So how much caffeine can kill you?
This is up for debate. The following is from a very good website for those interested in the dangers of caffeine called Energyfiend (www.energyfiend.com). This site in very blunt about the dangers of caffeine. Here are the documented cases of caffeine over dose:
Caffeine Overdose Documented Cases
Caffeine overdose does happen and has been documented. Here are some of the more recent cases easily found on Google resulting in death or hospitalization;
■ 19 year old James Stone dies after taking 25 to 30 No Doz pills in 2007. (at least 2.5 grams of caffeine)
■ 40 Seagulls die from caffeine overdose in Canada this year from eating used coffee grinds.
■ 17 year old Jasmine Willis, a Durham, UK waitress overdosed by drinking 7 double espressos in 2007. She was taken to the hospital, but recovered soon after. (that’s roughly 1.078 grams)
■ In the late 1990′s an Australian women, with a heart condition died after consuming a guarana based shot from her local health food store. This product is no longer on the market. (10g/liter, ok that’s just nuts!)
■ 2010 a 23 British man from Mansfield, England died after taking to 2 spoonfuls of pure caffeine powder washed down by an energy drink at a party. His death was ruled accidental.
■ 2011 Fourteen-year-old Anais Fournier, died after she reportedly consumed two 24 ounce Monsters (480mg of caffeine) in a 24 hour period. Cause of death was a heart arrhythmia due to caffeine toxicity. There seems to be some conflicting stories as to how much she really consumed and this seems true since 480mg in a 24 hour period isn’t a toxic amount. Update October, 2012: Her parents are suing Monster Energy for wrongful death although the girl did have a known pre-existing heart condition.
■ 2012 The FDA is investigating Monster Energy since the energy drink has been linked to five deaths over the past year.
■ 2013: According to the Substance Abuse and Mental Health Services Administration, energy drink related ER visits have doubled in the last 4 years, however, 42% of these visits involved caffeine in combination with other drugs such as alcohol or other narcotics.
■ 2013 a New Zealand woman died from cardiac arrhythmia associated with her 10 liter/day Coca-Cola habit. She also smoked 30 cigarettes a day and barely ate. Caffeine was a contributing factor, but the 900-1000mg daily dose wasn’t the only factor.
What is also pointed out is that while a normally healthy person can consume much larger amounts of caffeine then even stated in the cases above, there are protective side-effect mechanisms like nausea and vomiting which prevent humans from consuming a lethal amount of caffeine. Now fatalities and harmful outcomes can occur because of unknown pre-existing pathologies or complications from side effects such as vomiting.
Using the formula of the LD50 dose which is the median lethal dose that would kill 50% of a test group, you would get a caffeine LD50 number of 150mg/kg. Now a 100 pound person would weigh 45 kilograms and a 200 pound person would weigh 90 kilograms.
It would take 85 cans of monster to get enough caffeine to become fatal in a 200 pound person. It would take 42 cans to become fatal in a 100 pound person. For a Starbucks Grande (their name for small) hot coffee it would take 41 cups to be fatal for a 200 pound person and for a 100 pound person it would take 20 cups. Interesting that it takes less coffee, but there are other reasons why energy drinks may be of more concern and I will address this later in this article. The problem with the LD50 number is you do not want to be on the wrong side of the median 50% mark and that is what I tell teenagers in my practice when I talk about energy drinks. The truth is that if you look at statistics from the American Association of Poison Control Centers you would find that while caffeine overdosing does occur it is not as common as the media would want us to believe.
As stated before caffeine is a xanthine and xanthines are broken down in the body in two main places, the cytochrome P450 enzyme system (P450) found in the liver and the liver cells themselves when the P450 system is full. The P450 system also breaks down female sex hormones and clears the body of cancer producing compounds.
Women who are still menstruating need to realize that during their period their body is being flooded with hormones and they need the p450 enzyme system to clear those hormones from their body. If the P450 enzyme system is flooded with xanthines then hormones from menstruation have to be sent to the alternative site for breakdown, the liver cells themselves. In the liver cells the hormones are broken down via the alpha-reductase pathway. The alpha-reductase pathway breakdown comes with a price though, it is not as efficient a pathway and the breakdown of hormones results in toxic byproducts not found in P450 breakdown. This is the cause of menstrual PMS. Because a woman floods her body with xanthines she has to breakdown her hormones in a way that slightly makes her toxic for 3-4 days with physical and mental-emotional symptoms. The advice here is to stay off of coffee and energy drinks containing caffeine for the week before her menstrual period.
There are additional ingredients that are used as well to lend a unique sales story to the beverage.
Guarana is an amazon herb. It’s beans contain twice the caffeine of coffee beans. It is used in South America for making soft drinks. It actually exerts a healthy effect on platelets in blood making them aggregate less reducing risk of clots in the circulatory system.
Ribose is a 5 carbon sugar that is used in the cells of the body to enhance cellular energy. It is used by athletes and is also useful for people recovering from major medical procedures.
Ginseng is an herb from the Chinese pharmacopeia. It is classified as a tonic, which means the Chinese thought it was safe to take every day. While it has been shown to increase stamina and give a mild energy boost it was primarily seen a a digestive strengthener by the Chinese that would allow for more nutrients to be absorbed from food. That was how you got an increase in energy according to the Chinese herbal practitioners, but there have been people in this country who are sensitive to ginseng and have reported feeling jittery or staying awake when they took it in the evening.
People can also be very sensitive to caffeine making them more likely to have a reaction to a large dose of caffeine.
The reasons for this sensitivity were unknown until the genome project started mapping out genes in the human body and along with gene mapping came additional research and from that we learned that some people have the same genes, but variations in parts in that gene called receptors. It turns out that a variation in the adenosine A@A receptor gene can make a person more sensitive to caffeine. The variation makes it harder to clear caffeine from the body.
The issue here is not whether caffeine is safe. There have been numerous studies that show while it is addictive and while it can cause medical symptoms when not used properly it is relatively safe. It is even classified in the U.S. as a Generally Recognized As Safe (GRAS) product and it even had a recent review. The problems here are a matter of balance in consumption and of education. Everything we consume must be used in moderation and balance. Sugar found in candy and many of our most consumed foodstuffs is found to cause diabetes and immune suppression, there is even a syndrome with reported deaths called water intoxication. It is not a matter of something being out and out dangerous like tobacco, for caffeine has been shown repeatedly to improve cognitive function and physical performance. It is a matter of using caffeine wisely and educating people about it. Now that is a problem for most young adults because part of being a child and a young adult is that they are just learning about power and making their own decisions and that means they have yet to establish boundaries for their decisions. That is where parents, schools and yes, even retail outlets can come in and assist young adults on making wise choices before they find out the hard way by abusing something as simple as caffeine. Should retail stores be prevented from selling energy drinks to minors? No, I do not think so. We do not ban coffee sales to minors and coffee can typically have more caffeine than the average energy drink. We need to teach balance to young adults so they can make wiser choices and the energy drink companies should get involved.
Takeaway points
- Limit caffeine intake to 400mg or less in a 24 hour period.
- Educate young adolescents about using caffeine and how too much can cause harm or give off frightening symptoms
- Use caffeine when you need it instead of making it a part of your daily routine.
- Take multi-vitamins daily away from caffeine to replenish those lost to kidney clearance.
- Advise menstruating women to abstain from caffeine the week before their menstrual period.
