Monday, November 19, 2012

Safety of Energy Drinks?

Perhaps this was a timely article on CNN on the safety of energy drinks.
'Under investigation' however is not evidence of guilt, as they say. But I'm certainly cautious of things myself because of a recent case with a patient (and as they say, anecdotal evidence should carry as little weight as stories of bigfoot sightings, so caveat emptor!)
Mr. P was a 56 year old man with diabetes and hypertensive nephrosclerosis. I saw him for his usual visit and drew some routine labs. As always, his hemoglobin A1c was well controlled. The electrolyte panel, however, takes a few hours to be resulted. I saw him at 3PM. The lab calls me at 5:30PM to inform me of his critical potassium of 6.7, with his creatinine being as it's always been- slightly elevated but not too bad. I verified that it was a clean, unhemolyzed sample. I then called him up suggesting he gets his butt to the ER for urgent workup.
His labs were repeated in the ER at 8PM (I suppose 'urgent' to him meant after a nice dinner with his wife)- back down to normal levels. They sent him home and I called him the following day to follow up on things.
It was puzzling- there had been no medication change and he had been asymptomatic. No change in health status to explain the spike in potassium.
And then he shares, "Say, I was tired in the afternoon and took one of those energy drinks an hour before the labs were done...."
Now, this clearly is far from cause and relationship. And it's possible it was an erroneous result. But these days, especially in my renally impaired patients, I advise caution.


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