Wednesday 22 May 2019

Leading expert warns of dangers after man (34) dies from caffeine toxicity

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Rachel Farrell

Rachel Farrell

A LEADING toxicologist has spoken out about the dangerous effects caffeine can have with stimulants after it has emerged that a 34-year-old man died from caffeine toxicity.

Waterford Coroner’s Court found that the man, who had consumed caffeine tablets while he attended the gym, died in his apartment with a fatal level of caffeine and a high level of amphetamine in his system on April 30, 2018.

According to the Waterford News and Star, Coroner John Goff ruled the cause of death as caffeine toxicity after Dr. Nigam Shah, Consultant Pathologist at University Hospital Waterford, discovered the presence of amphetamines and a “very high” level of caffeine in his body.

The court heard that the deceased had been taking caffeine tablets and had attended the gym the night before he was found.

When consumed by humans, caffeine stimulates the central nervous system, and in moderate doses "increases alertness and reduces sleepiness", as described by the European Food Safety Authority (EFSA).

According to Dr Craig Slattery, Assistant Professor of Toxicology and Regulatory Affairs at University College Dublin (UCD), the recommended daily allowance of caffeine is 500mg per day- the equivalent of approximately six espresso shots.

However caffeine tablets or supplements, which typically include 200-300mg of caffeine or a double espresso shot, can become dangerous territory if the consumer takes too many.

"Coffee is not the only thing you get caffeine in, but also soft drinks and energy drinks, which are the equivalent to a caffeine pill with 200 to 300mg of caffeine, or 2 to 3 cups of coffee," Dr Slattery told Independent.ie.

"The issue there is if you’re drinking coffee, an americano may have two espresso shots and water, but your stomach can't physically fit more than 2 or 3 cups of coffee at one time. The issue with caffeine tablets is that you could swallow the whole bottle and not feel full.

"Caffeine tablets are legal, they're not prescription and they are available in many health shops, but unfortunately a lot of people think that a little bit is good, but more would be better.

"Once people follow the instructions as provided, there should be no problem."

Dr Slattery explained that one would need to consume tens of thousands of caffeine milligrams to reach a state of caffeine poisoning, which comes after intoxication.

"If someone was taking 1,500-2,000mg of caffeine per day, they may experience irritability, headaches, insomnia, sometimes palpitations. But to reach a fatal level, it would be massive quantities, between 12,000-15,000mg (50 caffeine tablets) for caffeine poisoning."

Dr Slattery added that stimulants such as alcohol or amphetamines can make the effects of caffeine "much more potent".

"You could have 8 or 10 energy drinks on a night out. If you're in that territory, you could be in caffeine intoxication, before caffeine poisoning. You're out of the safe zone. Mixed with alcohol, caffeine makes you more alert, but alcohol does the opposite.

"What tends to happen is they don’t notice the effect when they drink more and more, and then they could be in danger. On the surface they could be a perfectly healthy teenager or an adult, but of they have any sort of undiagnosed heart problem, caffeine can trigger it."

According to the EFSA, caffeine is absorbed rapidly into the system.

"The stimulatory effects may begin 15 to 30 minutes after ingestion and last a number of hours. In adults the half-life of caffeine – the time it takes for the body to eliminate 50pc of the caffeine – varies widely, depending on factors such as age, body weight, pregnancy status, medication intake and liver health. In healthy adults, the average half-life is approximately four hours, with a range of two to eight hours."

However the EFSA says that alcohol consumption "at doses up to about 0.65g/kg bw, leading to a blood alcohol content of about 0.08pc – the level at which you are considered unfit to drive in many countries – would not affect the safety of single doses of caffeine up to 200mg.

"Up to these levels of intake, caffeine is unlikely to mask the subjective perception of alcohol intoxication."

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