By Scott Meeker

smeeker@joplinglobe.com

There’s a hole in Dakota Sailor’s memory — a gap from the evening of Thursday, Feb. 4, until late afternoon on Saturday, Feb. 6.

The Carl Junction teen remembers going to school that Thursday, drinking two high-powered energy beverages, and later falling asleep on the couch in the living room.

He next remembers waking up in St. John’s Regional Medical Center on Saturday when physicians removed him from a ventilator.

The 17-year-old junior — a defensive end and tackle for the Carl Junction High School football team — had no history of seizures, and a series of medical tests found no apparent cause for this one.

His mother, Monique Burrows, found him that Friday morning after hearing what she described as a strange “gurgling” noise. She said that she found her son on the couch, where he had aspirated and turned blue. She yelled for her husband, who performed CPR on Sailor until an ambulance arrived.

He spent five days in the hospital, Burrows said.

Doctors concluded that her son’s seizure was likely triggered by the energy drinks he had consumed that evening.

“It was upsetting, and it’s life-changing,” Sailor said. “I never thought a drink could do something like that to somebody.”

Caffeine toxicity

Since Red Bull was launched in 1997, energy drinks have become a multibillion dollar industry, with more than 500 new products launched in 2006 alone, according to Nutrition Journal.

Sailor was drinking NOS, a high-performance energy drink that is labeled an “energy supplement.” NOS is short for “nitrous oxide,” which can be used to boost speeds in race cars.

Each 16-ounce can contains two servings, and each serving contains 130 milligrams of caffeine; 1,000 mg of the organic acid taurine; 200 mg of the compound L-carnitine; 100 mg of inositol; and 50 mg of ginseng extract.

The back of the can warns that the drink is powerful and not recommended for children, pregnant women or people who are sensitive to caffeine.

Sailor consumed two full cans — four servings, with 520 mg of caffeine — in a short amount of time. This was on top of soda he had already consumed that day.

“I drank pop constantly,” he said.

While it was the first time that Sailor had tried NOS, he said that he’s enjoyed other energy drinks in the past — Red Bull, Monster, Full Throttle, he’s tried just about all of them.

“They’re popular and advertised everywhere, and I just thought they tasted good,” he said. “I didn’t get jittery from them, but they can cause a crash sometimes.”

Or worse

Ahmed Robbie, a neurologist with Freeman Health System, said it’s entirely possible for a seizure to be caused by drinking too much of an energy beverage.

He said side effects from consuming too many energy drinks — or any high-caffeine product, for that matter — range from restlessness and headaches to tremors, confusion and seizures.

“It can even become fatal,” said Robbie. “It can cause an irregular heartbeat and severe hypertension. There have been reported cases of death from caffeine toxicity.

“There’s also an addiction problem. People who have a caffeine addiction have a tendency to drink more and more of it.”

Robbie said that 80 to 250 mg of caffeine a day would be the range that he would consider safe. Side effects could begin to set in after more than 250 mg, and become more serious past 500 mg.

He said he believes that energy drinks should come with a more prominent warning label that mentions the serious side effects of ingesting too much caffeine and that it is not recommended to drink too many of them.

Even the American Academy of Neurology in recent years has been asking questions about possible links between new-onset seizures and the consumption of large amounts of energy drinks, but did not have enough data to draw conclusions.

A spokeswoman for Coca Cola North America, which markets NOS and other energy drinks such as Full Throttle and Monster, said she could not comment on Sailor’s experience or whether the company had heard of any similar incident with the products.

‘Effects unknown’

Emily Melies, a dietitian with St. John’s Regional Medical Center, said pregnant women should steer clear of energy drinks because high levels of caffeine can increase the risk of birth defects, and the risk of adverse side effects from drinking them is higher for children because of their smaller body mass.

She said that energy drinks often prominently display the supplements they contain — such as the taurine and L-carnitine in NOS.

“Those supplements added in there say they will improve your performance and mentality, but most of those are added in as a marketing thing,” she said.

“As far as research goes, those things haven’t been proven to give you any positive effect. (Energy drinks) are not FDA regulated. The manufacturers put those extra additives in there to make them look good, but the effects are unknown.”

Because energy drinks are frequently marketed as dietary or energy supplements, they fall under the Dietary Supplement Health and Education Act, which was created in 1994.

Companies creating the product are themselves responsible for making sure those products are safe and claims made about them are not false or misleading, according to the U.S. Food and Drug Administration. They do not require the FDA to approve them before they are marketed.

In response to questions from the Globe about energy drinks, the FDA provided a draft guidance notice created in December 2009 that the administration hopes, when finalized, will offer recommendations on products marketed as supplements.

Titled “Guidance for Industry: Factors that Distinguish Liquid Dietary Supplements from Beverages, Considerations Regarding Novel Ingredients, and Labeling for Beverages and Other Conventional Foods,” the draft recommends that liquid products served in “bottles or cans similar to those in which single or multiple servings of beverages like soda, bottled water, fruit juices and iced tea” be considered as “conventional foods.”

According to the draft, factors such as name, packaging and serving size should be used to determine whether a product is marketed as a conventional food or a supplement.

A wake-up call

Though energy drinks are frequently marketed to youths in a flashy manner, Melies said there are much healthier ways to get an energy boost.

“For athletes, the best way to fuel your energy is to get an adequate amount of sleep, get plenty of exercise and eat healthy,” Melies said.

Burrows said her son’s experience has been a wake-up call for her family.

“It’s a mother’s worst nightmare,” she said of his recent seizure. “I just thought about (energy drinks) as kind of like soda pop ... like a strong Mountain Dew. But you wouldn’t let an 8-year-old sit down and drink 12 cups of coffee. (Young people) are just not aware of what could happen.”

Sailor, who is feeling better, began easing back into his routine at school last week. He is still trying to adjust to the realities of life after experiencing a major seizure.

Besides having to be on anti-seizure medication for the next year, he’s not allowed to drive for six months, and he has to wear an oximeter at night to monitor his heartbeat and oxygen levels.

Sailor said that doctors advised him to limit the amount of soda he consumes and to stay away from energy drinks.

That’s not going to be a problem, he said.

“I’m just trying to get the word out,” he said. “They’re not good for you.”



Not a good mix

While it has become a popular trend in bars and nightclubs, St. John’s dietitian Emily Melies said it is not a good idea to pair energy drinks with alcohol.

“Alcohol is a depressant, and energy drinks are a stimulant,” she said. “It can also increase the risk of alcohol consumption because energy drinks can cause dehydration, and alcohol as well, and both can increase your heart rate.”