Did a 16 year old Really Die from a Caffeine Overdose?
Sixteen year old Davis Cripe started having heart rhythm problems and collapsed last month at his South Carolina high school, passing away. His autopsy was released today Doctors said they had found no previously existing heart problem. They believe his death was from a caffeine overdose which caused a heart arrhythmia (irregular heartbeat.) Reports say that in the two hours before his collapse, the teen drank a large diet mountain dew, a McDonald's latte and an energy drink.
While I'd of course think that too much of anything could cause of problem, but I'd not heard of a caffeine overdose before. I like my coffee, hard to even imagine giving it up, particularly in the morning. So this made me curious to look into what has been seen to be safe consumption levels.
How Much Caffeine is Too Much?
Most places I've seen set the safe daily limits of caffeine to be 400mg per day for most adults. Obviously there is some fluctuation between what each of us can handle due to factors such as weight, existing health issues, etc. To get a little better perspective, let's see how much caffeine is in our drinks.
Coffee and Tea
An 8-oz cup of coffee has 95 milligrams of caffeine. Espresso shots typically each deliver between 130 - 150mg. This would make up to four cups within the general safe range. Admittedly my personal coffee cup is larger than eight ounces and frequently ordering a Venti size at Starbucks (20 ounces.)
Since coffee shops usually serve caffeinated teas as well, I figured it was worth including that most teas have between 15 - 95mg averaging around a 16 oz drink. The range varies between the brand (Arizona, Starbucks, Lipton, etc) as well as type (Green, Black, Oolong, White, etc.) For those of you that prefer to make your own tea from leaves, the common amounts per type are:
- Black Tea: 23 - 110 mg
- Oolong Tea: 12 - 55 mg
- Green Tea: 8 - 36 mg
- White Tea: 6 – 25 mg
Source
What I found interesting with teas is that if you wanted to reduce the caffeine delivered, you can either:
- Steep your tea in cooler water for a shorter period of time or
- Steep your tea normally for 45 seconds, discard of that, and then brew it like you normally would. This makes a difference because the vast majority of caffeine is released in the first 30 seconds or so.
I've not been able to find reports of people dying from a caffeine overdose purely from coffee or tea.
Soda
I found it interesting that the FDA has an official limit of caffeine in a 12 ounce "cola and pepper soft drink" set at 71 milligrams. I tried to get the following levels adjusted for 12 ounce cans to make the comparison easier to see. However, it's important to remember that not everything is served at this size, some being at 16 or even 20 ounce cans or bottles.
Now it wasn't shocking that near the top of the chart I saw Mountain Dew (54 mg), Mountain Dew Black ([62.3 mg] (https://www.caffeineinformer.com/caffeine-content/md-black-label)) or Mountain Dew Game Fuel (72.6) However some of the more surprising ones to see up there included Pepsi One at 54 mg, Pepsi Zero Sugar at 69 mg or Diet Coke at 57 mg.
Even though I'm not a huge soda drinker, I'd always heard of regular Mountain Dew having higher caffeine levels that regular sodas. So seeing Diet Coke and Pepsi equaling or beating it was unexpected.
To fall within the 400 mg safe daily limit of caffeine, this would allow for up to 6 to 8 sodas (12 oz) to be drank. It's worth noting that there are some other soft drinks with higher levels, I just listed some of the more common brand names here.
While the health effects of drinking lots of soda are rather well known such as putting on weight and sugar intake, the caffeine portion tends to not even be mentioned.
I did see one report of a woman's death being attributed to excessive soda intake, but it seemed to be more an effect of the sugar versus the caffeine. It was said the she amazingly drank over two gallons of soda per day!
Energy Drinks
This is where things can get a little dicey. It's worth mentioning that energy drinks and shots aren't regulated by the FDA, meaning they don't have to label it's ingredients or caffeine levels, instead they can just list proprietary energy blend.
Energy drink manufacturers—just like all other manufacturers—are not required by the Food and Drug Administration to disclose the amount of caffeine in their products,” says William Wallace, a policy analyst at Consumers Union, the policy and mobilization arm of Consumer Reports.
-Source
Consumer reports did their own tests on 27 energy drinks finding not all of those that did label caffeine levels were correct with "Some under-reporting it by 20% or more as while one actually have 70% less." A few of their findings showed the energy shots topping the list with 5 hour energy at 215mg per container with 5 hour energy extra strength reaching 242mg. Some of the larger drinks also showed extremely high levels (which I broke down to 12 ounces for easier comparison, even though the can sizes vary):
- Spike Energy Drink - 262.5mg
- Wired X344 Energy Drink - 258mg
- Many Rockstar Energy Drinks - 180mg
- Java Monster - 150.4 mg
- Mega Monster Energy Drink - 120mg
- Full Throttle - 120mg
- NOS Energy Drink - 120mg
- Red Bull - 113.5mg
A full list can be seen here.
