Energy drinks aren't worth the buzz

Q: I work full-time, and it seems like I am tired all the time. Do energy drinks work? Are they OK to use every day, or should I use them only when I need a boost?

A: Energy drinks such as Red Bull are popular right now. You find them in cans or bottles not only in grocery stores, but at bars as well because some people like to combine them with alcohol in mixed drinks. They usually contain large amounts of sugar and caffeine, although some "diet" versions contain artificial sweeteners instead of sugar. In addition, some brands add B vitamins, herbs such as ginseng or ginkgo, and the amino acid taurine.

In general, the short-term boost you get from energy drinks is mostly from the caffeine content. The amount in different brands varies from about 80 to 160 mg — which is equivalent to one or two cups of instant coffee.

The problem is that some brands don't clearly state the amount of caffeine they contain, or else the caffeine is disguised. Few people know, for instance, that the herbs guarana and yerba mate contain caffeine. So even if you read the label, you may not know you are drinking a caffeinated beverage.

From a holistic point of view, there are major downsides to relying on caffeine and sugar for energy. Many holistic providers consider it a short-term gain with negative long-term consequences. If you think about it, that makes sense. Drinking lots of caffeine may allow you to avoid the fact that you haven't slept well or relaxed in three years. Eventually such lack of self care will catch up to you. And when it does, it's probably going to hit a lot harder than if you had put in the time up front.

Conventional medicine holds that caffeine is safe when used in modest amounts by a healthy person. Yet taking in large amounts rapidly can potentially cause a heart attack or abnormal heart rhythms. This may be a problem with energy drinks because they are cold beverages. As a result, people may be more prone to gulp several down and get a large amount of caffeine too quickly.

As a general caution, you should never use energy drinks when you exercise. The caffeine acts as a diuretic, and you can get severely dehydrated. I don't recommend combining the drinks with alcohol either, because the caffeine's stimulant may mask how much you are being affected by the drink you just had.

Fatigue can be frustrating for many people. I will tell you that the payoff is huge for people who are willing to look at long-term solutions, especially if the fatigue is chronic.

Dr. Astrid Pujari is a Seattle M.D. with an additional degree as a medical herbalist; she practices at the Pujari Center and teaches as part of the residency programs at Virginia Mason and Swedish/Cherry Hill hospitals. Send questions to apujari@seattletimes.com for possible use in future columns. All information is intended for education and not a substitute for medical advice. Consult your doctor before following any suggestions given here.