By Mike Leifheit, PharmD
Pharmacy Clinical Coordinator, Blanchard Valley Health System

Caffeinated beverages are no longer limited to just coffee and soda these days. Caffeine can be found in popular energy drinks, teas and loaded teas. Looking at loaded teas and energy drinks, you will find different amounts of vitamins, antioxidants, supplements and stimulants (mainly caffeine). Most of these products have trendy names and are advertised on social media platforms.

Products like energy drinks and loaded teas are sold as nutritional supplements which allow them to bypass some of the Food and Drug Administration’s (FDA) regulations. As long as the label on these products contain the disclaimer “these supplements have not been evaluated by the FDA,” the product can make claims about increasing energy, enhancing performance and boosting the immune system.

The recommended amount of caffeine for children and adolescents may be surprising to some. The maximum recommended daily intake of caffeine in children is 2.5 mg/pound per day for children less than 40 pounds and should not exceed 100 mg total per day for children and adolescents over 40 pounds. An adult (18 years and older) has a recommended amount that is four times that of adolescents at 400 mg per day. As a point of reference, most caffeinated colas will contain about 20 mg per eight fluid ounces and standard brewed coffee will have about 90 mg per eight fluid ounces. 

Since caffeine is a stimulant, you will not be surprised to see that too much caffeine can lead to increased heart rate, cardiac arrhythmias (when your heart does not beat at a regular rhythm), inability to sleep (insomnia), unable to pay attention or focus, tremors, nervousness, agitation, mood changes and facial flushing. Too much caffeine can also lead to gastrointestinal disturbances and an increase in body temperature.

Extreme cases of too much caffeine can lead to hallucinations, seizures and even death. A concerning trend in health care is that energy drink related visits to emergency departments by adolescents (ages 12 to 17 years) are rising along with increased calls to poison control. 

With this potential health risk due to increased caffeine consumption in the youth, what can you do? The most important thing you can do is be aware. The “read labels, understand interactions, notice signs/symptoms" (RUN) method may be a useful tool for parents and adolescents to be responsible. The first step is to read labels. It is important to know what is being consumed in these drinks.

Maybe even more important is to also know how much is being consumed. Keep in mind, the maximum amount would be 2.5 mg/pound per day for children less than 40 pounds or 100 mg per day if over 40 pounds.

The “understand interactions” step requires an understanding around how caffeine can have additive effects on other medications like those used for the treatment of attention deficit disorders.

The final step of the RUN method is to “notice” signs and symptoms of too much caffeine. The common signs to watch out for include changes in heart rate, nausea, anxiety and changes in mood. 

Caffeine is here to stay and will be a part of some people’s daily lives. Increasing public awareness around these drinks can lead to healthy decisions for our kids.