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Updated March 28, 2010

Rather than “yes” or “no,” the best answer is “maybe.” Review studies have not shown that taking daily multivitamin supplements will prevent any chronic disease. However, taking supplements will help ensure you are getting enough of nutrients that may be missing from your diet.

Eating a healthy, well-balanced diet should provide you with all of the individual nutrients you need. Not everyone has a good diet so some of those nutrients might be deficient. For example, a person who hates fruits and vegetables might not get enough vitamin C and someone who refuses to eat dairy products will frequently need extra calcium.

Taking a daily multivitamin is an inexpensive and easy way to be sure you are getting the vitamins and minerals you need. A few individual dietary supplements have been shown to have positive benefits for your health too. Adding these extra supplements may be beneficial:

Calcium

Many people don’t eat enough calcium-containing foods. This can add to a person’s risk of developing osteoporosis, or weakened bones. The recommended amount of calcium for most adults is about 1200 mg per day.

Vitamin D

Some of the vitamin D you need comes from the food you eat, but most of it is made by your body after exposure to sun. Vitamin D is important for calcium absorption and the two nutrients are often combined into one supplement. An average adult needs about 400 IU of vitamin D.

Fish Oil

Omega-3 fatty acids will help prevent cardiovascular disease. Fatty fish is the best dietary source of omega-3 fatty acids, though plants such as flax contain omega-3 fatty acids. Studies suggest that 0.5 to 1.8 grams of fish oil per day is an effective amount.

Folic Acid

Folate is a B vitamin and folic acid is the supplemental form of folate. Folate is found in green leafy vegetables, citrus fruit and legumes. Folic acid supplementation is recommended for any woman who may become pregnant and may also help reduce homocysteine levels, which might help reduce the risk of heart disease. The recommended amount for adults is 400 mcg per day.

Chondroitin and Glucosamine

Researchers from the Glucosamine/Chondroitin Arthritis Intervention Trial found that participants with moderate-to-severe osteoarthritis pain found statistically significant amounts of pain relief with 1500 mg glucosamine combined with 1200 mg chondroitin sulfate supplements.

Antioxidants and Zinc

The Age-Related Eye Disease Study results showed that a combination of antioxidants and zinc taken as a dietary supplement reduced the risk of advanced age-related macular degeneration. The formula used in the study was:

• 500 mg of vitamin C
• 400 IU of vitamin E
• 15 mg of beta-carotene
• 80 mg of zinc as zinc oxide
• 2 mg of copper as cupric oxide

Probiotics

Foods like yogurt and fermented foods naturally contain bacteria called probiotics. These bacteria are similar to the friendly bacteria normally found in your digestive system. Probiotics are also available as dietary supplements and may be beneficial for people with irritable bowel syndrome and diarrhea.

Dietary Supplement Safety

In general, dietary supplements are safe. However keep these points in mind when you take them:

• Eat a healthy diet. Multivitamins and other dietary supplements will not replace an unhealthy diet. Focus on eating sufficient amounts of fruits and vegetables, low-fat dairy products, whole grains, lean meats, fish, poultry, nuts, seeds and legumes.

• Don’t overdose your supplements. Some vitamins such as vitamin D, vitamin A and vitamin B6 can be bad for your health when taken in extremely large amounts for extended periods of time. Follow the dosage instruction on the label.

• Tell your doctor. Some dietary supplements can interact with medications, so tell your doctor about the dietary supplements you take.

• Understand the label. Dietary supplement labels can make claims about how the dietary supplement may affect the structure or the function of the body, but not claims to treat or cure a disease.

More About Labels:

The labels on dietary supplements can be very confusing. Supplement manufacturers can make health claims if they are approved by the FDA. One example would be “adequate folic acid may reduce a woman’s risk of having a child with a neural tube defect.” Label claims may not promise cures, or guarantee that taking their supplement will prevent any disease

Mayo Clinic
Dietary supplements: Nutrition in a pill?

When using dietary supplements, assess your needs, evaluate the merits of taking supplements, and understand how to choose and use them.

