especially in populations with varying degrees of risk,” he said. Which means consumers should read the labels of energy drinks and dietary supplements and be aware of the risks. “There is a potential for a serious outcome.”
Adverse events reported to the FDA involving energy drinks include hyperventilation, chest pain, convulsions, heart rate abnormalities, loss of consciousness, vomiting, blood pressure fluctuation, vomiting, hallucinations, cardiac arrest, hemorrhages, strokes and death.