Are Energy Drinks Bad For Your Liver?

Overview

Energy drinks are becoming more popular in the United Kingdom. Up to a third of youngsters in the United Kingdom consume at least one energy drink every week, according to a new study. High levels of intake are associated with headaches, sleep issues, alcohol usage, smoking, irritability, and school exclusion. These beverages, marketed as both mental as well as physical performance enhancers, include caffeine and sweeteners, as well as B-vitamins, amino acids, and herbal stimulants. Due to the possibility for excessive caffeine or sugar consumption or the hazards of mixing such drinks with alcohol, the safety of such beverages, especially their effect on liver function, has been called into doubt.

Energy drinks

Energy drinks are beverages containing chemicals that are promoted as enhancing energy and cognitive performance. Caffeine is included in almost all energy drinks to enhance brain activity and improve alertness and attention. However, the quantity of caffeine varies across products.

Key ingredients in energy drinks

Nearly every single energy drink comes with its own special "energy mix" of components. Keep in mind that manufacturers are not compelled to disclose the amounts of each of their product's components. 

Caffeine may increase energy, alertness, and athletic performance in modest doses. However, one should not drink more than twice a day, and take no more than 200 mg of caffeine. 

Ginseng, a plant native to East Asia, has not been demonstrated to increase energy and has been shown to impair exercise endurance. Since it reduces blood sugar, diabetics who are on diabetes medication should avoid it. 

B-vitamins are water-soluble nutrients (B6, B12, niacin, folic acid), therefore any excess is immediately flushed out of the body, making them relatively harmless. However, experts believe that they are unlikely to provide a boost of energy. 

Some 16-ounce (500ml) cans of energy drinks contain up to 62 g of sugar, or 15½ teaspoons. This may easily reach 250 calories per can, which is equivalent to a 20-ounce (568 ml) bottle of soda. 

An amino acid, taurine, may enhance physical performance and metabolism. Daily doses of up to 3000 mg of taurine are regarded as generally safe. 

Green tea extract is used to provide a boost without a shock, since it contains just trace amounts of caffeine. While studies reveal that it is an excellent source of cancer-fighting antioxidants, there is little evidence to support claims that it helps decrease blood pressure or aid in weight loss. 

Guarana extract, derived from the seeds of the South American guarana plant, has twice as much caffeine per weight as coffee. Its claims (that it promotes weight reduction and combats weariness) are, at best, dubious. 

Green coffee extract is derived from unroasted coffee beans; this novel product is devoid of coffee flavour but still contains caffeine. Claims that the extract aids weight reduction have not yet been supported by scientific evidence. 

A herb derived from the leaves of an ancient Chinese ginkgo tree, is supposed to combat mental weariness and enhance memory. However, the evidence on these statements is contradictory. In addition, a recent National Toxicology Program research ties ginkgo extract to malignancies of the mouse thyroid and liver. 

Supposedly, the amino acid carnitine increases endurance and boosts fat burning. Since we only need more carnitine if we have a deficiency (which is uncommon), supplementation is mostly unnecessary. In general, less than 3 g per day is regarded as safe; higher might cause stomach distress and perhaps seizures.

Benefits of energy drinks

Energy drinks are used for a number of reasons. Increasing mental alertness by enhancing brain activity is among the most prominent reasons. Multiple studies demonstrate that energy drinks may genuinely enhance brain function, as measured by memory, focus, and response speed, while lowering mental tiredness. ^{1, 2, 3, 4} In fact, one research showed that consuming a single 8.4-ounce (500 ml) can of an energy drink improved focus and memory by 24%. ¹ Others have argued that the mix of caffeine and sugar in energy drinks is required to provide the greatest effect.² 

People also take energy drinks to help them operate when they are sleep-deprived or exhausted. On lengthy, late-night car journeys, drivers often use energy drinks to remain attentive behind the wheel. Multiple studies utilising driving simulations have indicated that energy drinks may improve driving performance and minimise drowsiness in sleep-deprived drivers.^4,5 Similarly, many night-shift employees rely on energy drinks to do their duties at hours when most others are sleeping. Although energy drinks may also assist these employees to remain aware and awake, at least one research suggests that their use may have a detrimental impact on the quality of their sleep after their shift.⁶

Risks of energy drinks

According to research, energy drinks may increase brain function and keep you attentive when you're exhausted. Concerns exist, however, that energy drinks may lead to cardiac issues. Several incidences of cardiac issues requiring emergency department visits have been linked to energy drink use, according to one study.⁷ Additionally, approximately 20,000 emergency department visits are attributed to energy drink use annually in the United States alone.⁸ 

Furthermore, several human studies have shown that ingesting energy drinks may raise blood pressure and heart rate, and reduce vital indicators of blood vessel function which may be detrimental to heart health.^9,10 Most specialists feel that cardiac issues caused by energy drink use are due to excessive caffeine consumption. Many of the individuals who had major cardiac issues after using energy drinks were ingesting more than three energy drinks at once or combining them with alcohol. If you have a history of heart illness, you may need to exercise caution while using energy drinks. However, healthy persons with no history of heart disease are unlikely to develop cardiac issues by eating them infrequently and in acceptable quantities. 

The majority of energy drinks include a substantial quantity of sugar, one 500 ml can containing upwards of 27 g (7 teaspoons) of sugar. This amount of sugar can cause anyone's blood sugar levels to jump, but those who have trouble regulating their blood sugar or diabetes should be very careful while consuming energy drinks. Consuming sugar-sweetened beverages, such as the majority of energy drinks, may be harmful to your health, particularly if you have diabetes. 

