The Scary Truth About Energy Drinks and Teens

Your teen is anticipating a big day: midterm exams followed by band practice and a soccer game. The pressure is on to perform at a high level.

It’s easy to grab an energy drink for a pick-me-up—the promise of enhanced focus and athletic performance attracts many teens. But these drinks have serious downsides. The high dose of caffeine in energy drinks can disrupt sleep, make the heart race, upset the stomach and interact with medications.

For these reasons, UNC Health family medicine physician Sarah Ruff, MD, warns children not to consume energy drinks or other caffeinated beverages.

“I always talk to young patients in my office about caffeine,” she says. “There’s a time for caffeine in your life, and it’s not now.”

The American Academy of Pediatrics (AAP) agrees. The AAP’s Committee on Nutrition and its Council on Sports Medicine and Fitness both say that caffeine and other stimulant substances found in energy drinks have no place in the diets of children and adolescents.

But many teens and their families haven’t gotten the message. Up to half of all adolescents in the U.S. consume energy drinks, according to the Centers for Disease Control and Prevention.

Teens and Caffeine

A big concern is that energy drinks contain significant amounts of caffeine. Several of these products contain 200 milligrams of caffeine per serving (12 or 16 ounces), which is equivalent to six 12-ounce cans of cola.

Healthy adults can consume about 400 milligrams of caffeine a day without side effects, according to the U.S. Food and Drug Administration. It has not set a limit for children.

“That sounds like a lot,” Dr. Ruff says. “But if you have two 12-ounce cups of coffee, that’s 300 milligrams. Then, if you have a soda later in the day, you’ve hit your daily limit.”

The American Academy of Child and Adolescent Psychiatry recommends that children ages 12 to 18 have no more than 100 milligrams of caffeine per day. Most energy drinks have more than that amount in one serving.

Too much caffeine can cause unwanted side effects, including heart palpitations, elevated heart rate, elevated blood pressure, anxiety, gastrointestinal upset and dehydration, Dr. Ruff says. In children, the effects of caffeine can include irritability, insomnia and nervousness, according to the AAP.

“It’s a stimulant, so it can make you jittery and feel like things are crawling on your skin,” she says. “It can cause sleep issues, especially if you have it later in the day.”

Watch Out for These Other Ingredients

Energy drinks not only have higher concentrations of caffeine but also often contain ingredients such as guarana, taurine and L-carnitine L-tartrate. When combined, these can cause serious health issues including abnormal electrical activity in the heart and higher blood pressure that continues for several hours.

“The ingredients are not regulated,” Dr. Ruff says.

What’s more, energy drinks usually contain added sugars (up to 27 teaspoons per can) and carbohydrates, contributing to weight gain, obesity, type 2 diabetes, heart disease, kidney disease and tooth decay. “Kids shouldn’t have more than 6 added teaspoons of sugar a day,” she says.

Despite the concerns about caffeine and other ingredients in energy drinks, it’s easy for kids to access them. Energy drinks are widely available in convenience stores, grocery stores and school vending machines.

“Seventy-five percent of schools don’t have a policy on energy drinks or caffeine,” Dr. Ruff says. “We should be teaching them about the impact on their health.”

Caffeine Can Affect Some Medications

Caffeine can alter the way our bodies absorb, metabolize and eliminate certain medications, which could make a difference in how the medications work, says UNC Health pharmacist Amy Donnelly, PharmD.

Be careful, for example, about drinking caffeinated beverages while taking medicines for attention-deficit/hyperactivity disorder and other mental health conditions, she says.

“It can definitely be an issue,” Dr. Donnelly says. “You’re adding a stimulant to a stimulant.”

Caffeine can also interfere with mood stabilizers, including those that contain lithium. It can heighten the effects of some cold medicines, especially those containing pseudoephedrine. The combination may increase restlessness and insomnia in some people.

What You Can Do About Caffeine

You can become physically and psychologically dependent on caffeine, and cutting back could result in headaches, heartburn or a lack of energy, Dr. Ruff says. If you consume a lot of caffeine daily and then abruptly stop, you may experience symptoms of caffeine withdrawal: restlessness, nervousness, irregular heartbeat, gastrointestinal disturbances, sleeplessness, headaches, fatigue and drowsiness, depression, difficulty concentrating or flu-like symptoms.

The best approach to curbing caffeine is to first take stock of how much you drink and then gradually reduce your intake—for example, cut back by one caffeinated drink each day.

If caffeine is a concern for your teen or for you, it’s a good idea to evaluate your relationship with it.

“Think about why you’re drinking caffeinated beverages,” Dr. Ruff says. “If you’re drinking caffeine all day to stay awake, talk to your doctor about what other underlying conditions may be making you tired and sleepy.”

If you’re concerned about the amount of caffeine that your child is consuming, talk to your doctor. Need a doctor? Find one near you.