This man got hepatitis from his energy drinks. How the heck does that even happen?

The diagnosis: a severe case of acute hepatitis, an inflammation of your liver that can lead to permanent damage or scarring.

Tests revealed that his liver enzymes were off the charts. Doctors performed an abdominal ultrasound and liver biopsy to see what was going on.

The diagnosis: a severe case of acute hepatitis, an inflammation of your liver that can lead to permanent damage or scarring.

The doctors were stumped on how he had contracted it. Tests revealed a virus wasn’t responsible as it is in most cases of acute hepatitis and the man didn’t abuse drugs, alcohol, or take any prescription meds that could cause liver disease, either.

But then the man mentioned his habit of drinking 4 to 5 energy drinks per day over the past 3 weeks to get through his labor-intensive workdays.

That’s when the pieces finally came together. The man’s case was detailed in a recent issue of BMJ Case Reports.

“We believe it was overconsumption of one of the components in the energy drinks, in higher-than-recommended doses, that may have led to acute liver toxicity,” says Vikas Khullar, M.D., a University of Florida fellow in gastroenterology and hepatology.

In particular, B vitamins—particularly niacin, or vitamin B3—may have been the main culprit behind the man’s acute hepatitis.

That’s because B vitamins like niacin get stored in your liver, and when too much of them accumulate there, it can cause your liver to malfunction, says Dr. Khullar.

As a result, your liver becomes inflamed and unable to properly filter toxins from your body. That could lead to hormonal imbalances and higher risk for certain cancers—and hepatitis.

The amount of B-vitamins—often included as part of a drink’s “energy blend”—varies among brands, but they can often exceed more than the recommended daily allowance, says Dr. Khullar.

For example, one 16-ounce can of Monster Energy contains 40 milligrams (mg) of niacin. That takes it well beyond the 16 mg recommended daily allowance and the 35 mg max dosage for adults given by the National Institutes of Health.

So if you were drinking 5 cans of that a day, for example, you’d be taking in an extra 200 mg of niacin a day, or more than 5 times the recommended max.

The level of niacin in energy drinks is a significant concern, says Men’s Health nutrition advisor Alan Aragon, M.S.

Going slightly above recommended levels by having one can every so often isn’t a big deal, but continually going over the max becomes a risk for liver health, Aragon says.

And the influx of caffeine can be a problem, too: A safe limit of the stimulant is up to 400 mg per day, Aragon says—or about 4 cups of coffee.

Some of the popular energy drinks contain up to 200 mg per can, which means the patient in the recent study was consuming around 1,000 mg daily.

Excessive caffeine may lead to stomach upset, insomnia, and increased levels of the hormone epinephrine, which can raise blood pressure and heart rate.

What’s more, the “proprietary blend” of energizing ingredients these companies use is often undisclosed, so you can’t be exactly sure what’s even in them, Aragon says.

Bottom line: An energy drink once or twice a month probably isn’t going to hurt.

But if you feel yourself needing an energy boost more frequently, getting more sleep or sticking to coffee or tea is probably your best bet, Aragon says.

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