Beware Energy Drinks: A Case of a Toxic Triad Syndrome in a Diabetic Patient With Nonalcoholic Fatty Liver Disease

Am J Med Sci. 2019 Oct;358(4):304-311. doi: 10.1016/j.amjms.2019.07.015. Epub 2019 Aug 2.

Abstract

Energy drinks are widely used and very popular. They are touted as "harmless" energy boosters for use in professional, recreational and domestic settings. They are typically high in monosaccharides, and caffeine with other assorted products like ginseng. Careful study of the potential risks of their use is nonexistent while rigorous documentation of their touted energy boosting capacity is also meagre. We present the cautionary case of a 46-year-old Caucasian man with well-controlled type 2 diabetes and nonalcoholic fatty liver disease who developed a toxic triad syndrome of gastritis, hepatitis and pancreatitis within 4 months of commencing daily consumption of 2-3 160z cans of the energy drink Monster Energy. His clinical symptoms and biochemical derangements promptly resolved with stopping the beverage. We discuss the potential risks inherent in unsupervised liberal consumption of energy drinks and the need for both caution and vigilance among clinicians and patients.

Keywords: Caffeine toxicity; Energy drinks; Pancreatitis; Sweetened beverages; Toxic hepatitis.

Publication types

  • Case Reports

MeSH terms

  • Diabetes Mellitus, Type 2
  • Energy Drinks / adverse effects*
  • Gastritis / etiology*
  • Hepatitis / etiology*
  • Humans
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease
  • Pancreatitis / etiology*
  • Syndrome