Dietary supplements aren’t intended to be a food substitute because they can’t replicate all of the nutrients and benefits of whole foods, such as fruits and vegetables. So if you’re generally healthy and eat a balanced diet, daily dietary supplements may not be worth the expense. However, if you can’t eat enough healthy foods or have certain conditions, you may benefit from taking a daily dietary supplement

Whole foods: Your best source of micronutrients

Whole foods are your best sources of vitamins and minerals. They offer three main benefits over dietary supplements:

Greater nutrition. Whole foods are complex, containing a variety of the micronutrients your body needs — not just one. An orange, for example, provides vitamin C plus some beta carotene, calcium and other nutrients. A vitamin C supplement lacks these other micronutrients.

Essential fiber. Whole foods provide dietary fiber. Fiber, as part of a healthy diet, can help prevent certain diseases, such as type 2 diabetes and heart disease, and it can also help manage constipation.

Protective substances. Whole foods contain other substances recognized as important for good health. Fruits and vegetables, for example, contain naturally occurring food substances called phytochemicals, which may help protect you against cancer, heart disease, diabetes and high blood pressure. Many are also good sources of antioxidants — substances that slow down oxidation, a natural process that leads to cell and tissue damage.

Who needs dietary supplements?

If you’re generally healthy and eat a wide variety of foods, including fruits, vegetables, whole grains, legumes, low-fat dairy products, lean meats and fish, you likely don’t need dietary supplements.

However, if you can’t eat enough healthy foods, you may benefit from taking a daily dietary supplement.

Dietary supplements may be appropriate if you:

Don’t eat well or consume less than 1,600 calories a day.

Are a vegan or a vegetarian who eats a limited variety of foods.

Are pregnant, trying to get pregnant or breast-feeding.

Are a woman who experiences heavy bleeding during your menstrual period.

Are a postmenopausal woman.

Have a medical condition that affects how your body absorbs, uses or excretes nutrients, such as chronic diarrhea, food allergies, food intolerance or a disease of the liver, gallbladder, intestines or pancreas.

Have had surgery on your digestive tract and are not able to digest and absorb nutrients properly.

Talk to your doctor or a dietitian about which supplements and what doses might be appropriate for you.

Be sure to ask about possible side effects and interactions with other medications.

Choosing and using dietary supplements

If you decide to take a vitamin or mineral supplement, consider these tips:

Check the supplement label. Read labels carefully. Product labels can tell you what the active ingredient or ingredients are, which nutrients are included, the serving size — for example, capsule, packet or teaspoonful — and the amount of nutrients in each serving.

Avoid supplements that provide megadoses. In general, choose a multivitamin-mineral supplement that provides about 100 percent of the Daily Value (DV) of all the vitamins and minerals, rather than one which has, for example, 500 percent of the DV for one vitamin and only 20 percent of the DV for another. The exception to this is calcium. You may notice that calcium-containing supplements don’t provide 100 percent of the DV. If they did, the tablets would be too large to swallow.

Look for USP on the label. This ensures that the supplement meets the standards for strength, purity, disintegration and dissolution established by the testing organization U.S. Pharmacopeia (USP).

Check expiration dates. Dietary supplements can lose potency over time, especially in hot and humid climates. If a supplement doesn’t have an expiration date, don’t buy it. If your supplements have expired, discard them.

Store all vitamin and mineral supplements safely. Put supplements in a locked cabinet or other secure location out of children’s reach. Don’t leave supplements on the counter or rely on child-resistant packaging. Store dietary supplements in a dry, cool place. Avoid hot, humid storage locations, such as in the bathroom.

Check alerts and advisories. The Food and Drug Administration keeps a list of dietary supplements that are under regulatory review or that have been reported to cause adverse effects. Check its website periodically for updates.

Centers for Disease Control and Prevention

Vitamins and Minerals

Vitamins are organic substances (made by plants or animals), minerals are inorganic elements that come from the earth; soil and water and are absorbed by plants. Animals and humans absorb minerals from the plants they eat. Vitamins and minerals are nutrients that your body needs to grow and develop normally.

Vitamins and minerals, have a unique role to play in maintaining your health. For example Vitamin D helps your body absorb the amount of calcium (a mineral) it needs to form strong bones. A deficiency in vitamin D can result in a disease called rickets (softening of the bones caused by the bodies inability to absorb the mineral calcium.) The body cannot produce calcium; therefore, it must be absorbed through our food. Other minerals like chromium, copper, iodine, iron, selenium, and zinc are called trace minerals because you only need very small amounts of them each day. The best way to get enough vitamins is to eat a balanced diet with a variety of foods. You can usually get all your vitamins from the foods you eat.