These blood sugar spikes have been linked to elevated levels of oxidative stress and inflammation, which have been involved in the onset of almost every chronic illness. ¹¹ However, even those without diabetes may need to consider the sugar content of energy beverages. One research found a correlation between daily consumption of one or two sugar-sweetened drinks and a 26% increased risk of type 2 diabetes. ¹²

Are energy drinks bad for your liver?

Energy drinks are described as nonprescription commercial beverages with a high caffeine concentration that are marketed as enhancing energy, including mental alertness and physical performance. There are over 50 energy drink brands available in grocery stores, nutrition centres, beverage shops, and online.¹³ Several incidences of clinically obvious acute liver damage, which may be severe and end in death or urgent liver transplantation, have been related to excessive energy drink use.¹³ It is unclear which components of energy drinks cause liver damage, and caffeine alone has not been related to liver damage.¹³ To determine whether people are prone to liver failure due to energy drink intake, more research is required. 

Which drinks can affect your liver?

Mainly alcohol as the liver may manufacture new cells, but chronic alcohol abuse (drinking excessively) over a number of years might impair its capacity to regenerate. This may result in severe and irreversible liver damage. Alcohol-related liver disease (ARLD) refers to liver damage resulting from excessive alcohol use. ARLD is prevalent in the UK. Alcohol abuse has led to a rise in the prevalence of the disorder over the last few decades. There are several degrees of severity and a variety of symptoms.  

ARLD often does not create symptoms until the liver is badly damaged. When this occurs, possible symptoms include:

• Feeling unwell 
• Weight reduction 
• Lack of hunger 
• Jaundice 
• Inflammation of the ankles and abdomen 
• Disorientation or sleepiness 
• Vomiting blood or passing blood in your stools 

This implies that ARLD is typically identified during testing for other illnesses or at an advanced stage of liver damage.

What are the signs of a damaged liver?

In addition to fighting off infections, metabolising medications, producing energy from meals, and functioning as a toxin filter, the liver performs a crucial role in the body. This organ has the capacity to rejuvenate itself in order to continue performing its function properly. However, overworking the liver may result in severe liver disease. Inflammation, scarring, cirrhosis, malignancy, and finally life-threatening liver failure may result from repeated liver trauma. 

Cirrhosis, an accumulation of scar tissue in the liver, blocks the flow of blood through the liver. As a consequence, the liver is unable to function properly, resulting in fluid collection in the belly (ascites) or even swelling in the legs and ankles. In 50% of patients with cirrhosis, fluid retention is the most prevalent sign that the liver may be damaged. 

Typically, the liver has little difficulty filtering out bilirubin, a yellow pigment found in bile. A buildup of bilirubin may give the skin and the whites of the eyes a yellowish hue if the blood is unable to be digested efficiently. In addition to jaundice, liver disease may also cause itchy skin. 

If the liver is not adequately filtering out toxins, a buildup of toxins in the bloodstream may cause nausea and vomiting. Chronic nausea is a frequent sign of liver disease in its early stages. As the damage develops, further symptoms may include appetite loss, diarrhoea, abdominal pain, and other digestive distress. 

The usual, black hue of faeces is a result of the bile salts that are routinely produced by the liver. Stools that are pale may be an indicator of liver disease. As stools get lighter, urine may become darker owing to the same bilirubin accumulation that causes jaundice. Due to blood travelling through the digestive system, black, tarry stools may also be an indication of liver issues. Immediately seek medical treatment if you are vomiting blood or seeing blood in your stool. 

A damaged liver cannot create the proper quantity of clotting proteins, resulting in increased bruising and bleeding. In addition to liver disease, a number of causes might induce easy bruising.

Should people with liver problems drink energy drinks?

As energy drinks include several potentially harmful compounds, including caffeine, taurine, B-vitamins, and others, this is not advisable. Niacin (vitamin B3) has been demonstrated to produce liver toxicity (hepatotoxicity) ranging from modest aminotransferase increases to severe hepatic failure.¹³ When niacin doses surpass 2000 mg per day, there is a higher than 50% likelihood of hepatotoxicity, according to the available research.¹³ Vivekanandarajah et al. documented a young lady who developed severe hepatitis after consuming 10 cans of energy drink over the course of two weeks.¹⁴ She had ingested 300 mg of niacin each day, and it was determined that this was likely the cause of her severe hepatitis. This is a lower dose of niacin than was previously known to cause hepatotoxicity, indicating that a cumulative impact may have played a role in the development of liver failure, or that the patient's excessive alcohol use rendered his liver more susceptible to additional damage.¹³ 

According to previous research, persistent alcohol use promotes activation of the detoxifying enzyme CYP2E1, whereas niacin reduces its activity.¹³ The Maria and Victorino scoring system is used to assess causation in drug-induced liver damage. This method was used on the  patient, who presented with a score of 10 points, indicating a "possible" causality for his drug-induced liver disease. Similarly, a lady who used 10 energy drinks daily for 2 weeks was diagnosed with hepatitis or liver inflammation, while a man was diagnosed with liver failure after consuming 3 sugar-free energy drinks daily for a period of time. ¹⁴ To determine the mechanism and effects of these substances on cytochrome activity, liver metabolism, and drug-induced liver damage, more research is required.

Summary

Regular and long-term intake of sugar-sweetened or alcoholic beverages may offer health concerns to the liver. Despite the dearth of study on liver consequences, a few case reports imply that excessive use of energy drinks may result in liver damage.  If you are a healthy adult who intends to take energy drinks, you should restrict daily consumption and avoid these if they create adverse side effects. If you are a kid or adolescent, you should avoid these beverages unless your doctor permits moderate use. Lastly, if suffering from any medical conditions, see your physician before ingesting these drinks.