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"The use of energy drinks is very dangerous as there is a very high content of caffeine in a small volume,". Dr. Khan, the health minister of Trinidad & Tobago, told the Trinidad Express Newspaper in an interview.

The journal reports that a person died of a heart attack from caffeine toxicity after drinking two cans of some energy drink.

I'm skeptical of this claim because I use to drink these energy drinks and I feel very good, so I wonder if there is evidence to support it.

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How do you define "very dangerous?" What dangers does Dr. Khan say can come from high caffeine content in a small volume? –  Flimzy Nov 17 '12 at 18:20
    
@Flimzy, yes, you are right: it need to clarify what "very dangerous" means. Let us premise that the claim is a reported speach, I guess Dr Khan though that energy drinks reduce heart rate variability, potentially increasing the risk of a heart attack. By the way, read the news article I linked to. –  Carlo_R. Nov 17 '12 at 18:33
    
@Rory Not really. Trinidad Express Newspaper reported that such Anais Fournier died of a heart attack from caffeine toxicity after drinking two cans of some energy drinks. –  Carlo_R. Nov 17 '12 at 18:54
    
Why the down votes? This is actually a pretty interesting question, worthy of examination. –  Carlo_R. Nov 17 '12 at 20:16

2 Answers 2

up vote 8 down vote accepted

Yes it can cause heart attacks.

In 1989, the US Food and Drug Administration (FDA) limited the amount of caffeine in OTC products to a maximum of 200 mg/dose. The ingestion of such concentrated sources of caffeine is the general cause of acute caffeine toxicity.

Caffeine has differing CNS, cardiovascular, and metabolic effects based on the quantity ingested. Average doses of caffeine (85-250 mg, the equivalent of 1-3 cups of coffee) may result in feelings of alertness, decreased fatigue, and eased flow of thought. High doses (250-500 mg) can result in restlessness, nervousness, insomnia, and tremors. In high doses, caffeine can cause a hyperadrenergic syndrome resulting in seizures and cardiovascular instability.

Because caffeine overdoses, intentional or unintentional, are relatively common in the United States, physicians and other medical personnel must be aware of caffeine toxicity to recognize and treat it appropriately.

The 14-yo girl you mention drank, on consequitive days within 24 hours, two 710 ml cans of Monster Energy (Described as "vicious" and "killer" on the site.) at 34 mg/100 ml caffeine, totalling 480 milligrams of caffeine. And she had a genetic vein issue that affects 1 in 20 Americans.

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480 mg of caffeine is about five mugs of instant coffee or three and half mugs of filter coffee. I suggest that many people routinely drink that quantity a day. –  RedGrittyBrick Nov 18 '12 at 12:00
    
"With heavy use, strong tolerance develops rapidly and caffeine can produce clinically significant physical and mental dependence." - Wikipedia –  Cees Timmerman Nov 18 '12 at 12:09
    
Quite so. I suppose the issue is whether the minister is justified in singling out energy drinks as "very dangerous" by comparison with, say, drinking brewed coffee, crossing the road, using electrical appliances or any number of commonplace risks of death which the parents of many 14 year-old girls accept daily without concern. –  RedGrittyBrick Nov 18 '12 at 15:56
    
@RedGrittyBrick: we would need stats on how many 14 year old girls die after drinking that energy drink vs how many die by crossing the road. –  nico Nov 18 '12 at 16:29
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Crossing roads does not have a healthier alternative (i.e. water and enough sleep vs. caffeine), and energy drinks are pushed on teens, daring them to "pound it down". –  Cees Timmerman Nov 19 '12 at 10:44

Two cans of a "normal" energy drink is less dangerous than a cup of brewed coffee of 350 ml (12oz) - in terms of caffeine.

According to Medscape

Caffeine has differing CNS, cardiovascular, and metabolic effects based on the quantity ingested. Average doses of caffeine (85-250 mg, the equivalent of 1-3 cups of coffee) may result in feelings of alertness, decreased fatigue, and eased flow of thought. High doses (250-500 mg) can result in restlessness, nervousness, insomnia, and tremors. In high doses, caffeine can cause a hyperadrenergic syndrome resulting in seizures and cardiovascular instability.

According to Wikipedia referencing Factors Affecting Caffeine Toxicity

The LD50 of caffeine in humans is dependent on individual sensitivity, but is estimated to be about 150 to 200 milligrams per kilogram of body mass or roughly 80 to 100 cups of coffee for an average adult

According to The BBC

Use this guide for the amounts of caffeine in products:

  • One mug of instant coffee: 100mg
  • One mug of filter coffee: 140mg
  • One mug of tea: 75mg
  • One can of cola: 40mg
  • One can of energy drink: 80mg
  • One 50g bar of plain (dark) chocolate: around 50mg
  • One 50g bar of milk chocolate: around 25mg

If the above is correct, two cans of energy drink is a lot less than a lethal dose.

Given an average body weight of 80 Kg, the LD50 is 12000 to 16000 mg which is 150 to 200 cans of the above Energy drink.

(Update:) A girl aged 14 might weigh only 50 Kg, a thin girl maybe only 40 Kg. Therefore LD50 = only 6000 to 8000 mg which is 25 to 33 cans of an unusually strong 240mg/can drink. So 2 cans is a lot but not a lethal dose for most thin 14 year-old girls.

Obviously some people are more sensitive than others and will have complicating factors such as high blood pressure or other existing medical conditions.

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I'm quite surprised the LD50 is that high. I would have thought the caffeine in 80 cups of coffee would kill a vast majority of people. –  Oddthinking Nov 18 '12 at 13:01
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@Cees's answer suggests these cans of energy drink have 240 mg, rather than 80 mg. –  Oddthinking Nov 18 '12 at 13:02
    
@Oddthinking: true, but still not far above a strong mug of coffee (see table in first link in Cee's answer: "brewed coffee, 12oz = 200 mg caffeine"). –  RedGrittyBrick Nov 18 '12 at 15:26
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Still, many energy drinks recommend drinking only half a can, and not exceed 2 cans daily. (examples here and here)‌​. Furthermore caffeine is not the only thing in energy drinks. Do you have any information on the LD50 of caffeine in the presence of taurine, citicoline, phenylalanine etc etc.? Some of these drinks have ingredients that stimulate adrenaline release, what is the interaction of those with caffeine? –  nico Nov 18 '12 at 16:27
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I'd be careful with using the LD50 alone, as it doesn't reflect non-lethal harm caffeine could cause. –  Fabian Nov 18 '12 at 16:53

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