This is the first in a series of articles discussing the health effects of energy drinks and related products.

Did you know energy drinks have added ingredients in amounts not yet tested for safety? Or that energy drinks can lead to high blood pressure, dehydration and heat illness?

Yes, energy drinks and shots – those pick me up, speed me up, carry me through the “morning after” products that are very popular – could wreak havoc with your health.  Whatever their form – beverages, shots, mints, coffee additives – these potent stimulants have stirred controversy and raised concern about their safety. In the name of health and safety, athletic organizations and employers alike have begun to discourage or even ban their use.

Energy drinks and shots are not the same as sports drinks like Gatorade, Powerade or All Sport that have no stimulants in them. However, the American Beverage Association lists energy drinks in the same “functional beverage” category as sports drinks. The functional beverage title means the manufacturer of the beverage or shot alleges it has a health benefit such as increasing energy or replenishing fluids. However, energy drinks and shots are not yet defined by regulatory agencies in the United States and, therefore, are not under any regulatory control. Healthcare professionals, parents and politicians have raised questions about their safety, and wrongful death lawsuits are currently working their way through the legal system.

Energy drinks in the U.S. stem from a reformulated version of a supplement called “Krating Daeng” sold in Thailand since the 1960s. The reformulated version, introduced to Austria as “Red Bull” in 1987 and the United States in 1997, has become very popular, and many other brands have arisen since that time. In 2012, U.S. energy drink and energy shot sales climbed to $12.5 billion (yes, with a b) and still higher in 2013. Even with the lawsuits and legal fees, the energy drink market has been very profitable with the two leaders alone (Red Bull and Monster) raking in a whopping $746 million in net profits for 2012.

If you read food labels, you may have noticed some differences in energy drink labeling. Some energy drink manufacturers use “Supplement Facts” panels on their products while others opt for “Nutrition Facts” panels (see Table A). “Nutrition Facts” panels on energy drinks exempt manufacturers from reporting adverse health events to the Food and Drug Administration (FDA) and allow the purchase of energy drinks with food assistance money.

According to the FDA, “One way to distinguish dietary supplements from conventional foods is by looking at the nutrition information on the label of the product. Conventional foods must have a ‘Nutrition Facts’ panel on their labels, but dietary supplements must have a ‘Supplement Facts’ panel.”

Energy drink labels are unclear because of the lack of regulation. Many ingredients in energy drinks are “proprietary,” and details are often not disclosed or may not be accurate. For example, some have 20 percent more caffeine than disclosed on the label.

It is up to the manufacturer to decide whether to list “nutrition facts” or “supplemental facts” on the label, and only benefits – not the potential harmful effects – are highlighted. The next articles in this series will discuss in more detail the adverse health effects of energy drinks, what is really in the can or bottle and safer alternatives to get an energy boost.

[Kim Dennison is the Medical Professional for the Michigan Laborers’ Training and Apprenticeship Institute located in Perry, MI.]