CDC, Calcium and Bone Health

Bones play many roles in the body. They provide structure, protect organs, anchor muscles, and store calcium. Adequate calcium consumption and weight bearing physical activity build strong bones, optimizes bone mass, and may reduce the risk of osteoporosis later in life.

CDC, Folic Acid

Folic acid is a B vitamin. It is used in our bodies to make new cells. If a woman has enough folic acid in her body before she is pregnant, it can help prevent major birth defects of her baby’s brain and spine.

CDC, Iron and Iron Deficiency

Iron is a mineral needed by our bodies. Iron is a part of all cells and does many things in our bodies. For example, iron (as part of the protein hemoglobin) carries oxygen from our lungs throughout our bodies. Having too little hemoglobin is called anemia. Although anemia has a number of causes, iron deficiency anemia is the most common type of anemia.

Salt

Most of the sodium we consume is in the form of salt, and the vast majority of sodium we consume is in processed and restaurant foods. Too much sodium is bad for your health. It can increase your blood pressure and your risk for a heart attack and stroke.

Sodium and Potassium:

Nearly all Americans eat too much salt (sodium). Most of the salt comes from eating processed foods (75%), or adding salt to food while cooking and using the salt shaker at meals (5% to 10%). On average, the more salt a person eats, the higher his or her blood pressure.

The latest round in conventional medicine’s ongoing attempts to discredit (and ultimately outlaw) nutritional supplements is found in a highly questionable study published this week in the Journal of the American Medical Association, which claims that vitamins actually increase the risk of death.

The study claims to have analyzed a collection of previous studies on Vitamin A, beta carotene, Vitamin C, Vitamin E and selenium, concluding that most of the nutrients are actually dangerous to human health. Of course, this is research from conventional medicine – an industry that promotes patented chemicals as perfectly safe, even though FDA-approved pharmaceuticals are killing 100,000 Americans each year. (Imagine the uproar if vitamins killed even a fraction of that number…)

To avoid getting hoodwinked by questionable research on “vitamins,” you have to strongly consider the financial interests of the source of this research. JAMA accepts millions of dollars in advertising from drug companies each year, and its pages are absolutely packed with drug ads. The American Medical Association, for its part, has long worked to discredit alternative medicine and has even been found guilty by U.S. federal courts of engaging in a conspiracy to destroy chiropractic medicine. The AMA, which is largely considered a joke by anyone familiar with natural health, is hardly a credible source for publishing scientific findings on nutrition. To protect the multi-billion dollar drug industry, the AMA would say practically anything, I believe.

How to fake a vitamin study

Faking a vitamin study to show supplements as harmful is extremely easy to pull off, by the way. All you have to do is use synthetic forms of the vitamins and avoid using natural, food-sourced vitamins. These synthetic vitamins – which are really just industrial chemicals – may be called “Vitamin E” or “Vitamin A” or even “Vitamin C” but they have no functional resemblance to the real vitamins that occur in nature. Every single study over the past two decades that has sought to discredit Vitamin E, for example, focused on using synthetic Vitamin E in order to show harm. It is curious that no researcher from the world of conventional medicine will ever test the natural, full-spectrum vitamins, nutrients and phytochemicals that appear in nature. You know why? Because they would discover a universe of natural medicine that makes patented prescription drugs obsolete.

A second way to fake a vitamin meta-data study is to simply cherry-pick the results you want to include in your meta-data analysis. This is a routine trick used by dishonest researchers who have an agenda of discrediting nutritional supplements. To pull this one off, they simply eliminate all previous studies that showed positive results for vitamins, and include only previous studies that showed negative results. Then they run a statistical analysis on all the studies they hand-picked and declare – surprise! – those vitamins are dangerous! Many of the studies on vitamin E, by the way, were conducted on dying heart patients who were only expected to live two weeks, regardless of what they took.

