Hype, Health and Energy Drinks

It seems that whenever I turn on my TV these days, I’m besieged by another commercial for the 5-Hour Energy drink. The commercials, noting how many people experience midday energy drops, suggest that consuming 5HE will prevent such short-term energy crises. The first thing to ask, however, is why so many people apparently feel the need for an energy boost in the middle of the day or at other times.

Perhaps it’s that they don’t exercise enough or aren’t eating properly. Working out regularly changes your metabolism in such a way that you become more efficient at producing adenosine triphosphate, or ATP, the immediate energy source for all cells in the body. All nutrients that provide energy, including protein, fat and carbohydrate, are eventually converted into ATP. Since the body works on a use-it-or-lose-it principle, you become less efficient at maintaining vital ATP stores if you’re sedentary. And that leads to the proverbial midday energy drop.

What you eat can also affects your ability to sustain energy throughout the day. Skipping breakfast is almost guaranteed to result in an afternoon energy drag, and eating junk for breakfast, such as coffee and doughnuts, will boost your blood glucose rapidly, followed by a rapid decline as insulin is secreted to deal with the elevated glucose. You feel it as an inability to focus as well as fatigue and even sleepiness.

Let’s say, however, that you’re working out regularly, eating a good, well-balanced breakfast that features a good protein source, such as eggs, with some fat to sustain you and smaller amounts of carbs, such as fresh fruit, yet still experience the dreaded afternoon energy lag. It could be that something is affecting you psychologically. You may be under mental stress for one reason or another, and that can result in fatigue. The same is true for mental depression. In situations such as those, having a protein drink may work wonders. Some of the amino acids in protein are precursors of brain chemicals that can rapidly boost mood. For example, tyrosine is converted in the brain into neurotransmitters, such as dopamine, that make you feel energetic and driven.

The next question is whether taking an energy drink will help. While the topic of energy drinks encompasses a lot of data, I will focus here on a typical energy drink, perhaps the most publicized and popular, 5HE. The ingredients are typical of other energy drinks, including Red Bull, which is also a popular brand. The cornerstone ingredient is caffeine. In the case of 5HE, one bottle contains the same amount of caffeine as a large cup of coffee.

Still, the drink works not just because of its caffeine content but also the alleged synergistic effects of the rest of the ingredients, which include various B-complex vitamins. The B-vitamins act as coenzymes for reactions that convert food into energy.

5HD also contains a few other ingredients that may aid energy lags, including citocholine, which is a form of choline. Choline is the raw material for acetylcholine, a primary neurotransmitter in the hippocampus section of the brain. Acetylcholine is involved in memory, learning and mental focus. The citocholine form of choline is more easily transported into the brain.

Another amino acid included in the 5HE formula is taurine, considered a nonessential amino acid because it can be made in the body. Taurine appears to help heart and brain functions through its modulation of minerals that affect nerve transmission, including calcium and magnesium. Taurine also may produce a cell-hydration effect that turns on a metabolic switch for anabolic reactions in cells, including muscle. All that said, the amount of taurine found in 5HE is probably too little to have much of an effect. My bet is that taurine is included mainly because it’s a primary ingredient in Red Bull.

The 5HE formula also contains two other amino acids, tyrosine and phenylalanine. Why they are both included is a bit of a mystery, since phenylalanine can be converted into tyrosine in the body. Both can be converted into neurotransmitters associated with alertness and mental energy, including dopamine, norepinephrine and epinephrine. The formula also contains glucuronolactone, which mimics the effects of glucose in the body.

The ingredient list of 5HE appears benign. The questions are, Does it work as advertised, and can it cause problems for some people?

As to whether it works, a recent study put 5HE to the test.¹ Eight men and three women, all college students, average age 22, participated in a double-blind, placebo-controlled crossover study. They completed five computer-based tasks before drinking either a caffeine-free placebo or the 5HE. The five tasks tested for attention capacity, math processing speed, reaction time, short-term memory and long-term memory. Afterward they were tested over a five-hour period, during which the researchers evaluated them for subjective focus, alertness, distraction and tiredness. That makes sense, since the 5HE is supposed to provide sustained energy over five hours.