Cardiologist Anna Svatikova, M.D., Ph.D. at the Mayo clinic researched these drinks said...
[they] contain other ingredients that act as stimulants, such as taurine, guarana, and ginseng. But not all of the ingredients have been well-studied in terms of cardiovascular effects.
-Source
Today's news of a teen's death being attributed to a caffeine overdose. Other reports over the last handful of years can also be found attributing people passing away to energy drinks. Unfortunately, none of them seem to say which drinks were actually involved, which seems like an important aspect with both caffeine levels and other "energy ingredients" varying among them.
As you can see, there is a HUGE range of actual caffeine levels per ounce. But it's important to remember these all come in varying can sizes with Red Bull only being a little over 8 ounces per can with others being 16 ounce sizes. But there is no denying that the energy shots are WAY more dense with caffeine.
Conclusion / TL;DR
There are tons of news stories today about David Cripe's death being attributed as a caffeine overdose by the coroner.
While I feel bad for the boy, his friends and family for their loss...the news seems to be missing what I would think are important pieces of information. It simply attributes it to caffeine levels, even though caffeine alone hasn't seem to show a history of acutely causing death from an irregular heartbeat. Also, it doesn't mention what brand of energy drink or soda was involved, nor the size of the coffee. These factors could easily have put him above OR below the 400mg safe limit (even though his personal limit may have been lower.)
I'm very curious if there was any history that could have led to this and/or the specifics of the drinks. This just as easily could have been effected by unspecified "energy ingredients" in the energy drink, which would lead anyone looking into this down a vary different path instead of pure caffeine levels.
[UPDATE: The coroner has refined his wording saying that is was not an caffeine overdose but rather ingesting too much over a short period of time. Quotes are included below.]
The teenager weighed 90kg (200 lbs) but would not have been considered morbidly obese, Mr Watts said.
"This is not a caffeine overdose," Mr Watts told Reuters news agency.
"We're not saying that it was the total amount of caffeine in the system, it was just the way that it was ingested over that short period of time, and the chugging of the energy drink at the end was what the issue was with the cardiac arrhythmia."
Caffeine would probably not have been seen as a factor in the teenager's death if witnesses had not been able to tell officials what he had been drinking before his death, the Richland County coroner said.
The main witness could not say which brand of energy drink Davis drank but said it was from a container the size of a large soft drink.
-Source
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I've been drinking 2 to 3 POTS(many days I drink more) of double strength black coffee every day for the last forty years..
Yea, after doing some digging to write this, it really seemed that it wasn't so much a caffeine issue versus those 'extra' ingredients in the energy drinks. That's why not naming the brands he had really made the coroners findings seem invalid.
I'm an avid coffee lover myself, easily going through 1.5 - 2 pots when I was younger working overnight shifts.
It could depend upon the person's body and the complex interactions between those ingredients, etc. I can't have very much coffee anymore because it gets me too wired, but I also know people who practically live on the stuff. Everybody is different.
Very very true. My boyfriend get's dizzy and lightheaded after having a small amount of caffeine. It just doesn't work well for him. Like you said, everyone reacts different to things. Personally, I couldn't imagine life without my morning coffee. :P
I do think the news headlines and the coroner could have found a better way to phrase things, since I take the phrase caffeine overdose to require a little more extreme consumption like dozens of cups of coffee, energy drinks, pills, etc, compared to what they said the kid had (one soda, one latte, and one energy drink.) But largely that's just a semantic thing at that point.
I worked nights since I was about 14 until a couple of years ago (I'm 66)
in other news..MASSIVE amounts of coffee, daily, has been found to (perhaps...always the weasel wording) prevent heart attacks, stroke, and to prevent the spread of cancer.
I hear ya...I have seen the various reports on the benefits of lots of coffee. I like to think I get to take advantage of those. Lol
Rofl! Gotta love Kramer!
However I don't think I'll ever going along with the idea of slathering myself in butter and going for a suntan. :P
It's almost impossible to hit the LD50 of caffeine without the use of caffeine pills or extracts. I did a fair bit of research into this in high school as I was drinking 8-10 liters of Mountain Dew a day (this was when it had 63 mg per 12oz.) so at some point I became curious about exactly how much caffeine I could indulge in before risking a trip to the hospital.