A third way to distort the science is to confuse people with statistical obfuscation. The reporting on this particular study, for example, confuses absolute risk with relative risk. Vitamin A, according to the reports on this study, increased mortality risk by 16 percent. But that is a relative risk number, meaning that if 1 person out of 100 normally died, then 1.16 people out of 100 would die when taking these synthetic Vitamin A supplements. In other words, it might not even be one additional person out of 100, or even out of 1000.

And yet, it is curious that when conventional medical researchers report the results of mortality risks for their prescription drugs, they always use absolute risk. They say things like, “Well, this drug only increased the risk by one percent.” But what they are not saying is that it may be a 200% relative increase in mortality risk, depending on the baseline absolute mortality numbers. So if only 0.5 people out of 100 normally died from heart disease during a particular study, but 1.5 people died when taking a drug during that study, the relative risk increase is 200%. But the medical journals and the mainstream media will report is at a “one percent increase.”

You see how the game is played? Here’s the con:

• All statistics on the dangers of prescription drugs are reported as absolute risk to make the numbers seem smaller (and make drugs seem safe).

• All statistics on the dangers of synthetic vitamins are reported as relative risk to make the numbers seem larger (and vitamins seem dangerous).

And this is how conventional medicine lies with statistics. It’s only one of the many tricks used to disinform the American public about the dangers of pharmaceuticals or the benefits of nutrition.

This research published in JAMA does remind us of one important point, however: synthetic chemicals are harmful to human health. If you take cheap “vitamins” made of these synthetic chemicals, you are doing yourself more harm than good. These cheap vitamin manufacturers, by the way, are usually owned by pharmaceutical firms. I would personally never take vitamins purchased at common retailers such as Wal-Mart or Walgreens. I only recommend and consume vitamins from high-end nutritional supplement companies.

Blurring the line to scare consumers

But conventional medicine researchers try to blur the line between “junk vitamins” and “quality vitamins” by classifying all nutritional supplements as “vitamins,” regardless of what they’re really made from. By discrediting a few synthetic chemicals, they can effectively dissuade the masses from taking ANY vitamins, including the good ones. And that is, of course, their goal: to use FUD (fear, uncertainty and doubt) to scare consumers away from nutritional supplements so that patients will flock to the patented, synthetic chemicals that earn drug companies billions of dollars in profits. Drugs make money for Big Pharma, and vitamins compete with drug sales. Once you understand the economics and the motives of the parties involved here, the junk science con becomes quite obvious: Pushers of pharmaceuticals will always use dirty tricks to discredit nutritional supplements because it is in their financial interests to do so.

My own financial interests, by the way, are squeaky clean. I sell no supplements, I earn no money from supplement companies, and in fact I am not even paid by NaturalNews for my work on these articles. In terms of potential conflicts of interest, I have far more credibility than the AMA, a shady organization that remains mired in blatant conflicts of interest and a frightening agenda of pushing drugs, surgery and radiation onto as many Americans as possible.

Now, here’s a common sense way to quickly realize the JAMA research is complete nonsense. Round up 100 people who are taking multiple pharmaceuticals, and compare their health to 100 people who are taking vitamins and nutritional supplements. Guess who’s healthier? The supplement crowd will be healthier every time. It’s the obvious question: If vitamins are so dangerous, where are all the dead vitamin takers? And if pharmaceuticals are so safe, where are all the super-healthy prescription drug patients? They are nowhere to be found.

The healthiest people, by far, are those who take supplements, who engage in regular exercise, and who avoid taking prescription drugs.

Why conventional medical researchers remain nutritionally illiterate

Western medicine still doesn’t “get” nutrition. They think all health effects are achieved by single, isolated chemical constituents. But nutrition doesn’t work that way. In nature, for example, Vitamin C is not a single chemical, but rather a symphony of complementary phytonutrients that work in concert. Conventional medical researchers almost never test plant medicine using full-spectrum nutrients. Why? Because they don’t understand the concept of nutritional synergy.

The bottom line? Only fools believe research about nutrition that comes from the American Medical Association or its journal. Conventional medical researchers declaring that vitamins are worthless is about as credible as Bush Administration climatologists claiming there’s no such thing as global warming.

With the publication of this research, the distortion of health reality is now complete. According to the American Medical Association, vitamins will kill you but pharmaceuticals will make you healthy.