The results showed no differences on the tasks and other measures of mental capacity and alertness between those who drank the placebo and those who got the 5HE. On the other hand, those who drank the 5HE did report an average 15 percent boost in attention capacity, which was likely the result of the caffeine. An hour after having the drinks, 90 percent of those in the 5HE group reported that the drink was “working,” while 20 percent of those who drank the placebo reported the same thing. Despite that, the 5HE group didn’t fare any better on the computer-based tasks designed to test mental function and attention. They showed no advantages in either long-term or short-term memory functions.

Based on this study, it’s reasonable to assume that 5HE does make you feel a bit more alert but doesn’t boost actual functions that require brain power. The next question is, Can habitually using such a product hurt you in any way?

A recent case study documented the effects of drinking 5HE in a 22-year-old woman.² Before I start, it’s important to understand that the woman had grossly overdosed on 5HE. The recommended use is not more than two bottles over several hours. This woman was slugging down 10 bottles a day.

She arrived at a local hospital complaining of upper-stomach pain, nausea, vomiting and a low-grade fever. She had been drinking that much 5HE for two weeks prior to showing up at the hospital. Initial blood tests showed elevated liver enzymes, but scans of her abdomen and pelvis appeared normal, so she was sent home. She soon returned—with increased stomach pain and signs of jaundice, pointing to extreme liver stress.

Sure enough, her liver enzyme counts were sky high this time. The diagnosis was hepatitis, which is a general term for liver inflammation. Hepatitis can be caused by viruses, bacteria or drugs. Bodybuilders who use large doses of anabolic steroids commonly acquire a chemical hepatitis. The oral steroids build up in the liver, which causes a swelling that interferes with the normal flow of bile through the liver. It shows up as elevated liver enzymes, and if it progresses, jaundice can appear. The condition recedes when the bodybuilders stop using oral steroids. In the case of the woman who overdosed on 5HE, since no other apparent substances or abnormalities were present, all the evidence seemed to point to the excessive amount of energy drink as the cause of her hepatitis.

Within a month after she cut out 5HE, the woman’s liver enzymes returned to normal. You have to wonder though, What is it about 5HE that caused the problem? Of course, she should never have chugged those 10 bottles a day, far more than the suggested maximum dose, but many people think that if a product is sold over the counter, it must be benign, which isn’t always true. Much of what happens depends on how much and how often you use a product. For example, if the woman had drunk 10 bottles of 5HE in a row, she would likely have experienced the toxic effects of caffeine, which can include anxiety, insomnia, headaches, restlessness and heart rhythm disturbances. She might even have died from a rapid intake of that much.

The physicians who wrote the case study think that the culprit was the B-complex vitamin niacin contained in 5HE. Most cases of niacin toxicity occur with doses of 1,000 milligrams or more, although smaller amounts can produce a “niacin flush,” manifested by a burning and itching sensation in the skin. The total amount of niacin that the woman got in the 5HE was only 300 milligrams. In most people that would cause no problems other than an annoying niacin flush. Yet the doctors think that it caused the woman’s hepatitis, which suggests that she had a sensitivity to niacin that most other people don’t have. That assumes, of course, that their theory is correct.

So what to deduce from all this information about energy drinks like 5HE? Save your money. The active ingredient affecting mental alertness is the caffeine, and you can get caffeine far more cheaply either by just drinking a few cups of coffee or taking a caffeine tablet or two. If you opt for the actual coffee, not only will you get a mental boost, but the polyphenol content of the java will also provide potent antioxidants that, among other features, help protect you against diabetes and cancer.

Editor’s note: Jerry Brainum has been an exercise and nutrition researcher and journalist for more than 25 years. He’s worked with pro bodybuilders as well as many Olympic and professional athletes. To get his new e-book, Natural Anabolics—Nutrients, Compounds and Supplements That Can Accelerate Muscle Growth Without Drugs, visit www.JerryBrainum.com.   IM

¹ Buckenmeyer, P., et al. (2011). Effect of 5-Hour Energy shot on cognitive function of college-aged individuals. Med Sci Sports Exerc. 43:644.

² Vivekanaandarajah, A., et al. (2011). Acute hepatitis in a woman following excessive ingestion of an energy drink: a case report. J Med Case reports. 5:227.