That's what I would have thought...outside just a case of an individual that didn't react to it well. From what I was reading while digging into this, it seemed like the non-caffeine ingredients in the energy drinks tended to cause more of an (acute) issue for people.
I once worked with an assistant manager that bought redbull by the pallet. Every month.
I remember my first coffe or energy : it works a lot more than expected.
Like all drug, first time is always a lot more powerfull than usual
Hehe, oh I bet!
I can't really remember my first time. When I was young, I would sneak a drink of of the cold, bottom of the cup that my parents had left there. I'm sure I was a pain for them to deal with after that though, lol.
Too many years doing wheel watch NOT to drink coffee. Tea is but an emergency ration. These energy drinks spoken about in the article are DANGEROUS.
While I have no doubt there can be some long term effects from high amounts of caffeine, I agree that the energy drinks are way more of a concern, especially with more immediate reactions like what I'm assuming affected the kid in this story. I was rather shocked that their not regulated at all, don't have to label what they include, or have any testing that what labeling is provided is actually accurate.
The other piece that I didn't really mention, was that energy drinks are mainly marketed to teens, boys in particular. Not only are they often smaller and sometimes still developing, they also tend to be a little more 'extreme' with their behavior. Sure...why not take 12 five hour energy shots, lol.
The caffeine situation is out of control. It is the number 1 drug in the world. I'm assuming it could have killed him but was probably in combination with his electrolytes getting out of wack or or something like that.
I can hear you there. It's almost like it's own food group nowadays. Luckily as I've gotten older I've toned it back to only having a couple cups in the morning. It was pretty necessary when I worked overnights though, lol.
That's my guess too, that it was something getting out of whack that messed with some of those levels. Personally, I don't think the headline used in the news stories of 'caffeine overdose' is an accurate way to describe the situation.
In theory it is possible but unlikely. Most deaths attributed to caffeine often involve combination with other drugs (often stimulants) and sometimes an existing cardiac issue (e.g. ectopic tissue that may predispose to rhythm issues). Also it is less likely in regular coffee drinkers due to tolerance. Certain medications like theophylline and other asthma medications can interact with it too.
Edit: Most case reports of caffeine related deaths I have seen involve the use of depressants like alcohol in combination with it. This can lead to people drinking too much as the caffeine seems to initially give the impression of blocking the depressant effects (as it may peak faster than alcohol levels). The drinker then continues to drink and can end up taking in fatal levels of the alcohol.
That was pretty much my conclusion/tl;dr. The doctors said he didn't have any prior "diagnosed health issues" (which could've existed, just not found) but I'd also be curious of the role ingredients beyond caffeine in the energy drink (even though we don't know which one) may have played.
Even putting the latte, soda and energy drink caffeine levels at the high ends of the range, it still wouldn't be too far outside the 'safe limits.' The news stories definitely seemed to be missing some important information and wanting to focus too much on the caffeine itself.
Yes I suspect he probably had an undiagnosed heart rhythm issue. Under normal circumstances it would have no effect but he was likely just unlucky.
Agreed. I definitely think that's a more likely cause versus the pure caffeine.
I believe it. I almost passed out at the gym the other day after drinking an iced coffee lol
Ooh, that sucks! I know my boyfriend gets dizzy, sometimes passing out when he has even a smaller amount of caffeine. It's doesn't mix well with him.
Are you a regular coffee drinker? Just out of curiosity.
I drink coffee maybe once every 10 days. I went out for a late lunch and had the iced coffee along with the food. About an hour later I went to the gym and towards the end of my workout I started getting a little lightheaded but I tried to finish my last couple sets. Right after I tried I got very lightheaded and wobbled to the bathroom (lol) and sat down on the couch area they have in there with the TV. I went home about 10 minutes later after waiting for my heart rate to drop back down.
There are times where I would take death over kidney stones from caffeine. ;)
I totally don't blame you there! I've been lucky to avoid those myself, but have heard from friends that did how horrible they are to deal with. Often heard it described as the worst pain possible. :(
I personally know a person who went to the hospital from a caffeine overdose. She was a thin person, in graduate school and so focused on getting ready for exams. She just drank coffee after coffee after coffee. It affected her heart-rate and made her 'out of it'. She stayed in the hospital overnight and it took her a couple days to recover from the stress. I think her small size and not eating (just drinking coffee continuously) had a lot to do with her overdose. So I can see how someone small, like a kid, with an underlying heart problem, could actually die.
I definitely feel bad for her..that had to suck, especially during exams.
That I can understand though, between her being small, the not eating and the constant coffee. I'm surprised she just didn't get sick/nauseous before getting to that stage, especially without the food. :(