Summary

Invest the time to educate yourself about nutrition and your own personal nutritional needs. For thousands of years, mankind has somehow found a way to survive based on the quantity and quality of foods indigenous to their surroundings. Many civilizations were lucky and thrived while others were not so lucky. Much of their success depended in large part upon where they were born, where they settled or perhaps where they were forced to move.

Today, however, with the abundance of food choices (which may or may not necessarily be advantageous), and the numerous studies and evidence supporting the findings, you would think we have a tremendous advantage over our ancestors, who did not have the ability or the knowledge to use the testing methods we have access to today.

Yet, many of our ancestors, still, consistently live to be over 100 years old, in part based on their surroundings, but more significantly, based on what they eat (or what they don’t eat). How can this be?

Because, they have maintained a nutritional regimen over hundreds, if not thousands, of years. They continue to maintain a basic “diet” (which is a misnomer, because diets really don’t work), consisting of all the various food groups, taken together in combination, that have enabled their people to live beyond our average life expectancy today. Essentially, they don’t “diet” because they would not even understand what that word means and they certainly don’t subsist on McDonalds, Burger King, Wendys, Dunkin Donuts or “fast food”.

So, what do vitamins have to do with choice of food groups and what you eat vs. what you don’t eat? Certain food groups are nutrient dense, offer all of the necessary carbohydrate, fat, proteins, vitamins and minerals, that we need for basic survival but, more importantly, in order to live a healthy life and perform at an optimal level of performance rather than maintain a marginal existence.

The basic question is do vitamins work? Some studies seem to be conclusive while others are inconclusive or, worse, contradict the findings of previous studies. So, then how do we know what is fact or fiction? Who do you listen to and how do you know whether or not you can trust them? The answer is that you need to educate yourself, read as often as possible, as many “reliable” sources of information as you can and come to your own conclusions. However, it is certainly plausible to put some level of faith in health professionals, who are “probably” less biased or perhaps even completely unbiased about nutrition and the true importance of supplementing your nutritional regimen with vitamins.

My sense, from many years of reading, inquiring and working with certain health professionals, is that there seems to be tried and true food groups and choices that we make, which will enhance our health rather than do nothing or even harm us. Do I believe in vitamin supplementation? Yes, absolutely. But, there does not currently exist (and probably never will) a substitute for healthy food groups. Throughout the history of mankind, it has been proven that certain civilizations have prospered and, so we would be wise to pay careful attention to what they consumed and continue to, in the way of a “healthy” nutritional regimen.

However, without a complete blood panel, it is impossible to know whether or not you have any deficiencies. A complete blood panel will test some of the following bodily functions:

Comprehensive Metabolic Panel

The Comprehensive Metabolic Panel (CMP) is typically a group of 14 specific tests that have been approved, named, and assigned a CPT code (a Current Procedural Terminology number) as a panel by Medicare (although labs may adjust the number of tests up or down). Since the majority of insurance companies also use these name and CPT codes in their claim processing, this grouping of tests has become standardized throughout the United States. The CMP is a frequently ordered panel that gives your doctor important information about the current status of your kidneys, liver, and electrolyte and acid/base balance as in good health, as of your blood sugar and blood proteins. Abnormal results, and especially combinations of abnormal results, can indicate a problem that may need to be addressed.

The CMP is used as a broad screening tool to evaluate organ function and check for conditions such as diabetes, liver disease, and kidney disease. The CMP may also be ordered to monitor specified conditions, such as hypertension, and to monitor patients taking specific medications for any kidney or liver-related side effects. If your doctor is interested in following two or more individual CMP components, he or she may prescribe the entire CMP because it offers more information.

The CMP includes:

Glucose
Calcium
Both increased and decrease levels can be significant.

Proteins
Albumin
Total Protein

Albumin, a small protein produced in the liver, is the through protein in serum. Total protein measures albumin as well as adjectives other proteins in serum. Both increases and decreases surrounded by these test results can be significant.

Electrolytes:

Sodium
Potassium
CO2 (carbon dioxide, bicarbonate)
Chloride

The concentrations of sodium and potassium are tightly regulated by the body as is the symmetry between the four tests. Electrolyte (and acid-base) imbalance can be present with a broad variety of acute and chronic illnesses. Chloride and CO2 test are rarely ordered by themselves. (Magnesium may also be tested but would be a separate test.)

