Commentary

A few moments of scrutiny for 5-Hour Energy

By Craig Bowron

Craig Bowron is a writer and physician at Abbott Northwestern Hospital in Minneapolis.

Last month, 5-Hour Energy became associated with a different number — 13 — when the FDA announced it had received reports of 13 deaths whose circumstances included the use of the popular energy booster.

Of course, association is not causation, and both the FDA and the manufacturer of 5-Hour Energy, Living Essentials, were quick to point that out. Obviously, no self-respecting energy booster wants to be associated with the ultimate energy drain — death— but when you're selling 9 million of these ditties every week, as the company claims, you're bound to stir up some trouble.

In the meantime, all the negative publicity spurred the public to ask, "What's really in those things?"

5-Hour Energy is a combination of caffeine and what Living Essentials calls an "energy blend," a mix of B vitamins, amino acids and metabolites. How much caffeine? According to the Center for Science in the Public Interest, 5-Hour Energy contains 208 milligrams of caffeine. The caffeine content of coffee varies markedly from product to product, and of course by size: Do you order an espresso, or the 86-ounce mucho grande bucket?

But compare 5-Hour Energy's 208 milligrams to the 133 milligrams of caffeine in a 16-ounce McDonalds coffee; or the 330 milligrams in a 16-ounce Starbucks; or the 40-60 milligrams you'll get in a can of caffeinated soda or a cup of tea. Pick your potion, but remember there's a considerable amount of caffeine in a two-ounce 5-Hour Energy shot -- 58 milligrams more than you'll get in a two-ounce Starbucks espresso.

Energy drinks might be a new product, but caffeine has been around forever, and we understand it well. Drug levels peak in an hour or so, but caffeine hangs around for a good while after that. In fact, it takes the liver four to five hours to metabolize half of a caffeine dose.

So is the only thing "new" (so to speak) in a 5-Hour Energy its proprietary "energy blend," which the ads say "make it last"? I asked Dr. Linda Brady, a nutritionist at the University of Minnesota, what she thought of all these "make it last" additives.

She said, "In one sense it's true: You need vitamins and amino acids to have a healthy metabolism, for the body to work right; but it's untrue in the sense that taking extra amounts of these things are of any benefit in those who aren't deficient. If a person consumes ample amounts of these vitamins and amino acids, and almost everyone does these days, there's no evidence that taking more will make you super-functional."

If the energy blend isn't adding energy, could it somehow be making the caffeine last longer? There are some drugs, birth control pills for example, that prolong caffeine's effects by slowing down its metabolism, but it seems highly implausible that 5-Hour's energy blend could do the same. These vitamins and amino acids are a ubiquitous part of the human body. If they do hobble the liver's ability to metabolize caffeine, they should be doing it all the time, since they are always there.

But maybe 5-Hour Energy has the evidence! Hey, looky here: According to its website, in 2009, 5-hour Energy performed its own study, which found that in terms of attention and alertness, 5-hour Energy significantly outperformed ... placebo.

Hey, we know enough about the stimulant effects of caffeine that we don't need a study to see if it will outperform a placebo. It should have just matched 5-Hour Energy against its self-stated competitor, coffee, to see if the "energy blend" does what the ads say it does. But this is business, not science.

You might think of 5-Hour Energy as just coffee in a 2-ounce jug, but there are a couple of important differences: One tends to sip coffee, but chugging an energy shot puts one more at risk of caffeine toxicity. And keep in mind that the health benefits of coffee and tea aren't from the caffeine, but rather from the beneficial anti-oxidants that wash out from the coffee bean, or the tea leaf.

For that reason, if you need an eye opener, I'd shun the jug and stick with the bean or the leaf.