In September 2022, a college student named Sarah Katz died after drinking a highly caffeinated beverage, Charged Lemonade. Many teens unknowingly exceed the recommended daily limit for caffeine use; caffeine overuse becomes riskier when youth have certain health conditions; and managing excessive use requires identifying and addressing reasons for use, says Richard Zhang, M.D., M.A., and Eunice Y. Yuen, M.D., Ph.D. Sarah developed cardiac arrest within hours after consuming the drink, whose large-size serving contained almost the Food and Drug Administration’s 400-milligram daily limit of safe caffeine intake—in healthy adults. It was a tragic incident, and dumbfounding to many who thrive on caffeine. Is it not the world’s most popular stimulant?
More than 90 percent of U.S. adults consume caffeine in some form each day. Caffeinated products are ubiquitous, whether coffee, tea, sodas, pre-workout drinks, or energy drinks. Their societal acceptance in America certainly exceeds that of nicotine and other recreational substances. These beverages enhance wakefulness, focus, and productivity by blocking drowsiness-promoting adenosine activity in the brain, pulling us through the day. They help facilitate coffee dates and socialization. Caffeine is not known to markedly increase cancer risk as tobacco does, cause nasal injuries or even aortic tearing as cocaine can, or shrink the brain as crystal meth would.
Unfortunately, Sarah was reported to have a heart condition that made it risky to consume stimulating substances in large amounts. Cases of fatal cardiotoxicity from caffeine are otherwise extremely rare. Moderating use, factoring in any medical, mental health, and family medical history one has, is pivotal to whether intake becomes positively adaptive or risky for one’s health.
Many young adults are not aware of healthy portion sizes for caffeine, especially while under academic pressures to study or finish schoolwork. Plain coffee aside, apart from Red Bull, Monster, and Prime, there are more than 190 energy drink brands on the market. The United States does not set a cap on most beverages’ caffeine content. If independent adults do not recognize this, how would our younger youth know?
An estimated 83 percent of adolescents regularly consume caffeinated drinks. Some exceed the advised 100-milligram daily limit of caffeine for teens, equivalent to one 8-oz standard cup of coffee. One 16-oz Monster (160 mg) or two 12-oz cans of Mountain Dew (110 mg) already exceed this threshold. While younger children are recommended to refrain from caffeine altogether, how many youths are tracking caffeine amounts in readily accessible, sugary energy drinks?
Moreover, Sarah’s tragic death reminds us that caffeine overuse can exert health effects, especially in physically predisposed youth.
Impacts of caffeine overuse on youth physical health
Caffeine overuse, such as consuming multiple, high-potency energy drinks daily, speeds up and strains the heart even in healthy people. This raises the chances of palpitations or even arrhythmias. Risks increase for those concurrently taking certain medications like attention-deficit/hyperactivity disorder (ADHD) stimulants, and especially the small percentage of youth with pre-existing cardiovascular conditions or predispositions. Examples include hypertrophic cardiomyopathy, long QT syndrome, Wolff-Parkinson-White syndrome, or heart diseases acquired from certain childhood infections. While usually ruled out at routine pediatric appointments, if these rare conditions are suspected and then confirmed by specialized testing, they may warrant limiting caffeine use.
As for noncardiovascular bodily symptoms, caffeine overuse can precipitate increased urination, loose stools, sweating, tremors, or restlessness. Some research suggests abruptly massive amounts of caffeine may raise seizure risk in those with epilepsy. Caffeine overuse increases risks for dehydration and, if used beyond the afternoon, sleep cycle disruptions; both are known potential triggers for epilepsy. Besides caffeine itself, abundant sugar in numerous caffeinated beverages contributes to youth obesity and dental erosion risks.
Impacts of caffeine overuse on youth mental health
Overuse can disrupt both current and future youth mental health. Many who present to clinical appointments with anxiety or sleeplessness unknowingly have an underlying contribution from caffeine overconsumption. There may be a detrimental cycle of daytime overreliance on caffeine, which worsens sleeplessness, to compensate for tiredness from sleeplessness. Moreover, caffeine dependence is possible at all ages: Chronic heavy users may notice temporary withdrawal symptoms of irritability, inattention, and fatigue when abruptly stopping intake altogether. Caffeine use regularly late enough to cause prolonged sleep deprivation also comprises an indirect risk factor for long-term psychiatric conditions that arise in the transitional-age youth period, such as mood disorders. Early-age use of caffeine may also reduce the growing brain’s own incentive to develop certain connections facilitating memory and learning. While further explanatory research is warranted, substantial childhood use could possibly adversely impact one’s cognitive abilities in adulthood, even if one refrains from external substance use at that point.