Kidney Tests:

BUN (blood urea nitrogen)

Creatinine

BUN and creatinine are waste products filtered from blood by the kidneys. Increased concentrations in the blood may indicate a conditional or chronic decrease contained by kidney function. When not ordered as part of the CMP, they are still usually ordered together.

Liver Tests:

ALP (alkaline phosphatase)
ALT (alanine amino transferase, also call SGPT)
AST (aspartate amino transferase, also called SGOT)
Bilirubin

ALP, ALT, and AST are enzymes found in the liver and other tissues, while bilirubin is a consume product of the liver. All can be found in elevated concentrations surrounded by the blood with liver disease or dysfunction.

Coronary Risk Screen – BHD #218 includes Cholesterol, Triglycerides, HDL, LDL, VLDL, Chol/HDL, Homocysteine, Lipoprotein (a), CRP, CPK

Cholesterol – Cholesterol is a wax-like substance, produced in the liver and is also introduced into the body from dietary sources. It is transported in the blood by owner proteins called lipoproteins that allow it to be soluble in serum and thereby transported to all parts of the body. Cholesterol, a critical component of cell membranes, is also the organic material from which adjectives of the body’s steroidal hormones are made and plays an essential role in the formation of vitamin D and bile salt. Too much cholesterol in the blood, however, can wreak deposits of cholesterol inside arteries. These plaques can narrow the artery adequate to block blood flow. This process known as atherosclerosis commonly occur in the coronary arteries which give food to the heart.

Triglycerides – Triglycerides are composed of a glycerol molecule to which three fatty acid chains are attached. These illustrious energy fatty sour chains provide much of the energy that the body’s cell need to function. During times when triglycerides are not available from dietary sources, the liver produces triglycerides itself. While there is no direct evidence that elevated triglycerides pose an independent risk for heart disease, they invariably accompany other focal risk factors. However, it is clear that when triglycerides are elevated, HDL (the good) cholesterol levels decrease.

HDL – High-density lipoproteins transport cholesterol from the blood stream spinal column to the liver for processing and elimination from the body. HDL makes it less credible that excess cholesterol in the blood will be deposited surrounded by the coronary arteries. Therefore HDL cholesterol is often referred to as the “good” cholesterol.

LDL (Direct) – A direct breadth (not a calculated value) of low-density lipoproteins that transport cholesterol from the liver to the rest of the body. When there is too much LDL cholesterol contained by the blood, it can be deposited on coronary artery walls. Therefore LDL cholesterol is often referred to as the “bad” cholesterol.

Thyroid Screen – BHD #218 includes T3 Uptake, Total T4, Free Thyroxine Index, Free T3, Free T4, TSH
T3 Uptake – T3 Uptake provides an estimate of thyroxine binding globulin in the body, the protein that carry most of the T3 and T4 in the blood. These bound hormones serve as the reservoir of available thyroid hormone as contrasted near unbound hormone which is the “free” or “bioactive” fraction.

T4 – This test is for T4 or thyroxine and it measures both the bound and free fractions of the hormone. Less than 1% of T4 is in the unbound bioactive form.

Free Thyroxine Index – Free Thyroxine Index is an estimate of the amount of Free T4 in the blood base on the amount of thyroxine binding globulin present.

TSH Ultra Sensitive (the most advanced, highly sensitive assay of TSH available on the flea market today) – Thyroid stimulating hormone (TSH) is a hormone released by the pituitary gland that triggers the thyroid gland to produce thyroid hormones. Assessing levels of TSH within the blood is considered to be an important method of detecting thyroid problems.

Free T3 – Measures the free fraction/bio-active form of T-3 in serum. T-3 and T-4 are involved in the glum feedback mechanism on TSH levels/response.

Free T4 – Measures the free fraction/bio-active form of T-4 within serum. T-3 and T-4 are involved in the negative feedback machinery on TSH levels/response.

Depending on your age, your general medical condition and symptoms, your physician may direct other tests such as lipid profile, Hemoglobin A1c, C reactive protein, Homocysteine, PSA, etc.

