Parents need to be aware of the high amounts of caffeine that are in these products and be aware that caffeine is a stimulant. —Barbara Crouch, Utah Poison Control Center

SALT LAKE CITY — Marketed mainly as pick-me-ups, energy drinks have now come under fire for possibly causing the deaths of nearly two dozen individuals nationwide.

The U.S. Food and Drug Administration this week released reports it has received that 13 deaths in the past four years could be tied to 5-Hour Energy, a highly caffeinated energy shot available for about $2.50. The report comes on the heels of others released last month, presuming five deaths were due to another popular energy drink, Monster Energy.

While the death rate is low, it should be concerning to parents, as many such beverages and dietary supplements are aimed primarily at teenagers, said Barbara Crouch, director of the Utah Poison Control Center at the University of Utah. Dietary supplements, she said, are not regulated by the FDA.

The drinks contain caffeine, among other stimulants, which Crouch said is "a medication" and likely "the most common psychoactive medication in use today."

"It's a stimulant. It's a drug. You take enough of it and you run into trouble," she said.

The FDA hasn't verified that energy drinks are the sole cause of death in each of the cases, but it has begun an investigation to determine whether the risks are appropriately addressed on labels and in stores.

Regardless of the outcome, Crouch said, it would be difficult for the government to regulate caffeine consumption, because it is available in so many forms and is generally harmless in most people.

Individuals with a propensity for heart problems — who may not know such problems exist — are at higher risk of caffeine sensitivity, which Intermountain Medical Center cardiologist Brent Muhlestein said can be deadly.

Caffeine, he said, increases a person's heart rate and blood pressure, stimulating the heart and brain, and other parts of the body, leading to a perceived arousal effect and increased attentiveness, not necessarily increased energy. Too much caffeine can also lead to abdominal pain, vomiting, tremors and increased anxiety, among other side effects.

"The effects wear off as soon as the caffeine wears off," Muhlestein said, adding that he advises most patients to avoid large amounts of caffeine, which can be toxic at sufficiently high doses.

"The dose makes the poison," Crouch said.

Caffeine overdoses have led to an increase in emergency room visits over the years, from 1,128 nationally in 2005, to 16,055 in 2008, and 13,114 in 2009, according to a report by the Substance Abuse and Mental Health Services Administration.

An appropriate daily dose of caffeine, Muhlestein said, is up to 400 milligrams, or two cups of strong coffee for an adult, and less than 100 milligrams for children.

The problem, however, is that most energy drink manufacturers don't properly disclose how much caffeine is actually contained in each product. Caffeine, Crouch said, is also naturally present in other common ingredients in energy drinks, and many of the drinks contain other stimulant properties.

A recent Consumer Reports study revealed that of 27 products tested, five energy drinks contained levels of caffeine at least 20 percent higher than what the label reports, 11 didn't specify caffeine levels at all, and some even over-reported the amount of caffeine contained in the beverage.

Caffeine amounts in 5-Hour Energy, which is available in multiple strengths and flavors, range from 6 milligrams per serving to 242 milligrams, the report found. The 2-ounce bottle contains a caution on the label telling consumers to "limit caffeine consumption to avoid nervousness, sleeplessness and occasional rapid heartbeat." It also warns pregnant women, children under age 12 and anyone taking certain medications or with certain medical conditions not to consume the shot.

6 comments on this story

"You can't tell people to not drink coffee and soft drinks, which contain caffeine, so it is hard to know where to draw the line on some of these products," Crouch said, adding that consumption is largely an education issue. Some of the available products have large amounts of caffeine and others contain caffeine that can't be measured.

"Parents need to be aware of the high amounts of caffeine that are in these products and be aware that caffeine is a stimulant," she said.

E-mail:, Twitter: wendyleonards