Dr. Leslie Greenberg's Blog

Energy may be dangerous and yet drinks are becoming more popular.

As a physician I need to be aware of their potentially harmful effects.  The list of supplements used in energy drinks is lengthy.   As a consumer, you may not be aware of all the additives–as the labeling may not be complete.

Additives may include amino acids (like taurine and 5-hydroxytryptophan) and herbal products (like guarana, yohimbine, and ginseng) and bitter orange (containing synephrine) and ephedra (which is a stimulant).

The first energy drink was introduced in the US in 1997.  Since then, consumption has increased exponentially.  Did you know there were 200 new brands launched between 2006 and 2007?

Energy drinks have not been in existence long enough to build solid, evidence-based research to show long-term harm.  But, there is concern regarding their ingredients and the amounts.  Energy drinks can contain more than 500 mg of caffeine per serving.  Compare this to 75-150 mg of caffeine for a cup of coffee.  In addition, many of the herbs may also contain caffeine.  The side effects of consuming large amounts of caffeine may be fast heart rate, insomnia, anxiety or even acute caffeine intoxication and then withdrawal.

Interactions and side effects are important!

• bitter orange can cause cardiovascular side effects
• ginseng can cause bleeding problems and lower blood sugar levels
• 5-hydroxytryptophan should not be combined with MAO inhibitors (a class of blood pressure medication)
• Yohimbine can interact with blood pressure medication or tricyclic antidepressants
• ginseng can change the effectiveness of the blood –thinner warfarin (coumadin).

Consider stopping energy drinks…

flickr.com/photos /sudjuanda/ 2319413348

Anger may increase your risk of heart attack.  A study of nearly 4000 patients showed each increment of anger intensity increased the risk of heart attack in the two hours following an outburst.  If a patient is “moderately angry, so hassled it shows in your voice” increases the risk of heart attack by 1.7 times.  The risk of heart attack is 2.3 times greater after feeling “very tense, body tense, clenching fists or teeth.”  If you are feeling “enraged, lost control, throwing objects, hurting yourself or others” this resulted in the study in 4.5 times greater chance of heart attack.

Researchers extrapolated the greater the fury, the higher the risk of heart attack.

Consider yoga and meditation to help quell the anger.

flickr.com/ photos /sicilianitaliano/3281602519

The American Urologic Association (AUA) changed their guidelines regarding screening for prostate cancer.  The AUA now recommends AGAINST all routine prostate-specific antigen (PSA) testing.  It also recommends against screening men older than 70, men younger than 40 and average-risk men between ages 40-54.

This is a significant change.  This means that health fairs and hospital screening events should not offer PSA.

There is still some controversy regarding high-risk men 40-54 (like those with a strong family history of prostate cancer) and all men 55-69.  The AUA now calls for physicians to discuss the “limited potential benefits and substantial harms of screening for prostate cancer” with these patients whereas other screening organizations like the US Preventive Services Task Force and the American Academy of Family Physicians states that the PSA shouldn’t be used at all.

The AUA admits that for men ages 55-69 the decision to undergo PSA screening involves weighing the benefits of preventing prostate cancer mortality in 1 man for every 1,000 men screened over a decade against the know potential harms associated with screening and treatment (incontinence and impotence).

Interesting controversy…