Conclusion: From the CMP blood panel, unless we are qualified medical professionals, trained to prescribe and analyze this type of data, find a trusted health professional who can prescribe a CMP and analyze the data, specific to your bodily functions, rather than rely on any number of sources of information. Know your own body and what a CMP indicates, specific to your health, before you make the critical decisions of what to eat or not to eat, and whether you need to begin or continue a regimen of vitamin supplementation…what you eat in your early years of life will have a direct impact on your quality of life in later years…in other words, your life will depend on it!

The Downside of Energy Drinks – Negative Performance and Psychological Effects
By Conrad Woolsey, Ph.D., CHES

Active Voice is a column by experts in science, medicine and allied health. The viewpoints expressed do not necessarily reflect positions or policies of ACSM.

Conrad Woolsey, PhD, CHES, is an Assistant Professor of Health and Human Performance at Oklahoma State University and a sport psychology consultant. His research areas include brain chemistry, addiction, positive health behavior change, health psychology and performance in athletes. He has authored publications and several research presentations related to this commentary1 including one at ACSM’s Annual Meeting and World Congress on Exercise is Medicine™, held in Baltimore in June 2010. For further information, contact the author by e-mail via his institutional website.

Of the more than 500 brands of energy drinks (EDs) now available, several contain 3-4 times the amount of caffeine (300+ mg/8 oz.) as standard energy drinks (80 mg/8 oz.) such as Red Bull. New popular drinks such as Spike and Redline also contain other herbal stimulants such as evodamine and yohimbine which are more powerful and dangerous than caffeine. Strategic marketing campaigns proclaiming improved performance, concentration, and mood have influenced increased ED use. ED use significantly predicts increased alcohol use, the illicit use of amphetamines (Adderall), and risk-taking such drinking and driving. Additionally, in a randomly assigned double-blind placebo controlled study where we tested EDs on a dynamic performance skill, we found performance improvements only when examining one-dimensional variables (e.g., reaction time), which do not necessarily translate well into coordinated multi-dimensional skills. Performers perceived they were doing better, but actually made significantly more errors, due to being hyper-focused and/or over-aroused. Technical skills rely on timing and coordination, and EDs can and often do reduce performance. As a sport psychology consultant, I regularly work with elite athletes whose performances have suffered from using EDs, particularly in high-pressure situations.

There are several contributing factors, such as athletes’ reduced ability to self-regulate biofeedback and state-dependent negative effects on the cerebellum (responsible for coordination/sequencing of motor movements). Typically, my clients are able to effectively utilize relaxation and/or excitation techniques to improve biofeedback and hormonal responses as well as a performance mindset to improve confidence, concentration, and mood. However, due to the pharmacodynamics of EDs, as well as the adverse neurological and psychological adaptations, in the long run, athletes who regularly use EDs are likely to experience performance decrements and to suffer from neurochemical imbalances.

Describing the complex neurological and biochemical cascades resulting from ED use is difficult in a brief report; however, one can start by examining the pharmacological actions of ED ingredients (including stimulant and anti-anxiety effects) on the brain’s stress (amygdala) and neurotransmitter systems. Several ingredients, such as taurine and inositol, are known for their regulatory effects on neurotransmitters and the CNS. Taurine has been shown to act as an anti-anxiety agent by affecting GABA receptors. Inositol is a serotonin modulator and has been used successfully as an anti-depressant medication. Like drugs of abuse, EDs work by causing a large release and/or prolonged action of pleasure-reward neurotransmitters (dopamine/serotonin) and stress hormones (nor-adrenaline/adrenaline), which in turn provides a short term high followed by a low.

There are ingredients in EDs, such as L-tyrosine, which are precursors to the production of neurotransmitters; however, these will not balance out the deleterious neurological effects of ED use. Therefore, using EDs can raise pleasure-reward thresholds and damage neurotransmitter receptor sites. This results in more drug craving and/or thrill-seeking to satisfy homeostatic brain deficiencies and increases the chances of developing anxiety and depressive disorders. This is important because research indicates that significant brain modeling occurs to age 20 and those under 25 are at risk for developing addictive personality traits and behaviors due to incomplete development of the memory (hippocampus), stress, and pleasure-reward systems of the brain. Practitioners, coaches, athletes and athletic trainers need to be well informed that EDs can inhibit peak performance and regular ED use will result in more time feeling tired, anxious, and depressed.

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